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In my 4 years of medical school there were a total of 4 weeks explicitly focused on mental health. My residency training offered another 4-6 weeks. Outside of these "psychiatry rotations" there was little mention of mental health and substance use disorders during the rest of my training.
If you assume that your training should be preparing you for and reflective of what you will experience in practice I was left thinking that there would be relatively few patients needing my skills in mental health and that those who did would largely be taken care of by my psychiatry colleagues.
The reality when I entered practice was dramatically different. As a family doctor there is not a single clinic without a few patients from this population. Here in our own Emergency Department room almost every shift I worked had a significant percentage of patients presenting with mental health and substance dependency issues. I quickly realized there was no way that the great team of psychiatrists could possibly manage all these patients alone.
Naturally if we don't prepare people to manage and engage with mental health issues, we are setting the system up for a negative loop. Without adequate preparation, practitioners may avoid these cases when they enter practice, might be less likely to advocate for investments and they are less likely or able to teach the next generation how to best care for these patients and the problems repeats itself.
Interrupting this cycle requires that we bring it into the light, to better see the many small opportunities that can lead to a bigger impact. It is why Mental Health Week (May 6–12) is so important. It is a chance to have conversations we have avoided for too long. It is a chance to recognize the excellence that exists in our mental health system. It is also an opportunity to acknowledge the significant gaps that remain and to advocate for change. It is a chance to help break the cycle of ignoring and minimizing this critical issue.
As a health care organization we naturally and quickly turn to the needs of our patients. I would also like us to take time during this week to think about our own mental health and struggles with substance use disorder. I have written often about the growing recognition of the crisis in the health professions…and I think we likely under report. While we are skilled at taking care of others, we forget that we too can be vulnerable, can struggle and be susceptible to health issues. We go above and beyond for patients but may not think of offering ourselves the same care and compassion.
I am very proud that we take the time to actively participate in Mental Health Week as a time to care for our patients and ourselves. I am hoping it is a time when we not only raise awareness and engage in discussion but think about solutions.Joshua
President and CEO
May 9, 2019