Pyscho B***ch and a Few Thoughts on Mental Illness

Last night I headed to the Electric Theatre to see Tamara Lynn Robert perform PSYCHO B***ch, her very moving, intensely personal monologue about her experiences as a woman trying to manage her life with bi-polar disorder.

Robert describes a harrowing struggle to obtain some kind of equilibrium through therapy and use of medications.  Therapy worked (eventually).  Medication never did. She now has a good career (as a therapist) a loving partner, and the openness and insight to speak out about a subject that largely remains taboo.

Robert is a confident and compelling performer.  I've seen this show before, but I went back out tonight, in part because it's great material well-performed and, in part, because she is donating the proceeds of her run to Youthlink, a counselling service for gay, bi and trans-gendered youth, a community with a very high suicide rate. 

Left untreated, mental illness can cost sufferers theirs jobs and relationships, leading to homelessness, isolation, and poverty. Mental illness can also cost an afflicted person their physical health or in some cases, their life.

Sadly, the stigma attached to disclosing mental illness remains a powerful barrier to sufferers seeking treatment.  A lot of people with mental illness and their loved ones continue to suffer in silence, too ashamed to go get help. Substance abuse and addiction are both often efforts, conscious or unconscious, to self-medicate a mental health issue. We all know how well that tends to work out.

One in five Canadians suffers with some form of mental illness, me included. It is often a hereditary illness as was the case for me. A GP can refer you to a qualified mental health professional, assuming there are any where you live. It can takes months to get in to see a therapist covered by Medicare in smaller cities.  In Winnipeg, I waited 6 months and I found my own therapist that was covered by Manitoba Health.  The GP I disclosed my crushing depression to handed me a suicide hot line number on a piece of paper and sent me home. The shrink I did get to see, once, thanks to a doctor friend pulling some strings, told me she wasn't taking new patients.

One of the many ways we stigmatize the mentally ill is by providing so little treatment for mental illness under Medicare. By not financing mental health treatment as a health care issue of equal importance to say cancer or heart disease or diabetes, our society powerfully reinforces the idea that seeking treatment for a mental health issue is flaky or self-indulgent. 

Here in Toronto, the Canadian Centre for Addictions and Mental Health did a great campaign to support the destigmatization of mental illness when they opened their new facilities, but good luck getting them to give you or your loved one anything but an assessment.  It's great to know what's wrong with you but it is not much use without someone who is willing to try and help treat you fix it. The artist-health clinic at Western Hospital refers artists (average income $15K a year) to non-medicare covered psychotherapists who charge $89 an hour. Help you can't afford is worse than useless.

Can you imagine this being the way we deal with cancer or cardiac patients? "Yup, you're sick, sorry we won't treat you" or " Here's someone to treat you:  pay them yourself " or my favourite " we know you're still sick but you can only have short-term therapy and anti-depressants. We don't do long-term therapy, even though we know it works best for some people. It costs the system too much."  It would be a national scandal. This is in large measure how we treat the mentally ill until something catastrophic happens: job loss, marital breakdown, a suicide attempt, a run-in with the law, out of control substance abuse.

Many people with mental illness were horrifically traumatized as children and young adults.  Rich or poor, kids get abused at school and at home and it sets them up for mental health issues as adults. You don't have to grow up in a camp or a war zone to be abused as a child.

In her talk-back session tonight, Robert said she had paid tens of thousands of dollars out of pocket to get the talk therapy that actually worked when drugs didn't. That someone diagnosed with a serious mental illness was forced to go to the private sector for treatment in a country with universal health care is a disgrace.

Some of the smartest, most accomplished, creative and talented people I know have struggled with mental health issues.  We lose out on their abilities to give their best to society when we fail to provide them ready access to decent mental health care when they need it.

Poor mental health often leads to self-destructive habits that lead to poor physical health. As a society we need to accept that the mind and the body are connected and equally deserving of qualified, publicly funded care. When we don't, we get to pay for our neglect of mental health by treating the physical problems that result as a consequence.

As it is, many mentally ill people are left to struggle with no help.  If they have the personal resources they often end up having to both find and finance their own help, often-times from questionably qualified therapists. Those with no means to pay often end up with well-meaning but unregulated and largely untrained self-help groups and peer counsellors, if they get any help at all.  Twelve step is a great resource but it is no substitute for a mental health professional.

Mental illness deserves the same compassion and care as any other form of chronic illness that can lead to death. Thanks to people like Tamara-Lynn Robert and Clara Hughes, the great Olympic athlete and mental health champion, attention is finally being given to this important issue.  I feel extremely fortunate to have had the support of family and friends and an excellent psychiatrist here in Toronto to facilitate the treatment of my own metal health issues. My life is immeasurably better thanks to good treatment. I've survived depression. I know not everyone is so lucky. There have been suicides in my extended family.

I'd like to see Health Canada put pressure on the provinces to provide more and better access to qualified mental health practitioners covered by Medicare. How about a mental health check-up along with the annual or bi-annual physical?  I have a great GP who does check-in with me and who led me to my psychiatrist but it is not always the case as I found out in Winnipeg.

It's hard enough work trying to recover from mental illness without having to scramble for treatment.  Trust me I know.