Discovery and hope

By Dr. Catherine Zahn

A 2015 report commissioned by Canada’s Minister of Science about the health of Canada’s research ecosystem painted a troubling picture. The report found that investments in fundamental science in Canada have stagnated in recent years resulting in an erosion of our research competitiveness.

Canadians – including patients and providers – should pay attention to this warning as it has important consequences for the success of our health care system. While there are pressing and urgent care capacity issues in all areas of health care, our governments must have the vision and will to invest in both research and innovative care.

Nowhere is this more critical than in the area of mental health. The current state of access to mental health care in our country illustrates the consequences of overlooking research and innovation. In 2018, we have only a nascent understanding of the complex genetic, biological and social causes of many brain disorders, including mental illness. Mental disorders remain mysterious and frightening to us – fertile ground for the prejudice and discrimination experienced by our patients, siblings, children, friends and colleagues.

While there’s been a recent surge of interest in brain science, and solid investments and partnerships that have led to real progress over the past decade, mental health research is still behind research into non psychiatric disorders.  As a result, people suffering from life-threatening mental illnesses do not have the same prevention and treatment options that are available for many non-psychiatric conditions.

Research is not an economic drain, it’s an economic driver, with a substantial return on investment. Research also pays in the form of tangible clinical improvements. For example, at CAMH’s Temerty Centre for Therapeutic Brain Intervention, investigators have modified and evaluated a treatment – magnetic brain stimulation – for use in depression. For those whose symptoms don’t respond to medication and psychotherapy and the many others who abandon treatment because of side effects, this is a game changer. It’s the first new treatment for depression in decades. Research, innovation and product development are an investment in people, in populations and in the economy. They promote recovery and alleviate suffering.

Recently CAMH was entrusted with a historic $100 million donation from an anonymous donor in support of our clinical research enterprise. While the gift will spur research and innovation, it’s not the end of the story.  There remains an unconscionable gap in access to mental health care and supports in our country.  Wait times for services exceed standards and evidence informed treatments like structured psychotherapy are not covered by most provincial public insurance plans. Dedicated funding for mental health care falls well below a proportion that mirrors the societal burden of mental illness in Canada. Our country spends approximately seven per cent of our health care dollars on mental illness, behind other OECD countries that spend 10 to 13 per cent.

These are issues of equity and justice.

CAMH joins our partners across the mental health care sector to demand that governments of all stripes and at all levels, close the access to care gap by investing in both care and innovation as we work to advance our understanding of basic disease mechanisms in mental illness, and create new ways to prevent, treat and cure mental disorders.

As a physician, my duty of care is to individual patients. Those of us with leadership roles in our health care system have an additional duty of care – to patients of the future and to patients globally. We discharge the first by being excellent clinicians. We discharge the second by being good citizens, by advocating for justice and using our influence to drive positive social change through investment that enables discovery and innovation to Transform Lives.

Dr. Catherine Zahn is the President and CEO of the Centre for Addiction and Mental Health.