Health care is lacking for British Columbians with mental illness

Opinion: With the largest federal funding for mental health in the next three years, our government has a real chance to make meaningful change.

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By the age of 40, half of Canadians are diagnosed with a mental illness such as depression, addiction or anxiety. Without treatment, these can lead to disability and death.

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In contrast, less than 10% of Canadians have diabetes and less than 1% are diagnosed with cancer each year. Although mental illness costs Canada $50 billion each year, when it comes to health care funding, mental health is a poor cousin of these and other illnesses.

These statistics likely underestimate the true human and societal costs of mental illness, as stigma and barriers to treatment often prevent people from seeking treatment. Much of this stigma is perpetuated by our provincial health care system and its resistance to treating mental illness effectively and equally with other illnesses.

In December 2021, Dr. Lear was diagnosed with depression accompanied by suicidal thoughts. Like other sufferers, he had suffered from mental health issues for many years before being diagnosed. And, like many, did not know what care was needed. After being prescribed an antidepressant, treatment options were minimal. Wait times for a psychiatrist ranged from a few months to two years, a delay that can have devastating consequences as evidenced by the case of André Courtmarche, 16, on Vancouver Island in 2021. While he was on the waiting list to see a psychiatrist, his condition worsened until he died by suicide.

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When people have thoughts of harming themselves, they are told to go to the emergency room or call 911. Calling 911 usually means a police visit to your home. In effect, police report dramatic increase in mental health-related calls as more than 10% of emergency department visits are related to mental health issues. Also, going to the emergency room can be a traumatic experience. After being seen in hospital for as little as a few hours, patients are often discharged for follow-up with their family physician. With almost one in five British Columbians without a doctor, this advice is often ignored. Even for those who do, family doctors have limited options.

Hospitalization programs exist, but they concern the most serious cases and waiting times are long. Moreover, these programs result in “treatment and the street,” where patients go through without long-term solutions. This contrasts with cancer, heart disease and diabetes, where treatment teams are mobilized, the right intervention is delivered and follow-up care is carried out in specialized outpatient clinics.

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Private options do exist, but for many the cost is prohibitive. With nowhere to go, people with mental illness often resort to unhealthy coping strategies such as substance abuse and self-harm, which can lead to disability, homelessness, drug poisoning and death.

Recently, Minister of Mental Health and Addictions Sheila Malcolmson reported the provincial government’s progress in improving access to counseling services in emergency primary care centers and community systems. But counselors are currently an unregulated health profession. Only physicians, psychiatrists, licensed clinical social workers, and psychologists are trained to provide evidence-based assessment, diagnoses, and treatment for mental illness.

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We would never accept unregulated medical professionals to diagnose and treat cancer or heart disease. But that appears to be what the government considers appropriate care for people with mental illness.

Since 2018, based on decades of scientific evidence, the BC Psychological Association has urged the government to integrate psychologists alongside family physicians, providing assessment and treatment. A 2011 study in Ontario showed that placing psychologists side-by-side with physicians in two primary care clinics resulted in improved depressive symptoms and quality of life, as well as reduced wait times for all patients. Doctors also reported an improvement in their own well-being and a reduction in work-related stress, with 100% recommending the program. A recent study in British Columbia showed similar results with fewer than three 30-minute visits with a psychologist.

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With the largest federal funding for mental health in the next few years, our government has a real chance to make meaningful change. Including psychologists on care teams reduces wait times to see a doctor, improves patient outcomes, and saves government money through reduced utilization of health care and health services. emergency. If our government is serious about treating mental illness, it’s time to put money where our mouths are.

To note: Dr. Lear received treatment at a private facility for seven weeks and is now receiving outpatient care from a team of medical professionals.

Scott Lear is a professor in the Faculty of Health Sciences at Simon Fraser University and author of the blog Feel Healthy with Dr. Scott Lear; Lesley Lutes is a professor and director of the University of British Columbia Center of Excellence in Obesity and Wellness Research at the Okanagan campus. She is also co-director, public advocacy, at the BC Psychological Association.

Letters to the editor should be sent to [email protected]. The editor of the editorial pages is Hardip Johal, who can be contacted at [email protected]

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About Antoine L. Cassell

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