The Red Herring of Anti-Stigma

By Marvin Ross

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Anti-stigma red herring Image by PublicDomainPictures from Pixabay

Many of us have spoken up against the very popular mental illness anti-stigma strategies that have proliferated over the past few years. The problem has never been stigma but the lack of resources needed to properly treat serious mental illness. Queen’s University psychiatrist, Dr Julio Arboleda-Florez once stated that

“helping persons with mental illness to limit the possibilities that they may become violent, via proper and timely treatment and management of their symptoms and preventing social situations that might lead to contextual violence, could be the single most important way to combat the stigma that affects all those with mental illness.”

Sadly, we are not capable of doing that because we just do not have the psychiatric resources as a recent analysis by the Globe and Mail just revealed. Our resources are strained but thanks to anti-stigma policies and work-place wellness initiatives that reduce stigma, more people are seeking help.

Journalist, Erin Anderrson reports that half of Canadians have too few local psychiatrists or none at all. The result is chocked emergency rooms, long wait lists to see psychiatrists, frustrated families and stressed out doctors. Most of the psychiatrists are located in the large urban areas like Toronto and Vancouver and many of them not only do not take on new patients but have few patients on their roster.

Dr Paul Kurdyak of the Centre for Addiction and Mental Health (CAMH) in Toronto pointed out that some get too much care when they may not need it and those who do need it get too little. He co-authored a study in Toronto and Ottawa that found that 40% of full time doctors saw less than 100 patients a year and 10% saw less than 40. Those patients are in high income areas and have usually never been hospitalized. A 2019 paper found that about one in three psychiatrists only see less than two new out patients a month. And those patients tend to be wealthier and healthier than those seen by busy psychiatrists.

The bottom line as those of us on the front lines as family and advocates know, is that the seriously ill are pretty much abandoned, left to fend for themselves, are cared for by families, wind up homeless or in jail.

Instead of campaigns focusing on anti-stigma, concerned citizens (and corporate citizens) should be lobbying to encourage more medical students to go into psychiatry. Bell Let’s Talk could spend their efforts on setting up scholarships for med students to study psychiatry rather than their Let’s Talk program.

Bell and others could invest in financing hospital beds and units for those with serious psychiatric illnesses. Encouraging people to get help when there is no help available and both cruel and stupid.

What about housing for those with serious mental illness? Let’s say they are lucky enough to get treatment in hospital and are stabilized. Where do they go to live after? Not all have parents who can help and parents get burned out.

How do they pay for housing when they can’t work and disability payments are so low? Increases in disability allowances and guaranteed minimum incomes are needed but, in Ontario anyway, the minimum income project was cancelled and we can expect the right wing Ford government to soon begin attacking disability payments. The disabled in Ontario have still not recovered from the hatchet job done by the last time we had a right wing government in the early 1990s.

It’s time to throw anti-stigma out and move on to more lucrative strategies to improve the lot of those among us with serious mental illnesses.

8 thoughts on “The Red Herring of Anti-Stigma

  1. You raise pertinent issues. We will have few psychiatrists for a long time — better to step up treatment by GPs and community nurse visitation for support. As for housing and disability pensions, don’t expect anything from Ontario conservative government.

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      1. To clarify, GPs do treat mental illness, cancer etc now with referrals to specialists as needed. I’m just saying we have to involve more GPs in the maintenance of mental health and then the psychiatrists will have fewer crises to deal with.

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      2. You are correct and I was referring to a program called Shared Care which was developed in Hamilton. When patients are stable, they can be managed by a GP and, if problems arise, the psychiatrist can be called in. The day to day management is by the GP thus freeing up the time of the psychiatrist to focus on more serious issues and patients. Unfortunately, I do not think it has been well adopted. Dr Nick Kates who heads this up will be speaking to Home on the Hill about the program on March 5 in Richmond Hill. It will be taped.

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  2. In Colorado the problem isn’t a lack of med students interested in psychiatry. It’s a lack of anyplace where they can do an internship. Many of our facilities have closed or been converted to other services because they were losing money.

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    1. Training and experience are essential for tending to people who are so afflicted. You raise a very important point Bowgoeril.

      Certainly having family doctors being part of the team may be important and indeed is common sense, but this does not in anyway mean that these very serious medical conditions can be managed effectively without experts in the field. Access to appropriate timely effective care and treatment should be a top priority in order to promote the best outcome. We do not ask a carpenter to do heart surgery so we should not expect untrained people to care for people afflicted with these very serious mental illnesses.

      These illnesses present in early adulthood and are lifelong and they should be given proper care at the time of their presentation and on an ongoing basis . Stigma is often dissipated when the illness is stabilized.

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