'All roads lead to stigma,' says mental health expert

Officials from every province and territory are meeting in Yellowknife this week to discuss mental health and substance abuse in Canada.

The Mental Health Commission of Canada is gathering to learn about the unique mental health challenges in the North, said commission president Louise Bradley.

"You can't really understand the place and some of the issues without being there," she said.

The commission promotes national research and program development. Its Northern focus includes targeting children and youth, preventing the development of mental illness and addressing the social determinants of health – including the impact of colonization and residential schools in the region.

Bradley pointed to a proposed NWT plan to place councilors in schools as the kind of strategy the commission has supported in the past. School-based mental health is "critically important," she said.

The commission's research has gleaned insights on mental health and homelessness that are applicable to the North, she said. One such example, according to Bradley, is the stigma attached to housing someone with complex mental health needs in an apartment building alongside the general population.

That's just a part of changing cultural attitudes toward mental health and substance abuse, she said.

"We made a lot of progress (on stigma) over the past 10 years or so, but we still have a long way to go," she said, adding that while the level of stigma varies depending on culture or location, it's always present. For her, a key challenge is educating decision makers of the issue.

That's at least partly achievable through a dollars and cents analysis. A 2010 study from the Mental Health Commission of Canada found that mental health problems cost the economy $50 billion per year.

Without reducing stigma among leaders, there will be little change in policy or the allocation of funding, she said, adding that, "Stigma and discrimination is a problem everywhere."

Among developed countries, Canada spends the least amount of its health budget on mental health, said Bradley.

"I'm not saying the answer is just money ... it's the way it's invested," she said. "It's a matter of changing the system."

Mental health stigma worsens when its accompanied by substance abuse, she said.

This costs the system. A 2013 NWT hospitalization report found that on an annual average, the territory spent $7.5 million on in-hospital care of alcohol or drug-related issues of 429 patients between 2008-9 and 2010-11.

Another government report on the same period found that 68 per cent of mental health hospitalizations were related to substance abuse, amounting to 49 per cent of the costs to the system.

"All roads lead to stigma," Bradley said about tackling challenges to mental healthcare.