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| Dr. Kathi Kovacs |
By Dr. Kathi Kovacs
Psychiatry is the branch of medicine focused on the diagnosis, treatment
and prevention of mental, emotional and behavioural diseases. Psychiatrists’
education and training allows them to understand the relationship between
mental health and other illnesses, make a diagnosis and work with the patient
to develop a treatment plan.
Mental illnesses are disorders which affect mood, thought processes,
perception and reality testing. Depending on the nature and severity of the
disorder cognitive function, insight and judgement may be affected. Mental
illness may also result in changes in behaviour and bodily functions such as
sleep, appetite and energy. Mental illness is typically categorized as
anxiety/mood disorder, major depressive illness, bipolar illness, psychotic
illness, eating disorders, and substance abuse disorders.
Anxiety disorders are perhaps the most prevalent. As a category, it
includes several subtypes including performance anxiety, separation anxiety,
generalized anxiety somatization and panic disorder. As an example of how
common anxiety disorders are, a recent Statistics Canada report indicated that
about 2.6 per cent of Canadians aged 15 and older reported symptoms consistent
with generalized anxiety disorder, a condition characterized by a pattern of
frequent, persistent worry and excessive anxiety about several events or
activities. For major depressive illnesses (disorders characterized by
sustained low mood as well as significant changes in sleep, appetite, energy,
motivation, libido, concentration, and decision-making) 4.7 per cent of the
population aged 15 and older were affected.
Mental illness affects all ages and backgrounds. In any given year, one
in five Canadians will experience mental illness. In Canada, 6.7 million people
live with a mental illness, compared to 2.2 million Canadians who have Type 2
diabetes. Mental illness hits earlier in life than most other medical
disorders. More than 28 per cent of people between 20 and 29 years of age
suffer with a mental illness in any given year. By the time a Canadian is 40
years old, one in two will have had a mental illness.
Suicide accounts for 24 per cent of deaths in the 15-24 years age group.
Self-harm is on the rise, and the impact of mental illness on society is
astronomical. It affects families, friends, classmates, workplaces and health
care facilities. The Mental Health Commission of Canada determined the economic
cost, due to mental illness, of at least $50 billion per year. Approximately
$7.7 billion of this are direct costs related to hospital care and morbidity
and mortality.
The most serious impact, however, is on the individual. Having a mental
illness can be isolating and often results in shame and guilt. It is even more
difficult for patients with mental illness to navigate a stressed healthcare
system. Even within a caring environment, there is stigmatization. Mental
health patients may be considered to be less serious cases in busy waiting
rooms. These patients often have more difficulty in advocating for themselves.
For proper assessment and treatment, a multidisciplinary approach is
optimal. The first step is to visit a general practitioner (GP) so that medical
causes can be ruled out as causes of the mental illness. Even some medications
may have psychiatric symptoms as side effects. Often the GP will initiate
treatment with therapy and/or medication and will often refer their patient to
a psychologist, mental health social worker or other healthcare provider. A
psychiatric consultation can be made by the GP if needed.
In Ottawa, there are several community agencies that provide excellent
counselling, urgent care and crisis intervention. Safety is key and for
emergency care there should never be any hesitation in contacting emergency
services. There are many initiatives underway in our area to improve our
knowledge of mental illness, but there is still much to learn about the
interplay between the mind, body and life experience.
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