David Goldbloom is the vice-chair of the Mental Health Commission of Canada, a professor of psychiatry at the University of Toronto and the senior medical adviser of education and public affairs at the Centre for Addiction and Mental Health, where he was also the inaugural physician-in-chief. Dr. Goldbloom has worked in psychiatry for more than 23 years treating patients, teaching young doctors and schooling the public about mental illness and the stigma that it still carries.
One of the main goals of the Mental Health Commission is to combat stigma. Why - in this age of reality television, tell-alls and a general tendency to publicize the personal - are people still so reluctant to talk openly about mental illness?
It can't be because it's a rare phenomenon. The reality is that one in five Canadians over the course of their lives can experience mental illness in one of its many manifestations, and what that ultimately means is that every single family in Canada has in some way been affected by mental illness. There's nobody in our country who can stand up and say, "Not my family, not my aunts or uncles or cousins or grandparents, children, siblings, spouse or self." And yet the reluctance to talk about it, to acknowledge it openly, to treat it as a form of human suffering like any other illness, relates in part to how threatening this set of illnesses is to our sense of who we are.
It's about the core of our identity.
That's right. If you break your leg, you're still you. If your mind is somehow broken by mental illness, you're not you in the eyes of yourself and you're often not you in the eyes of other people.
Your mental abilities are the last frontier of acceptable discrimination at work. Do you agree?
We're living in an increasingly postmodern world, which means that the things for which we're often most valued in the workplace is our above-the-neck capacity, our cognitive abilities, but also our relationship abilities and other manifestations of our minds and our brains. The problem is that when mental illness hits - and I should point out, it doesn't discriminate on the basis of intelligence - and if we think about it in the context of the workplace, it's not simply that it makes you feel sad. It interrupts your cognitive abilities - your ability to concentrate, pay attention, make decisions, remember things, feel motivated - and it leads to judgment by colleagues and managers that your productivity has dropped off, you shouldn't be here.
You've been travelling the country, going to workplaces from Empress, Alta., speaking to oil rig workers, to Bay Street, speaking to wealth-management groups. What's that about?
What we're seeing is a growing awareness in the Canadian workplace that this is a hot-button issue. Good data now shows us that in the Canadian public sector and in the Canadian private sector, these are the leading causes of short-term disability. It has a profound economic impact on the workplace. So it's enlightened self-interest for business places to understand this set of problems better and it's also a compassionate response.
And, unlike other medical conditions that tend to strike later in life, mental illness most often hits people in their prime.
That is a distinguishing characteristic. When you think of the other sets of illnesses that we have championed as a nation, whether it's heart and stroke or cancer or dementia, these hit, in the mean, a different age group than the people who are affected by mental illness. Most mental illness has its onset in late adolescence and early adulthood, just as people are coming into their own personal identities, their work identities, starting to form long-lasting relationships at an adult level. So the disruption is substantial. The World Health Organization predicts that by the year 2020 depression will become the No. 2 cause worldwide of years lost due to disability. That's a profound impact. A large, palpable, expensive set of human problems has been neglected far longer than any other set of problems in the context of the health of Canadians.
