Over 250 minds in Ontario’s health care system came together at the 2017 Medical Psychiatry Alliance (MPA) annual conference, “A Matter of Life” in Toronto on October 6 to discuss new approaches to care for patients with severe mental illness.
“Creating health care system change is central to the work of the MPA. We need to use our voice to support advocacy for people living with mental illness,” urged Dr. Catherine Zahn, President and CEO of the Centre for Addiction and Mental Health (CAMH), in her opening remarks. CAMH hosted this year’s MPA conference.
Dr. Zahn asked attendees to consider the impact of inadequate access to both mental health care and physical health care for people with severe mental illness such as bipolar disorder, schizophrenia, and severe depression. “These patients are dying younger than the average Canadian due to prejudice and discrimination – with less access, and poorly coordinated health care services. I encourage you to champion this cause in your professional circles, advocate for better integration and become a catalyst for change,” she said.
Zahn’s remarks were followed by a video which told the tragic story of one of her former patients, Sarah Campbell. Sarah was diagnosed with schizophrenia at 20 and passed away prematurely at the age of 45 due to a missed diagnosis of cancer. Sarah’s story is not unlike the 1.3 million Ontarians who are living with a physical and mental illness at the same time, struggling to access timely health care in a system that is traditionally not equipped to care for both, together.
The packed day, co-chaired by CAMH’s Athina Perivolaris and Dr. Latika Nirula, saw key presentations from three international plenary speakers, interactive workshop sessions, and an insightful panel discussion. Panelists included Drs. Adrienne Tan, Belinda Lennox, Suzanne Vogel-Scibilia, Tania Tajirian and Ms. Camilla Dalglish, who shared thoughts from her own family’s personal experience.
Dr. John Newcomer, Professor of Integrated Medical Science at Florida Atlantic University, highlighted the increased risk for cardiometabolic disease in patients with severe mental illness. His presentation pointed to high rates of preventable disease which are not being treated in major mental illness, and provided a road map to health care providers to begin regular monitoring of these conditions in their patients.
Dr. Suzanne Vogel-Scibilia, a psychiatrist and former President of the U.S. National Alliance on Mental Illness, shared her own personal journey as a patient living with bipolar disorder, as well as the stigmas and challenges that she faced within the health care system when she needed physical health care services. "It's the stigma that makes us sick," Dr. Vogel-Scibilia said. Her experiences highlighted gaps for patients navigating care.
Dr. Belinda Lennox, a consultant psychiatrist and professor at the University of Oxford, spoke about the importance of integrating physical and mental health care right at the start of a patient’s mental illness diagnosis, to improve outcomes. “Patients with severe mental illness in the U.K. have the same life expectancy as the average North Korean,” she pointed out. She described current projects that aim to improve these mortality rates in the U.K., which could be potentially adapted for the Ontario landscape.
The day wrapped up with closing remarks from Dr. Benoit Mulsant, MPA Executive Director and the Chair of the Department of Psychiatry at the University of Toronto. Dr. Mulsant emphasized what he had asked health care providers and policy makers to consider at the start of the day: “Imagine that your son is suddenly diagnosed with a severe mental illness. After several months of psychiatric treatment, he is finally stable. However, you know your son is going to gain 25 pounds on his medication; you know that he may develop diabetes, heart disease, or kidney failure. Eventually, he is likely to die 10 or 15 years younger sooner than his brother who does not have a severe mental illness.”
Dr. Mulsant concluded, “We have to change this. We have to work together to start designing a system so that we can prevent this from happening and ensure that he has a longer, healthier life.”