Thursday, May 3, 2018

The threat of untreated mental illness

It became obvious very quickly when a rental van deliberately ploughed into crowds of Toronto pedestrians that this was not a terrorist attack. Terrorists do not jump in front of armed police and beg them to shoot them in the head.

Television media was wetting itself hoping it was a terrorist incident. Terrorism makes for sensational television. Politicians and others interviewed seemed similarly inclined, emphasizing the word ‘attack.’

In fact, this was yet another incident of a mentally ill person who snapped, producing a tragedy of unthinkable proportions.

Terrorism gets more prominence than deadly acts by persons who are mentally ill. The attitude is that terrorists are an inherent evil to be exterminated while the mentally sick are aberrations best left to health care professionals to deal with.

No one is immune from terrorist acts these days, but at least we are reasonably well protected by national security and law enforcement services. More attention needs to be directed at how society can better protect itself from what many see as a growing epidemic of untreated mental illness.

Mental health problems are a public health concern around the world. The Global Burden of Disease study found that in 2016 there were 1.1 billion people suffering mental health and substance abuse disorders. Also, major depressive disorders ranked in the top 10 causes of illnesses in all but four countries worldwide.

Some epidemiologists say that at any given time up to 25 per cent of  our population suffers from a mental health problem serious enough to impair normal functioning.

Our federal government says that one in three Canadians experiences a mental health problem or substance abuse disorder in their lifetime. Plus, only 57 per cent of adults and 43 per cent of youth report a high capacity to deal with day to day demands and difficulties.

The mental health industry goes to great lengths to promote the message that the mentally ill are no more violent than anyone else. This might be true but it is a message designed to prevent the stigma of mental illness, which in itself is a worthy goal. There should be no stigma attached to mental disease.

In trying to eliminate the stigma, however, the message ignores the fact that untreated mentally ill people are potentially dangerous and a threat to society. Emphasis on untreated.

The World Health Organization (WHO) estimates that in developed countries 35 to 50 per cent of people with severe mental health issues do not receive treatment. The figure is 76 to 85 per cent in developing countries.

The result is that we see more violence by mentally ill people not treated or who have ignored the treatments or medications prescribed for them.

The man who shot and killed six people at a Quebec City mosque in 2017 was not taking his anti-depressants as prescribed by his doctors. The man who shot and killed three RCMP officers in Moncton in 2014 had a history of drug problems.

The guy who drove a van into a crowd in Muenster, Germany last month had mental problems that were not being treated. Similarly the driver of a car that ploughed into Christmas shoppers in Melbourne, Australia last year had a history of mental problems and drug abuse.

A doctor for the gunman who killed 58 in Las Vegas last year believed his patient had a bipolar disorder and refused to take a prescription for anti-depressants.

The growing number of these incidents surely tell us that our society needs new thinking and new approaches to untreated mental illnesses. Finding ways of getting the homeless off the streets and into decent housing where they can get treatment is one example of attacking the root causes of the mental illness crisis.

The root causes are many. Poverty, racism, global human displacements, changing economies and wildly widening inequality are among the issues creating more anxiety and more depression. Not to mention a noticeable rise in intolerance for other peoples’ customs and views.

Yes, terrorism is a threat and society needs to keep up its guard to protect against it. But untreated mental illness also is a serious threat to us all and it needs more attention, more new thinking and more resources.


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