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Out of the Shadows At Last reflects a thorough and comprehensive review of the consultation conducted from coast to coast to coast and provides recommendations on how the issues should be addressed: prevention and promotion, integration, evidence-based systems, and much more.
The report addresses not only issues relating to mental illness; it emphasizes mental health by discussing prevention and promotion. For children and youth, the Senate Standing Committee stresses the importance of reaching them early through the school system. Promoting dialogue about both mental health and illness at an early age is key to building a generation where stigma no longer jeopardizes the lives and well-being of those in need of support and/or treatment. The consultations confirmed that the impact of stigma is significant. It is therefore key that it be addressed now.
The report looks at the systems responding to mental illness. Not surprisingly, our society’s response is found lacking. There is an important recognition of the need to integrate the mental health sector and significantly enhance its funding. The community and medical / institutional approaches must be seamless in order to better serve the interests of children, youth, families and caregivers. There is diversity among consumers, but the way individuals access services is not based on needs. Not only is the mental health sector in need of integration, the report acknowledges the importance of bringing all related sectors, such as child and youth welfare, health, youth justice and education, into the solution. It particularly addresses the needs of transitional youth moving to the adult sector. A smoother process will better address the needs of young adults as they take this step.
Part of the proposed solution lies in building on evidence-based approaches. This is linked to creative approaches to research and to exploring alternative treatments. The cultural and geographic diversity of consumers further represent challenges. The report recommends that more opportunities for the development of new technologies such as tele-psychiatry need to be explored in order to ensure that the needs of children, youth and families are adequately met.
These issues are explored in more detail in the chapter dedicated to child and youth mental health. They are also included throughout the discussions and recommendations of the full report.
The Provincial Centre of Excellence for Child and Youth Mental Health at CHEO strongly supports the Senate Standing Committee’s initiative and process in developing this report. For the most part we are very pleased that this process was undertaken and that child and youth mental health has been provided a dedicated place in the report. There are a number of challenges and opportunities, however, that continue to need addressing.
Specifically, a holistic human resources plan needs to be developed. Such a plan would have a national-provincial agreement for a long-term approach, which includes the needs of the child and youth mental health and related sectors. It would further include provisions for human resource planning at the training, recruitment and retention levels throughout the system.
Given that child and youth mental health is inadequately funded, even in relation to the adult sector, we believe a clear funding mechanism within the broader envelope is necessary. We need to establish more clarity in order to feel confident that children and youth are not pushed back once again to being the ‘orphan of the orphan’.
Linked to resource planning at the human and financial levels is the decision-making process around child and youth mental health issues. While we are pleased to see that the Commission will include a representative from our sector, we continue to be concerned that the voices of children, youth and families must be heard and respected.
It is essential that child and youth mental health and illness issues be kept at the forefront throughout this process. Without early intervention, we run the risk of perpetuating a system that is always trying to catch up to the needs of children and youth who suffer needlessly and who invariably grow up to access the adult system.
The Senate Standing Committee has brought to light that we must think of both mental health and mental illness. This is a bold move that is ultimately good for Canada as a whole. We look forward to collaboratively building the structures to sustain a broad and integrated mental health and illness national strategy where the needs of children and youth are also given the consideration they are due.
Before Out of the Shadows At Last the Senate Standing Committee submitted an interim report A Proposal to Establish A Canadian Mental Health Commission in October 2005.
The plan is still to have the Commission in place over the next several months. It will be set up as arms-length from the government and as a not-for-profit corporation.
Its mission is:
The Commission will be staffed by 25-30 people led by an executive director. The composition of the Board of the Commission has been updated since the initial report. A representative for child and youth mental health has been added as well as a representative for aboriginal issues.
Senator Michael J. L. Kirby
Senator Kirby, a member of the Senate of Canada since 1984, is Chair of the Senate Standing Committee on Social Affairs, Science and Technology. In 2002 the Committee published six reports on health care, culminating with Recommendations for Reform. The Kirby name has become synonymous with these reports.
Senator Kirby and the Senate Standing Committee continued their work through an extensive consultation and review of the country’s mental health system. Last fall, he tabled a proposal recommending that a Canadian Mental Health Commission be established. The Commission would act as a national body to promote mental health and the rights of those with mental illness.
Senator Kirby is also chair of the Advisory Council of the Provincial Centre of Excellence for Child and Youth Mental Health at CHEO. He brings with him a wealth of prestigious academic, business and government experience. He sits on the boards of directors of a number of public companies, has taught in the academic sector, was involved in both provincial and federal politics and been a successful businessman and senior bureaucrat.
He holds a Ph.D. in Applied Mathematics from Northwestern University and an honorary Doctor of Laws degree from Dalhousie University.