Winnipeg Free Press - PRINT EDITION

A mental health crisis is needed

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Former senator Michael Kirby says it's time Canada experiences the equivalent of an Arab spring in mental health -- ordinary, suffering citizens rising up to demand governments and the health system undergo a revolution in services for the mentally ill. Read that term "suffering" broadly: Who among us has not felt the pain of mental illness personally or through a loved one?

Mr. Kirby, who produced a Senate committee report on mental health in 2006, is now piloting the national mental health commission, established under the Harper government. The commission will launch its strategy in a couple of weeks, and the first of its campaigns, targeting children and youth, in the fall. The plan is to raise awareness and chip away at the stigma of mental illness and to pressure governments to improve the way the medical system handles those seeking help.

With estimates of one of every three or four Canadians suffering a mental health episode at some point in their lives, Mr. Kirby told the Free Press editorial board he expects a successful campaign will lead to governments and the health systems being overwhelmed by demands for service. This is a deliberate tactic to "create crisis" in the system.

Canada has been the only western government without a mental health strategy. Stories are common of people poorly served by the system, with catastrophic results -- people in crisis typically show up at emergency wards that are ill-equipped to care for them among the heart attacks, broken legs and earaches.

Hospitals respond to those who are in a psychotic state or suicidal, but if a person is not in need of admission, they are typically told to contact a family doctor or community organization. That doesn't work well for those who are insecure about their mental health or who fear the stigma attached to people grappling with depression, anxiety or schizophrenia.

Canadian politicians now recognize the priority of mental health, the prevalence of illness and the toll it takes personally and economically, but the medical system remains prepared only to respond to crises and in a limited way. Psychiatric care after referral through a primary care system is an insured benefit, but in such limited supply wait lists are long. Therapy from other practitioners works for many conditions, and especially for children Mr. Kirby notes, but it is an option available primarily to those who can afford private counselling.

The conventional approach to mental illness is inefficient, and incapable, of managing the needs of people with mental illness. In early 2013, the Winnipeg Regional Health Authority expects to open a mental health crisis centre a stone's throw from the Health Sciences Centre, which should improve access for people in need of crisis or diagnostic service, and help them plug into existing resources.

But like much of Canada, Manitoba does not have the capacity to meet what is a silent and pent-up demand within the community for mental health services. The new crisis centre, for example, will help adults only.

Mr. Kirby's plan to blow the lid off the well of quiet desperation means Manitoba, and all of Canada, may soon see a surge of demand that cannot be met by the medical systems and their budgets. This problem requires broader thinking than the standard response of shovelling billions of dollars into medicare. Health care ministers across the land should start planning now.

Editorials are the consensus view of the Winnipeg Free Press’ editorial board, comprising Catherine Mitchell, David O’Brien, Shannon Sampert, and Paul Samyn.

Republished from the Winnipeg Free Press print edition April 27, 2012 A14

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