From the Editor

Readings in recent weeks have drawn from several journals and a major autobiography.

Recognizing that mental health is increasingly part of our public and private conversations, we draw from newspapers and news sites this week.

image001Starbucks: fraps, breakfast sandwiches, and psychotherapy (for employees)

The decision of Starbucks to expand employee coverage for psychotherapy leads this week’s lineup.

We also consider the first Parliamentary speech of an Australian politician and a new British exhibit of old art – from asylums.


Benefits and the Benefits of Therapy

“Why Starbucks Canada’s investment in mental health therapy matters”

Erin Anderssen

The Globe and Mail, 5 October 2016


For many Canadians struggling with mental-health issues, therapy isn’t an option. Private help is expensive and the psychologists and social workers in the public systems are difficult to access. Doctors report having too few options for patients who need therapy but don’t have the money or employee insurance to pay for it. And even those with workplace benefits often don’t get enough to cover more than a handful of appointments.

That’s what makes a new step by Starbucks Canada so significant: The coffee chain announced Wednesday that it will give $5,000 a year to its employees to cover the cost of therapy, up from $400. The decision creates one of the largest pots for this kind of coverage in the country. It’s earning praise from mental-health advocates, for removing the nickel-and-diming from a valuable treatment and being touted as a smart business decision by benefits experts, an example to other companies competing to keep happy their millennial work force.

image003Erin Anderssen

So begins a Globe article by Erin Anderssen on Starbucks and employee benefits. The article describes the decision by this large employer – with some 19,000 employees – and puts it into a larger context. The benefit would apply to those who work more than 20 hours/week, or roughly three-quarters of their workforce.

She notes:

· Employee benefit packages aren’t usually so generous. Federal civil servants – whose benefit package is considered generous by private sector standards – have a maximum of $2,000 per year for therapy.

· According to VP of Human Resources Sara Presutto, the idea for the benefit came from a series of employee forums. “[Mental health] was the No. 1 topic they wanted to talk about.”

· Louise Bradley, CEO of the Mental Health Commission of Canada, calls it “a bold step.”

Mark Freeman, who has struggled with depression and OCD, blogs about his past experiences with limited therapy benefits – and what a difference Starbucks-style benefits could make for someone. He notes, however, that not all therapy is created equal: “You can easily blow $5,000 on a therapist that helps you do nothing or practices a type of therapy that isn’t at all an evidence-based approach for the mental illness with which you’re struggling. Quality matters as much in therapy as it does in Frappucinos.” Ultimately, he hopes to see more quality measures, guiding people to better therapists with better quality data. (You can read his full comments at

Putting the Starbucks’ initiative in a larger corporate perspective: it’s a dramatic move – and unusual in the corporate world. As a recent Conference Board of Canada noted, just 39% of Canadian employers have a mental health strategy.

But what Starbucks realizes – and what employers increasingly realize – is that mental health problems affect the bottom line. Absenteeism due to mental illness is more common than absenteeism due to diabetes or cancer. And the numbers aren’t small: 500,000 Canadians didn’t attend work this week because of mental health problems. For employers, that means significant disability payments.

Starbucks is trying something different. And this company isn’t alone.


· Bell Canada managers receive mental-health training, allowing problems to be identified early and addressed; redesigned human-resources programs better accommodate people with these problems. To date, short-term disability cases are down 17% at Bell Canada due to mental illness, with employees away for shorter periods of time.

· NAV CANADA recently launched a mental health strategy that includes education, an anti-stigma campaign, and a peer-support program (which includes training to employees who want to serve as peer supporters). The latter has proven popular, accessed by hundreds of employees.

Over time, we’ll see what works in term of improving health and reducing disability costs. But if employers once ignored mental illness, the Starbucks’ announcement shows that they are thinking long and hard about it these days. #Progress.

Politics and Mental Illness

“Liberal MP Julian Leeser Opens Up About Father’s Suicide In Powerful Maiden Speech”

Emily Brooks

The Huffington Post Australia, 14 September 2016


Liberal MP Julian Leeser had the House of Representatives united in applause on Wednesday evening as he retold the heartbreaking moments following his father’s suicide, pledging to spend his time in Parliament advocating for mental health reform.

The speech went beyond calling for more government funding, calling instead for social reform led by the government, which struck a chord with every politician in the room.

At the tender age of 20, Leeser heard the sound of his mother’s footsteps walking down the hall recognisably faster than they usually did.

Then she threw open the door and told him his dad was gone.

image005Emily Brooks

So begins a short Huffington Post Australia article by Emily Brooks on the first Parliamentary speech (referred to as the maiden speech) of Julian Leeser.

The article describes Leeser’s speech and includes a clip of it.

It’s difficult not to be moved by Leeser’s words. Leeser notes his own guilt over his father’s death:

I remember as a self-absorbed 20 year old the petulance and rudeness with which I waived away the opportunity to help my father, a man who so often helped me, and not a day goes by that I don’t regret it.

Suicide, they used to say, is a victimless crime, but they never count the loved ones left behind.

He also notes the role of society in preventing suicide, as well as the need for government action. And he commits himself to the cause:

As a member of this House I want to do what I can to help pierce the loneliness, the desperation and the blackness that people who suffer depression feel.

During my time here I will always be an advocate for better mental health policy.

image006Australian MP Julian Leeser: speaking out about suicide

A politician speaking openly about how mental illness has touched his family – it’s difficult not to marvel at the progress that we have made.

Art and the Asylum

“Bedlam: The Asylum and Beyond review – missed opportunity to truly explore mental health”

Jonathan Jones

The Guardian, 19 September 2016


Sir Alexander Morison stands tall and sombre with his top hat in his left hand and a white handkerchief in his right. His eyes are grey and slightly sunken, his lips thin, his face long and gaunt. He seems marked by the sadness of his profession. For Morison was an “alienist”, a 19th-century doctor of mental illness, at London’s infamous asylum Bethlem Hospital, popularly known as Bedlam, whose history and cultural significance are explored by the Wellcome Collection’s new exhibition Bedlam: The Asylum and Beyond.

The man who painted this portrait of Morison there in 1852 was one of his most pitiable patients. Richard Dadd had been marked out for a brilliant career but this gifted young painter became confused on the way back from a trip to the Middle East in 1842, thinking he was receiving messages from the ancient Egyptian gods and had uncovered a plot by the pope to have him killed. In 1843, he met his father on a country lane in Kent and stabbed him to death because he thought he was the devil. Dadd spent the rest of his life in Bedlam and at Broadmoor. In both institutions, his doctors provided him with materials and space to paint – contradicting modern caricatures of the Victorian asylum as a brutal ‘madhouse’.

Dadd’s portrait of his doctor is an eerie masterpiece whose take on reality is captivatingly askew.

image008Jonathan Jones

Guardian art critic Jonathan Jones explores a new exhibit of asylum art. Jones admires the art but his review of the overall collection is a bit harsh.

He notes of the Dadd painting (see below): “[He] is fascinated by Morison. He sees him as a heroic, lonely pillar of compassion. Yet with his wild white hair the alienist looks like he could just as easily be an inmate as a doctor.”

image009Dadd’s Alienist

Jones goes on to contrast the Dadd work with a current patient of a mental hospital, whose work is shown and described in a video.

Jones sees the exhibit as something of a lost opportunity to explore the evolving view of mental illness.

image011Van Gogh’s portrait of his physician, painted shortly after his release from an asylum

The Guardian runs a series of pictures from the art collection. Jones writes well and makes good points, but he is upstaged. The images are mesmerizing and thought-provoking.

Reading of the Week. Every week I pick articles and papers from the world of Psychiatry.