While substance abuse is on the rise, as are the number of mentally ill cases treated, society has been slower to become educated and enlightened about mental health advancements.
According to the August 2008 annual National Report Card on Health Care for the Canadian Medical Association, only 50 per cent of people would discuss a mentally ill family member with friends or co-workers, while 72 per cent would discuss a cancer diagnosis.
When a person suffers from both a mental illness or disorder and substance abuse problems, it’s a concurrent disorder, which leads to an increased number of challenges and obstacles for the sufferer.
Mental health and substance abuse have many connections and, concerning concurrent disorders, contribute to one another. “One might be creating the other,” said Pat McNulty, manager of Alberta Health addictions services in Red Deer.
Some people self-medicate to relieve symptoms of mental illnesses such as insomnia or anxiety. Substance abuse can also be a risk factor for mental illness; the substances or withdrawal can worsen psychiatric symptoms, such as depression or hallucinations.
The Canadian Mental Health Association, British Columbia division, says concurrent disorders, due to their cycles similar to substance abuse and mental illness, can often lead to poverty and homelessness. Because of the prevalent socio-economic situation and behavioral issues, people with concurrent disorders are more likely to come to the attention of police and other authorities.
Since it’s easier to spot substance abuse than mental illness, which can also be masked by substance abuse and mistaken for substance abuse, many sufferers of concurrent disorders are criminalized rather than treated, says the association’s article.
It’s been difficult for those with concurrent disorders to receive treatment because the disorder could be misdiagnosed as a single disorder due to the commonality of symptoms. Also, in some cases, mental illness treatment programs may reject someone with substance abuse problems and addiction treatments may refuse a mentally ill person.
There weren’t many specialized programs to deal with concurrent disorders; part of this behavior stems from the fact that treatments used to treat one half the disorder is in appropriate for the other half.
The British Columbia division says in some cases substance abusers needed a confrontational approach to their treatment, which could disturb a mentally ill person.
However, the model of treating the two sides of the disorder separately is no longer frequent. “I think that’s old, that idea is old. Years ago, in addiction it was the chicken before the egg,” said Carla Prediger, care manager with community addiction and mental health, central zone.
At one time there were debates about whether the mental health issues needed to be dealt with first or if it needed to be the other way around.
“You’re always treating both, no matter what, nothing is not discussed. You’re working simultaneously to deal with the issues that stem from both those problems. It’s by far the best way to treat mental health and addiction issues,” said Prediger.
Treatments can be performed by a single clinician trained in both mental health and addictions issues or by a mental health therapist and an addictions counsellor working together. Patients can also be met on an outpatient basis.
“Sometimes it’s important to give a patient intensive interventions, perhaps including detox and stabilizations,” said McNulty. “Sometimes it’s not necessary for that level of intervention.”
Prediger and McNulty say concurrent disorder treatment has improved since mental health and addiction assistance began working together. “I think mental health and addiction services are an integral part of every community. And I think what has probably been a challenge and is truly an asset for us now is the ability for us to work together,” said Prediger.
Also, treatments for concurrent disorders have become more personalized. “It’s very individualized. What any good clinician does is they try to meet the client, understand who the client is, what is the mix of their concerns, what is the mix of their strengths or assets and try to individualize their treatment,” said McNulty.
“I think it’s really based on where the person is at. We’ve got people coming in for many reasons, and with many different backgrounds and histories. So I don’t think there is any one specific modality,” Prediger added.
McNulty says for people just concerned about concurrent disorders there are plenty of people to talk to in Ponoka.
An addiction counsellor from Red Deer comes to Ponoka, to the Mental Health Centre, on Wednesdays.
The office is open Monday to Friday and offers a range of services, including a children’s mental health program, adult short-term therapy services, a seniors’ mental health nurse, and a community mental health assertive outreach program which is for the more persistent, severe mentally ill, said Prediger.
The Centennial Centre for Mental Health and Brain Injury also offers a concurrent disorder inpatient program staffed with mental health and addictions personnel.
“But frequently, for a centre like Ponoka or some of the other rural places, the resources that aren’t available locally the local professionals can help the client get connected,” said McNulty.
Ponoka has both the mental health and addictions office. Lacombe has a mental health office and is serviced by an addictions counsellor from Red Deer, as is Rimbey and Rocky Mountain House, who also have their own mental health offices. Wetaskiwin and Drayton Valley each have a mental health office and an addictions office.
Ponoka’s mental health office can be contacted at 403-783-7903. To make an appointment with a counsellor at the Red Deer addictions office contact 403-340-5274. And the phone number to the 24-hour Alberta Health Link is 1-877-303-2642.