David Swann on Mental Wellness

Mental Wellness Needs to Begin Upstream of Psychiatric Treatment

At some points in life every Albertan is touched by mental illness and addiction. Released last month, the Alberta report on addictions and mental health highlights the system changes which are critically needed to reduce wait times, improve quality care, and reduce the cost of our current systems of care. There are many concerns that the report does not focus on well-recognized underfunding for mental illness beds and the important role of psychiatrists.

Child and adult psychiatrists do play a vital role with severe mental illness along with teams of supporting professionals. However, it’s clear that the great majority of mental health and addictions issues could and should be handled by other professionals, including psychologists, family physicians, and their teams.

Furthermore, to improve patient outcomes, there must be a shift of resources upstream into prevention efforts with individuals, families, and communities at risk. Without a dramatic shift in the planning and allocation of resources to identify and reduce risk factors earlier and prevent breakdown, the human and financial toll will continue to rise in Alberta. Alberta Health and the new health board must take leadership and also provide a new planning partnership that includes education, human services, housing, and police.

Two questions must lead the transformation this report calls for.

First, how do Alberta Health and Alberta Health Services lead a dramatic change within a massive and entrenched top-down culture let alone include other ministries in a new collaborative planning process? Moving across silos, including critical expertise from the front lines and shifting more resources to prevention, will take extraordinary and courageous leadership. Historic communications difficulties and distrust must be confronted if a new culture of respect is to develop both within Health and across the other ministries.

Second, how do the primary care networks step up to a larger role as the mental health home for the 1 in 5 people who need ongoing treatment-based, team-based care to be well? Again, Alberta Health must take bold leadership with the doctors.

The evidence is clear. We can prevent much suffering and death and save millions of dollars annually, but transformative leadership is essential to co-create the patient-centred, team-based preventive care that we urgently need.

Dr. David Swann, Co-Author Valuing Mental Health – A report of the Alberta Mental Health Review Committee