Letters to the editor, June 15, 2017
Mind with body
Thanking you for publishing the "Quiet crisis" cover story (part of the Overburdened project by the King's Investigative Workshop, May 18). Clearly a magnitude of research went into its creation and reflects the dedication of both the King's investigative journalism team and those courageous enough to lend their voice through the sharing of personal experience.
I would like to shed some light on systemic issues that are possibly contributing to this mental health care crisis. We have departed from age-old wisdom and refer to the mind and body as if they are separate entities. But as there is no duality, there technically should be no treatment of mental illness as different from physical care: All experiences of being human are accompanied by emotional and cognitive responses that comprise part of our mental health and wellness, and similarly can be afflicted with dis-ease.
Our current provision of care is predicated on an illness-based model. This approach aims to treat disease, not the person. It focuses on deficits and lack of capacity. No wonder it does not serve mental health care needs and contributes further to the stigma that already surrounds "mental illness." A wellness-based model is one that considers the whole person. It seeks to educate, build skills and capacity and foster resilience, which is both protective and therapeutic.
The reality is that our system is not well, nor is it serving the needs of patients or providers. Some mental health care clinics hang what is internally referenced as "the wall of shame"—provider quotas for the day, week and quarter are visible to patients and for the viewing of colleagues walking by. This fosters competition, resentment and misunderstanding, and undermines the therapeutic relationship.
The greatest threat is to our system is the mental health of all front-line health care workers—this is more pronounced in those who provide mental health care. This further contributes to the care deficit, as it is accompanied by greater rates of compassion fatigue, burn out, sleep disorders, anxiety, depression, higher rates of substance abuse and suicide.
The very narrowly defined scope of collaboration has limited us. NPs, RNs and pharmacists are extremely valuable, but do not comprise what is a full constitution of mental and physical health care providers. This leaves a huge gap and negates the wisdom and expertise of a large number of practitioners who could ease the burden on the institutionalized system, family doctors, patients and their families. It would also help decrease wait times. These, for example, include the role of certified clinical counsellors, psychologists, trauma-informed therapists, clinical social workers and counselling nurse practitioners, midwives, many medical sub-specialties, physical therapists, massage therapists and dieticians. Food is medicine. Exercise is medicine and so on. It takes a team and we underestimate the capacity of existing resources by devaluing the role of others.
We all have a role and responsibility in engaging the system and contributing to a community and a society that begins to see possibilities, think creatively and find solutions to our growing crisis. These are the shared values that do not undermine a system and deter people from using it, but rather build trust and encourage people to access care by knowing there will be value in a humanizing experience. This is at the heart of what can transform our medical system.
As someone who has both used mental health care services as well provides them, I have intimate knowledge of just how hard it can be. The difference between a human and a human being with mental illness is a degree of suffering. It is time to humanize this experience and work together towards a shared vision with common values for health and well-being that should serve to attract people to work here, as well to retain those of us who really believe in healthy sustainable collaborative practices. —Maria Patriquin, founding member of the Association for Positive Psychiatry of Canada and founder of Living Well Integrative Health Centre, Halifax
Last week's "Not guilty" cover story by Katie Toth stated that two men accused in a 2015 home invasion pled not guilty to charges. As the Public Prosecution Service tells The Coast, the two men have since changed their pleas to guilty and been sentenced for the crime.