Advertisements and billboards around Canada are encouraging us to discuss mental health problems as part of Bell's "Let's Talk" campaign on Feb. 12. Featuring Olympic medalist Clara Hughes, who has bravely shared her battles with depression, the campaign is a part of a multi-million dollar initiative to promote awareness and treatment of mental illnesses.
However, those of us who wish Canadians could finally receive much needed public education about psychotic disorders are disappointed. Given that 3 per cent of the population has these often life-altering illnesses, people need to understand them.
Bell is contributing funding to a course promoted by the Mental Health Commission of Canada to train Canadians to recognize and respond to mental health emergencies.
Unfortunately, members of the public who want to take this course have to pay which may partially explain why only 50,000 people have taken it so far. The same program is offered free of charge in the U.S. Even though this program isn't a substitute for the widespread public education that is needed, easier access to it would be helpful.
The fees aren't insignificant. The program is often administered through the Canadian Mental Health Association and fees vary but the basic course in Vancouver charges $150 for the weekend training. The course for adults working with youth, seemingly an educational initiative we should be eager to promote, costs the participants $350.
Bell's contributions to mental illness research are enormous. For instance, Bell is donating $ 2 million to the Douglas-Bell Canadian Brain Bank at the Douglas Mental Health University Institute in Montreal. Ironically, however, a quick look at the early intervention program for psychosis at the Douglas Mental Health University illustrates the problems that emerge without adequate public awareness of psychosis and the resources available to respond. The website mentions how fortunate it was that a desperate family's physician happened to hear about the Douglas resources. When even physicians don't know about essential services, something is very wrong.
Canada is fortunate to have quite a few early psychosis intervention programs. But given the poor state of knowledge about both the early signs and the existence of programs, too many families aren't getting the knowledge they need.
Last week I talked with a couple whose son has been struggling with psychotic symptoms for several months. This couple is well-educated and obviously want to get whatever help they can for their ill son. However, even though they have had scattered interactions with various parts of the mental health system, including a Vancouver area hospital, they haven't been able to connect on an ongoing basis with a psychiatrist. Difficulties accessing a psychiatrist aren't unusual.
What was surprising is that during this process, no one had told them about Vancouver's Early Psychosis Intervention (EPI) program. They were astonished as I explained that they could contact EPI themselves and that they would be able to quickly get a psychiatric assessment. If their son needs ongoing care, he can become part of their program. He can access psychiatric care as needed, as well as other useful services.
The parents would be offered an education program about these disorders where they could also connect to other families. The psycho-education program for people learning to manage their illnesses provides knowledge about psychosis from a science-based perspective.
It also offers a crucial component that is not available in either of the two programs generally offered to adult mental health clients. Neither the "Wellness Recovery Action Plan" nor the Schizophrenia Society of Canada's new "Your Recovery Journey" program let people know about the lack of awareness of being ill, also known as anosognosia, that usually accompanies psychosis.
It's this dangerous symptom that creates such havoc for people living with these disorders. EPI educational programs are the only rehabilitation services I have seen in Canada that offer this critically important information.
We know that the 3 per cent of the population who develop psychotic illnesses have better outcomes with early intervention. We have programs that can provide effective help even if there are too few of them and they need better funding.
Early Psychosis Intervention is a part of the Canadian mental system that we can be proud of. In the U.S., however, there has been little progress in establishing early psychosis intervention programs. Only now, through the work of the U.S. National Institute of Mental Health, are there concerted efforts to introduce this comprehensive approach and demonstrate its effectiveness.
Even if the U.S. develops good early psychosis programs, it suffers from the same lack of public education that limits access to programs. As well, the U.S. shares Canada's problem about lack of appropriate education of some mental health professionals about psychotic illnesses. Many social workers and counseling psychologists receive no science based curriculum about these disorders so they don't recognize the early signs of these illnesses or understand the necessary treatment.
These are major public health problems. Let's talk about them.
Personally, I took the Mental Health First Aid course 2 years ago for $50. It may be informative to someone who hasn't chosen/ doesn't have an interest in mental health but it only confirmed what I have learned through my education. The east coast suffers tremendously when it comes to funding for programs because we don't have the numbers behind us like other provinces.
There are too long of wait lists for psychiatry, to even be considered, for both adults and youth. Two years is far too long for a suicidal person to hold on for someone with a disorder who needs treatment to prevent symptoms from getting worse. Many people need to go on disability because they become unable to work during these waiting periods and the government ends up spending more in disability checks and more counseling only because the money isn't coughed up to end this mental health crisis.
Overall, Bell did a great thing. I just hope that the money can be evenly distributed to the provinces instead of keeping Atlantic Canada tucked away in it's early 20th century views on mental health.
These saved us, starting with this book:
Bernard Rimland - The Dyslogic Syndrome
Then this article:
http://news.bbc.co.uk/1/hi/scotland/highlands_and_islands/8009930.stm
and this book as well:
Kenneth Bock - Healing the new childhood epidemics
Research shows that family recovery education and support dramatically improves the lives of individuals and families and promotes long-term recovery.
For the education course:
http://practicerecovery.com/
and a recovery-oriented support group for families:
http://familymentalhealthrecovery.org/
Much more of what I see involves family members trying to get very ill relatives treated when their illness is preventing them from seeing that they are not able to take care of themselves; this is how so many mentally ill people become homeless or end up in prison.
Too often families aren't able to help the person get the treatment they need. It's important to remember that for many of us our family member, when they are restored to sanity, appreciates what the families had to overcome to get the necessary treatment.
CMHA seems to cling to social theories of mental illnesses. But the public needs to understand the scientific brain research that has shown that these are biological diseases of the brain.
I hope a research scientist and a well-informed psychiatrist gets a decent share of time to explain the recent brain research that has not yet reached a mass audience. .
An education process is required, unfortunately that education is left to those who care for the individuals. Very often it is left to the parents or family to look out for the needs and aspirations of the mentally ill. The end result is the carer is simply spending all their time seeking ways to get around the system. In the end, many simply end up as cared for themselves because they just run out of energy.
It's really sad that on the day we are supposed to be raising awareness, only 2 people have seen fit to comment on this pervasive and challenging subject.
It is awful that many people - I think an increasing number - are denying the existence of psychotic disorders. We're told that somehow, if we just empathize in exactly the right way, people will get better. These beliefs are supposed to reduce stigma since all mental distress is seen by some as a natural response to social adversity.
These beliefs are dangerous to people with psychotic illnesses and to the families who struggle to help them.
The early psychosis intervention programs I've seen don't rush to give a diagnosis or prescribe unnecessary medications. Even without the impact of street drugs, some people have a single episode of psychosis.