Over the years, I’ve written about this issue, for four reasons.
Many of these columns begin quite unexpectedly – with an image, an overheard remark, a vague feeling. This week’s is no different.
When we are in distress, when are in peril, we rely on our first responders. Firefighters. Paramedics. Police. And, the dispatchers who sort through often-harrowing calls and stay on the line until help arrives.
Last month, Sean Eckford wrote a story in the paper I write for about psychiatric care at Sechelt Hospital that ought to concern everyone in our community.
I have been thinking about art and love in the last month or so – what they are and what they can do to lift our wings and, perhaps, elevate mental health and stay the storms that buffet mental illness.
In a long-ago Peanuts comic, Charlie Brown asks Linus “But is it art?” The next panel shows Snoopy’s garishly redecorated doghouse, with its grinning owner dressed like a used-car salesman standing proudly beside it. Both human characters just sigh.
With October 17 and the legalization of pot approaching, we have much to celebrate but also much to ponder.
Canada adopted the American criminalization of marijuana in the “Reefer Madness” days of the 20s and 30s because that is what we did. We, as mice, did as we were told by the elephant south of the border. No research – American or otherwise – validated the vilification of pot. It is arguable that anti-marijuana laws were racist in origin, because in the early part of the 20th century, African-Americans were targeted for all manner of “antisocial” behaviour; consumption of the demon weed was one.
So, we have turned a corner as an enlightened nation. As such, we owe ourselves the duty to ask what our newly minted law may mean. As this column deals principally with mental health issues, I will toss out a couple of ideas (and perhaps some unwelcome research outcomes) for discussion.
Pot is undeniably good for folks who’s mood might be lower than they’d like. The euphoria and all-round sense of ease THC (the psychoactive component) creates can only be a good thing. However, in my view, the sense of well-being we seek is best found in non-chemical ways. Certainly, it seems better to go for a hike in nature than to coat our lungs and pollute our blood with cancer-causing volatile combustion products.
But onto the research, which deals in large part with marijuana consumption and bipolar disorder – or, as it currently called, “bipolar spectrum disorder,” as there are currently four recognized varieties of this illness.
First, research shows that marijuana use is statistically more prevalent in folks who live with bipolar than in the population at large or those living with other mental illnesses. Why this is so has been subjected to close attention, but because the data are subjective few satisfying interpretations have been reached. Interviews with three pot-smoking folks living with bipolar have told this reporter that any long-term hazards associated with marijuana use are mitigated in the short term by the sense of ease and contentment created by THC.
Now, on to those negative things.
Research (I’d be glad to supply the list of scholarly articles I here summarize) shows that in bipolar patients marijuana use can lead to exaggerated and rapidly cycling mood states, psychosis, a decrease in the remission of symptoms, and an overall decrease in what is called “global functioning.” This simply means that behavioural control and the ability to maintain acceptable patterns of thought are diminished.
Further, research shows that with increased use of marijuana, folks with bipolar face poorer therapy/treatment outcomes, greater risk of suicide, higher rates of hospitalization, and a general increase in the degree and frequency of both manic and depressive symptoms. These, naturally, lead to increased levels of overall disability.
Where should an understanding of this research lead us? Ought we reconsider the legalization of pot because it will lead to increased consumption among the vulnerable mental health community?
I say, emphatically, no way.
Alcohol is legal. Tobacco is legal. Access to other psychoactive medications is legal.
It would paternalistic in the extreme to single out pot for legal sanction because it has negative consequences for folks living with a mental illness.
Note: Primary research reference and link to scholarly publications: “Effects of Marijuana on Mental Health: Bipolar Disorder,” Alcohol and Drug Abuse Institute, University of Washington, June 2017. Author: Susan A. Stoner. No kidding.
We all deal with stress. And it is worth thinking about how we feel it and what we can do about it.
Harsh experiences – all of us have had them. In childhood or after.
When a person living with a mental illness reaches the point of hospitalization, those who care sigh a breath of relief.
“Thank goodness,” we say to ourselves, “our loved one is in good hands.”
And that is true. The mental health professionals both inside and outside the hospital setting do their jobs well and ensure that within the structure of our health care system the most vulnerable and unwell receive the attention they need.
But once outside the institutional system, mental health patients fall off a cliff and enter a revolving door of inside-outside. Allow me to give you an example, from personal experience.
Someone I care about deeply lives with bipolar disorder, a devastating illness that requires constant monitoring and assertive treatment.
Hospitalization has been a frequent feature of this person’s life, but beds on the psychiatric unit are scarce. Six beds serve the whole of the Sunshine Coast. So, when acute medical needs were deemed to have been addressed, this loved one was let out – without a formal discharge plan or follow-up.
The inevitable happened.
Still unwell with her mood cycling dramatically, and with new medications not yet having their effect (psychiatric meds typically take weeks to work), my friend entered the twilight zone between care and chaos.
Homeless, because her landlord did not want her around, and without social support because her behaviour estranged her friends, this incredibly bright and caring woman fell into life on the streets, bush, beaches, and dark alleyways of Sechelt.
In through the out door.
Predictably, after causing a rumpus, she was arrested and again taken to hospital. Released again, she is back on the street – unwell, and vulnerable to the predations of (mainly) men with unfriendly intentions. It’s only a matter of time when the revolving door will once again deliver her into care, eventual release, and back into the cycle.
One does not have to read this sad story all that closely to realize that there is a large and perilous gap between structured, acute care and outpatient well being.
Vancouver Coastal Health funds mental health services. As few as eight years ago, there were several mental health social/outreach workers who attended to the needs of recently discharged patients. Now, I think there is one for the entire Sunshine Coast, though I hear this may change for the better.
Until a few years ago, the Homelessness Project (modestly funded) connected with patients while in hospital to help them find stable housing upon discharge. Yes, the organization that now runs the Upper Deck homeless shelter has, in its remit, the task of finding homes for the homeless. It is a daunting task, as there is no affordable housing on the Coast.
As a caring community, we must do what we can to address the bottom, most fundamental level of Maslow’s Hierarchy Of Needs, which is safe and stable shelter and the basic elements of comfort.
Perhaps you have a spare bedroom you can let out to a person in need. I did, and I did.
If there is anything you can do to help bridge the gap between care and nothingness, then drop by the Arrowhead Clubhouse in Sechelt and talk with staff. Shelter. Clothing. Camping equipment for folks living rough. Anything.
Caring for those in need is our moral imperative.
Note: This regular column on mental health and social issues will appear 11 May at www.coastreporter.net