Every time a Canadian has a drink,
he or she may soon be toasting the nation's collective
mental health. Out of the Shadows at Last, a 500-page
report chaired by Senator Michael Kirby, calls for a
nickel-a-drink tax on every libation consumed in Canada
to fund better mental health services.
The idea is Senator Kirby's brainchild.
But though he has a PhD in math, he wasn't sure the
sin tax would add up to the half-billion dollars we
need to get our mental health services up to snuff.
"I didn't believe there were enough drinks consumed
in the country to raise that much money," he said.
"I played around with a whole bunch
of numbers," Senator Kirby told the Toronto Star,
before he hit on the nickel-a-drink notion. "It was
a pure attempt on our part to make it very difficult
for the government to say: 'We can't afford it.'"
For UBC psychiatry professor Dr
Kerry Jang, PhD, the booze tax overlooks the fact that
we're already a highly taxed country that runs huge
surpluses. But he's happy with some of the hefty report's
117 other recommendations, especially suggestions to
improve affordable housing and a compassionate clause
that allows people to receive employment insurance if
they quit their job to take care of a mentally ill loved
one.
WITHOUT
SHAME
Dr Jang, who was recently recognized by the Confederation
of University Faculty Associations of BC for setting
up a community-based homelessness program in Vancouver,
feels another of the senate report recommendations —
a 10-year anti-stigma publicity campaign for mental
health — is more interesting.
"Out of ignorance and fear, people
in the community shun the mentally ill and actively
work to have transition homes closed or moved to someone
else's back yard," he says. "When the mentally ill are
released into the community, they find there are few
supports and their conditions worsen. Many self-medicate
with street drugs and get involved in the sex trade
and crime to support their new habits."
Dr David Goldbloom, a psychiatrist
at the Centre for Addiction and Mental Health (CAMH)
in Toronto who contributed to the senate report, also
stresses the need to battle mental illness stigmas.
"It's a sad reflection that in the 21st century a report
such as this is deservedly called Out of the Shadows
at Last. We're talking about illnesses that affect one
in five Canadians — illnesses that cause immeasurable
suffering to individuals, their friends and families,
and that cause measurable cost to Canadian society."
CALL
FOR HELP
Psychiatrist Dr Robert Cooke, medical director of Telehealth
at the CAMH, is pleased the senate report calls for
more telepsychiatry. "It can certainly help address
the problem of access to physician services in under-serviced
areas," he says. "In fact, it can assist in MD recruiting
and retention, since it reduces the isolation of rural
health professionals, who can access consultations by
specialists and educational programs by videoconferencing,
rather than feeling unsupported and on their own."
Dr Cooke also fully backs the senate
report's cure for red tape.
"The call to address interprovincial
medical licensing issues in order to facilitate cross-boundary
services is very appropriate," he says. "Now, physicians
have to apply for a licence on a temporary, repetitive
and case-by-case basis each time they offer service
to another jurisdiction. It's time consuming, expensive
and provides one more barrier to improved distribution
of health care resources."
Dr David Goldbloom agrees we need
to embrace telepsychiatry. "The reality of Canadian
geography and demography is that we need to leverage
technology wherever possible," he says. "I would encourage
rural family doctors to inquire whether their nearest
academic health sciences centre is offering such services."
MIND
OF STATE
After all his work on the senate report, Dr Goldbloom
sees our mental healthcare performance as a mixed bag.
"Canada is a significant contributor to improved understanding
and care of people with mental illness. There have been
tremendous advances in the basic sciences — like
brain imaging — and in clinical areas as well,"
he says. "But there's no getting around the plain and
simple fact that far too many people with mental illness
— both youth and adults — get no help at all,
get treatments that do not meet our highest standards
of care, and have the experience of illness compounded
by shame, stigma and discrimination."
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