Mental illness still misunderstood, says psychiatrist

There still isn't enough being done in Canadian emergency rooms to help health-care providers deal with mental health patients, said the chief of psychiatry and medical director of the mental health program at North York General Hospital.

In a recent 2011 Pan Canadian Mental Health Survey by the Mood Disorders Society of Canada report, 50 per cent of respondents who had visited a Canadian emergency room due to their mental illness indicated that they were moderately to extremely dissatisfied with the care they received, said Thomas Ungar.

“Not a lot of procedures are being done to help emergency room staff understand mental illnesses — that's the problem,” said Ungar. “It's a problem nationally, provincially, and not just in hospitals. I feel that the reason behind the stigma is the fact that (health-care) providers don't appreciate that it's a real illness because there isn't an easy way to detect certain mental illnesses with easy blood tests.”

Ungar was a guest speaker at the North East Local Health Integration Network's (LHIN) Mental Health and Substance Abuse forum on March 19. He recently co-developed a national online anti-stigma learning module, Combating Stigma for Physicians and other Health Professionals, for the Mood Disorder Society of Canada, Mental Health Commission of Canada and the Canadian Medical Association.

He made his presentation via videoconference.

Mental illness can be anything from manic depression to schizophrenia, said Ungar, who has co-developed the Anti-Stigma Initiative program in order to teach health care providers including emergency personnel about mental illnesses and to improve skills, knowledge and attitudes to improve quality of care.

The program targets health-care providers to educate them on handling mental health cases with the proper care. A major component uses proper behaviour analysis to assist health-care workers in determining whether a patient actually is mentally ill.

There has been positive feedback to a trial run of a broad based hospital antistigma initiative at Central LHIN locations in collaboration with researchers from the Mental Health Commission of Canada, said Ungar.

An important part of the process and pilot project is to bring in presenters with lived experience suffering from different illnesses such as schizophrenia, bipolar and alcoholism to get a wide perspective on what it's like to live and cope with a mental illness, and to give health providers contact based education with a person in recovery, said Ungar.

Louise Paquette, chief executive Officer for the North East LHIN, said she hopes the LHIN adopts the strategies and methods used in the Anti-Stigma Initiative program.

To help with the education and understanding process, Paquette would like to have presenters talk about how they cope with mental illness on a day-to-day basis.

“In our three-year strategy, we have four main priorities: better primary care, better transitions and co-ordination of care, which includes better access to mental health and substance abuse assistance, as well as being more sensitive to cultural diversity,” Paquette said.

Putting that strategy into motion would ultimately create a more understanding emergency room environment, she said.