Not every men­tal health con­cern re­qui­res a doc­tor

Per­haps the eli­xir of good fee­ling is avai­la­ble at a friend’s hou­se, at the next desk in the of­fi­ce, or from a part­ner or spou­se

La Jornada (Canada) - - PORTADA -

Ca­na­dians suf­fer when im­por­tant men­tal health ser­vi­ces are una­vai­la­ble or wait ti­mes are too long.

In la­te No­vem­ber, Sta­tis­tics Ca­na­da re­lea­sed its com­prehen­si­ve re­pFor­tu­na­tely, many of us - in­clu­ding chil­dren, pa­rents, ot­her re­la­ti­ves and friends - may find and im­ple­ment worthw­hi­le so­lu­tions to im­por­tant pro­blems whi­le peo­ple wait.

Ho­we­ver, so­me peo­ple are afraid to try. They be­lie­ve that trea­ting men­tal health pro­blems al­ways re­qui­res me­di­cal or pro­fes­sio­nal trai­ning.

Do­mi­nic Cov­vey

Ima­ge una­vai­la­ble

Im­pro­ving thoughts, fee­lings and beha­viour are the only di­rect pur­po­ses of men­tal health in­ter­ven­tions. Ever­yo­ne with a men­tal health is­sue wants to feel bet­ter, beha­ve dif­fe­rently or think in dif­fe­rent ways.

The good news is that most of us may ha­ve pro­found in­fluen­ces on men­tal well-being and can help suf­fe­rers sol­ve or mi­ti­ga­te many men­tal health pro­blems. Each of us, every day, in­ten­tio­nally or unin­ten­tio­nally in­fluen­ces the men­tal health (thoughts, fee­lings and beha­viour) of tho­se around us.

Men­tal health in­ter­ven­tions ha­ve only th­ree pur­po­ses: to chan­ge the way peo­ple think, how they feel and how they beha­ve.

Psy­cho­lo­gists, psy­chia­trists, friends and neigh­bours use a va­riety of tools. Me­di­cal trai­ning is usually not ne­ces­sary be­cau­se most peo­ple with men­tal health pro­blems don’t ha­ve test re­sults that show they ha­ve a known bio­lo­gi­cal ill­ness. Most peo­ple can be hel­ped wit­hout me­di­ca­tion.

Peo­ple with men­tal health pro­blems fit in­to th­ree me­di­cal ca­te­go­ries.

The first ca­te­gory in­clu­des peo­ple who ha­ve known trea­ta­ble bio­lo­gic pro­blems. In ot­her words, the­re’s so­met­hing iden­ti­fiably wrong with how their body works. In the ca­se of de­pres­sed fee­lings, this in­clu­des peo­ple with thy­roid di­sea­se or adre­nal di­sea­se.

Blood tests and phy­si­cal exa­mi­na­tion allow doc­tors to iden­tify what’s out of ba­lan­ce and to pres­cri­be drugs to co­rrect the im­ba­lan­ce. Doc­tors and pa­tients mea­su­re suc­cess by trac­king chan­ges in la­bo­ra­tory va­lues and im­pro­ve­ment in mood.

Da­vid Zit­ner

Ima­ge una­vai­la­ble

The group of pa­tients with known me­di­cal di­sea­se re­qui­res in­ter­ven­tion (me­di­ca­tion) that can only be pres­cri­bed by phy­si­cians.

The se­cond ca­te­gory, a lar­ger group, in­clu­des peo­ple who ha­ve no de­tec­ted ab­nor­ma­li­ties in blood che­mistry or ot­her bo­dily fun­ctions. For most peo­ple in this group, it’s ap­pro­pria­te to try non-me­di­ci­nal in­ter­ven­tions as a first choice. The­se non-me­di­ci­nal in­ter­ven­tions re­qui­re peo­ple skills but not a me­di­cal li­cen­ce.

This ca­te­gory in­clu­des peo­ple who are de­pres­sed be­cau­se they eat poorly and don’t exer­ci­se, or their li­fe con­text is de­pres­sing. Their bio­logy is the sa­me as tho­se of their neigh­bours, who would al­so feel de­pres­sed if they ate and beha­ved in the sa­me way, or if they suf­fe­red si­mi­lar los­ses in their li­fe.

The third ca­te­gory in­clu­des peo­ple who feel de­pres­sed wit­hout any known cau­se. They ap­pear me­di­cally nor­mal and ha­ve no de­tec­ta­ble bio­che­mi­cal ab­nor­ma­li­ties. They might ha­ve an un­dis­co­ve­red ill­ness or a me­di­cal pro­blem their phy­si­cian hasn’t con­si­de­red.

De­pres­sion, the most com­mon men­tal health pro­blem, usually re­sol­ves wit­hout the need for me­di­ca­tion. A re­cent ar­ti­cle in the Jour­nal of the Ame­ri­can Me­di­cal As­so­cia­tion re­por­ted that an­ti­de­pres­sant me­di­ca­tion only helps the small num­ber of peo­ple who are most se­ve­rely de­pres­sed. Most peo­ple im­pro­ve wit­hout me­di­ca­tion.

Ot­her help­ful in­ter­ven­tions in­clu­de con­ver­sa­tion with psy­chot­he­ra­pists, psy­cho­lo­gists, friends and neigh­bours, and chan­ging li­festy­le, in­clu­ding diet and exer­ci­se, to im­pro­ve mood.

Drugs might be use­ful in so­me ca­ses whe­re the pro­blem is of no known cau­se. Drugs can al­ter the way peo­ple think, feel or beha­ve, re­gard­less of whet­her they ha­ve a bio­lo­gic ab­nor­ma­lity or che­mi­cal im­ba­lan­ce.

Un­for­tu­na­tely, the cu­rrent men­tal health mo­del in­sists that most peo­ple see a phy­si­cian to en­ter the sys­tem to get help. This is des­pi­te the fact that drugs are the only uni­que treat­ments of­fe­red by phy­si­cians and many peo­ple im­pro­ve wit­hout me­di­ca­tion.

May­be we’re going to the wrong sour­ce for men­tal health sup­port. Per­haps the eli­xir of good fee­ling is avai­la­ble at a friend’s hou­se, at the next desk in the of­fi­ce, or from a part­ner or spou­se. The le­vers that can con­trol how we feel are avai­la­ble to all of us. We ha­ve to be­lie­ve in our­sel­ves and in our neigh­bours.

Chan­ging the way com­mu­ni­ties sup­port men­tal health ser­vi­ces will not only im­pro­ve ac­cess to help, it will al­so sa­ve mo­re peo­ple from the con­se­quen­ces and side ef­fects of un­ne­ces­sary drug treat­ment.

-TROYMEDIA

Do­mi­nic Cov­vey is a re­ti­red pro­fes­sor, aut­hor and foun­der of the Ca­na­dian Or­ga­ni­za­tion the Na­tio­nal Ins­ti­tu­tes for Health In­for­ma­tics. Da­vid Zit­ner is a re­ti­red fa­mily doc­tor and health po­licy fe­llow for the Atlan­tic Ins­ti­tu­te for Mar­ket Stu­dies.

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