Tackling thousands of cases of posttraumatic stress disorder became a high-profile mission of the Canadian military as it wound down combat operations in Afghanistan. A group of civilian researchers, care providers and patients are executing a plan to expand the awareness created by soldiers to take on depression and PTSD in the wider population.
Years after mental illness began to emerge from the shadows, bad information, limited treatment options and stigma still hang over diagnosis and treatment in the civilian world, according to a report prepared by about 60 leading experts in the field to be released this week by the Mood Disorders Society of Canada.
There is also deep misunderstanding of who suffers from PTSD, according to Zul Merali, the scientific director of the University of Ottawa Institute of Mental Health Research. Dr. Merali helped lead the discussion group that produced the report.
“It’s not restricted to people who spent time in a theatre of war,” Dr. Merali said in an interview. “It can happen to people who suffer sexual abuse as a child, who are in car accidents, who witness traumatic events. It can all lead to PTSD, and it’s very often intertwined with depression.”
Dr. Merali is setting up a national network for research and intervention for PTSD and depression and has asked the federal government for $5-million to fund it.
Three million Canadians suffer from depression at any given time, according to the Canadian Mental Health Association. A 2008 study by McMaster University researchers found about 9 per cent of Canadians had suffered PTSD at some point in their life. People with PTSD often also have depression, Dr. Merali said.
Most people who seek treatment for depression and PTSD see their family doctor first. Dr. Merali says general practitioners are usually quick to prescribe drugs and “often feel at a loss when the typical run-of-the-mill drug” is not working. About two-thirds of patients show little or no immediate response to drug treatment, he said.
“The physician sometimes gets stumped. What we would like to do is have a mechanism where they can approach us about the best evidence-based practice, and give them some solutions. If that fails, we could refer them to one of our expert clinics,” Dr. Merali said. “Right now our community involved in diagnosing and treating depression is not well co-ordinated.”
Health-care providers sometimes even put up obstacles to the ill getting treated, according to Phil Upshall, executive director of the Mood Disorders Society of Canada.
“One of the biggest problems is the stigma among mental-health care providers. It’s worse than demoralizing,” said Mr. Upshall, who has been treated for bipolar disorder. “The vast majority of doctors are unfamiliar with the early indications someone is suffering PTSD. They might have a notion armed forces members suffer from it, they don’t think of RCMP and police officers, prison guards, Inuit and Métis people who suffered abuse.”
Mr. Upshall’s organization is planning an education campaign targeting 77,000 family physicians in Canada. “It’s a good first step,” he said.
In addition to continuing education, another goal of the new national network is to ensure more research is translated into improved treatment, Mr. Upshall said.