Praise for mental health plan

Tory move toward addictions focus draws cautious applause

Mental health advocates are praising the Conservatives’ plan to shift the mandate of the mental health commission to research linkages between drugs and mental illness, as long as it remains arm’s-length from government and the politics of its anti-drug strategy.

The shift would mark a new and what many call long overdue chapter for the Mental Health Commission of Canada (MHCC), which since its creation in 2007 has steered clear of addictions research and focused on priorities such as reducing stigma, mental health in the workplace and helping the homeless with mental illness.

But advocates say integrating is critical because addictions and mental illness are “co-occurring disorders.” Those who suffer from mental illness often have addiction problems — from alcohol and prescription drugs to gambling — and alcoholics and drug abusers can develop mental illness.

One in five Canadians is diagnosed with mental illness every year and addiction is the second most commonly diagnosed one, said Peter Coleridge, CEO of the Canadian Mental Health Association.

“There is a significant number of people who have mental health conditions and substance use problems or vice versa. The two go hand-in-hand and the problem is we have treated them independently,” he said.

Michael Kirby, the founding head of the commission, lauded the move. He said it sets the stage to eventually merge the Canadian Centre for Substance Abuse with the commission. It would streamline operations, save money and better co-ordinate issues around addictions and mental health.

But the pledge for the MHCC’s new mandate was made by Conservative Leader Stephen Harper on the hustings as part of his antidrug strategy while driving home his strong opposition to the legalization of marijuana — a hot election issue among the parties. The Conservatives oppose legalizing pot; the NDP want to decriminalize it and the Liberals want to legalize it.

Harper promised more money for the RCMP to target clandestine drug labs and marijuana grow ops, to set up a national toll-free hotline for information on drug use among youth, and to refocus the MHCC’s mandate.

That has some worried a reelected Conservative government may try to advance its tough-ondrugs campaign through the work of the commission.

Chris Summerville, co-chair of the Canadian Alliance on Mental Illness and Mental Health, said the commission should remain at arm’s length from government and its work based on the best research.

“Whether to legalize or not is a political question and we have no position on that. We want people to be informed with the latest knowledge about substance use and mental illness so they can make wise and healthy choices,” he said.

Benedikt Fischer, a senior scientist at Toronto’s Centre for Addiction and Mental Health (CAMH), questions whether making it part of the Conservatives’ anti-drug agenda could influence the scope and perspective of research.

“We need to better understand why and how they co-occur and the implications … so it doesn’t make sense to investigate one without the other and for that reason alone the announcement makes sense in principle and should be supported based on evidence,” Fischer said.

“What is of concern to me is that the government is wrapping this in an anti-drug strategy. … Their ideological position is anti-drug and that could lead to problems in the perspective and outcomes of investigations.”

But Kirby said such concerns are overblown and he is confident the commission will remain above the political fray.

He said he’s not surprised Harper would announce the new focus in a speech about drug policy, but the integration of addictions and mental health is such a logical move that it will likely be the direction followed by whatever party is elected.

The commission grew out of the landmark 2006 Senate committee report, Out of the Shadows At Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. Kirby, then a Liberal senator, headed the committee and was named by the Conservatives to chair the commission.

Kirby said the commission is ready for a new mandate, having accomplished its priorities and drafted Canada’s first national mental-health strategy. That mandate and original 10-year funding expires in 2017.

The Conservatives extended the MHCC’s $15-million a year funding in the last federal budget — adding suicide prevention to its priority list — and put former Conservative politician and longtime mental health advocate Michael Wilson at the helm as chair.

The MHCC is now awaiting its new mandate letter from the next Health minister and Kirby argues Harper’s announcement is “precisely what I would have proposed.”

Kirby said the MHCC should also tap into a national grassroots network created by the charitable organization, Partners for Mental Health, which he created. He said mental health needs a charitable and community base like those with breast cancer or HIV-AIDS, built to bring their issues to public attention.

Coleridge said the CMHA lobbied to renew MHCC’s funding, calling for a “co-ordinated” approach to addictions and mental health, including the research of the Canadian Institutes of Health Research. The CMHA is calling for new indicators to measure what treatments are working, and an innovation fund.

Officials at the MHCC wouldn’t comment, saying it was inappropriate for a government-funded not-for-profit agency to comment on policy issues raised during the election campaign.

The Centre for Substance Abuse also wouldn’t comment on whether a merger with the commission is in the cards, but clearly the groundwork has been laid for more collaboration between the two organizations.

It teamed up with MHCC and the Canadian Executive Council on Addictions for a report — Collaboration for Addiction and Mental Health Care: Best Advice — to bring the two sectors together to improve treatment and reduce health costs.

In an email, CEO Rita Notarandrea said the centre has a responsibility to work with the MHCC to help those with both mental health and addiction problems but “remain focused on our specific mandates as well.”