Survey raises warning signs on mental health services

The Canadian health-care system continues to critically underperform for individuals with mental illness, according to the Mood Disorders Society of Canada’s pan-Canadian survey of the country’s mental health community. The survey, conducted in June received 2,245 responses.

“These survey results reinforce that while there have been some improvements across various federal and provincial mental health-care systems, there are many areas where changes are desperately needed," said Dave Gallson, associate national executive director of the society. "What has been made abundantly clear by respondents is that significant gaps and shortages in community mental health-care continue to be ignored and dedicated investments in mental health services remain a strong priority for Canadians.”

Of the top two priorities suggested for government action, a total of 91 per cent of respondents indicated that increasing access to mental health-care professionals (such as psychiatrists, psychologists and social workers) was a top priority, while 88 per cent reported a need to focus on increasing community mental health services.

When asked directly, 38 per cent of respondents indicated that the time between initial help seeking and diagnosis exceeded a period of 12 months. Retrospectively, following a similar 2011 Mood Disorders Society of Canada national mental health survey, it was reported that a total of 35 per cent of respondents indicated having to wait more than 12 months for a diagnosis. These comparative results show that our performance on diagnosis has not improved. Comments received indicated a shortage of professionals available to diagnose and treat individuals with mental health issues.

The majority of individuals had been dealing with mental illness for more than 10 years, either first-hand or through provision of care for someone experiencing mental illness, found the survey.

Canada’s mental health-care system is perceived to need substantial improvements. The provision of adequate, appropriate and timely services to support individuals with mental illness as well as their family members, caregivers and even health-care professionals is generally considered to be lacking and ineffective, making them critical areas for government attention, said the society.

Of great concern, said the society, is the finding that one-third of those with an undiagnosed mental illness ignored their condition or self-medicated.

While the majority of those surveyed had both provincial and private health coverage, more than one-half believed their coverage was inadequate, including a greater proportion of those with an undiagnosed mental illness. Additionally, those with provincial health coverage alone were more likely than their counterparts to face cost barriers to treatment. Across survey results, several key factors were found to influence perceptions and experience of care, including health coverage, cost barriers, receipt of a diagnosis and age.

Coping strategies for those dealing with an undiagnosed mental illness varied across age groups. Specifically, younger individuals were more likely to ignore/deny evidence and existence of their mental illness, while middle-aged individuals were more likely to self-medicate and older individuals more likely to rely on friends and family for support. These findings suggest a need for greater access to support services, particularly for youth who are more inclined to engage in maladaptive behaviours to manage undiagnosed mental illness. ?

Above all, perceptions were largely positive regarding availability of community mental health organizations and the overall treatment of mental illness through family doctors and other health-care professionals. However, the availability of health-care professionals as well as care provided through walk-in clinics and hospital emergency rooms warranted further attention, said the Mood Disorders Society of Canada.

Moving forward, the society recommends efforts to improve the overall treatment of patients with mental illness in all health-care forums should be focused around:

•the degree of respect and empathy demonstrated by staff?
•addressing perceived lack of prioritization for mental health patients?
•reducing wait times?
•addressing reports of being rushed among healthcare providers during patient consultations.