Your publisher received a request to re-publish this column, which he wrote for www.coastreporter.net a while back.
This month, I’d like to talk to you about two delicate issues: mental health, and addictions.
It is a touchy matter because substance abuse and addictions are not unique to folks living with a mental health problem. But it is even more difficult because of the stigma attached to both.
So, let’s split the issue in two and look at the numbers. As impersonal as they are, statistics tell a flesh-and-blood story.
One in five Canadians will experience a mental health problem in their lifetime. In any given week 500,000 employed Canadians will be unable to work because of this. Statistics Canada reports that the Canadian economy loses $51 billion in annual productivity and health care costs due to mental illness, which is the No. 1 cause of reported disability and which accounts for 70 per cent of disability claims.
Addictions have similarly horrifying numbers. One in seven Canadians suffers from an addiction – to alcohol, drugs, gambling, or tobacco. The last on the list, smoking, is responsible for 25 per cent of premature deaths in Canada. The health care and lost-productivity costs associated with smoking-related illness and disability are a subject of debate. However, the figure is in the very high tens of billions.
When we carefully merge these stats – the incidence of mental illness and addiction – we find that one in three Canadians living with a mental illness also suffers the effects of addiction. Due to under-reporting, the number is likely higher. My bet is that it is more like one-in-two.
So, what is to be done?
Addiction is as old as time, and attempts to eradicate drugs, alcohol, and gambling through legal means have failed – demonstratively and catastrophically. Our prisons are filled with people who should not be there; and thousands of Canadians have criminal records they ought not to have.
Mental health issues are, similarly, an eternal feature of the human condition. We can’t “cure” either addiction or many mental health problems, so we must adopt a new approach.
Harm reduction is a school of thought that advocates the management of harms and consequences associated with illness and behaviour. Its believers, like me, understand that legal sanction is an inappropriate way to deal with sometimes-illegal activity (like drug use, prostitution, gambling). We feel public policy ought to be directed toward reducing personal and social harms through enlightened social approaches.
The so-called “dual diagnosis” of mental illness and addiction is a prime candidate for a harm-reduction approach.
First, we stop treating personal drug use and other addictions as a crime. We try to understand the reasons behind these behaviours and attempt to mitigate the social and medical harms that come with them. Jail is no place for an unwell person.
Stable and safe housing is key. Without it, anyone – ill or otherwise – is vulnerable to the predations of the social vultures that prey on the weak. We do not have enough affordable housing on the Coast, and this aggravates the psychiatric and addiction problems many of our fellow citizens suffer.
Access to decent nutrition is, too, a persistent problem. It is, in my view, just unforgiveable that an affluent community like ours condemns the poor and unwell among us to lousy, boring food and poor housing.
So, here’s what we do: We demand that our local governments step up with funding for affordable housing. We give to the food bank and volunteer our time at the cold-weather shelter in winter. We show our care by our actions.