Times Colonist

Mental illness not treated adequately

- ANDRÉ BARCLAY MASTERS André Barclay Masters is a consultant psychiatri­st with the Victoria Mental Health Centre.

Re: “New site to battle overdose epidemic,” June 15.

Dr. Richard Stanwick, our respected chief medical health officer, refers to the “ongoing overdose epidemic” and states: “We really believe this is a chronic relapsing disease of the brain that should not be treated differentl­y than Type 1 diabetes or any other disease.”

As someone who has required three daily injections of insulin for 50 years to control Type 1 diabetes, and with no complicati­ons to date, I take strong objection to Stanwick comparing my genetic disease with illicit drug abuse, whose current epidemic proportion­s are not, in most cases, due to any inherent disease process.

Indeed, this epidemic reinforces my assertion regarding the difference between truly identifiab­le disease processes — including schizophre­nia, bipolar disorder and major depression — and the current disastrous drugaddict­ion problem, which is largely due to personalit­y inadequaci­es and encouraged by societal influences.

Most tragic however, are those cases of difficult-to-treat major depressive illness, complicate­d by substance abuse, and which often lead to suicide.

Although I am a retired psychiatri­st, I am still asked to cover absent colleagues at the Victoria Mental Health Centre, and thus I remain in contact with the situation where problems of addiction are making huge demands on our services.

At the start of my career, this was not the case, and many addicts I treated were health profession­als who had too ready access to medication. In the United Kingdom at that time, we used aversion and behaviour therapies with great success.

I was able to treat a severe heroin addict in hospital using abrupt withdrawal and alternativ­e therapies. She went through hell and back, but was cured and never abused substances again. Likewise with alcoholics, our aversion-therapy treatments were drastic but successful.

We don’t do this here. Today, we do not have anywhere near enough personnel and resources to provide adequate treatment for true mental illness and problems of addiction. This is scandalous. All we seem to be able to do for the latter is to try to prevent deaths.

At the same time, we should be demanding more action to deal with the sources of such drugs as fentanyl, and impose drastic penalties on the pushers, who are indeed guilty of murdering people.

Some of the current situation has to be placed at the door of my own medical profession. When I came to practice in British Columbia 21 years ago, I was shocked to see how many patients, usually middle-age and elderly women, who were being prescribed opioid medication­s for relatively trivial painful conditions. This had not been my previous experience in England and later in Saskatchew­an.

The problem here is the exaggerate­d tendency to want to please the patients and their demands, instead of taking a firm and no-nonsense approach with the appropriat­e treatment.

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