There is a strong connection between addiction and mental health disorders and the two are often mutually sustaining. People with this dual diagnosis often have to contend with a lack of available resources, a slow-moving system, and isolation.
An Overstretched System
On March 3, 2020, the Ontario Health Minister announced an unprecedented 25-million-dollar investment to overhaul mental health and addiction services. In order to drastically reduce diagnostic wait times for mental health and addiction disorders, the Minister announced a plan for major changes and a much-needed systemic transformation. Earlier in 2020, Children’s Mental Health Ontario published a study showing that wait times for mental health services had more than doubled in two years and that 28,000 children and youth were waiting to access mental health services in the province. Although the investment was unanimously applauded by hospital and community organizations, it was not deemed sufficient to reduce waiting lists and, according to these organizations, would require a 380-million-dollar investment.
Québec has grappled with that same issue for many years. In 2020, the government promised an emergency 31-million-dollar investment in mental health services. Nevertheless, hospitals and mental health organizations had already been sounding the alarm for years. The legalization of cannabis in 2018 brought the debate into the public arena. Several experts worried about the impacts of cannabis use and concomitant mental health disorders on youth. Montreal psychiatrist Amal Abdel-Baki works on the early detection of psychosis in youth, especially those who live on the street. According to Dr. Abdel-Baki, early intervention can help prevent the further deterioration of this mental health condition. In a Radio-Canada interview, she stated that 50% of youth with mental health disorders who live on the street had left the youth protection system and found themselves without a home, income or mental health services. She added that 45% of the young people she treats in her CHUM program are addicted to cannabis. Asked about the state of the Québec health system, Dr. Abdel-Baki responded that it has the resources to treat mental health and addiction disorders, but access to these resources is extremely complex due to a lack of funding.
Access services for mental health and addiction are in a precarious state and investments are insufficient for an already weakened system. In the midst of this critical situation, there are women with dual-diagnosis mental health and addiction disorders who need help, but trying to access services can be like trying to run an obstacle course. These women have become a major concern for Portage.
Mental illness is a social taboo. Nonetheless, it is prevalent in contemporary society and takes many different forms. Disorders such as schizophrenia impact not only patients, but their loved ones, who often feel helpless and misunderstood. The mother of a former Portage resident evoked the isolation she felt, stating that ʺUnfortunately, mental health issues are taboo in our society and dependencies are not something we like to discuss. We can’t talk about it with just anyone and, if by chance we do find a good listener, genuine understanding is hard to come by and people are quick to judgeʺ.
ʺI couldn’t do anything anymore, anything but exist. When I was diagnosed with a schizoaffective disorder, I started taking medication but it had a lot of side effects. I fell into a depression and started using againʺ, recounts a graduate of Portage’s MICA program for women. There are many similar stories among the women in Portage’s program for mentally-ill chemical abusers (MICA). Located in downtown Montréal, the MICA centre started welcoming women in May 2018, providing services for a clientele without means, home or future. Many of the people who apply to the MICA program with a diagnosed mental disorder have been hospitalized repeatedly and take medication on an ongoing basis. But just like the young woman in the above testimonial, many stop taking their medication because of side effects and instead turn to drugs. Without any means of support, they gradually slip into the street and into homelessness. They live outside the system and become virtually invisible.
Extending a Helping Hand
In the mid-1990s, Portage became increasingly concerned by the growing number of mental disorders diagnosed among people struggling with addiction. This specific clientele required additional help and adapted services. Antonio Maturo, Director of the MICA program, explains: ʺIn 1995, Portage assessed the needs of a different clientele that could not be admitted into established programs. A clientele that had mental health disorders and required a specialized medical team to start the addiction rehabilitation process […] I have a lot of admiration for the clients of the MICA program. I have worked with them every day for 13 years and I see them struggle with the adversity brought on by mental health and addiction disorders. Several former residents have gone on to do great things, including three who now work as counsellorsʺ.
Programs such as the MICA program for women are scarce in Québec. Thanks to Employment and Development Canada’s Homelessness Partnering Strategy and to the help provided by the Portage Foundation through its generous private donors, there is reason to hope for women struggling with mental health and addiction disorders. The MICA program offers them a viable alternative to hospitalization and to homelessness. At the inauguration of the MICA women’s program more than a year ago, Peter A. Howlett, the President of Portage, expressed his joy at the new service offering: ʺPortage had been hoping to implement the program for several years. While there was already a men’s program, there was a pressing need for a women’s program and we are happy that donors rallied to support itʺ.
Now, in January 2021, the program is still full and requests for admissions show no signs of slowing. But funding to maintain the program is not following suit. There are as many people in need of help as ever, and the COVID-19 health crisis has further impacted a system that is already in dire straits.
For tips and tricks on how to take care of your mental health during these difficult times, check out our blog.
Bell Let’s Talk
Whether you take the time to listen to a loved one, or encourage a friend to ask for help, when it comes to mental health, now more than ever, every action counts. On Bell Let’s Talk Day, we all have the opportunity to make our voices heard. Join the conversation today, January 28.