Canadians urged to support mental health plan

Canada's Mental Health strategy8:05

Canadians shouldn't waste the opportunity now before them to help improve the mental health system, the chair of the Mental Health Commission of Canada said Tuesday as its landmark strategy was officially launched.
The commission's report, Changing Directions, Changing Lives, contains 109 priorities and recommendations for action and is being called a blueprint for change. It was obtained in advance by media outlets and its details publicized on Monday.
Mental health advocates, Parliamentarians, including Health Minister Leona Aglukkaq, and members of the commission celebrated its official release at an event in Ottawa on Tuesday and called for its recommendations to be implemented.
"This is a time of great opportunity for mental health in Canada. With governments, corporations, communities, families and individuals expressing growing interest in mental health, we must not squander the best chance we've ever had to make the biggest improvements in our history," Dr. David Goodbloom, the newly appointed chair of the commission, said. "We owe it to all Canadians to act and to act immediately."
The report is one of the signature initiatives that the Mental Health Commission of Canada has been working on since it was created in 2007 by Prime Minister Stephen Harper's government.
It has a 10-year mandate and its establishment was borne out of a major report from a Senate committee in 2006 on mental health.
The strategy's recommendations, divided into six strategy areas, are aimed at governments, the private sector, health professionals, social services providers, and all Canadians. It addresses all age groups and Canada's diverse population, including new Canadians and First Nations communities.
It wants recovery to be put at the heart of mental health reform so that the consequences of mental illness can be minimized, and it also calls for timely access to the right combination of treatments, services and support.
"We expect this for people confronting heart disease or cancer. Why should we expect anything less for people living with mental health problems and illnesses?" said Goldbloom.
More health professionals, better access to medicines, and peer-support programs are needed but enhanced social and community services, such as housing, are also required, he said.
The report says that the current mental health system is fractured and chronically underfunded and the commission wants to see at least $3 to $4 billion invested in it over the next decade.

Every Canadian has a role to play

But Goldbloom said in addition to more investment, existing resources also need to be used more efficiently.
Goldbloom said that while progress has been made and Canadians are talking more openly about mental health problems, there is still a long way to go, and it's not just up to the government to change the way mental illness is treated.
"While the federal government has asked us to create this strategy, this plan is far more than just government. Thousands of Canadians have already played a role in creating this strategy and every Canadian has a role to play in making it work," he said.
Momentum has been building in recent years, and the commission says collaboration, leadership and support from all Canadians is needed to keep it going.
An estimated one in five Canadians will be affected by a mental health problem or illness, which means almost every Canadian will be touched by it either themselves or through someone they know, and mental illness is estimated to cost the economy $51 billion annually.
"If there is one thing we need Canadians to hear today it's this call for action. We all have a stake in this," said Louise Bradley, CEO of the commission.
She said the commission will be reaching out to governments, national organizations, and community groups and encouraging Canadians and decision-makers to implement the plan.
Louise Bradley, CEO of the Mental Health Commission of Canada, left, and Health Minister Leona Aglukkaq, listen to remarks from speakers at an event in Ottawa to launch the commission's national mental health strategy. (Sean Kilpatrick/Canadian Press)Health Minister Leona Aglukkaq was also at the launch and called Canada's first mental health strategy a "milestone."
Aglukkaq said she hopes the strategy will "further energize the national dialogue about the importance of mental health" and said the report represents a call for all levels of government, the private sector, and volunteers to keep working to change the system to meet the needs of vulnerable citizens.
"No single person, group or government will succeed on its own," she said.
Now with the release of the report there is pressure on Ottawa to dedicate more funding to the mental health commission to follow through on its report. The government has also been criticized in recent weeks because budget cuts at the Department of National Defence are trickling down to mental health programs for veterans.Aglukkaq announces new research funds
Aglukkaq said her government has made significant investments in mental health and suicide prevention since it took power in 2006 and that the investments "are worth every dime."
She also announced during her speech that the federal government is issuing a new call for research proposals on the issue of homelessness and mental illness. The government is committing about $800,000 for new research projects.
But when asked after her speech whether the government will listen to the call for billions more dollars to be invested in mental health, Aglukkaq said the federal government is committed to providing stable, long-term funding to the provinces to deliver health care and that its investments in research parallel the commission's work.
"It's not going to be one government to address this strategy, it's going to involve all partners," the health minister said.
Goldbloom's predecessor, retired Senator Michael Kirby, was more blunt about whether the primary responsibility for implementing the report falls to the federal or provincial governments.
"The strategy outlines a variety of actions that are needed, which ones the individual provinces will pick up and decide to act on will vary. It depends, for instance, in particular on what services they now have available – the gaps in some provinces are totally different from the gaps in others," he said at the event. "So in my view there is absolutely not a role for the federal government on the implementation side because it's an area of provincial responsibility."
During his remarks, however, he said federal and provincial governments must make mental health a priority after decades of keeping it in the shadows.
"We simply cannot allow the current situation to continue," he said. The challenge that lies ahead now that the report is done, is getting decision-makers in the private and public sectors to act on it, he said.
"To sell it, to get it adopted, is going to require a very strong marketing effort," he said.

Dragon boat coach beating the drum for mental health

Patrick Couling, Coach, Conquering Waves Dragon Boat team

As dozens of teams get ready to churn the waters of False Creek this weekend at the Rio Tinto Alcan Dragon Boat Festival, there’s one representing Canada’s most stigmatized population – the mentally ill.
Conquering Waves, now eight years running, is made up of 20 people living with various diagnoses, their friends and family, and workers from community agencies such as Coast Mental Health and Open Door Group.
Beating the drum at the back of the boat is volunteer coach Patrick Couling, 61, a mild-mannered export consultant with a passion for paddling. A former star athlete – he attended Washington State University on a track-and-field scholarship – he has been involved with dragon boating for 25 years, and has helped many competitive and charity teams race to the finish.

First steps
It all started in 1985, when I helped create the False Creek Racing Canoe Club out of the community centre on Granville Island. After I stopped paddling, I got into coaching competitive teams, and gradually moved into what they call special population teams. I helped get a team started for multiple sclerosis patients, and I’ve worked with some breast cancer teams as well. Eight years ago, I was asked to coach Conquering Waves by some community agency staff who were looking for an outlet for people with mental illness to socialize and become physically active.

The pitch
We’ve got people with schizophrenia, depression and OCD, but with most of my team, you really wouldn’t know who has a mental illness and who doesn’t. These are just normal people, and yet there is no group more marginalized by society. There’s a reluctance to recognize how many people suffer from mental illness. Part of our goal is to get them out on the water so people can see the team, but mostly it’s an avenue for a bunch of really nice people to exercise, socialize and go out for some good food.

What keeps you going?
The sense of accomplishment and the smiles at the end of every race. Dragon boating really pushes the concept of teamwork to the edge – if one person is out of sync, the entire boat suffers. With competitive teams, you work and work and you barely make any progress. With these guys, you’re seeing major breakthroughs every time you practice. It’s incredibly rewarding.

My hero
Hugh Fisher, the Olympic gold medallist in sprint kayak and my first coach at the False Creek Racing Canoe Club in 1985. He created the sport of dragon boat in Canada.

Next steps
When I’m not at work, I’m volunteering. It’s part of who I am. I’m also coaching a kidney dialysis team called O2P – Oh to pee, get it? – which runs almost year-round. They’re trying to raise awareness of organ donation, and they’re some of the sickest people I’ve coached, but if they can do it, anyone can.
This interview has been condensed and edited. Send suggestions for the Action Figure to livebetter@globeandmail.com.
Special to The Globe and Mail

Together Against Stigma Conference

 

Art on Display at Stigma Conference

“Stigma prevents people from seeking help and prevents many others from providing it.” – David Goldbloom
“At one point I wondered if becoming an outspoken advocate for mental health would affect my career.” – Actress Glenn Close
“My mom was told, she’s not depressed. She’s just lazy and spoiled.” – Erin Hodgson
“We are treating more people with physical disorders in poor countries than mental disorders in rich countries.” – Graham Thornicroft
I came home yesterday from the Mental Health Commission of Canada’s Together Against Stigma Conference. Wow. Those were three jam packed days, full of good content with people in attendance from around the world. There were folks from Japan, Spain, Denmark, the US, the United Kingdom and the list goes on.
I was surprised to hear speakers say that stigma is getting worse, not better – despite the reality that the public has become more educated about mental illnesses being medical brain disorders. Bernice Pescosolido, for example, noted that if you believe that mental illness is in the genes, then you are more likely to stigmatize. Why? “Because now it’s permanent.” I heard no one at the conference deny that mental illnesses were medical conditions and many of the speakers were medical professionals. It was noted that science is useful, but the message of inclusion is really the important one. Over and over, people said that direct contact with those who live with mental illness, either live or via video helps to reduce stigma. Norman Sartorius noted that if you just provide knowledge about mental illness people just become more prejudiced. Knowledge is only useful if you also increase competence in dealing with problems and combine it with structural change, for example, laws. Anthony Jorm described mental health literacy as knowledge that you put to practical use, not just knowing about brain disorders.
Stigma amongst health care providers was discussed. Graham Thornicroft noted that if mental health workers only see people who don’t do well and are not seeing people when they are doing better, that can add to stigma. Peter Bryne noted that a major source of stigma and discrimination are the health care providers themselves. Thomas Ungar said that research has shown that patients with a history of depression receive poorer treatment for physical conditions. People with mental health diagnosis in general receiving poorer treatment for physical ailments was also discussed. Ungar recommended multiple stigma interventions for different learning groups. For health care providers, he talked about the biological information about mental illness helping to reduce stigma.
Another population discussed at the conference was youth. Heather Stuart noted that stigma impact shows an age gradient. People under twenty five years old bear the brunt and are most affected by stigma. She said that anti-stigma programs should be offered over a longer period of time in schools, not just as “one offs” and she recommended they incorporate direct and video contact with those who live with mental illnesses.
The above are just a few of the highlights that stood out to me. There was a ton of information in the conference. I took over 16 pages of notes and I was not jotting everything down! Nor could I attend everything. There were many break out sessions that overlapped. I was often torn – wanting to go to multiple sessions that occurred at the same time. Twitter came in handy on such occasions. There were a number of people sending out notes from the conference over Twitter. I was able to see those notes or “tweets” from other sessions as I sat in the one I had chosen. Pretty cool.
The most powerful part of all of it for me were the personal stories. There were lots of these – from people who have mental illness and from family members. Andrea and Michelle Zoephel, a mother and daughter team, were amongst those who spoke. Their story was touching. Michelle developed schizophrenia at a very young age and her mom, Andrea, was the main support. Andrea recalls watching her daughter be taken to hospital by police in handcuffs at the age of twelve because she was ill. It was heart wrenching to hear.
The two have started a website called EMIS, which stands for Eliminate Mental Illness Stigma. It’s new and still under construction but sounds very promising. Give it some time to develop and check it out. They gave out fuzzy EMIS pins at the conference and invited us to take several so we can give them to others we know. They’ll be conversation pieces and, if folks ask about them (and they will), they’ll provide an opportunity to start a conversation about mental illness and stigma. We need more of those conversations. I took a handful.

A Wellness Day

As we continue our exploration of wellness in anticipation of the next issue of On Our Way: Recovery News, we are pleased to present this piece by guest blogger, Winter Hammell.

A Wellness Day

Winter Hammell

My heart was raging like a wild beast.
It was a wellness day…
I walked into the fierce, sea-scented autumn wind, head up, eyes watering in the dazzling sunshine. The cold air passed through me, cleansing my mind. Out on English Bay, whitecaps were surging and storming. Nine black-hulled cargo freighters rode the waves, straining at their anchors.
Foaming olive-green waves thundered against the wall of grey granite blocks, sending frothing fountains of salty spray forty feet up onto the path. It was a game to race between the waves which made the path shiver and shudder and the air sparkle as if with liquid diamonds. Dozens of people were playing the game.
“Look!”
Everyone looked up.
A little jot of wonder made my heart jump in its cage of bone. Hundreds of crows like black, flickering shards in the sunshine passed overhead, riding inland. Then they were gone.
I followed the seawall as it curved west and north. On my left heaved the bay. On my right loomed the thick forests of Stanley Park, full of wilderness and mysterious shadows…
I felt a strange kind of happiness. I felt well.
What is `wellness`? Is it just physical health? Or is it that and mental and emotional well-being? Is it creativity? Is it spirituality? Is it playfulness? Is it having fun, and enjoying activities? Is it being with other people, with animals, with plants? Is it being a part of nature in all its guises, from sunny afternoons to winter`s rainy days? Is it loving, and being loved? Is it all these? Yes–!
Wellness is walks along the seawall and playing on the swings at Second Beach. It is playing Scrabble and painting a picture and cooking spaghetti. It is thoughtful prayer in a quiet place – church or temple or forest glade. It is everything any person can do.
Wellness is being vibrant, alive to the endless possibilities each day brings.
Wellness is caring for oneself as well as caring for others. It is an act of self-love. It is protecting, nurturing, comforting…
At the Third Beach concession stand I bought hot chocolate and sat on a sun-blanched cedar log facing into the wind, my hands folded around the paper cup.
I sat there a long time.
I felt better than I had felt in a long time.
It was a wellness day.

© 2012 Winter Hammell

Canada lags behind in mental health spending

Canada lags behind most developed countries in the amount it spends to treat mental illness, with Ontario and Saskatchewan spending the least, according to a major study of mental health spending in this country.

By The Ottawa CitizenMay 22, 2008Comments (2)

Canada lags behind most developed countries in the amount it spends to treat mental illness, with Ontario and Saskatchewan spending the least, according to a major study of mental health spending in this country.
The study represents the first time Canadian researchers have tried to measure mental health spending by province.
In 2003-04, Canada spent $6.6 billion on mental health, representing just 4.8 per cent (or $197 per person) of the total health budget, says the study, published this month in the Canadian Journal of Psychiatry. The amount is less than the five per cent that European health economists consider the minimum acceptable amount to treat mental illness.
That puts Canada, along with Italy, at the bottom of the list in mental health spending by developed countries. As a share of the total health budget, Britain spent the most (12.1 per cent), followed by Germany (10), the Netherlands (8), Denmark (8), the U.S. (7.5), Ireland (6.8) and Australia (6.7).
The research also shows wild fluctuations within Canada, with Ontario ranking near the bottom. As a share of the total health budget, Ontario spent just 4.3 per cent to treat mental illness, or $185 per person.
Only Saskatchewan, at 3.5 per cent, or $146 per person, spent less.
British Columbia was the top spender at 6.4 per cent, or $258 per person.
The study's findings have caught the attention of the Mental Health Commission, a new organization chaired by former Liberal senator Michael Kirby to figure out how Canada can better care for its mentally ill.
Howard Chodos, the commission director in charge of developing a national mental health strategy, says the study highlights the need for an integrated approach to treating mental illness.
"We do need to develop a much clearer picture of what the total amount of spending is on mental health in this country in order to be able to know if we're spending wisely and if we're spending equitably."
Because health care is a provincial responsibility, with different provinces providing varying levels of mental health services, it's difficult to compile a complete picture of how much is being spent across the country, says Philip Jacobs, project director of the Alberta-based Institute of Health Economics and the study's lead author.
As Mr. Jacobs is quick to point out, his study only touches on direct costs, such as hospital stays and doctor visits due to mental illness.
Not included are the indirect costs, such as income and employment supports for the mentally ill, mental health services for those caught in the justice system and school-based services for young people suffering from depression, anxiety or other mental health problems.
The resulting information vacuum makes it difficult for policymakers to identify gaps, improve service and provide integrated care, Mr. Jacobs says.
He argues that the country needs to develop clear, consistent measures to better guide spending.
"We're a low-spending country as best as we can determine, and to do policy, some effort has to be made to co-ordinate and organize the data collection," says Mr. Jacobs.
Mr. Chodos says the difficulties faced by researchers seeking data are nothing compared to those faced by Canadians who try to access the country's patchwork of mental health services.
"The challenges they face navigating a fragmented and disjointed system would make people in the best of health blanch."
- - - -
Share of Health Budget Spent on Mental Health
- British Columbia: 6.4 per cent, or $258 per person
- New Brunswick: 6 per cent, or $242
- Prince Edward Island: 5.8 per cent, or $231
- Alberta: 5.6 per cent, or $242
- Manitoba: 4.9 per cent, or $219
- Nova Scotia: 4.9 per cent, or $203
- Newfoundland and Labrador: 4.8 per cent, or $200
- Quebec: 4.5 per cent, or $166
- Ontario: 4.3 per cent, or $185
- Saskatchewan: 3.5 per cent, or $146

© (c) CanWest MediaWorks Publications Inc.

Mental health plan unveiled in N.S.

Reaction to mental health strategy3:48

The Nova Scotia government will place more clinicians in schools and assess children as young as 18 months old as part of a broad mental health strategy aimed at intervening early and reducing wait times for care.
Health Minister Maureen MacDonald laid out the province's first mental health strategy on Wednesday, saying it will provide $5.2 million for various initiatives in the first year.
MacDonald said the focus of the five-year plan will be on identifying potential mental health conditions early and trying to deliver care to people outside of hospital settings, if possible.
"We need a system that's more community based, we need faster access sooner and we need to intervene earlier," she told reporters.
"These are all things that will provide us with much different results so that people don't end up in crisis."
Health Minister Maureen MacDonald laid out Nova Scotia's first mental health strategy. (CBC)The province plans to increase the number of schools with psychologists, nurses or social workers to about 80 as part of an ongoing program to detect mental health concerns, start treatment or refer young people to specialists.
MacDonald said early detection is critical since 70 per cent of mental illnesses begin before the age of 25.
She said they will also screen every child for mental health conditions at 18 months of age to identify any developmental delays and provide suitable treatment.

Not enough health-care workers, says opposition

But Liberal health critic Leo Glavine said that while the initiatives are laudable, the NDP hasn't provided enough health-care workers to handle any increase in the number of people needing care.
"Now we're going to get early interventions and more assessments and diagnoses, but we don't have the resources — that's the whole issue," he said.
"We do not have enough mental health experts."
MacDonald, a former social worker, said the province is expanding a 12-week telephone-based program that helps families manage children with mild to moderate behaviour problems.
She said they will also boost the number of peer support workers to help people with mental health disorders transition from hospital to their communities.
Stephen Ayer of the Schizophrenia Society of Nova Scotia praised the strategy, saying it was key to identify mental illness early to prevent the development of more serious, chronic problems.
He cited $500,000 in funding for certified peer support workers as a good boost for frontline help.
"We're moving forward with mental health care in this province and hopefully taking a leading role in the country," he said, adding that his group was consulted on the strategy. "I'm very pleased."

Advisory panel made recommendations

The report comes almost a month after an advisory panel called on the province to shorten wait times for children and youths who have been referred for a mental health assessment.
The advisory committee produced 61 recommendations for creating the mental health strategy.
It found that long wait times for children and youth with symptoms of mental illness were a particular concern and recommended that urgent cases should be offered an assessment within a week instead of 10 days.
As well, it said semi-urgent referrals should be offered an appointment within two weeks instead of four weeks, and regular cases should be seen within 21 days.
MacDonald conceded Wednesday that the province doesn't meet some of its standards, with some people waiting months beyond the acceptable time limit.
She said they hope to change that and meet their standards with the new strategy.

One in five affected by mental illness

It is estimated that about 180,000 people in the province — or one in five — are affected by mental illness.
The government announced in 2010 that it would draft the mental health strategy following some high-profile cases and scrutiny.
Nova Scotia's auditor general criticized the Health Department in June 2010, saying it failed to evaluate the quality of mental health services across the province.
Months later, provincial court Judge Anne Derrick released her final report into the death of Howard Hyde, a mentally ill man who died in 2007 after a struggle with guards at a Halifax-area jail.
Many of Derrick's 80 recommendations call for improved training, more funding for mental health services and better co-ordination and communication between justice and health officials.