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March 11, 2015

Marking a week for mental health

Reuel S. Amdur

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Various health conditions have their day, week, or month. Mental health and illness have at least two.

The Canadian Mental Health Association (CMHA) promotes an annual Mental Health Week, this year from May 4 to 10.  Then there is the Canadian Alliance on Mental Illness and Mental Health (CAMIMH).  Its week is in the fall.  As for the more specialized occasions, there are special dates for children’s mental health, autism, aphasia, Alzheimer’s, Down syndrome, and schizophrenia.

“CAMIMH works to improve services and supports through advocating for improved government policies, private industry practices and by improving public perceptions and engagement in mental illness and mental health in ways that will benefit people affected by mental illness.”  It is an alliance of organizations involved in provision of mental health services and organizations of consumers and their families. 

The week began in 1992 as an initiative of the Canadian Psychiatric Association. CAMIMH started its sponsorship in 1998.

The Romanow Report on health care in 2002 favored inclusion of mental health care as part of home care.  Not much else about mental health was included.  In 2003, First Ministers agreed on various matters, setting a priority on certain procedures: hip and knee replacements, hip fracture repairs, coronary bypass, cataract surgery, and cancer radiation. 

Terminating in 2014, the First Ministers’ Accord was neither renewed nor replaced.  Over the ten years, little progress was made.  The focus was on cutting and radiation, with mental health well on the back burner.  Surgery was the big thing.

The most common mental health problems are anxiety and mood disorders, especially the depression family, including clinical depression, dysthymia which is somewhat milder but chronic, and “the blues”, milder yet.  CMHA says that 22% of the population suffers from mood and anxiety disorders. 

PSAC, the Public Service alliance of Canada, is in contract negotiations with the federal government.  It wants to include dealing with mental health in the new collective agreement. 

High on the list of illnesses involved in absence from work are psychological conditions, especially anxiety and depression.  This is not a surprise, given the nature of government employment, with a high proportion of the work force lacking security, with much of the work force on short-term contracts rather than permanent status.  They are left with constant uncertainty about their future.  Then there is the possibility in some cases of toxicity in the workplace.

According to the Mental Health Commission of Canada, our economy loses $6 billion a year due to mental illness-related absenteeism and presenteeism. 

Presenteeism is the condition in which a person goes into work when ill and performs at a less than optimal fashion. 

Turning to the CMHA again, of children in need of treatment only one in five gets it.  Overall, one third of people needing help for mental illness get it.

Bell Canada, one of the main supporters of the CAMIMH week, has its own “Let’s Talk” program to promote public awareness.  As part of their program, they discuss how we interact with people who are mentally ill and how we talk about them.  We don’t say that someone is “nuts” or “crazy”. 

“Let’s Talk” features people who have dealt with or are dealing with mental health issues.  Among them are three comedians, Mary Walsh who has had an alcohol problem, Michel Mpambara, bipolar, and Howie Mandel, with Obsessive Compulsive Disorder (OCD) and Attention Deficit Hyperactive Disorder (ADHD).   

Perhaps most of us know or know of someone who is mentally ill, perhaps in our own family. 

I think of a friend who has since died, Donna.  She had a recurrence of a schizoaffective disorder.  That is a condition combining schizophrenia and mood disorder.  I knew she was ill again when she told me that the car she was in had an accident because the police did not want them to go to Hamilton.  In further conversation, other bizarre and paranoid notions also came into play.  She was very frightened and agreed to go with me to Women’s College Hospital in Toronto. 

In talking to the triage nurse, her presentation was not that out of the ordinary.  The nurse said she did not see anything much.  Then I said to the nurse, “Let me help you.  Donna, who is after you?” 

“The licensing body.”  She was a court reporter.

“And the police?”

“Yes.”

“And the church?”

“Yes.” 

“I’m beginning to get the picture,” said the nurse.  Donna was admitted.  The psychiatrist told me that she was potentially suicidal.  I asked her later while she was still in the hospital if she was apt to kill herself. 

“If people keep talking about me that way,” she replied.  I probably saved her life.  She died of natural causes.  While she was never able to return to work, she was the one of three who got the help she needed.  

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