Mental Podcast Show

By Marvin Ross

It’s nice that governments try to promote understanding of mental health (or illness) in these awareness weeks and months but to what end? We do not have the resources to make a dent in alleviating the suffering experienced by the victim or his/her family. It’s difficult to get proper statistics on the resources we do have but some data does exist in various places. As an aside, lack of proper statistics hampers any rational planning. It is difficult to know where we are empirically today so that we can decide where we want to get to in the near future. And deciding our goal requires that we have measures to determine if we have reached them.

As a baseball fan, I’m amazed by the stats they have. If a pinch hitter comes into the game, the opposing manager knows what types of pitches he hits or doesn’t and what his record is with the current pitcher on the mound. He also knows what other pitchers he has and their record against that player so he can replace the current pitcher with someone who has had better success. Baseball is only a game while governments make what are often life and death decisions. Shouldn’t governments have as much information as a baseball team?

According to the Canadian Medical Association (CMA) , in 2019, Canada had 13.1 shrinks/100000 population. Some provinces had very few like PEI at 5.2, New Brunswick at 6.6, Saskatchewan at 7.4 and the Territories at 3.2. Compared to Europe, this is pathetic and on par with countries like Cyprus (12) and Malta (11). Switzerland has 52, the UK 18, Norway 25. The CMA suggests that 15 per 100,000 would be an appropriate number.

Just having more psychiatrists won’t necessarily improve access as an Ontario study found. While Toronto had more psychiatrists than most other areas of the province, they saw fewer new patients. Areas with more did not result in more patients being seen. Those psychiatrists saw fewer inpatients and outpatients, and they enrolled fewer new outpatients per year, but they saw their patients more frequently and for longer visits. The patients who were seen more frequently were wealthier and less likely to have had a prior psychiatric hospital admission.

Those who likely really needed help were not getting it.

Psychiatrists also need hospital beds for their patients but thanks to deinstitutionalization and the discovery of anti-psychotic medication, beds have been drastically cut. In a 2019 research study to try to calculate the optimal number of beds needed, the authors state that “evidence shows that bed numbers have been reduced below a minimal threshold”. Total hospital beds in Canada have been falling drastically since the early 1990’s. Between 1976 and 1990, there were about 690 beds per 100,000. By 2020, the number had dropped to 255 beds. It is no wonder that covid overwhelmed hospitals. With a reduction of all beds, psychiatric beds would also decrease as well.

The Canadian Psychiatric Institute and the Treatment Advocacy Center in the US suggest that an appropriate number of psychiatric beds be 50 per 100,000. In a comparison of 35 countries, Canada ranks 29th in beds slightly ahead of New Zealand, the US, Chile and a few others.

In Ontario, mental illness counts for 10% of the burden of diseases but only gets 7% of health care dollars. The Centre for Addictions and Mental Health calculates that spending on mental illness is short about $1.5 billion. OECD countries spend between 10-11% of their health care budgets for mental illness while we spend about 7%.

It’s nice to recognize mental health but so what? Government needs to do more.

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