A Letter About Mental Health

As a family physician, a large part of our practice deals with mental illness. Mental illness is far more common than one might expect. It is also exceedingly complex, and requires extensive resources and time to treat properly. It deserves all the attention we can give it.

Unfortunately there is still a large stigma surrounding mental illness. However, people should feel comfortable about talking about it like any other disease or physical ailment. Few die “a courageous death” from mental illness as they would cancer, but it takes immense courage to battle the demons associated with it on a constant daily basis. Often, these struggles are hidden or not discussed. Yet, the need for greater awareness about mental illness is reflected statistically: every three minutes in the world someone dies of suicide. Suicide takes more lives per year than motor vehicle accidents in the USA.

Mental Healthcare remains under-funded and under-serviced. It is no secret that our Mental Healthcare system is lacking province-wide. Numerous articles have been written in this regard and several surveys have been done by the Ministry of Health. The awareness seems to be there, yet little improvement has occurred. Mental illness has actually been criminalized; more patients than ever end up in court and jail. Access to a psychiatrist, although slightly improved recently, continues to be a longstanding problem. Over the years it has not been uncommon to see family physicians, frustrated by the delivery of mental healthcare, go back into training to become psychiatrists.

Sadly, over my thirty years in family medicine, I have lost patients to mental illness and suicide. It has to be the most heartbreaking and frustrating part of being a family doctor. In recent years, I lost a former teammate and friend (Steve Kokotec), as well as a young family friend (Chris Salvador). In the past year, mental illness – suicide – has taken both my eighteen-year-old niece and twenty-four-year-old nephew. Sophie and Geoff were both athletic, intelligent, beautiful young people from an excellent family. Like both their parents, they shared a passion for basketball and excelled at it.

Debunking the myth surrounding suicide is a positive step to becoming an educated population. A common and concerning misconception surrounding suicidal youth is that they are seeking attention. In reality, many of them face difficult life situations and combat mental illnesses. Another fictitious thought is that those who commit suicide are acting selfishly without regard for loved ones left behind. However, experts in the field suggest that a suicidal person is suffering from pain so acute and severe that they see no other escape than death. With this in mind, it becomes apparent that it is inappropriate and unjust to accuse suicide victims of being oblivious to the emotional damage they cause to loved ones.

The devastating impact of suicide prompts many to consider its origins. As such, this is an area of intense research. It is indicated in various studies that 90% of suicide victims have a diagnosable psychiatric illness. This does not mean that those with different psychiatric illnesses all commit suicide for the same reasons. A depressed person may commit suicide out of extensive hopelessness and despair, while a schizophrenic may partake in this action because they are hearing instructive voices associated with their disease. Special attention is thus required for each of the varying psychiatric illnesses and their correspondence with suicide.

An oft recognized trend is that of the tendency of suicide to run in families. For this reason, a genetic link has been proposed. A genetic link to suicide provides hope that future researchers can eventually target a gene for treatment, and in doing so, could potentially save countless lives in years to come. It is estimated that twenty-four percent of all deaths among 15 – 24 year olds are attributed to suicide, compared to 16 percent among 25 – 44 year olds. The many stresses associated with young adulthood may be strongly connected with this peak in rates around the teen and young adult ages. Men die by suicide at a rate of four times higher than women, while women make 3 – 4 more suicide attempts. This suggests that men are more likely to commit the act than women, with the exact reasons for this remain unknown. Extra precaution and monitoring might therefore be required for young suicidal males as they are in the greatest danger of tragedy.

In recognizing the need for more awareness and community involvement in dealing with mental illness, I am proud to be part of a recently established committee of ten outstanding local citizens and former basketball players. It is composed of Mike Brkovich, Dennis Byrne, Paul Carter, Pete Cusumano, Sante Salvador, Tom Smith, Chuck Smith, Cristina Meret, Julie Davis and myself. We will be coordinating an initial fund-raising dinner Saturday November 8, 2014 at the Walkerville Brewery. Speakers will include Toronto guests Aisha Alfa – comedian and motivational speaker, Ted Ball – health policy consultant, and Jordan Smith – Sophie and Geoff’s older brother. A very small portion of the proceeds of the fundraising dinner will go towards sponsoring a basketball banquet, which will be held November 28 at the Caboto Club. Some of the best high school basketball teams throughout the province will be participating in the annual Freeds tournament, which will be held at the brand new St. Clair College Athletic Facility. Our banquet will feature both a mental health expert (a local psychiatrist) and a motivational speaker for this strategically targeted group. We hope to make the tournament a lifelong memory that will have tremendous positive impact on their futures as leaders. Looking forward, we plan to host a similar banquet alongside a high school girls’ tournament (hopefully in London Ontario). The purpose is both to promote mental health awareness and to provide education to our youth. We are committed to doing anything possible to reduce young peoples’ risk of developing a mental health problem or illness, or of becoming so desperate as to contemplate suicide. We also strive to defeat the stigma that has bigoted peoples’ attitudes and fed the discrimination that many have endured. This is in the hope that people will feel comfortable about talking about mental illness like any other disease. The slogan that we want spread and openly discussed by players and their families is “STIGMA – ENIGMA”.

The other purpose of our committee is to help our community realize how important it is to support and contribute to a vital mental health care facility for our youth. A pertinent example in Windsor is Maryvale: a children’s mental health treatment centre. At Maryvale children and teens with serious emotional and psychological distress can receive assessment and therapy from a team of experts. They have an acute care hospital bed programme directly dealing with suicidal teenagers from the emergency department. Despite growing needs, they have suffered major cutbacks, especially in this past year and there has been no plan in place to accommodate the loss of services. Our community is very generous when it comes to supporting other aspects of healthcare. For example the hospice programme in Windsor is outstanding. If only our mental healthcare system had such tremendous support.

All proceeds from our fundraising efforts will be going directly to the Maryvale program. We strongly encourage as much community support and/or donations to Maryvale as possible. For more information on how to donate to this cause please contact Connie Martin at cmartin@maryvale.ca or 519-258-0549 ext 2137.

RE: Speaker Ted Ball – health policy adviser – He has excellent connections at Queens Park. He has worked as a speech writer and policy advisor to ministers of health from all three political parties. He has also worked as a transformation coach to CEO’s of major hospitals in Ontario

Best Regards,
Dr. Patrick Xavier Smith