Helping young people between the ages of 16 and 30 afflicted with the recent onset of depression and anxiety is the major focus of both the clinical practice and clinical research of Dr. Elizabeth Osuch, the London Health Sciences Centre psychiatrist who created the First Episode Mood and Anxiety Program (FEMAP) to help young patients get back on track. This innovative new program is the first of its kind in Canada.
“The overall goal of FEMAP is to create mental health-care services that currently do not exist, for a population where the stakes are extremely high, to get youth back to optimal functioning while ensuring that they live as symptom free as possible,” Dr. Osuch says. “One of the most satisfying aspects of my work with this age group is that they generally respond well to treatment. And if the patient and I can do a good job working together, even if not all of their symptoms go away forever, it’s going to help them for the rest of their lives and it will be a lot easier for patients to get psychiatric care in the future because they will have a positive, rather than a stigmatized impression about the mental health care process,” she adds. “As a result, FEMAP will allow us to create lifelong improvements for the health and wellness of our patients based on these initial positive experiences.”
Although FEMAP is still operating as a small, fledgling project, if you ask Dr. Osuch about the patients she sees she can relay dozens of success stories about how many people have been helped over the past two years. The program is based upon the premise that mental illnesses will be more efficiently and cost-effectively handled through early identification and effective treatment, before things become so bad for patients that their symptoms irreparably disrupt their lives or they need hospitalization. “It’s extremely satisfying when a young person goes from being so distressed and unable to function to completely back to wellness with appropriate diagnosis and treatment,” she says. “This reminds us how important this work is and how much it needs to continue and expand.”
Dr. Osuch’s strategy is to diagnose and treat young people early enough so they can lead fulfilling, productive lives. This approach translates into significant cost savings for the mental health-care system because fewer patients will require emergency room visits, inpatient services, and disability benefits caused by mental health problems that started out mild to moderate but became severe* due to lack of treatment. “If we treat young people early for the most common psychiatric conditions, those being mood, anxiety, and substance abuse disorders, we can prevent them from developing chronic psychiatric conditions, which come at a huge cost to the Canadian health-care and social service systems.”
She says that while one per cent of the population has schizophrenia, between 20 and 35 per cent are afflicted with depression, anxiety, and/or substance use disorders that can usually be treated into full remission if they are detected early. And currently, there is no place to obtain mental health services for the vast majority of young people dealing with such mental health conditions. “There is a built-in gap across Canada for 16 to 18 year-olds because they are at the tail end of children’s services, and services provided by long-term care are aimed at a much older population,” she says. “And 18 to 20 year-olds put into adult inpatient or ambulatory services don’t get what they need because the needs of youth are different from those of older adults.”
This lack of service is the area Dr. Osuch is targeting. Dr. Osuch’s broad vision is to grow FEMAP into a comprehensive program with an interdisciplinary team focused on reaching out to this vulnerable segment of the population. The program has already made tremendous strides with London Health Sciences Foundation donations, and the limited funding provided by London Health Sciences Centre and the Schulich School of Medicine and Dentistry at the University of Western Ontario. But Dr. Osuch says that some of the current support won’t last much longer and overall resources are insufficient given the needs in the London region.
*Mild to moderate mental illnesses are in contrast to “severe” mental illnesses. People with mild to moderate mental illnesses are expected to return to baseline levels of functioning with treatment, while those with severe mental illnesses are not. Untreated or inadequately treated mild to moderate illness can become chronic and interfere with occupational and social functioning.