Month: December 2017

Reading of the Week: The Best of 2017

December 28, 2017 /

From the Editor

No one should feel abandoned when their child is in a mental health crisis. Yet, sadly, I’ve met with families who’ve felt like they were. I’ve met with families who have had the courage to seek help, and have been sent away. I’ve heard of cases where brave souls have come forward, but without accessible and timely [care], have taken their own lives. I know of cases where parents miss out on work to support their kids. And where 18 year olds fall through the gaps when transitioning to adulthood.

It’s an annual tradition. At the end of each year, we take stock, reviewing the best of the past year.

And this past year has been remarkable in terms of good news.

Consider:

  • Earlier this year, the federal and provincial governments agreed to big investments in mental health.
  • In December, the Quebec Minister of Health committed his province to publicly funded psychotherapy for people with depression and anxiety provided by nurses, social workers and psychologists.
  • Ontario had made a similar if smaller commitment in the fall.

And the political push for mental health reform continues. Just this past weekend, Ontario PC Leader Patrick Brown wrote the above quotation in an opinion piece for the Postmedia Network. He called for a massive infusion of money into the mental health care system above the federal commitment.

The promises are big, but paper after paper shows that there is much work to be done. Studies this year found people with schizophrenia die at a rate eight times higher than that of the general population; that ECT use is declining despite its efficacy; that the vast majority of people post-suicide attempt aren’t seen by a psychiatrist within six months.

And so, we end 2017 in an usual position – those of us in mental health who have longed for a day when funding would improve and political interest would grow can feel satisfied. We should also feel a bit anxious. We now have a remarkable opportunity. We shouldn’t waste it.

And so with an eye on the future, let’s look back at the last year. In this final Reading of 2017, there are six selections, covering everything from the effectiveness of antipsychotics to the journey of a great uncle through Ohio asylums. Enjoy.

Please note that there will be no Reading next week.

DG

Continue reading

Our Globe Essay: “For better mental-health care in Canada, look to Britain”

December 24, 2017 /

It may be the biggest change to mental-health-care services in five decades. Earlier this month, Quebec Minister of Health Gaétan Barrette announced that his province would publicly fund psychotherapy for people with depression and anxiety provided by psychologists, nurses and social workers. Ontario made a similar, if smaller, promise earlier this year and other provinces are considering similar initiatives. But how can we turn these big promises into big help for the hundreds of thousands of Canadians who could benefit? Two words of advice: go British.

So begins my new op ed, co-written with CAMH’s David Goldbloom, from Monday’s Globe and Mail.

The full piece can be found here:

https://www.theglobeandmail.com/opinion/for-better-mental-health-care-in-canada-look-to-britain/article37358415/

Reading of the Week: Better Pay, Better Service? The CMAJ Paper on Pay for Performance in Psychiatry. Also, a Father’s Memory

December 21, 2017 /

From the Editor

Does pay for performance work for psychiatry?

This week’s first selection is a paper just published by CMAJ that considers that question. Drawing on Ontario data, the authors looked at practice patterns when financial incentives were introduced for psychiatrists to take care of patients after discharge and after suicide attempts. Spoiler alert: they didn’t work.

http-i-huffpost-com-gen-1291505-images-n-free-health-care-canada-628x314Paying for Performance – Getting Performance?

In this Reading, we consider the paper and the larger debate.

We also consider a short, moving essay by radio host Charles Adler on the memory of his father – and his father’s memory. The award-winning broadcaster describes his father and his Alzheimer.

DG

Continue reading

Reading of the Week: Ethics & Medical Assistance in Dying – the new Simpson Paper. Also, Exercise for the Cognitive Symptoms of Depression?

December 14, 2017 /

From the Editor

It may soon be the law… but is it ethical?

In 2016, Parliament passed Bill C-14, legalizing doctor-assisted suicide. The legislation represents a major change in many ways: from public policy to the practice of medicine. And, in the coming years, it’s quite possible that the scope of this legislation will be expanded, and could include those with mental illness.

In this week’s Reading, Dr. Wayne (Sandy) Simpson of CAMH weighs in on the ethics of medical assistance in dying (MAiD) and mental illness in this provocative “perspective” paper just published by The Canadian Journal of Psychiatry. He considers the nature of mental illness before concluding: “[A]cting as a partner in helping people recover as well as acting as an agent in a patient’s death is an impossible burden that is not ethically justifiable or legally necessary.”

ethics-cert

Also, this week, we consider another recent paper by The Canadian Journal of Psychiatry that considers the impact of exercise on cognition in patients with depression.

DG

Continue reading

Reading of the Week: Do Patients with Cancer Struggle with PTSD? Yes – the new Cancer Paper. Also, Quebec Covers Therapy

December 7, 2017 /

From the Editor

I spent a dozen years working at a community hospital. One of my richest experiences was working with cancer patients and their families. For so many patients, not surprisingly, cancer isn’t just a physical illness, but a psychiatric one, too – patients often experience depression and anxiety.

How common is PTSD in cancer patients? Surprisingly little work has been done in the area. In this week’s Reading, we look at a new study that considers PTSD and cancer. The study is particularly impressive in that patients were followed for years after diagnosis.

Big diagnosis, big treatment, big psychiatric problems?

In this Reading, we consider the paper and its findings.

And, with an eye on treatment for those with or without cancer, we consider a good news story: on Sunday, the Quebec government committed itself to cover psychotherapy for those with depression and anxiety in the public system.

DG

Continue reading