This is part of a series examining the mental health experience in Canada's workplaces.Take part in our short survey (tgam.ca/mentalhealthsurvey) and add your voice to this important conversation. This series supports The Globe and Mail and Morneau Shepell's Employee Recommended Workplace Award, which honours companies that put the health and well-being of their employees first. Winners for 2017 will be announced at a conference in late spring. Sign up to receive an e-mail about registration for 2018 at www.employeerecommended.com.
Have you or a loved one been faced with the question, "Should I take a medication to treat my mental health issue?"
To answer this question effectively, you will benefit from understanding the primary role and benefits of the medications being recommended to treat you or your loved one's mental health issue, as well as the risks and negative side effects.
The right medications can be effective. The wrong medications can be harmful. Sometimes medications simply don't work. The National Institute of Mental Health found that nearly 40 per cent of people treated with medication for depression did not respond to first-line antidepressants.
Awareness
When properly prescribed, medications for mental health issues can be helpful to reduce unwanted symptoms, such as depression and anxiety. The type of mental health issue defines the type of medication and the average treatment period. Many people with anxiety or depression are put on medication as a first step to help manage their symptoms so they can gain control of their emotions and thinking.
If you agree to take a medication, one proactive action to increase the likelihood of success is to include pharmacogenetic testing as a part of your decision-making process. Pharmacogenetic testing examines your genetic makeup to help predict what medications will be the safest to prescribe, as well as which ones may have the least-negative side effects and highest potential to curb symptoms. The testing is non-invasive and requires only a simple cheek swab that takes less than five minutes to do.
Accountability
Nearly 60 per cent of all Canadians on prescription medications are unhappy with the results, 95 per cent of adverse drug reactions go unreported, and up to 75 per cent of people are non-responsive to certain medications and may never know it.
You own your mental and physical health and, with the growing trend towards personalized medicine, it's incredibly important for the average person to empower themselves with their own unique health information.
Action
The following checklist is designed to help you make a good decision, using pharmacogenetic testing, before you take a medication for a mental illness:
How to find pharmacogenetic testing?
Pharmacogenetic testing can be acquired through your doctor or pharmacist. Just have a conversation about it. Be aware that all health care professionals might not be completely informed on this type of testing, as it is a relatively new facet of personalized medicine.
If this happens, you can search online for a reputable pharmacogenetic laboratory, and testing can be provided directly to the consumer.
When doing your own research, ensure that the lab is fully certified with CLIA (Clinical Laboratory Improvement Amendments). Only the best labs will have this certification, so it's an easy way to discern the good labs from the others. Always remember that your doctor should be the one to change your medications as a result of the test – never make decisions on your own. Also, check with your employer to see if they provide this type of testing as an employee benefit. Many employers have already done their due diligence in choosing a pharmacogenetic testing company to serve their organization.
Who pays for these kinds of tests?
Canadian governments have been slower to adopt pharmacogenetic testing than their American counterparts, who are now covering this testing through insurers and Medicare, and the U.S. Food and Drug Administration strongly recommends it. Because of this lack of coverage by the government, pharmacogenetic testing can be paid for as an out-of-pocket expense, or through your employer. Many employers cover this testing because they have seen that it reduces employee absenteeism and disability, while simultaneously making their drug plan run more effectively. If medically necessary, pharmacogenetic testing can also be covered in an organization under a health care spending account, as it is considered a metabolization test by the Canada Revenue Agency.
How many times will I need to do a test?
The good thing about pharmacogenetic testing is that you only need to conduct this test once, because your genes remain the same throughout your lifetime. Pharmacogenetic reports can be updated based on new scientific findings within the field, meaning you are protected for life.
What happens after the test?
After testing, a pharmacogenetic counsellor will follow up with you to discuss the results. They will check all factors that affect medication response, including environmental factors such as smoking and diet, and incorporate all results into a summary. After the consultation period, the pharmacogenetic counsellor will forward the report to your doctor, so it will be in your medical records. If the doctor is unsure about results, the counsellor will walk them through it.
Bill Howatt is the chief research and development officer of work force productivity with Morneau Shepell in Toronto.
Michael Prouse is the director of operations at Personalized Prescribing Inc. in Toronto.
Bill Howatt