Consultations on Mental-Health and the Pandemic: What did we learn; what must we do now?
We are not all equal in the face of this crisis.
Open letter from David Birnbaum
This stark and succinct observation was at the heart of consultations on the mental health of Quebecers during this pandemic, held over two days earlier this week. France Labelle, a long-standing expert and community activist, invoked these words in describing the isolation, danger, distress…the Hell being lived by the homeless in Montreal and across Quebec.
Each one of us, in our own way, is dealing with the stress and uncertainty unleashed by this pandemic. We learned, nonetheless, from the dramatic and documented presentations to these public consultations that its impact is singularly unequal – it is doubly difficult for seniors who are alone, teenagers trapped too long in front of their computer screens, women disproportionately challenged by balancing family and work responsibilities, the homeless and those already afflicted with problems of depression, anxiety, consumption or behavior. Women, men and their children who face these challenges, and who live in sparsely populated regions are surely not equal in the face of this crisis, either.
What did we learn during the consultations? What must we do now?
First, we learned that we must talk more, and publicly about mental health. I, and the Quebec Liberal Party, have been calling on the CAQ government for six months to hold this crucially important discussion. We commend Junior Minister Responsible for Health and Social Services Lionel Carmant for ultimately acting on our recommendation. Together with the government and the other opposition parties, we helped develop and preside over the sessions.
The impact of the pandemic on the psychological well-being of Quebecers is real: the feelings of distress and loss of control are well-documented by research, by increased calls to crisis centres, prescriptions filed for anti-depressants, by statistics on climbing divorce rates and school drop-out numbers.
Experts agree that the initial reservoir of resilience that might have protected Quebecers last spring is now largely spent. Prof. Catherine Brian of the Institut Universitaire en Santé Mentale de Montréal, explained to us that the European experience should serve as a necessary warning that the heightened risk of mental-health crises of last spring is sure to translate with increasing intensity into confirmed diagnoses this winter. Women and young people, particularly those already vulnerable before the pandemic, and the people who are charged with helping them, will be the first to live the consequences.
But the portrait needn’t be all black, even if this winter will be grey. There exists a path to active prevention in mental health, with proven tools; it is the crucial moment to deploy them. It is not too late to anticipate the psychological consequences of this crisis and to invest wisely in surmounting them. Above all, it is essential that we improve access to services and remove the roadblocks to that access.
Identifying those at risk, rigorously evaluating needs, delivering therapeutic intervention and sustaining recovery are the four key steps we must implement and follow. The danger that stalks us is limiting additional investment to the two first steps, and neglecting the other two. This current CAQ government tendency will only lengthen delays in treating vulnerable individuals for months, even years. To invite people to ask for help, only for them to be met with closed doors will unleash further problems and further social division.
That is why our Official Opposition has tabled a formal proposition, complete with an ambitious cost plan, for the delivery of psychotherapy to all who need it, within reasonable delays and without financial barriers. The Premier is right to say that one cannot train a nurse in six months. But one in two psychologists in Canada works in Quebec. There is no shortage, but there is a two-tiered and inequitable system. That must stop, and promptly. The urgent need for intervention demands no less.
Finally, these two days of consultation will have taught us that the urgent and responsible answers to this crisis in mental health must be guided by accelerated and duly funded research, intensified support for grassroots community intervention, expert and compassionate accompaniment of our young people, our seniors and our neighbours in distress. Let our actions be dedicated determined and rigourous to reduce inequalities in the face of this crisis.
David Birnbaum is a Liberal MNA and the Official Opposition Critic for Mental Health.