Canada - ENMental health is still a major problem in Canada, but there are two bright recent developments. The Canadian people have almost ceased to look upon mental disease as something to be ashamed of and to cover up, and the Canadian governments are expanding provision for treating mental diseases adequately.
There is no stigma attached to mental ill-health. Patients are sick people. The idea that they are weak characters who could get over their disability if they would only pull themselves together is on its way out. The superstition that they are possessed by demons is being killed by education. Mental illness is no more disgraceful to the sufferer or his family than a broken leg.
It is no wonder that there should be diseases of the mind as well as of the body. The human brain is the most complicated structural apparatus known to science. A great neurologist says: “If all the equipment of the telegraph, telephone and radio of the North American Continent could be squeezed into a half-gallon cup, it would be less intricate than the three pints of brains that fills your skull and mine.”
What are the signs of mental health? Not merely the absence of disease, but deeply-felt happiness. Mental health is the adjustment of human beings to the world and to one another with a maximum of effectiveness. It means having the ability to maintain an even temper, an alert intelligence, an acceptable social behaviour, and a happy disposition.
The mentally healthy person knows himself, accepts himself and is himself. A leaflet on the subject says people who are mentally healthy feel comfortable about themselves, feel right about other people, and are able to meet the demands of life.
Conditions in Canada
When we test ourselves by these standards we learn the great distance to be travelled before all Canadians will be mentally healthy. Mental illness fills half of all hospital beds. One person in every ten suffers from some form of serious emotional disturbance during his lifetime, and one in every twenty is for a while a patient in a mental hospital or receives psychiatric care. Thirty per cent of us fail to achieve all we could of robust mental health because of emotional instabilities. The rest of us can benefit by preventive measures.
In 17 years the number of patients in Canadian mental hospitals increased 65 per cent, and now there are more than 50,000. All of this does not represent a real increase in the extent of mental illness, because increase in population, growing reliance of our people on mental hospital care, and the ageing of our people must be taken into account.
A year ago we were spending at the rate of $34 million a year to provide care and treatment, and in addition the country lost $500 million in wages and productivity.
In helping to restore people to mental health, the mental hospital still holds the position of chief importance. Recognizing this, the Federal Government announced health grants four years ago which included provision for an extensive programme of mental health research, treatment and prevention.
Because responsibility for the health of citizens rests primarily with the provinces, the Federal Government grant is being advanced to them for use as they present their plans. Up to January this year there had been 8,019 mental hospital beds constructed under the plan, representing 30 per cent of the estimated requirement.
Though the mental hospital is the biggest factor in curing the mentally ill, it is not usually the first to get into touch with the patient. The mental health service in a community commonly begins with the mental health clinic, which is a team of professional specialists in three fields of knowledge: psychiatry, psychology, and psychiatric social work.
The work of these clinics, expanded under the government grant, should lessen the number of patients requiring further care in hospitals. The clinics, as well as being important preventive agencies, provide the best means of treating many people who need specialized attention but not hospital care.
In the forefront of effort in Canada to promote mental health is the Canadian Mental Health Association, which has been operating since 1918. Canada was the second country in the world to establish a national voluntary agency to promote mental health progress.
The committee was responsible for establishing two institutes, the Institute for Child Study in Toronto and the Mental Hygiene Institute in Montreal. A CBC programme, “In Search of Ourselves”, was sponsored by the committee, and films and literature are distributed by it.
About Mental Upsets
Just as a man with a physical ailment may be mildly sick or severely sick; have an acute illness which begins and ends suddenly, or a chronic illness which lasts a long time: so the mental patient may have one of many kinds of illness and of varying degrees of intensity.
Mental upset cannot be pinpointed like so many physical ailments. The behaviour of the mentally ill person is only an exaggeration of normal mental mechanisms. His illness is a matter of degree. It may be “functional”, which means that there are no obvious physical changes to account for it, or it may be “organic”, when there are evidently physical causes, such as old age, brain tumor, alcoholism, or severe infections.
However, this much is known: the emotional and nervous upsets to which every one of us is subject, and which reduce our usefulness and happiness, are separated only by degree from the more serious mental disorders which need professional care.
These tiny upsets, undetected or uncontrolled, may lead into such formidable social problems as juvenile delinquency, drug addiction, chronic alcoholism, habitual law-breaking and broken marriages.
What Causes Breakdown?
Our nervous system is the most complex mechanism in the universe. In these days, it is subjected to strains and burdens never before thought of.
Breakdown of the system may appear to be caused by tragedy or sudden changes in fortune, but these things are only the trigger on a gun that is already loaded.
Apparently little things are important. For example, a business man was headed for mental illness. It was found that his wife, with the best intentions, insisted on his leaving his business troubles at the office. She provided company and entertainment aplenty for the evenings. But what he really needed was to talk out his troubles in a sympathetic atmosphere.
Fear is a first-class spur to neuroses. There are all sorts of fears, some justified and others not. One authority divides them like this: fear without object or reason is an anxiety neurosis; a persistent recurrent fear, foreign to the personality, is an obsession; fear that compels one to an absurd action is a compulsion.
The power of fear is illustrated by an Eastern legend. A pilgrim met the Plague, and asked: “Where are you going?” The Plague replied: “I am going to Bagdad to kill five thousand people.” A few days later the pilgrim met the Plague again, and charged him with killing fifty thousand instead of five thousand. “Oh, no,” said the Plague, “I killed only five thousand; the others died of fear.”
Closely akin to fear is worry. In fact, one psychiatrist has defined worry as a circle of inefficient thought whirling about a pivot of fear.
It is not abnormal to think seriously about things which threaten our safety or our ideals or our plans. It is because of this ability to see ahead, detecting dangers and planning to avoid them, that man has been able to achieve what he has.
Worry in the bad sense is quite different. It means fretting over a misfortune which has already happened and cannot be altered; it means living through every experience three times: in imagination, in actuality, and in foolish retrospect.
The solution is to get perspective. Everything is not just the way you would like it to be. It never will be. When you have done your best towards bringing it closer to your heart’s desire, don t fret.
Disturbed Emotions
A great deal of happiness is lost through the milder forms of emotional disturbance. It is said that among the patients at public clinics and dispensaries as many as four out of every ten have some degree of emotional or nervous disorder, and 30 to 50 per cent of the reasons underlying visits to doctors are of emotional origin.
We are too ready to think that our advanced state of civilization has eradicated our impulses. In truth, the structure and function of man’s primitive brain still dominates most of his existence. It is this primitive brain which breaks forth in explosive rages, in attacks of acute irritability, jealousy, suspicion and self-pity.
Life would be drab and spiritless without emotion, but for the sake of our health and happiness we need to cultivate the useful emotions and discard the harmful. As Dr. Griffith Binning truly says: “Mental health consists in the attainment of emotional maturity, in the ability of the individual to face the storms of life alone efficiently.”
It isn’t enough to keep others from knowing of your emotional turmoil. That is only camouflage, which, besides failing to cure the trouble, may even increase it.
In fact, we cannot escape trouble or mental disturbance by any method of covering up, or of rationalizing. When we rationalize we drum up a reason to justify whatever we do or think. So long as this is a trick which we know of, we retain control of the situation, but as soon as we begin to fool ourselves as well as the rest of the world, then the trick has us in its power and we need help.
It is a grand thing to have a friend to whom to confide the things that thwart us every day. When we tell someone in whom we have complete confidence of the frustrations, the hopes and the troubles of a day, we are taking a reasonable and effective step toward mental health.
What to Do
Anyone who feels himself mentally out of step needs to recognize first of all that the situation calls for reasonable treatment, and not for panic. Many patients now in mental hospitals might have remained at home and at work if only they had made this concession and sought help in time.
The family doctor is the first person to consult. If the illness is minor, he may be able to treat it; if not, he is better qualified than anyone else to refer you to the psychiatrist you should consult. Quickness of examination and treatment are just as necessary in illness of the mind as in illness of the body.
The plain fact is that no brain trouble is really minor: it may be kept so by early and effective care. Don’t brush off recurring mental upsets as being just “nervousness.” Don’t try to ignore emotional upheavals that leave you feeling ragged and worn.
There is nothing more damaging to the attainment of mental health than the idea that mental illness is incurable. That view may have been justified a half century ago, but it is not true today. Many cases of mental illness can be treated successfully, provided the condition is recognized and treated in time.
It is significant that while admissions to mental hospitals in Canada in 1950 totalled 16,378, there were in that same year 11,714 patients discharged. Every community has successful men and women in the professions, in business, in skilled crafts and in the home, who were at one time mentally ill.
Mind and Body
Though we speak of “mental health” and “physical health, there is no such thing as a disease of the body which does not affect the mind. Every illness of the mind is a cause of agitation in the body. We are so adept in the art of transference that approximately half of the sick people in the world are people whose physical ills originate in their minds.
Professional people have given us a word to describe this relation between ills of the mind and of the body: they call it “psychosomatic illness.” It isn’t produced by a bacterium or by a virus, but by the circumstances of daily living.
No one ever knew of a mind which was not associated with a living person, any more than anyone except Alice in Wonderland ever saw a Cheshire cat with a smile and no body. Mental illness is illness of men and not illness of minds.
That is why people who are trying for things beyond their reach often develop ulcers or chronic illnesses, and those who suffer from some physical ailment allow themselves to drift into a state where they become mentally ill.
When should a psychiatrist be consulted? There are people who put it off until the force of circumstances or the importunity of relatives makes them go. This is just as foolish as to put off consulting a family physician until tuberculosis, cancer or kidney trouble become so serious as to make us bedridden.
The psychiatrist, like the general medical practitioner, can help us to stay well by attending to minor ailments. The psychiatrist can treat normal persons who have an emotional problem before that problem turns into a serious disability.
Few miracles are worked by psychiatry. Every person has a different problem and different power of recovery. But steady, progress is being made, and the chances are increasing year by year of the mentally ailing person taking his place in society again.
How to Keep Well
To be well mentally, a man must be master of himself. The attention given by psychologists and psychoanalysts is designed to provide a person with knowledge of himself, to resolve internal conflicts, and to replace irrational acts by acts of judgment.
Our grandparents had the right idea when they described a person whose mental health was good as “a well-balanced person.”
Our very existence depends upon our ability to make adjustment to our environment, to the people around us. Two infallible tests of mental health are: the ability to face life with equanimity, and the ability to get along well with other people.
What is wrong with many of us is that we have allowed ourselves to be pressed into an ever-narrowing circle of interests and activities. It is only by pushing the circumference of that circle outward into the world that balance can be restored. This applies to all facets of life: work, recreation, social activities and physical wellbeing. Our mental health depends upon our own emotional balance and on our relationship with relatives, associates and the community.
The Family’s Influence
It is impossible to over-emphasize the importance of the family in good mental health. It is in this compact union of persons that our social relations can best be worked out; if home life is disordered, there starts the emotional tension that can result in later years in mental disaster.
This is why courses in marriage and family living, now coming into such popularity, are important. They prepare the pupils for real-life situations.
During the school year 1945-1946 the National Committee for School Health Research conducted a survey in the elementary and secondary schools of Canada which showed a definite need for greater knowledge and understanding of mental health problems.
Elementary school inspectors across Canada told of the mental health problems of pupils which they believe to be the most frequent and the most serious. These include problems arising out of unsatisfactory home conditions, fear, social maladjustment, inferiority complex, a sense of insecurity, and problems which arise from the student’s attitude that minimum effort is enough to “get by”.
Fundamental in our thinking about mental health should be the realization that mental illness ripens over a long period of time. It develops in children before the eyes of parents, teachers and friends, until it blossoms forth into full bloom to their distress and surprise.
Mental health comes most easily to children who have good relations with parents and teachers, who are happy and relaxed. The preservation of mental health begins the day the child is born, and it demands of parents the same intelligent care they give to physical health.
Balance enters the picture here again. Parents need to balance the freedom they give their children with an equal weight of responsibility. Building robust, wholesome, “able to cope” personalities in children lays the basis for mental health. Children need, not over-protection but immunizing experiences in small doses, enabling them to measure up to the bigger doses of conflict, frustration and disappointment in adult life.
This means, of course, that parents should check themselves once in a while, and shore up their own deficiencies. They need to examine their prejudices and beliefs, and to understand them before passing them along to the children.
How Far can we Go?
Every one of us must live within his own resources of strength, physically and mentally. One trouble in today’s world is that even keen executives and professional men fail to do so. They become agitated if their children have difficulty in breathing, indulge riotously in evening dates, carry a heavy load of school subjects, or become moody. But these same executives will drive themselves to the point of exhaustion in work, play or social activities.
If a man feels always tired, or tires more easily than his fellow-workers, he should consult a proper professional man. If there’s nothing organically wrong, then look at the mind: is there something out of balance there?
Hundreds of breakdowns are due to preoccupation with efficiency and getting things done. And, sadly enough, the longer an executive is right and the higher he climbs, the greater becomes the pressure of having to continue to be right and to climb still higher. The least hint of failure is enough to set a breakdown in motion.
The person who is endowed with a healthy body, to the continuing wellbeing of which he gives reasonable attention, and with an understanding family, will carry his load well.
“Rest” is not enough. The sort of repose that contributes to mental health does not depend altogether on external conditions, but on sound adjustment to tasks, opportunities, pleasures and the general order of a man’s life.
The value of a hobby is beyond question. Many a man finds the mere fact of having a piece of wood in a vise, or a stamp collection in a book, or flowers in his garden – something that is his by creation or by organization – has given him an aid to mental poise that is of priceless value.
Preserving Happiness
In seeking to preserve our mental health we should not plan in fear and review with regret. It is better to plan carefully, to perform joyfully; to review critically but calmly, and then go on to new experiences with buoyant anticipation.
None of us is likely to pass through life without experiencing periods of lowered mental health. The hazards are different at different ages, but if we take our bearings in each age bracket and heed the signs, we can assure ourselves of the topmost satisfaction and happiness that are available to us.
Here is advice drawn from various informed sources: quit looking for a knock in your motor every day; learn to like your work, thus escaping tension and gaining satisfaction; have a hobby; learn to like people, don’t carry grudges or dislikes; have the serenity to accept things you cannot change; you can’t escape adversity, but don t let it bowl you over; practise saying the cheerful, humorous, useful thing, and avoid saying mean things however much you want to.
Finally, meet your problems with decision. Work out a plan of analysing them so as to know their real nature; make a plan to solve them; and then quit thinking about them.