Mental Health Systems for Non-professionals

Mental Health Systems for the Non-Professional 

OUTLINE

The Title 

I. Introduction

1. Language

2.. Background and qualifications

    i. Experience:

    ii. Training and work:

3. Scope

II. Prevention

A. Primary prevention

B. Secondary prevention

Treatment

A. Emergency

B. Community

C. Institutional 

1. Hospitals

2. Long-term institutions 

Para-and post treatment

A. group homes 

B. support groups

C. Self-help groups

Prisons

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The Title

Most of us agree, when it comes to the crunch, nothing is more important than our health. In our contemporary, increasingly rushed, stressed and divided world, mental health is perhaps by now the largest component of health that concerns us all. The toll that poor mental health takes on our families, our communities, not to mention our emotional suffering and the economic costs, is truly staggering. Given all of that, I intended this for those having difficulty understanding and navigating these systems, hence the given title. Also, there is no one system. There are many, according to the type of care or treatment offered, or the geographical area in which one finds one self, to name but a couple of variables in which systems can be found.

I. Introduction

1. Language

Some words about language would also be in order. To begin with, what follows is not about differentiating between mental health and mental illness. Nor will there be explanations of the different types of mental illness and their treatments. There are many resources available to answer questions about those subjects. However, I think one of the weaknesses in this whole area is obtaining the care necessary, which means, in a sense getting into ‘the system.’ This is what presents the first hurdle to good mental health when it has been adversely affected, and also one of the most notoriously difficult to get across. My purpose is to try to shed some helpful light on that for those who are looking for help for themselves or those near and dear to them.

Also,  when I first entered this field, individuals in care of any type were referred to as patients. Now, with increased focus on collaboration of care between individuals with autonomy, their families and caregivers, the term client is preferred by many. Along with that, has come the shift to speak not of outpatient care but as individuals in community care. Similarly, the tendency is to speak more of hospital care versus inpatient, or certainly the more foreboding, for many, institutional care.

2.. Background and qualifications

i. Experience:

Let me put forward first of all what I would consider my qualifications for writing in this area. I am fortunate in that we have not really had significant mental health troubles in our own family or my family of origin, other than the woman who became my stepmother when I was already a young adult, now suffers from dementia. Therefore, I cannot claim to speak from the authority as someone who has, as the expression now goes, much ‘lived experience.’ However, I have certainly faced mental health issues in my extended family.

ii. Training and work:

On the other hand, I have worked in the healthcare field for over 50 years. The first few years of that were as a frontline worker, a nursing orderly in hospital care. Then, I served a rural community, followed by a small city, for 12 years as a family physician. During the 4.5 years I spent in that city, I also worked in one of the long term mental health care facilities that were spread across our country. This was done even though I was a family physician, because of the shortage of psychiatrists in all but the larger centers. As such, I work in a variety of words, including tending to admissions, and oversaw the transfer of care, in the case of an older adult unit on which I was the primary care physician, to a brand new long term care facility. Here, I stayed on as the Medical Director/attending physician for a couple of years. This was during the 1980s when the old long-term mental health care institutions were being emptied out across the country. Then I added to that 21 years as a psychiatrist. In that capacity I worked in community (outpatient) care, special school classrooms and programs for mentally disturbed students, and both institutional (inpatient) and emergency care.

3. Scope 

It needs to be mentioned here as well that this is being written by one whose primary knowledge of the field is based on what we have in Canada. Even within that, it relates to what has existed during my lifetime. Furthermore, although I have some knowledge of systems across the country, and there are similarities, the experience I speak from is mainly in the places where I have worked, namely Manitoba, both rural and urban, and British Columbia, suburban/urban.