You Can Make a Difference

What comes to mind when you see the word health? For many, it might just mean one’s physical condition. While physical health is part of it, health is not only of the body, but also of the mind. A number of people of people are uninformed, or pay no attention to this equally important side of health. Physical health and mental health go hand-in-hand and it is extremely important to raise awareness for people to take care of their body and their mind.

Statistics and fast facts are often used as eye openers about health and different diseases. How much do you know about mental health? You can check numerous reputable websites with statistics on just how much we are all affected by mental health. Quick fact from the Canadian Mental Health Association website: 20% of Canadians will personally experience a mental illness in their lifetime. That’s more than 6 million Canadians – and mental illness is not just some cold that will bother you for just a few days. For some, it could last years and years of their life. People who are unaware and have an undiagnosed mental illness could go on for years without treatment and have their lives adversely affected.

I’d like to talk to you about To Write Love On Her Arms, an organization started by Jamie Tworkowski. Don’t recognize the name? He’s not exactly a celebrity. Jamie is an ordinary guy who turned a passion into something big. Another example is that of the group of 12-year-olds who started what is now known as Free The Children. Ordinary people do extraordinary things everyday. You don’t have to be famous to make a difference, and you don’t have to look far to see ordinary people doing remarkable things. Even in your own community, you can find people who are making a difference.

So what can YOU do? There is still much research to be done to improve the mental health system in our country – and your ideas are important. There aren’t always easy answers to problems, but combining our personal experiences and knowledge can help improve mental health for everyone.

There are endless ways for everyone to help. If we want to change something, we have to start with ourselves. You can take the time to learn more about the issues and share your thoughts. You can help and support projects or events that would also help raise awareness and stigma.

Stigma is a major issue experienced by those suffering from mental illness. People are stigmatized because of the lack of knowledge on mental health. In 2008, the national report card from the Canadian Medical Association stated that 46% of Canadians, almost half, believe that people use mental illness to excuse bad behaviour. It also states that one in four Canadians are afraid to be around people suffering from mental illness. What does this mean for people legitimately suffering from a mental illness?

It may be difficult to change the minds of adults but we must still try. It starts with education. As with abolishing problems such as racism and other kinds of prejudice, educating people at an early age about mental health is one of the most effective ways to reduce stigma.

Youth are also profoundly affected by mental health. It is a time when we’re fragile and undergoing changes and maturity. In a survey for youth with a diagnosed mental disorder, nearly 70% had their onset of symptoms at early ages.

These points all bring me to the most important question: Why should we care? We need to be concerned about the well-being of those affected by mental illness. We mustn’t stray away from this issue and start thinking of these figures and statistics as just numbers. We need to put a face to this problem and think of the people we care about. It could be your parent, sibling or perhaps a friend, who is suffering from mental illness. So, what will you do?

--Karl Yu

Check This Out

Her name is Laura Burke, and if you do not know her or what she does already, you will by the time you finish reading this blog. But before you go any further, check out this link: http://www.youtube.com/watch?v=23a18HKYLW4. Ok, so here we go.

Recently it was my privilege to present Laura with the first ever youth award in the Champions of Mental Health Awards history. And she is a worthy recipient. She has worked hard to get well and to stay well. She takes her challenges head on and addresses them. She does not look for pity or solace she looks for recognition of her strengths. In short, she fell down, she got up, she dusted herself off and she began all over again. Kudos!

I am not sure if this is what the legion of resilience researchers are talking about or not. It seems that not a day goes by that I do not read about a new program or a new direction that will transform the lives of young people by enhancing their resilience. Usually this is achieved (or more properly said to have been achieved without the solid evidence we need to critically determine the outcomes) by some kind of learning of how to be resilient, taught no doubt by a well meaning and well paid human services provider.

And what about people like Laura. How did she become so resilient? Maybe she had it in her all along. Maybe everyone does. Maybe we need to work at ensuring environments support the development of that. Maybe we need allow young people to fall down gently, so that they can learn to stand up, dust themselves off and start all over again.

--Stan

The police and mental health

Just was reading an interesting article on police and mental health.  Not the mental health of police, although that would be a very important issue to know more about.  Can you imagine the stresses of that occupation?  But about how police respond to individuals who are exhibiting mental health problems, or individuals with mental disorders who are in distress or acting in such as way as to be causing distress to others.  So here is the piece: http://www.theguardian.com/commentisfree/cifamerica/2010/jul/14/police-mental-health-training. As you can see the title is: US Police need proper training in mental health.  And the sub-title is: “People suffering mental health crises are too often subjected to brutality by poorly trained and frightened police officers”  According to the writer (in a UK paper by the way): “Every day in various American communities, people enter mental health crises and their friends and family members pick up the phone to call for help. Often, the first responders on the scene are police officers, and the resulting interaction does not go well. Poorly trained and frightened police officers may resort to excessive force, and sometimes this ends in death for a person who is guilty only of being in urgent need of psychiatric care.”

Although the piece is long on hyperbole and heart wrenching descriptions of police attacking individuals suffering from mental disorders, and short on any substantive data and overall balanced reporting regarding what police forces are actually doing, the writer does bring attention to an important issue. Certainly police officers should have more training in dealing with the unique needs of peole who have mental illnesses and who are behaving in a way that may put them or others at risk of harm. Certainly we need more and better community based mental health care services. These needs are real and we have to get working on doing more. 

But it is also important to recognize that much has been done in the last decade or so.  Here in Halifax, there is a mobile crisis service that I am proud to have been part of its launch.  It pairs police officers with mental health professionals.  It goes to where people need them and it works – not perfectly mind you, but it works.  One of my colleagues, Dr. Bianca Horner and members of the Department of Psychiatry and the Mental Health Program have developed a national training program for the RCMP, called “Recognition of Emotionally Disturbed Persons” regarding this matter.  Other police forces in Canada are now beginning to address this issue.  I have had the opportunity to be part of the Minister’s task force on TASER in Nova Scotia and the privilege to chair the sub-task force on excited delirium.  As a result of these reports there have been substantive movements towards improving all aspects of first responder approaches to individuals with mental disorders.

While these are a good beginning we certainly have to do more.  It is not appropriate nor is it fair nor is it right that our prisons have become holding bins for people who require mental health care.  The federal government has decided to build more prisons.  I for one would like to see them invest more in mental health care instead.  Don’t you think it’s preferable to treat someone who has a mental disorder in such as way as to assist and support their recovery instead of throwing them in jail?  I do.

--Stan

Who Makes the Decisions?

Recently there was a report of an extraordinary example of political interference in mental health treatment. A political interference based not on knowledge but as far as I can tell, based on stigma or perhaps with a bit of so called “law and order” pandering to the uninformed.

The story unfolds in this way. A person who is in secure treatment for a murder committed when he was psychotic applied to have supervised outdoor walks. The mental health treatment team supported that application and it was permitted by the Criminal Code Review Board who are charged with the responsibility for such decisions. Without these walks (remember that they would be supervised – that is, the person who as far as I know has improved with treatment would be accompanied by two trained mental health staff during short outings) the person would have to languish indoors all summer.

Upon hearing about this decision, the Minister of Justice in Manitoba – Andrew Swan, overturned the board’s decision, ordering that no supervised walks could be allowed! Why? According to Swan it was “contrary to the interests of public safety”.

What hogwash. Since when did Minister Swan get his credentials in mental health? And what possessed him to overturn a duly constituted and credible evaluative process? Could it be stigma against the mentally ill? Could it be the lowest form of political pandering to ignorance and fear? What kind of a message does this send to people living with mental illness? What message does this send to their families? What message does this send to society in general?

Shame on Minister Swan. This is something we could have expected in medieval times, not in 2010 in Canada.

--Stan

Advancing mental health through gender equality

When I read the piece in the Globe andMail about the G(irls) 20 Summit delegates, I was impressed. Kudos to Belinda Stronach and her Foundation for this innovative and necessary initiative.

Unlike the ongoing boondoggle involving fake lakes and public toilets well out of the reach of the public and denial of reproductive rights enjoyed by Canadian women to women in other countries, the Stronach initiative strikes the right notes.

Domestic violence, rape, the need for gender equality, the need for high quality easily accessible education, maternal health and well-being (including family planning) where all issues identified by the young delegates profiled in the Globe article. Of course these are all issues that are too familiar with here in Canada as well – not to the same degree as in low and middle income countries but certainly in kind. Guess what. These are mental health issues as well.

Empowering girls and women and ensuring gender equality in all social, civil and economic undertakings are interventions that will spill over into mental health promotion and prevention of negative social and health outcomes. This is an excellent way to address the social determinants of mental health – everywhere.

We have to do a much better job in this area globally and at home! The mental health of nations must be built in part on national policies that promote and ensure the well-being of girls and women. This is a task that we all must participate in. I for one would like to see very piece of federal, provincial and territorial legislation reviewed to ensure that it promotes this agenda. Sure we need mental health policies, programs and plans. But we need a pro-gender equality framework that informs everything we do.

--Stan

Girls not boys and definitely not in between or beyond (another opinion)

The G(irls) 20 Summit delegates, Globe and Mail article, resonates with me. There is no doubt that the equality of women should be a joyous and wonderful thing celebrated by all women everywhere! But what is this meeting of delegates missing? Focusing entirely on women fails to address women’s equality and health. What? That’s crazy! Women and girls are facing inequality resulting in health disparities—shouldn’t we then focus on women? No, actually we shouldn’t.

Focusing exclusively on women is bad for the health of men and women. It fails to provide the necessary variety of perspectives about how gender interactions are contributing to inequality and how this could be addressed in a comprehensive manner.

There are negative consequences of societal gender expectations on all members of society. This includes the people, too often forgotten (at least in North America) who don’t fall into this fabricated gender binary. What about people who are not male or female? What does that mean? You know, people who identify as something other than male or female, including (but not limited to) gender queer people, transmales, transfemales, and intersex people. These groups of people are often ignored completely and face oppression to an exponential degree in comparison to women.

Imagine this. You’re suffering with mental illness and searching for your identity in a society that doesn’t represent you on the washroom label. You’re unsure of your gender identity because examples of others like you are lacking and your existence is denied in innumerable ways. How do you then go about treating your mental health issues (in a society poorly structured to deal with mental illness in the first place) or for that matter any of your other health issues that largely fly under the radar of most mainstream doctors?

Many trans people face a complex web of health issues (mental, sexual and physical health). This is further complicated by the lack of research pertaining to trans people and plausible solutions to the issues they face. A potential starting point for society to tackle this challenge is by backing trans-supportive organizations to take the lead on an international initiative with money and resources. Taking trans initiatives international has potential to provide insights about how other cultures treat trans people and how to improve our society.

But most importantly, we should be tackling the problematic gender expectations and we should be doing it in an all-encompassing/collaborative manner. That is, if we want to address inequalities and related health disparities successfully. Or we could continue attempting to separate inseparable social issues (gender inequality vis à vis males) and members of society (female, male, or gender queer) to create an illusionary solution for the illusionary “separate” issue.

--Holly Huntley

Digital Media and Mental Health

Recently the Globe and Mail published a story about a study that purported to show that college students in the USA were 40 percent less emphatic than those of a few decades ago. Whether this is indeed correct cannot really be determined by the methodology used in the study quoted but that does not seem to stop enthusiastic speculation about what has “caused” this so called drop in empathy. As expected, the usual boogy-men have been trotted out. None of these have been demonstrated to be causal in this change but that does not seem to stop pontification, particularly if it leads to sales of programs or newspapers.

So what are the suggested causes? Of course, the digital media – facebook and myspace. The argument here is that they are “physically distant online environments” [that allow] people to “lionize their own lives” and “functionally create a buffer between individuals, which makes it easier to ignore others’ pain, or even at times, inflict pain upon others.” This hyperbole makes good theatre but is not very good social science.

Of course the usual cause for every generational “issue” is then also brought to the table. It’s the fault of the parents: “These kids were born around 1980. It could be a change in parenting style. … Kids are getting the implicit message from parents that success is what really matters. It’s hard to spend your life pursuing success and at the same time pursue empathy, because empathy takes work.” So here we are treated to more unproven hyperbole. It sounds plausible so therefore it must be true (that at least is the reasoning). And guess what – there is a program that can be purchased to fix this supposed deficit.

So what is the back story? First, is there really a significant change in empathy (even in the face of the research limitations of this study)? Well the first question is: what does a drop in 40 percent mean? Is this a relative drop or an absolute drop? A drop from 0.1 percent to 0.06 percent of the population is a 40 percent drop – but likely means very little. A drop from 100 percent of the population to 60 percent of the population is also a 40 percent drop but likely means a lot! Beware any news story that uses percentages! Stop confusing co-relations with causality. Sure facebook and myspace are new social realities. So are globalization and climate change. Parenting styles are blamed for every social ill. Darn parents, if only they could learn to do things right!

Well there are some very interesting things on the horizon in terms of understanding empathy and how it develops and how it may change over time. Research into children with the rare genetic condition called Williams syndrome (one of the features is extreme sociability) is peeling away the complexity of interactions associated with racial stereotyping.

Other research has identified mirror neurons in the human brain that are associated with abstract thinking, planning and ability to empathize. This type of research, linking our understanding of how brains develop in response to their environments will help us sort out these important issues. The rest provides lots of impetus for speculation and opportunities to spend our money on programs that work about 40 percent of the time.

--Stan