By Marvin Ross
In mid October, Bridgeross author Susan Inman (After Her Brain Broke), did a piece in Huffington Post about standards for mental health services in Canada being developed by an organization in Ottawa called Health Services Organization (HSO). Susan pointed out that “HSO minimizes the impact of severe illnesses and then fails to suggest needed services. It’s important to note that the committee creating these standards did not include any psychiatrists”
In the Tyee, Susan pointed out that with these new standards, those with severe mental illness will wind up getting even worse care than they do now. I agree with Susan on the absolute stupidity of developing guidelines on an illness while not consulting doctors who treat people with those illnesses. That’s like developing standards of care for those who have heart attacks and neglecting to include cardiologists in the development.
Their draft standards were open for consultation till the end of October and I gather they are still considering the comments that they received.
My blogging partner, Dr David Laing Dawson, summed up the gist of their standards into one sentence:
“We should all treat each other nicely and kindly and use as many euphemisms as possible.”
One of my readers complained to them as well about the lack of psychiatric input and was asked if she could recommend a shrink. My only reaction to that is to quote Little Richard and “good golly miss molly”. This is an organization “formed in February 2017, to unleash the power and potential of people around the world who share our passion for achieving quality health services for all. We are a registered non-profit headquartered in Ottawa, Canada.”
Are they not capable of finding psychiatrists?
The Canadian Psychiatric Association (CPA and also in Ottawa) is only 4 miles away from them in the same city. A short cab ride (Uber if you prefer) or they could meet in the middle. But then, when the CPA found out about what they were doing, they sent them a letter. On October 26, the president of the CPA told them that “I am writing today to express the CPA’s concerns about the proposed standard, and in particular, about the composition of the advisory committee, which did not include any psychiatrists.” You can read the full letter here.
On November 3, psychiatrist Nachiketa Sinha wrote a blog on the CPA site suggesting that the disregard for experts in mental health is a symptom of the stigma that mental illness faces. Dr Sinha added “How can I possibly trust that the care I am receiving is appropriate for my illness if the policy and programs have been created by laypeople, administrators, and NO EXPERTS on my mental illness and the care I need?”
And while I used the example of heart disease standards needing cardiologists to develop them, Dr Sinha wondered if anyone would trust a bridge built by people with no engineers involved.
On twitter, HSO commented to Dr Sinha that they are “trying identify a psychiatrist to join this committee.” Again, “good golly” how hard can it be to find experts to work on this? And I should point out that the CPA along with similar organizations in other countries, does produce clinical practice guidelines that detail how various diseases should be best treated based on all of the current evidence. CPA has guidelines on the treatment of anxiety disorders, depressive disorders and schizophrenia. And, of course, so does the American Psychiatric Association. And we should not forget all of the reports (over the course of 11 years) developed by the Mental Health Commission of Canada.
Do we really need someone else to reinvent the wheel at considerable cost? The money wasted could be well spent on funding more beds which are desperately needed.