TagCanada

Reading of the Week: Mood & Anxiety in Four Countries – More Care, Better Outcomes? The Jorm et al. Paper

From the Editor

Earlier this month, the Commonwealth Fund released a report that surveyed 11 countries for the performance of their health-care systems; it received much media attention. Their work helps provide perspective on our system’s strengths and weaknesses.

International comparisons are relevant in mental health, of course. As stigma fades and as evidence-based treatment options have expanded, we can ask: are people with common mental health problems getting better? And are there lessons to learn from our national experiences?

Four countries, one big problem?

This week, we look at a study that has just been published in World Psychiatry, drawing data from four countries. In the paper, Jorm et al. find that – looking at the prevalence of mood and anxiety disorders and symptoms – people aren’t better off today. The authors consider several explanations.

This paper hasn’t gather much attention here in Canada. But as we look to increase funding for mental health services, it’s an important and relevant paper.

DG Continue reading

Reading of the Week: Remembering Dr. Elliot Goldner

From the Editor

I met him just once. Dr. Elliot Goldner was invited to give the Distinguished Member Lecture at the Canadian Psychiatric Association’s 2015 Annual Conference in Vancouver. Before a packed room, he gave a lucid speech on the state of the system – a speech peppered with insights and statistics, drawn from numerous papers; it was mesmerizing. After, he stayed to talk with people, and I joined the group that had gathered. Late for my own presentation, I received angry texts from my co-presenter. I couldn’t resist the opportunity to talk further about the access issues that he had so clearly discussed.

But if we met just once, over the years, I have read many of the papers that Dr. Goldner wrote and co-wrote. A Goldner paper – like a Goldner presentation – is impressive and memorable.

Dr. Goldner died in late November.

Dr. Elliot Goldner

In this Reading, we look at his life and career through the comments of some colleagues. We also consider his 2011 Canadian Journal of Psychiatry paper on access and psychiatry.

DG Continue reading

“Mental Health Now!”

From the Editor

Will they cut a deal?

Ontario Minister of Health and Long-Term Care Eric Hoskins speaks during a health ministers’ meeting last week in Toronto

It’s the question that will be discussed for weeks to come.

But for those of us in mental health, a possible deal is more than an item on the evening news. After all, a new federal-provincial accord could be important, with more money for mental health services. And let’s remember: right now, just 7 cents on every dollar of health spending goes to mental health (in the UK, by contrast, spending is 12 cents on the dollar).

But we hope for more than just a new deal. We hope for a smart new deal – one that will help improve mental health services.

What are steps the federal government could take?

This week’s Reading considers the new report issued by the Canadian Alliance on Mental Illness and Mental Health (or CAMIMH), an alliance of sixteen member organizations, including the Canadian Psychiatric Association, the Canadian Medical Association, and the College of Family Physicians of Canada. This thoughtful document lays out a five-point plan for bettering mental health services from coast-to-coast-to-coast. Spoiler alert: the plan calls for more spending, yes, but also efforts to improve access, better measurement of the system, and a targeted basic income to help less affluent Canadians.

Also in this reading – tying back to the UK – we look at an article from The Guardian about making mental health services stronger across the Atlantic.

The two pieces offer a strong contrast: about where our debate is in this country – and where mental health services could be with some needed reforms.

DG Continue reading

Reading of the Week: What’s New in Psychotherapy – The Cuijpers et al. Paper

From the Editor

What’s new in psychotherapy?

If there is one area of psychiatry that seems to have been transformed in recent years, it’s psychotherapy. Not surprisingly, then, past Readings have looked at the expanded role of short-term, evidenced-based therapies – in particular, Cognitive Behavioural Therapy, or CBT.

Today’s psychotherapy: a long way from Freud

Over the next two weeks, we’ll look in more detail at new developments in psychotherapy.

This week. A major new review of IPT.

Next week. An overview of psychotherapy developments.

This week, we consider a new paper published in The American Journal of Psychiatry on Interpersonal Therapy, or IPT. This paper is clear, lucid, and worth reading.

Is there evidence for IPT? Yes – and more than just for depression.

DG Continue reading

Reading of the Week: C-14 and Medically Assisted Dying

From the Editor

Over the years, Readings have considered big papers and big essays. This week’s Reading considers big legislation.

Last Friday, C-14 was given Royal Assent, having finally achieved Senate approval, thereby becoming law.

The Parliament of Canada

“An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)” is unlikely to be the end of this debate. Indeed, it is likely to be part of the beginning of a larger societal debate on death and medicine.

In this Reading, we look at C-14 and, as well, an essay by Dr. Sonu Gaind on mental illness and physician-assisted death.

DG Continue reading

Our New Paper: “Making Evidence-Based Psychotherapy More Accessible in Canada”

Happy to see that our paper has just been published (online first) in The Canadian Journal of Psychiatry. And what a great project. My co-author, Dr. David Goldbloom, is a former supervisor from my training, a mentor, and a friend. Back in residency, we talked about a joint project – so glad that, after a few years, it happened.

As usual, I learned much from working with him.

You can find the paper here:

http://cpa.sagepub.com/content/early/2016/04/05/0706743716642416.full.pdf+html

Reading of the Week: How Successful Are We at Treating Canadians with Depression? And More

From the Editor

How successful are we at treating Canadians with depression? How could Canada’s health care system serve these patients better?

This is the ‘all Canadian’ issue of the Reading of the Week.

Readings don’t necessarily follow a theme – but we do this week. The two papers are written by Canadian authors; they tackle Canadian topics; they were published in a Canadian journal, The Canadian Journal of Psychiatry.

The first paper considers depression in Canada, looking at prevalence and treatment over a decade. The second paper champions more effective care for Canadians. Both are readable and relevant.

DG Continue reading

Reading of the Week: Immigration and Psychosis (and Canada)

Meta-analytic reviews suggest that international migrants have a two to threefold increased risk of psychosis compared with the host population, and the level of risk varies by country of origin and host country. This increased risk may persist into the second and third generations. Incidence rates are not typically found to be elevated in the country of origin; therefore it is believed that the migratory or postmigration experience may play a role in the etiology.

The migration-related emergence of psychotics disorders is a potential concern in Canada, which receives 250,000 new immigrates and refugees each year. However, there is a notable lack of current epidemiological information on the incidence of psychosis among these groups.

So begins a new paper that seeks to answer a basic question: are there certain migrant groups more at risk of psychotic disorders in Canada?

This week’s Reading: “Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario” by Kelly K. Anderson et al., which was published in the CMAJ in June.

Kelly K. Anderson

Of course, studying the incidence of psychotic disorders in immigrant populations isn’t exactly novel – there is a rich literature in this field. And the Canadian angle isn’t novel either – as the paper points out, previous studies have considered B.C. hospital admission rates for schizophrenia in European migrants in the early 1900s.

But this paper aims to consider recent data and Canadian data – relevant in a country that takes in 250,000 migrants a year. The paper focuses on Ontario, where first generation migrants constitute almost a third of the population.

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