National Viewpoint -- How Canada fails people who have mental illnesses
Brandon Sun, The (Manitoba, Canada)Jan 29, 2015
In any developed country, politicians and clinicians are struggling to improve quality of care while reducing costs of health-care systems. To remedy this, groups of doctors across The goal of this initiative, called Choosing Wisely, is to improve quality of care and to address rising health-care costs. This campaign hopes to inspire a dialogue between clinicians and patients about making good, evidence-based, cost-effective choices about their health and health care. But the big dilemma for those working in the field of mental health is not about overuse or misuse, but how difficult it is to get any treatment at all. You can't choose wisely if you can't access care. There is overwhelming evidence that access to mental health care across This poor post-discharge followup rate is far worse than the nearly 100 per cent of patients who see a physician following a hospitalization for heart failure. So why do we do so poorly for people with mental illnesses? The answer to that question is complicated, but mental illness is one of the biggest predictors of inequitable access to care in this country. We know that having a mental illness means that you are far less likely to get the health care you need than someone without a mental illness and that mental illness is a bigger predictor of poor access to care than low income. This is truly bad for patients with psychiatric illnesses, but it's also bad business and costly to taxpayers -- the price of a physician visit following hospitalization is far less than the cost of ending up back in the hospital because you had no hope of continuing the treatment that helped you get better. The good news is that we often know what works for people with mental illnesses. There are many types of treatment, both drugs and psychological (talk) therapies, that are well-tested and effective. But in the mental health realm, we need to start 'Working Wisely' before we can 'Choose Wisely.' What would 'Working Wisely' look like? Cancer care is an example of a system of care that is largely efficient across In most provinces, we know what the population burden of cancer is and can create systems of care accordingly. Outcomes are also constantly measured and processes of care are modified based on continuous quality feedback. We have nothing close to this in mental health across the country, which means we don't have a good sense of population-based need. And if we don't have a clear sense of need, we won't be able to align existing resources with present demand. 'Working Wisely' for mental health care in The Mental Health Commission of One of the reasons we are hearing more about mental illness in the media these days is because there is less stigma thanks to courageous individuals who are willing to share their stories. People are no longer willing to suffer in silence, and we literally can't afford to ignore the burden of mental illness. But as people come forward seeking help for the first time, they need a system that is ready, responsive and able to meet their needs. Without that, we will simply continue to read the depressing headlines on a weekly basis. ยป