For some time now, the CMHA has struggled with the issue of community committal or compulsory community treatment. Proposed as an alternative or a supplement to involuntary hospitalization, community committal has strong support from family groups and the psychiatric profession. Many consumer groups are as strongly opposed. Views on community committal are influenced by personal experiences. Family members see their loved ones rejecting treatment and support, especially medication, and are naturally distressed by the suffering which is the usual result. Many consumers, on the other hand, have had very negative experiences with involuntary treatment. Ironically, both consumers and family members have experienced great frustration with obtaining adequate services, including hospitalization, on a voluntary basis.
The Canadian Mental Health Association recognizes that sexual exploitation and abuse by mental health service providers takes place. The Association also recognizes that without fail such exploitation and abuse are harmful to mental health consumers. Evidence has come from anecdotal reports, complaints to professional associations, and more recently from surveys of the general public and professional groups.
In 1993 CMHA conducted a cross-Canada study of violence towards people with mental health problems. The study focused on people who had experienced violence after becoming consumers of mental health services. It identified that the homes, public places and hospitals are the places where violence is most often experienced by people with mental health problems, and that family members, mental health service consumers and service providers are those most likely to be violent towards them.
Since its inception over seventy years ago, the Canadian Mental Health Association has been a unique advocate for the chronically mentally ill. During the past decade, CMHA has expanded its mandate from promoting service delivery to active support of self-help initiatives and the community resource base. The protection of individual rights in therapeutic programs and in the community has become a major focus.
A number of studies on women’s health have demonstrated strong links between health status and socioeconomic factors affecting women. Limited participation in public life, restricted decision-making, devalued role expectations, poverty, violence and sexual abuse encumber the potential for mental well-being. Social and economic stresses, coupled with the inequitable burdens imposed by role expectations, often have a negative impact on women’s health, happiness and potential for personal fulfillment and achievement.
Social inequality has damaging consequences for the mental and emotional well-being of women. Throughout their lives, women may be considered “at risk” of developing emotional problems due to a host of social factors. Limited participation in public life, restricted decision-making, devalued role expectations, poverty, violence and sexual abuse undermine the potential for emotional well-being. Social change is needed to strengthen the emotional well-being of women individually and collectively in society.
The Canadian Mental Health Association believes that social inequality has damaging consequences for women’s mental well-being. Inequalities continue to exist for Canadian women with respect to family life, education, training, employment, and decision-making roles in society. Although a small proportion of women are benefiting from policies designed to increase access to professional occupations that command higher incomes, the vast majority of women remain in low-status, low-income jobs. So far, efforts toward implementing employment and pay equity policies have had little impact. Women continue to be over represented among the economically disadvantaged.
Project IN4M is a three-phase research project, jointly funded by Health Canada and the Mental Health Commission. It’s overall goal is to improve the accessibility of high-quality mental-health services “through needs-based predictive modelling of health, social, education, criminal justice and private sector human resources – including informal caregivers.” Phase One, the subject of this report, examines possibilities for predictive modelling based on needs-based planning experiences in Canada and around the world.
Overall, Phase One of Project IN4M confirms that the potential exists to put in place a reliable, needs-based predictive model built around incidence and prevalence of mental health disorders and leading practices here in Canada and imported from other countries such as Australia. While the project confirms that mental health is, for the most part, a “data-free zone”, models exist for estimating the prevalence and incidence of some of the key mental health diagnoses and for better estimating the effective supply of the broader range of health and social service providers. We can also draw upon the lessons learned from the case studies conducted to refine our models around optimal mix of inputs to maximize health outcomes.