The recent release of the 2008 National Report Card on Health Care has some good news and some bad news for Canadians who have been personally impacted by an addiction or mental illness. The Canadian Medical Association (CMA) released findings of its 8th annual report card telephone survey by Ipsos-Reid that surveyed 1,002 Canadian adults between June 10 and 12, 2008.
This report is a must read for Canadians who want to know where we’re at as a country when it comes to mental illness and addiction. It’s worth noting that this is the first year that the survey has included questions on mental health care, mental illness, and addictions. Particularly telling were questions about the Canadian public’s personal experience with mental illness and addiction.
Like the start of so many doctor jokes, there’s good news and some bad news.
The Bad News: Attitudes of Canadians Regarding People with Mental Illness and Addictions
First, the bad news. Discrimination and prejudice of people with addictions and mental illness is, unfortunately, alive and well in Canada. The survey found that:
– Almost half of Canadians (46%) think people use the term mental illness as an excuse for bad behaviour;
– One in four (27%) Canadians are fearful of being around people who suffer from serious mental illness;
– Just half of Canadians (50%) would tell friends or coworkers that they have a family member suffering from a mental illness, compared to wide majorities who would discuss diagnoses of cancer (72%) or diabetes (68%) in the family.
– The majority of Canadians would be unlikely to hire a lawyer (58%), a child care worker (58%), financial advisor (58%) or a family doctor (61%) with a mental illness. Only one in three (31%) Canadians would hire a landscaper with a mental illness
When Canadians were asked specifically about alcohol and drug addiction, the results were even more troubling. The survey found that:
– Less than half of Canadians think alcohol and drug addiction is a mental illness;
– Only 1 in 5 Canadians would socialize with someone who has a drug or alcohol addiction;
– Less than 5% of Canadians would hire someone who has a drug or alcohol addiction.
– Only 32 percent of Canadians would socialize with a friend who has an alcohol addiction and 26 percent with a drug addiction
“These figures show clearly the insidious stigma still associated with mental health and mental illness,” said Dr. Brian Day, CMA President. “These are the attitudes that have kept mental health on the outside for far too long.”
The Good News: Canadians Attitudes Regarding Treatment and Diagnosis
While the attitude of Canadians toward people with mental illness and addictions is bad news, the public attitude towards the treatment of people with mental illness and addictions is good news. The survey found that:
– Almost six in ten (59%) Canadians say they expect the number of people with a mental illness to increase over the next 10 years;
– Most (60%) Canadians agree that the diagnosis and treatment of mental illness is underfunded
– nearly three-quarters (72%) agree funding should be on par with funding for physical health issues such as cancer and diabetes.
– three in ten believe that mental illness is hurting Canada’s economy.
– just over four in five Canadians say that many people suffer from mental illnesses that remain undiagnosed (83%)
– nearly nine in ten respondents (89%) say mental illnesses are like cancer and diabetes in that they require treatment by a health
professional while only one in ten (11%) choose the alternate statement, that most mental illnesses do not require treatment by a health professional, but can be treated by lifestyle changes.
Based on these findings, the CMA suggests that most Canadians feel that mental health is “not given the priority it ought to have in the health care system” (see page 18 of the report).
What We Can Conclude from the Survey
Conclusion #1: Canadians Are Clearly Ambivalent and Mental Illness and Addictions
So, what can we conclude by these findings? If anything, it shows that Canadians are ambivalent about mental health and addictions. On the one hand, most Canadians agree that they need professional help but, on the other hand, almost half of Canadians think addiction and mental illness is little more than a bad attitude. How can we make sense of Canadians who feel people with bad attitudes need professional help?
Conclusion #2: Canadians Have a “Not in My Backyard” Mentality
Consider that a quarter of Canadians are afraid of people with serious mental illness, yet 60 percent feel that mental illness and addiction treatment is under-funded and that afflicted individuals need professional help. This helps explain the uproar any time mental health housing or treatment is proposed in residential communities.
Conclusion #3: Canadians with Mental Illness or Addictions Face Discrimination
Discrimination in Canada’s labour market is alive and well since the majority of Canadians responded by saying they would unlikely hire someone with an addiction or mental illness.
As Dr. Day concluded, “This year’s report card shines a harsh, and frankly unflattering, light on the attitudes we Canadians have concerning mental health. In some ways, mental illness is the final frontier of socially-acceptable discrimination. Can you imagine the public uproar if mental health was replaced with race, gender or religion?”
Conclusion #4: Canadians Are Afraid to Talk About It
Just half of Canadians (50%) would tell friends or coworkers that they have a family member suffering from a mental illness, compared to wide majorities who would discuss diagnoses of cancer (72%) or diabetes (68%) in the family. Since this information could lead to diminished job prospects, fearful neighbours, and the perception of moral failing (refer back to the “bad attitude” statistic), who can blame them?
The Practical Implications of the Report Card Findings
It’s hard to say whether the findings of the National Report Card on Health Care is going to compel our government to increase mental health funding or address the systemic, institutionalized prejudice that affects the many Canadians struggling with mental illness and addiction. At Sunshine Coast Health Center, we have observed, first-hand, clients who have been terminated from tenured careers despite demonstrating continued progress and motivation, and clients from small communities forced to drive hundreds of miles just for a one hour appointment with a counsellor.
While the Report Card is short on recommendations, it does help explain why:
1. we don’t have enough mental health housing in Canada
2. the government is thinking of closing Insite, the supervised injection site in Vancouver’s Downtown Eastside (*)
3. addiction is the black sheep of health care in Canada
The fact that this survey was done at all is good news for any Canadian who is no longer to sweep mental illness and addiction under the rug.
Note: The Canadian Press article, Tony Clement questions ethics of doctors who back safe injection sites, is a telling indicator of the battle for public opinion being waged between those who believe that addiction is a moral failing and the scientific community which, in this case, is the Canadian Medical Association (CMA).
About the Author
Daniel Jordan is the General Manager of Sunshine Coast Health Center and hopes that these postings can help lower the stigma attached to addiction and, at the same time, raise the standard of today’s addiction treatment programs.