Since its inception over seventy years ago, the Canadian Mental Health Association has been a unique advocate for the chronically mentally ill. During the past decade, CMHA has expanded its mandate from promoting service delivery to active support of self-help initiatives and the community resource base. The protection of individual rights in therapeutic programs and in the community has become a major focus.
A number of studies on women’s health have demonstrated strong links between health status and socioeconomic factors affecting women. Limited participation in public life, restricted decision-making, devalued role expectations, poverty, violence and sexual abuse encumber the potential for mental well-being. Social and economic stresses, coupled with the inequitable burdens imposed by role expectations, often have a negative impact on women’s health, happiness and potential for personal fulfillment and achievement.
Social inequality has damaging consequences for the mental and emotional well-being of women. Throughout their lives, women may be considered “at risk” of developing emotional problems due to a host of social factors. Limited participation in public life, restricted decision-making, devalued role expectations, poverty, violence and sexual abuse undermine the potential for emotional well-being. Social change is needed to strengthen the emotional well-being of women individually and collectively in society.
The Canadian Mental Health Association believes that social inequality has damaging consequences for women’s mental well-being. Inequalities continue to exist for Canadian women with respect to family life, education, training, employment, and decision-making roles in society. Although a small proportion of women are benefiting from policies designed to increase access to professional occupations that command higher incomes, the vast majority of women remain in low-status, low-income jobs. So far, efforts toward implementing employment and pay equity policies have had little impact. Women continue to be over represented among the economically disadvantaged.
Access to mental health services is an issue that significantly impacts all Canadians, whether living with a mental illness or not. When the First Ministers convened this past February to discuss the long-term future of health care in Canada, improving access and quality of community mental health services was identified as one of eight priority areas. We believe the federal government has a critical role to play in facilitating federal/provincial/ territorial partnerships to begin to address many of the access barriers facing Canadians today.
The Canadian Mental Health Association (CMHA), Ontario has prepared this review to offer insights into strategies and action plans of other jurisdictions’ activities in mental health reform. The similarities in core elements reflect the growing recognition of factors that influence mental health and support the journey of recovery. The differences in implementation reflect the variations that arise from local context. Nonetheless, the degree of consensus in the need and direction of reform is illuminating.
Mental health promotion is not a new concept, but it is still not well understood. Nevertheless, research is showing that mental health promotion initiatives can have concrete, positive outcomes for the entire population. It is a powerful resource with significant potential for grounding the work of the Mental Health Commission of Canada.
Mental illness can affect anybody, regardless of age, gender, culture, ethnicity, or social class. But no matter who they are, people who have been diagnosed with a mental illness are all likely to experience stigma. Public attitudes and beliefs, often based on fear and misunderstanding, stereotype individuals with mental illness, exposing them to prejudice and discrimination. Stigma infects every issue surrounding mental illness, often with worse consequences than the illness itself. In 2001, the World Health Organization declared stigma to be the “single most important barrier to overcome in the community.”
If waiting for health service in general is difficult, waiting for psychiatric service is especially trying. For most of us, the worry of “losing your mind” is the greatest fear of all. Receiving a timely consultation and the knowledge that help is on the way are an enormous boon. It is equivalent to the relief experienced when treatment finally begins for any other serious health condition. For this reason, the Canadian Psychiatric Association (CPA) has identified appropriate clinical benchmarks for what the waiting time for psychiatric care should be. If clinicians do not establish appropriate targets themselves, then no service can be evaluated against good clinical criteria.
A Framework for Support is CMHA’s central policy regarding people with mental illness. This third edition retained the integrity of the model and is now positioned within the current context of population health, health promotion, and recovery. A Framework for Support, Third Edition, offers the best of something old and something new; and while the Framework has grown and changed over time, its original core principles continue to be as vibrant and relevant as ever.