The Challenge

MPA doctors with patient

Approximately one million Canadians suffer from the unexplained health outcomes of many common physical illnesses. In many cases, treatment of these patients fails because our health care system is designed to focus on either physical or mental illness but not both at the same time. As a result, physical symptoms with a mental health origin, go unaddressed. Similarly, debilitating mental illnesses such as depression and anxiety continue indefinitely because they may in fact be the result of physical ailments. The lack of an integrated approach perpetuates the condition.

In these cases, patients and their families endure prolonged suffering accompanied often by a growing sense of despair as they see little or no improvement in their health. The severity of their symptoms, combined with the time and energy required to attend a series of medical appointments, can result in absenteeism or poor performance at work and school, permanently hampering career prospects and quality of life. As time goes on, their ongoing condition can exact a tremendous personal toll, and lead to trauma and addictionn issues.

The gap in services can be particularly acute for those between the ages of 16 and 24 who fall between paediatric and adult streams of care. A difficult time of life in the best of circumstances, research has shown that the stress of transition into adulthood often precipitates the first episodes of psychiatric illness or a re-occurrence of a pre-existing condition. These particularly vulnerable patients may drop out of treatment if it is not relevant to their needs, resulting in increased symptoms, repeated medical interventions and withdrawal from school, the workforce and the community — potentially for life.

Family physicians share patients’ frustration and, in the absence of a comprehensive diagnosis, they may over-investigate the physical symptoms. The resulting unnecessary diagnostic testing and recurrent use of family doctors and emergency department resources drive up health costs by as much as 45 per cent. Based on similar health care systems around the world, it is estimated that Ontario spends $2.75 billion on individuals with combined illness. Untold costs include the impact on economic productivity associated with the loss of employment and education opportunities. The disconnect between treatment of mental and physical health issues is deeply rooted within the framework of the health care system. Its resolution requires a coordinated approach across the entire continuum of health care.