Guest Blog Will the New Federal COVID Mental Health Funds Help Those With Serious Mental Illness?

By Home on the Hill

Prime Minister Trudeau has announced an investment of $240.5 million to develop, expand, and launch virtual care and mental health tools to support Canadians during the COVID Crisis. This action is laudable, however, will people with serious mental illness be helped with this money?

Many have symptoms such as “anosognosia” or lack insight that they are ill and will not reach out and ask for the help that they need. Home on the Hill has heard from a family where the telephone crisis service asked that the family member with schizophrenia, and in crisis, make the telephone call himself which he did not do.  When things became overwhelming, the family called the police which they had done many times in the past.. While the police do treat families with respect, their actions are not subtle and five police cars can land on your street which causes consternation and suspicious questions from neighbours.

Kathy Mochnacki, a family caregiver and Chair of Home on the Hill, attempted to communicate that  “anosognosia” prevented people from accessing care at the Service Coordination Council on Mental Health and Addictions of the Central Local Health Integration Network (LHIN) and felt uncomfortable with the response of some members who did not appear to understand this symptom. Over the three year span of this Council, she repeatedly asked that a psychiatrist attend the meetings but this request was disallowed even though psychiatrists play a significant role in a family member’s care.  This Council was to embed the patient and family voice and an Interim Report from the Centre for Excellence in Economic Analysis Research (CLEAR) evaluation group of St. Michael’s Hospital in Toronto recommended  “meaningfully engaging people with lived experience and their family members”.

Despite this, the family voice was not heard. Until it is, scenarios like the above described example will continue to happen.

Education to service providers about the symptoms of psychotic illness would help them understand anosognosia and other symptoms of psychotic illness which prevent the individual from reaching out.  Service providers would then understand that by not asking for help, the individual  is not expressing a choice but demonstrating a symptom of his or her illness. And families are not left with the only option of calling costly emergency services such as the police. (please see a training opportunity about anosognosia education by Dr. Xavier Amador)

The above mentioned family are grandparents with their own health issues whose grandson was finally taken to hospital by the police but was shortly discharged.  He walked all the way home from one city to another and arrived at the family home around midnight.  When we last checked, the grandparents said they are “practicing deep breathing and are saying prayers” and desperately scrambling for emergency housing.

Is this how our society should treat its most ill citizens and their families?

Is there a way that this new funding could lessen the burden of this family when the reason for their distress is systemic?  

And why does the current COVID pandemic garner a response of mental health funds, when the ONGOING PANDEMIC OF UNTREATED PEOPLE WITH SERIOUS MENTAL ILLNESS who lie abandoned on our streets, and in our jails continues to be ignored? 

Five thousand citizens live with a serious mental illness in the city of Richmond Hill alone. These citizens deserve appropriate hospital stays, education for them and their families about the illness, a psychiatrist, a family doctor for the many physical issues that they experience, rehabilitative supports, appropriate supportive housing and a mental health system which listens to them and their families with respect.

The COVID pandemic is an opportunity to draw the curtains back, and ask some hard questions. The family home, out of necessity, has replaced the asylum and until we get adequate and appropriate supportive housing, this will always be. Family caregivers perform most of the care tasks and ask that this fact be appreciated.. It is not a role that they chose. While families are included in meetings with the doctor when the patient has cancer, they are so often excluded  from the discussion if their loved one has a mental illness even when the patient has given permission.

Is it not time for mental health professionals to help mitigate the myriad of barriers that families experience like the unrealistic Ontario Mental Health Act and entrenched attitudinal barriers. Can we not streamline, enhance (like increase hospital beds) and coordinate services that work to make it easier for patients and families?. Is there an opportunity to evaluate services and not depend solely upon inputs like the number of visits or the length of the wait lists but study outcomes such as whether the youth suicide rate has gone down?.

Are there innovative ways to engage vulnerable people at risk as 50% of people with schizophrenia have the symptom of “anosognosia”.  Could service providers look at less stressful ways to deliver care such as the practice of visiting nurses who give injections now practiced by St. Joseph’s Hospital in Hamilton. Finally, many families who look after a vulnerable relative with no help from the system are bewildered at the costly bureaucracy which appears detached and totally removed from what they are experiencing.  Is there a way, instead, to spend our precious financial resources on these aforementioned much needed determinants of health for people with serious mental illness?

Home on the Hill is a supportive housing initiative in Richmond Hill, Ontario. For more information, visit http://www.home-on-the-hill.ca/

Addendum

A recent editorial in the Lancet points out that the one group that is not getting any consideration during this pandemic are those with serious mental illness. The authors suggest that:

Those who wish to build fairer societies and health systems after the pandemic ends must learn about and prioritise the needs of people living with severe mental illness as a matter of urgency.

9 thoughts on “Guest Blog Will the New Federal COVID Mental Health Funds Help Those With Serious Mental Illness?

  1. Excellent call to action, thank you. I sincerely hope that the Canadian Psychiatric Assn will SPEAK UP on this important issue. Physicians and families affected by schizophrenia and other psychotic brain illnesses should be speaking loudly and with one voice here. This is no time for professionals who have a duty of care to their patients to be hiding in the weeds. People are dying.

    Liked by 1 person

  2. I agree 100%,

    My son needs support and I feel that the government does little to support people with serious mental illness – even when they apply for programs that are there to support them – if they are “non -compliant” – which many are because of their illness – they lose services.

    Because they are a group of people that aren’t well enough to fight for their rights and do not meet the standards of society – they are easily disposable – they fade into the streets – they are the “nuisance” in our society – they are not going to get out and vote when they can’t even look after themselves – instead, they are on the street – begging for change – my son’s ODSP was cut in half – and nothing has been done about it even though I take him in to try and get more support they won’t give it to him

    We should not call them homeless people – we should call them the “disposed” of people – the people that are treated with such unkindness by many.

    I am always trying to find solutions for my son.
    But it is like banging your head up against the wall – nothing makes sense – there is little to no help
    -but I am still in his corner.

    How well a society looks after the weakest link is the hallmark of that society.

    Liked by 1 person

  3. Concerned Mom’s reply moved me to tears. Where is the voice that speaks on behalf of all the heartbroken, exhausted families? Where are the psychiatrists and other doctors who care for the seriously mentally ill? We should all be marching in the street with torches! Let’s face it: Dogs are treated better in our society. A stray, abandoned dog in any urban Canadian neighbourhood immediately causes citizens to snap into action– demanding that the lost animal be rescued and properly treated. The homeless mentally ill should be so lucky.

    Liked by 2 people

  4. Seriously!!! We need supportive housing for our seriously mentally ill! Group homes or small pods in apt that allow for personal space and support with meals and health care support is needed. We have seriously failed in our society to help people with schizophrenia and bipolar illness

    Sent from my iPhone

    Liked by 1 person

  5. What alarms me is the apparent fact that we family members are so dispensable. If one of us dies through an act of violence by our untreated relative, or if our untreated relative harms himself or herself, there is no coroner’s inquiry. It is like no-one cares.

    To be invisible is the highest form of discrimination.

    And I can relate to the other mom’s reference to “banging your head against the wall”. No-one listens.

    I think at some point, there needs to be a reconciliation between families and the system. The

    system has caused so much hurt and I believe that they need to come to terms with this

    before we move on.

    Liked by 1 person

  6. Seriously! Why is it that no one seems to understand the serious mental illnesses like schizophrenia and bipolar? I believe because they are very complex illnesses and not easily understood even by the loved ones of those with the illness. My son has schizophrenia. I am a nurse of 40 years and I have studied this illness and lived with it as a parent and it is extremely complicated and misunderstood by the general public and professionals alike. Anyone who truly knows someone with these illnesses will understand what I am saying. The financial aid for serious mental illness needs to go into supportive housing. That means group homes with supervision with medications, activities of daily living, creating a sense of purpose and community. They need affordable housing with support from health professionals.
    They need medication supervision and continued follow up throughout their lives.. or they end up on the streets like so many already do. They are the forgotten ones, the throw always in our society .. it’s disgraceful how these people are treated and misunderstood in this day and age.
    Sent from my iPhone

    Liked by 1 person

  7. Hear! Hear! Too bad the Schizophrenia Society of Canada is no longer a family organization focused on helping the seriously mentally ill. Instead, it’s become just another advocate for ‘mental health issues’ and ‘the recovery model’. Based on outdated but popular community mental health system views (i.e, still stuck in the ’70s) the recovery model’s first tenet is: Self Directed Care. It’s like the old joke: “How many psychiatrists does it take to change a light bulb? Answer: Only one, but the light bulb must want to change.” Sadly, the recovery model completely neglects those who are most seriously ill, leaving them literally out in the cold.

    Liked by 1 person

  8. Lots of sad but truthful comments. Someone who doesn’t believe they have an illness won’t ask for help. They will not consent to help because their illness prevents them from being aware they are ill. We call for help and are told to have the ill person call or speak with them to consent to getting help. What a joke! I agree that everyone has rights but what about my rights! I need to live free of fear. I need to be able to connect to the care provider and share my concerns and fears. I’ve had to lock my bedroom door and use a door jam for the past 2 years to get a good nights rest. How many other families admit to living this way? Oh, we don’t talk about it. Now is the time to shout loudly and get a better system to care for those with severe mental illness. My son was recently told he is too well for the ACTT team. Where were they when he was so sick? He waited 2 years only to be rejected. He can’t even get ODSP to respond to his emails, no income for 2 months. I’m so disheartened by it all. We get to a point of apathy and that’s what the government wants. We don’t have the strength to fight anymore. As caregivers we are completely drained. Someone needs to help. Someone needs to step up. Please help us and our loved ones.

    Like

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