Medical challenges of the human mind, and the fixes

Medical challenges of the human mind, and the fixes

The NWT Legislative Assembly’s Standing Committee on Social Programs is touring communities seeking input, an attempt to “modernize mental health legislation” in the territory, but in spite of widespread demands for reform in how mental health issues are dealt with, the meetings often suffer small turnouts.

One in four people – 25 per cent of the population – will suffer from them in their lifetime, yet little is known about mental health issues. Our impressions of the disease (and yes, it is a disease) typically come from a few high profile cases involving a person who may do harm to others, especially if they “go off their meds.” Then there is suicide, which has become an epidemic in some small Northern communities. Nunavut in particular has one of the highest suicide rates in the world. “Ordinary” issues of mental health such as depression, anxiety, obsessive compulsive disorders, drug addiction, self-harming and personality disorders are more pervasive than we know.

Treatment options include medication and psychotherapy. Often, an individual’s condition comes and goes over time. Successful medication regimes can take years and multiple physicians to get right.

In the health-care apparatus, patients are plugged into a generic system that can be cumbersome and unresponsive, even unfeeling, in spite of all best efforts to tailor it otherwise.

The proposed legislation spells out new powers for the government, in particular enabling control over individuals who might harm others or themselves. It also goes to lengths to ensure that the rights of individuals are protected. The legislation aspires to fill in recognized gaps in the healthcare system, with measures to enhance resources and increase numbers of trained treatment counsellors. Reducing paperwork and streamlining administrative systems are also planned (and much-needed) changes. Notably there is also a commitment to offer new community treatment options that will offer care at the local level to those with mental health issues.

Our healthcare system is a bureaucracy with faults, flaws and foibles common to many government operations. In the health-care apparatus, patients are plugged into a generic system that can be cumbersome and unresponsive, even unfeeling, in spite of all best efforts to tailor it otherwise. On the legislative side, it can sometimes take decades for old, encumbering legislation to be replaced. Note that the last NWT mental health act came into effect in 1985. Circumstances and needs have changed dramatically in the ensuing decades.

It appears the NWT Department of Health and Social Services has listened to public concerns, striving to offer the best possible solutions in the new legislation – in a system that cares. No matter how effective the programs are, however, no amount of insight can offer up all the answers for a subject as mercurial as mental health. In addition, mental health issues change and evolve in a rapidly advancing world, especially since the attributes and responses required for youth may differ from what is needed for older generations. The new legislation and the programs that will stem from it must have built-in flexibility to accommodate those ongoing changes and new attendant needs. That flexibility must be built into the legislation so that it never gets too old – a review process that facilitates, even forces, ongoing refinement and evolution. Otherwise, resistance to change can be overwhelming.

Mental health issues will never be ‘fixed.’ In fact they need the opposite approach. Every affected person’s condition is unique, special and evolving. The approach in all cases has to be empathetic and discerning over time. The government, the health care system, the police, all have jobs to do with those who struggle with mental health, but they cannot do it all. Community support is needed, plus we can all have a role.

We must first be aware of mental health issues for what they are, so they are never ignored or stigmatized. The Mental Health Commission of Canada offers an excellent course, Mental Health First Aid (www.mentalhealthfirstaid.ca), which teaches how to recognize the symptoms of mental health issues and offers advice and instruction on how to handle and support an individual who is suffering. For example, for someone who may be contemplating suicide, empathy, understanding and support are all important until the person gets through that range of feelings. In many individuals those issues are recurring and they will have to be supported anew in future.

Mental health issues too often end in tragedy. With the proper treatment available, that need not happen. Get involved, be a part of the solution.

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