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"Let's Talk" About Psychotic Disorders, Too

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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.

 
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