Stigma: It is understood that one of the key goals of this new National group will be to combat stigma and discrimination. This issue is of particular importance to the CCSMH because seniors with mental health issues face what the CCSMH refers to as a double stigma or “ a double whammy” – the stigma of aging and the stigma associated with mental health. In order to address this problem, there is a need for increased public education, raising awareness and targeting anti-stigma and discrimination campaigns specific to seniors and mental health. Audiences need to include the general public, the media, healthcare practitioners, families and caregivers, administrators and policy makers.
Gaps in Information: Guidelines, Research and Knowledge Transfer A third major issue of concern is gaps in information. Until May 2006, Canada had no national, multidisciplinary guidelines pertaining to seniors’ mental health. With the support of funding from the Public Health Agency of Canada, the CCSMH brought together experts from across the country to develop first ever guidelines focused on depression, delirium, suicide and mental health issues in long term care homes. Approximately 11,500 hard copies have been sent to relevant stakeholders and approximately 10,000 copies of the guidelines have been downloaded from our website. A supplement of the guidelines in the Canadian Journal of Geriatrics was sent to 10,000 physicians.
Creation of these important clinical guidelines raised key issues:
1. There is a significant lack of evidence based research in Canada on seniors’ mental health.
2. There are tremendous disparities within and across provinces with regards to current provision of care. This is specific to the prevention, detection, screening, assessment, management, and monitoring of mental illnesses in seniors. 3. Mental health care must be approached from both a psychosocial and pharmacological perspective that includes the patient and family.
4. Access to mental health services and professionals across and within treatment sites, communities and provinces varies widely.
5. There is a serious need for training and education of health care practitioners on mental health and seniors
6. There is a lack of information for how to integrate guidelines into practice
Since the guidelines were launched, dozens of organizations, individuals provinces and various groups have begun to implement the guidelines. This requires leadership, time and evaluation. The coalition submitted a solicited request for proposal in January 2007 to the Public Health Agency of Canada, Population Health Fund to facilitate 7 large scale pilot projects to implement the guidelines. This request has yet to be approved.
Mental Health Services: Accessibility
Another key issue that must be raised is accessibility to mental health services. There are many compounding variables that should be further investigated to comprehend and respond to this issue including:
• Lack of mental health professionals
• Limitations in accessing community mental health services
• Limitations in accessing services that would assist in maintaining seniors in a healthy community or their own homes
• Lack of mental health services and programs available to seniors within long term care homes and acute care settings