From the Editor
Stigma. Suicide prevention.
This week we consider these weighty topics with two excellent papers.
The first, written by Patten et al., looks at the perception of stigma in those receiving mental health care in Canada. The second is a “viewpoint” that asks what we need to do to reduce suicide rates – which, across the West, has not decreased in the past decade.
Walrus Talk – March 21, 2016
My name is David Goldbloom and I’m a psychiatrist in Toronto at the Centre for Addiction and Mental Health and Professor of Psychiatry at the University of Toronto. And I’m here to ask you an important question about mental health in our country: What will it take?
Happy to see our review paper on iCBT has been printed in CMAJ, the country’s oldest medical journal.
And thrilled to see us land the front cover of the 1 March 16 issue.
From the Editor
As stigma fades, as mental health problems are recognized and discussed, we have an opportunity to re-think old approaches.
This week, the Readings touch on two large issues: how to handle mental illness in our society, and what to do about addiction and the law. The first comes from a recent speech by the Prime Minister of Britain; the second, from an editorial in The Lancet Psychiatry.
Readings have drawn from many sources over these past few years – journals, books, and newspapers. This is the first time we’ve looked to 10 Downing Street for material. But perhaps it wouldn’t be the last time. More and more, people discuss these issues with thoughtful comments; the political class can be counted among them. #Progress
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.
From the Editor
How to free the mentally ill from their chains?
This week, I’ve selected three Readings. We open with a moving essay about a man who works to free the mentally ill from their chains – literally – in Africa. In an op ed, Mental Health Commission of Canada’s Michael Wilson argues that the federal budget must make suicide prevention a priority. Finally, we look at a new study considering an old problem: access to mental health services.
From the Editor
Is the practice of psychiatry about to change?
We often think of change in terms of treatment developments – new drugs and therapies. But mental health services are delivered in a larger societal context, and our work is shaped by laws and court rulings. With that in mind, Carter v. Canada has the potential to reshape our work. As you know, last year, the Supreme Court of Canada struck down the provision of the Criminal Code prohibiting doctor-assisted suicide. Later today, a special joint parliamentary committee will issue its report, guiding the drafting of legislation that will legalize doctor-assisted suicide.
How will this future legislation affect those with mental illness? What will it mean for people like us who do clinical work? Obviously, it’s not possible to comment on legislation that hasn’t been drafted yet. But it is possible to look to other countries and consider their experience. In this week’s Reading, Kim et al. consider physician-assisted suicide and euthanasia in the Netherlands. In their study of a country across the ocean, there are lessons for our patients here.
From the Editor
Is the incidence of dementia falling?
What makes a good clinician?
This week, I’ve selected two Readings. We open with a NEJM paper suggesting a big trend: a decline in the incidence of dementia. That paper obviously has major implications for public policy. We then move on to a big and eloquent essay on a famous doctor, Oliver Sacks.
There isn’t much connecting these selections – except that both were suggested by readers, and they both raise big questions.
Enjoy.
From the Editor
Drug breakthroughs, better imaging, less invasive procedures. There are many amazing health-care stories from the past three decades but perhaps the most important one is decidedly low tech: the decline of stigma about mental illness, allowing millions of Canadians to discuss their problems and seek care.
That’s not to suggest that stigma doesn’t exist, of course. In November, we considered the Dabby et al. paper from The Canadian Journal of Psychiatry, which showed bias even on the part of psychiatrists and psychiatric residents. Though the problem continues, it’s difficult not to believe that we have turned a significant corner: late last month, for instance, Bell Canada Let’s Talk campaign managed to raise more than $6 million in a single day.
In terms of reducing stigma, it helps immeasurably when people come forward and discuss their mental health illness. I remember talking to a patient who had struggled with her diagnosis. Inspired by Olympian Clara Hughes, she posted on Facebook that she has Bipolar. In my office, she wept when describing the outpouring of support – from friends and families, yes, but also from strangers.
Stigma still exists; it takes great courage to come forward – but it’s incredibly important that people do.
This week’s Reading is one person’s story of mental illness and recovery, and his choice to tell his story.
He also happens to be the President and CEO of my hospital. And I’ve never been prouder to work at The Scarborough Hospital.
From the Editor
“Panel Calls for Depression Screenings During and After Pregnancy”
A government health-care panel making a revision to a past recommendation seems pretty ‘inside baseball’ – and hardly the stuff of international headlines. Last week, though, the decision of the U.S. Preventive Services Task Force to now recommend the screening of pregnant and post-partum women for depression was reported from New York to New Delhi.
For the record, The New York Times story (whose headline appears above) ran on the front page.
Why the change and what are the implications?
To screen or not to screen…
This week’s Reading looks at the big decision and we consider: is it a big bust?
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