A Global Opportunity to Advance Mental Health: Can we grasp it?

September 2011 will be an important month for many different reasons. One reason will be especially important for improving mental health across the globe. The United Nations will be holding a special session on Non-Communicable Diseases in New York that month. The purpose of that meeting is to encourage a global response to these diseases, and mental disorders are at the top of the list of diseases causing the greatest burden of illness worldwide. Unfortunately, mental disorders are not at the top of the list of the conveners of this special session. As we are all too familiar, mental disorders are too often not on the list when it comes to health care investment – not only here in Canada but around the world.

We know how important mental health is – in wealthy and in poor countries. It is well documented that mental disorders can lead to poverty, decreased educational attainment, job difficulties, incarceration and a poorer quality of life. They increase the risk for substance abuse (including alcohol and tobacco), a variety of physical illnesses and poor adherence to treatment for a number of different illnesses – including HIV-Aids. Mental disorders are very costly, in both direct (for example, hospital beds) and indirect (for example, decreased work productivity) ways. Effective and cost efficient treatments are available and have recently been catalogued and widely distributed to health providers across the globe by the World Health Organization (if you are interested, google mhGAP). What is now needed is to get mental health on the global health agenda.

And we need your help to do this.

Write your Provincial Minister of Health and the Federal Minister of Health and your local member of Provincial and Federal Parliament. Tell them that you would like them to bring this issue forward at this very important meeting. Ask your friends and neighbors to do the same. Not only may this have an impact at the global level, but it may help in your Province and in Canada as well!

Helping Early May Help in Unexpected Ways

Our team has been doing some interesting work in school mental health for a few years now. Much of it has been focused on enhancing mental health literacy for teens (through a secondary school curriculum) and teachers (through a variety of different mental health for educators training programs) as well as facilitating early identification and effective treatment for young people who have a mental disorder – such as depression, panic disorder; etc. While the potential mental health benefits of early identification and effective treatment are relatively easy to understand, there are other benefits that may be less evident but also very important. One area of such benefit is found in relation to a number of physical illnesses: diabetes; heart disease and maybe even some forms of cancer!

We have known for some time now that mental disorders are risk factors for a number of other illnesses. That means that the presence of a mental disorder (such as depression) can increase the probability that a person will develop another illness (such as diabetes). There is also some evidence that suggests that having a mental disorder following the onset of another illness, such as heart disease, increases risk for early death from that disease. Although there are many hypotheses about why this may happen, we do not yet really know how this happens and research into understanding how this may happen is currently under-way. Did you know that the same brain chemical that is involved in controlling mood (serotonin) may also be involved in controlling how platelets clump together in the blood? Could it be that problems with serotonin function in the brain can result in depression and at the same time may make blood clotting (which could lead to strokes or heart attacks) more of a problem? Ongoing research may help us better understand this issue.

So, it may also be that if we can better identify, diagnose and effectively treat young people when they first develop a mental disorder, we may also be able to decrease the risk of them developing another illness – such as heart disease, diabetes and perhaps even some forms of cancer. Or, if not that, maybe early and effective treatment of mental disorders might delay the onset of another illness or maybe improve treatment outcomes. Right now we do not really know the answers to these questions but being aware of this possibility is really important for us – both personally and for public health reasons.

Secondary prevention, meaning the prevention of another illness by effective treatment of a pre-existing disorder, of some physical illnesses might be achieved by early effective treatment of a mental disorder during the teenage years. This is an exciting possibility! Will this pan out? We don’t know yet. But, to my way of thinking, there is enough evidence on this possibility already available to further underscore the need to better identify, diagnose and treat mental disorders in young people. We know what needs to be done – now we only have got to get our act together and do it!

The Academy in Mental Health for Educators: A new opportunity

We have been working in the area of school mental health for some years now and have created a variety of programs and educational resources for educators, health providers, youth and parents. Over and over again we have heard from teachers, social workers, psychologists, nurses, principals, school superintendents and others about the need to provide more training for educators in the area of youth mental health and a better understanding of youth mental disorders. Over and over again we have heard that a summer program would be a good venue in which this could be done. So guess what – we listened and decided to do exactly that. Our first Academy in Mental Health for Educators will start next week – in Halifax, Nova Scotia. As far as we know, this is the first event of its kind ever in the Atlantic Provinces.

So what will happen at this Academy. First, it will take place over a two day period – actually two such two day periods. The first will be on a Monday/Tuesday and the second, on a Thursday/Friday will be a repeat of the first session.   There are a variety of different topics to be covered. These range from detailed information about common mental disorders in youth to advice on how to talk to teens and parents to understanding medications and their role in treatment to specific “classroom pearls” for helping young people who are living with a mental disorder be more successful in the school setting. Participants will also be exposed to a variety of useful and effective educational materials and programs.

We are really excited about the program and our presenters. In addition to key members of our Sun Life Financial Chair in Adolescent Mental Health Team, presenters will include psychiatrists; psychologists; teachers and others who work with youth, families and educators. We hope that the program will be fun and informative for all who attend. One of the fun components will be a “Halifax dine around” evening where participants can sign up to join one of the presenters for dinner at one of the many excellent restaurants in the city. Not only may people discover a great new place to eat, but they will have the chance to chat to an expert in the field – and hopefully that will be both fun and informative!

As always, we will be evaluating how the Academy turns out. Not only in terms of participant satisfaction and improvement suggestions but also in terms of learning that has happened during the sessions. And, as always, we will be posting the results of this learning on our website. Frankly, I am both a bit excited and a bit nervous about this. What if our learning evaluation does not show a significant positive impact of the session on participants’ mental health knowledge? Or horrors of horrors, what if it shows a negative impact on participants’ mental health knowledge? At best that would be so embarrassing.

--Stan