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Mental Illness — It Wasn’t Always This Way

The Mental Health Strategy for Canada recommends raising the percentage of every public healthcare dollar that is used to fund mental health to 9% by 2022, but this won’t happen all by itself. We are the deciding factor in determining the future for the mental illness sector, and we need to come together to support the cause.

Mental health is an issue that can no longer be ignored. In recent years, we have finally taken action to set up infrastructure and support systems to help those with mental illness.

According to the Mayo Clinic, mental illness is a “mental health disorder affecting one’s mood,” whereas mental health, just like physical health, is one’s everyday responsibility to maintain. Treatment for mental disorders can involve prescription drugs, seeing a psychotherapist for therapy or joining support groups.

There is much progress to be made in terms of reducing mental disorders across the globe. According to CAMH, one in five Canadians experience mental illness at some point in their life. As of 2010, the Canadian government spent 50 billion dollars annually on mental health. 150 years ago, the only infrastructure in place were insane asylums for those who were mentally ill. I can tell you that, at first glance, this can be seen as progress. However, we must also remember that, 150 years ago, doctors thought that, to the best of their knowledge, they were treating the mentally ill in the best way possible. 

But is this money spent in the right places? Are people getting the help they need? According to a 2012 Statistics Canada study, only 65% of them felt they got the treatment they needed. With 35% of citizens being dissatisfied with the mental health infrastructure in Canada, there seems to be a disconnect between the government and their people. Upon further research, I found that the Canadian government is only issuing 7% of every public health care dollar to mental health treatment, whereas New Zealand devotes 10-11% to mental health.

Even though Canada’s government is taking an amazing step forward in the development of infrastructure for mental health, we need to ensure that the money is being used in the right places. According to the Mental Health Commission of Canada, 4000 people commit suicide each year, the majority of which are experiencing mental illness. Just to put it in perspective, that is roughly two times the number of people who die in car accidents in Canada each year.

Today, I wanted to discuss the timeline for mental health stigma and infrastructure in Canada over the past few centuries so you, as an educated reader, can make a decision on how you think the government money should be spent. 

Stigma

Mental Illness — It Wasn't Always This Way

(Image Source: Coastal West Sussex Mind)

1700s – 1880s: Treatment of the mentally ill was a family responsibility. If they could not be treated at home, they were put in jails or poorhouses in deplorable conditions. They were seen as morally unfit and weak. They were treated as sinners. This view of mental illness peaked in the 1830s and 1840s when two “asylums for the insane” opened: one in St. John, New Brunswick in 1835 and one in Toronto, Ontario in 1841. 

1880s – 1940s: Many prominent doctors in America and Canada began voicing a different attitude for mental illness. Dorothea L. Dix, Richard M. Bucke, Charles K. Clarke, Clifford W. Beers and Clarence M. Hincks shared the sentiment that mental health is a “failure of the biological process by which mankind adapts to change,” rather than a sign of weakness and sin. They preached this message across North America, and it lead to the creation of the infrastructure used to treat mental illness today.

Post-WWII – Present: After WWII, soldiers came back with wounds both physical and psychological. It came as a shock for the world to see so many healthy, strong men come back as fragments of what they were. With all these men returning from war with depression, anxiety and many other mental illnesses, the world realized that mental illness cannot simply happen to the weak, but that it happens to everyone. This realization resulted in a large-scale effort to help cure mental illness, although the roots of our view of mental illness nowadays arose from the aforementioned doctors in the mid-1880s.

Infrastructure

Mental Illness — It Wasn't Always This Way

A Picture of the Insane Asylum in St. John, NB. (Image Source: johnwood1946)

1714: The first mental illness ward was created at the Hôtel-Dieu in Quebec. It first took in women only but later accepted 12 men.

1835: Canada’s first asylum for the insane was established in St. John, New Brunswick.

1841-1870: Four more insane asylums were established in Ontario. Toronto (1841), Hamilton (1848), Kingston (1859), London (1870). 

1876-1877: Dr. Richard Bucke, superintendent of the asylum for the insane in Hamilton (1876) and London (1877), changed the way people traditionally treated mentally ill patients in those two asylums. He stopped the practice of pacifying the patients with alcohol and stopped “restraining” the patients (who were severely beaten). He also organized cultural and athletic activities to create a sense of community and friendship in the asylums. 

1885: Dr. Dorothy Dix, a Massachusetts schoolteacher outraged about the deplorable conditions in the asylums for the insane, influences Newfoundland and Labrador to create a hospital for the mentally ill in St. John’s.

1887: Dr. Charles Clarke, superintendent of the asylum for the insane in Kingston, Ontario, changes the jail into a hospital with nurses and attendants to care for the patients.

1908: Clifford Beers creates the National Committee for Mental Hygiene. Beers also wrote a book entitled A Mind That Found Itself, which tells a personal story of his with mental illness. It was one of the first books written about a what it was like to have a mental illness.

1918: Dr. Clarence Hincks, with the help of Clifford Beers, creates the Canadian National Committee for Mental Hygiene.

1920: Dr. Clarence Hincks and Clifford Beers create the International Committee for Mental Hygiene.

1930: Beers and Hincks plan the first-ever International Congress on Mental Hygiene in Washington. 

1935: Alcoholics Anonymous is founded. Many other support groups follow the lead of AA to create a platform where the mentally ill can help to lift each other’s spirits and get out of cycles of addiction.

At this point in Canada’s history with mental illness, the basic premise for what we know today is already here in 1935. With reduced stigma and more infrastructure, all we need is for this movement to catch on to a larger scale audience. As we know, support for mental health increased exponentially after WWII once it became clear that mental illness did not only affect the weak, but also the strong. As a result, government funding increased in virtually every country.

10% of disease in Canada is mental illness, yet only 7% of every public health care dollar goes towards the cause. This shows that there is a discrepancy between the need for mental health treatment and what is being provided. In Ontario alone, mental illness is underfunded by 1.5 billion dollars. Still, an estimated 75% of children seeking specialized therapy do not receive it. Wait times for therapy can last up to a year in some parts of Canada, which is caused by two factors. Firstly, there aren’t enough doctors in the industry. When treating mental illness, one cannot rush the procedure of diagnosis or the process of treatment. Secondly, the specialized doctors that would be required to help people struggling with mental illness are not always easily accessible. Depending on the situation, a mental illness patient can have a team of five or more doctors, and it can be very hard to meet consistently with each professional, as they are all essential to helping you recover. 

When you invest more money into an industry, you can create a greater abundance of institutions which will be able to facilitate the requirements of more specialists to work in a communal environment so they are more accessible to their patients. When more money is available, there is also more competition for the potential of a higher salary (and greater chance of getting a job), which improves the quality of work for those who specialize in mental health.

While there has been much progress in eliminating the stigma around mental illness, there is still much progress to be made in funding the mental illness sector of healthcare to a point where Canadian citizens can actively seek the required treatments with a better wait time. Treatment can be the difference between the life and death for a patient, but it might as well not be there if only three out of every four patients can’t access the treatment they need. We need to act to make therapy a viable solution to help those with mental illness, and we need to do it soon.

Author

Mental Illness — It Wasn't Always This Way
Shaan is a Grade 10 student at Upper Canada College and writes research-driven pieces as well opinion pieces on issues that affect us today.