Typically, people tend to not look after their mental health to the same extent as their physical health. Despite research showing the prevalence of mental illnesses and related issues in Canada, mental health is still not a top health priority for the general public. Now, with the recent release of the voluntary national Psychological Health and Safety in the Workplace standard, employers and employees alike need to become more literate about mental health.
According to the World Health Organization, health literacy is “the degree to which people are able to access, understand, appraise and communicate information to engage with the demands of different health contexts in order to promote and maintain good health across the life course.”
Let’s look at mental versus physical health under the same criteria.
Access
Access to mental health services is significantly lacking relative to physical health. According to a Fraser Institute study (2008), the median wait time in Canada from the time you get a referral from a general practitioner (which is needed in most cases to see a specialist of any nature) is 1.8 months for urgent cases and 7.9 months for elective cases.
Seeing a non-medical practitioner (such as a counsellor or psychologists rather than a psychiatrist) takes much less time due to these services being offered in private practices. However, seeking help from any private service costs the user money and most employer-sponsored plans don’t offer a lot of coverage for these types of services.
For example, many employer-sponsored health plans only offer $500 per year in coverage for psychological services. Many psychologists charge $175 or more per visit.
According to a Statistics Canada report from 2003, for the entire population over age 20, 1.9% or 484,000 persons indicated that they had ever seen a psychologist. Of these, over 70% had some form of insurance for payment while almost 30% paid entirely out-of-pocket. According to Statistics Canada, having to pay out of pocket often deters people from seeking help.
Understanding
According to WHO, “mental health is a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively…and is able to (contribute) to her or his community.” The general definition of health from WHO is “…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
We have definitions, but we also know that physical and mental health are closely linked and the mind-body association is important. “A sound mind is a sound body” is not just a convenient cliché. Physical health and mental health are intertwined and one can positively or adversely affect the other.
Appraising
Are we able to appraise when our mental health is impaired? For example, anosognosia is a condition where a person who has an illness or disability may not be aware of that condition or may deny its existence. Kevin Thompson, Ph.D. and author of Medicines for Mental Health: The Ultimate Guide to Psychiatric Medication, calls anosognosia “the most devastating symptom of mental illness.”
Knowing that such a condition exists may help to at least partially explain some of the disconnect in mental healthcare in Canada. When people have a physical problem, it is usually much more apparent and we are usually much more active in seeking help.
Communicating information
When it comes to mental health, what information is being communicated by reputable organizations and subject authorities the general public? Are these organizations talking enough about issues, other than stigma?
There is now a national standard that seeks to address the prevention of workplace mental injury. While the standard cannot solely address the situation whereby someone has or develops a mental illness, a search of the document revealed that the word “stigma” appears only four times. This is significant because it’s a recognition that stigma isn’t the only reason people don’t seek help.
Contrast the general emphasis on mental health stigma with an example from physical health.
There used to be a lot of stigma regarding colon cancer and screening. In 2008, a public service announcement aired the backside of a fully clothed man, with an asterisk over his rear end. The asterisk was a footnote saying, “don’t die of embarrassment.” Shortly thereafter, the message became clear: if caught early, colon cancer has one of the highest cure rates for any cancer.
Do media and those practicing in the field of mental health properly advise the public of the prevalence of mental health issues and the success rates that evidence based and well researched interventions can have in dealing with conditions like depression and anxiety? Probably not.
However, things are now moving in that direction, but if we are going to better address mental health literacy, we must quicken the efforts.
The new national standard is one of the most important mental health initiative in Canada. This, combined with publications that highlight celebrities, athletes and others who are coming forward about mental health and their experiences, is finally turning the corner to a society in which mental health is seen no differently than physical health.
This story was originally published on Jan. 22, 2013.
David Michaels, B.A., M.H.Sc. is the CEO of the The Clinic For Emotional Wellness, Inc. david.michaels@theclinicforemotionalwellness.com.