More men­tal health beds meet only part of need

Simcoe Reformer - - OPINION - ZUL MER­ALI Dr. Zul Mer­ali is pres­i­dent and CEO of the Royal’s In­sti­tute of Men­tal Health Re­search.

In the shadow of its re­cent wave of fund­ing cuts to pro­grams and ser­vices across the prov­ince, one thing the On­tario gov­ern­ment has un­doubt­edly got­ten right lately is the recog­ni­tion that greater in­vest­ment into men­tal health ser­vices is ur­gently needed.

The Doug Ford gov­ern­ment’s an­nounce­ment at the end of De­cem­ber of 50 new men­tal health beds at 12 hospi­tals across On­tario, and an in­vest­ment of $ 3.8 bil­lion over the next 10 years to­ward the de­vel­op­ment and im­ple­men­ta­tion of a “com­pre­hen­sive and con­nected men­tal health and ad­dic­tions strat­egy” is en­cour­ag­ing for those fac­ing long wait times for treat­ment.

How­ever, it is crit­i­cal for de­ci­sion­mak­ers to keep in mind that re­duc­ing wait times by adding sys­tem ca­pac­ity will not im­prove out­comes if the treat­ments that pa­tients are re­ceiv­ing work only a frac­tion of the time.

In On­tario ( and Canada, at large), our avail­able treat­ments for men­tal ill­ness are in­ad­e­quate for around 60 per cent of pa­tients.

Through re­search and care, we are learn­ing more and more that not all in­di­vid­u­als di­ag­nosed with the same men­tal health dis­or­der re­spond to the same treat­ments. Yet OHIP still cov­ers only a hand­ful of ther­a­peu­tic op­tions.

For in­stance, repet­i­tive tran­scra­nial mag­netic stim­u­la­tion ( RTMS) ther­apy is a non- in­va­sive, non- drug brain stim­u­la­tion ther­apy, proven to be highly ef­fec­tive in treat­ing de­pres­sion in those who have been re­sis­tant to other treat­ments — or for those who can’t ( or won’t) take med­i­ca­tions for a va­ri­ety of rea­sons ( such as preg­nant moms).

In 2016, Health Qual­ity On­tario rec­om­mended RTMS be pub­licly funded for pa­tients where elec­tro­con­vul­sive ther­apy is not an op­tion.

How­ever, more than 16 years af­ter Health Canada first ap­proved RTMS as a treat­ment for de­pres­sion, it is still cov­ered by pro­vin­cial health in­sur­ance only in Que­bec and Saskatchewan. For those in On­tario who re­spond to RTMS, it re­mains a costly out- of­pocket treat­ment.

Through its new men­tal health strat­egy, the pro­vin­cial gov­ern­ment must di­rect fund­ing to­ward ef­fec­tive al­ter­na­tive treat­ments such as RTMS.

De­ci­sion mak­ers also need to en­sure the de­vel­op­ment of in­no­va­tive pre­ven­tion and in­ter­ven­tion strate­gies are key men­tal health pri­or­i­ties.

Be­ing able to strate­gi­cally in­ter­vene early and pre­vent men­tal ill­ness would not only im­prove the life tra­jec­tory for many On­tar­i­ans, but also have sig­nif­i­cant down­stream ben­e­fits for the econ­omy. ( Cur­rently, 500,000 Cana­di­ans don’t go to work each week be­cause of de­pres­sion.)

Ground- break­ing pre­ven­tion tools are emerg­ing through cut­ting- edge men­tal health re­search. For in­stance, a com­puter al­go­rithm that har­nesses ar­ti­fi­cial in­tel­li­gence to iden­tify and sort tweets by char­ac­ter­is­tics such as hope­less­ness or lone­li­ness to pre­dict sui­cide risk was de­vel­oped ear­lier this year by Dr. Zachary Kamin­sky, a re­searcher at the Royal’s In­sti­tute of Men­tal Health Re­search, but ded­i­cated gov­ern­ment sup­port and in­vest­ment is ul­ti­mately needed to roll out in­no­va­tive tools like this on a large scale.

The re­al­ity is that we can’t im­prove men­tal health out­comes in our prov­ince just by im­prov­ing phys­i­cal ac­cess.

It is an en­cour­ag­ing first step to see the pro­vin­cial gov­ern­ment mak­ing a strong com­mit­ment to im­prov­ing men­tal health.

Now, if we are able to di­rect some of this $ 3.8 bil­lion in­vest­ment to­wards re­search and pub­lic fund­ing of treat­ment al­ter­na­tives, we can en­sure that any new men­tal health re­sources that are be­ing rolled out are ef­fec­tive — and in many cases, might even re­duce the need for more hos­pi­tal beds al­to­gether.

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