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According to the World Health Organization, 'There is no health without mental health.' So why is it such a struggle to access affordable treatment in Canada? Readers, print and digital, analyze how to build a better mental health care system


In a beautiful community in a wonderful country, there was a fast-flowing river. The caretakers of the community noticed that over the past few decades an increasing number of residents were falling into the river and being swept downstream.

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The caretakers were committed to helping these people and had many debates about the best way to pull them out of the river.

Some folks thought placing a net where the river ran the fastest would be the best way to help. Others thought throwing a rescue line to people when they were in the calmest spot might be better.

A few caretakers asked why so many people were falling into the river, but most of the caretakers didn't want to consider that question. They just kept debating the merits of their different methods and finally decided that both were useful and should be supported by community resources. Together, they explored how best to make this happen.

This parable was prompted by the first article in your Open Minds series on mental health care, 'We Have The Evidence …Why Aren't We Providing Evidence-Based Care? (Focus, May 23), which points out that low-income Canadians "are three times more likely to report poor to fair mental health."

Given this "evidence," shouldn't we be using at least some of our public financial resources to alleviate this significant cause of mental illness (i.e. the poverty that throws people into the river), in addition to publicly supporting various treatment modalities (drugs and psychotherapy that serve as nets or rescue lines)?

Carolyn Campbell, Wolfville, N.S.


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I want to express my gratitude to The Globe for exposing the abhorrent lack of care and resources for the treatment of mental illness and for trying to dispel the misconceptions regarding these illnesses.

My family, or what is left of it, has experienced firsthand the panic, dislocation and complete sense of helplessness you write about in Open Minds as we try to cope with our son's eating disorder, one of the deadliest mental illnesses and one where those desperate for help far outnumber the available treatment resources.

Like sufferers of any physical illness, sufferers of mental illness do not choose their illness, nor can they will their way out of it but need intensive, comprehensive treatment to avoid prolonged illness, or worse, death.

When it comes to cancer, heart disease, diabetes – you name it – our system devotes enormous resources. This to perhaps prolong life for a year or two? Woefully, when it comes to mental illnesses, which often affect our best and brightest youth and can completely destroy their lives and their families, only a fraction of the resources are allocated and treatment is piecemeal.

A national strategy is indeed required. Immediately.

Brad Pierce, Calgary

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Twelve per cent of children have severe, persistent mental health issues. Children like this need services provided along a continuum of care, including support from primary care, hospitals, psychiatry, children's mental health centres and schools. Psychotherapy is a key component of this continuum of care, yet demand consistently outpaces need.

Our 2015 Report on Child and Youth Mental Health noted there are 6,000 kids in Ontario alone with significant mental health issues currently waiting an average of a year for psychotherapy.

While psychologists and psychiatrists play important roles, psychotherapy can be capably delivered by other trained mental health professionals, such as social workers. Adequately funding these professions as part of a continuum of care will ensure funds are used effectively.

Kimberly Moran, CEO, Children's Mental Health Ontario


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They should also fund more MBSR (mindfulness-based stress reduction, a.k.a. meditation) programs as well. Best treatment for depression and anxiety I ever received and I've tried them all. MBSR in conjunction with psychotherapy is key. Because if you have anxiety, for example, it is in fact your "thinking" that is making you ill.

Sarah Rimmington, Toronto


The Globe is to be commended for focusing on the importance of improving access to evidence-supported psychotherapies for treatment of mental illness in Canada. For Canada to sustainably build its work force of health professionals who can deliver these treatments, it is essential that postgraduate programs in family medicine, psychiatry, social work and nursing include psychotherapy training in their curriculums, which unfortunately is not usually the case.

The World Health Organization's rallying statement that "There is no health without mental health" calls for a systemic response to integrate mental health into all health care.

As a psychiatrist who practises psychotherapy, I believe our profession must provide the highest standards of treatment, through consultation, collaborative care, and evidence-based treatments of all kinds, including psychotherapy. Psychotherapy provides hu-mane care that engages with all the complexities of the lives of people living with mental illness. It needs to be accessible to the public as a vital component of health care.

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Paula Ravitz, associate professor of psychiatry, University of Toronto; Mt. Sinai Hospital Morgan Firestone Psychotherapy Chair


Raising your hand for help with a "weakness" isn't asking for a free pass. It's asking for help for you to be your strongest self so that you can compete the best you can. As much as we are competing with each other, as a community we have a vested interest in everyone bringing their A game to the competition to make it the best competition ever. Life is a journey, not just an end goal.

Emma Hyatt, Toronto


ON REFLECTION Letters To The Editor

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Letters to the Editor should be exclusive to The Globe and Mail. Include your name, address and daytime phone number. Try to keep letters to fewer than 150 words. Letters may be edited for length and clarity. To submit a letter by e-mail, click here:


On Sepp Blatter's watch

Re Soccer Scandal (May 29): FIFA president Sepp Blatter said he's the man to root out the soccer association's problems. Where was he during 17 years of alleged corruption, fraud and bribery? Oh yeah, at the helm.

FIFA needs a total makeover, beginning at the top.

Ken DeLuca, Arnprior, Ont.


From what I can tell, it sounds like FIFA has been suffering from a lack of Blatter control.

Harold B. Smith, Toronto


Teachers' threat to walk

Re Teachers Ponder Big September Walkout (May 28): Someone needs to remind Ontario's teachers that governments are elected and get to set the rules. Teachers' sole responsibility is to teach, nothing more, nothing less. Teachers who wish to make the rules regarding the education of our children should quit and run for elected office. This constant threat of "change the rules to suit us or we stay home" is both childish and selfish and it is the children who suffer from their actions. The time to change this system is long past.

Lloyd Hicks, Guelph, Ont.


Canada's Third World

The legacy of our historical maltreatment of Canada's First Peoples persists with little hope of retreating into history, unless urgent action is taken by aboriginals and non-aboriginals alike (McLachlin: A History Of 'Cultural Genocide' – May 29).

Our collective neglect and ignorance manifests itself in Third World conditions on reserves, rife with substandard health and education, substance abuse, suicide and existential pain. One can only hope Canadians will awaken to this tragedy and make it the election issue it's always deserved to be.

Ross A. Smith, Toronto


Apology, times two

Re Snoop Owes Me An Apology (May 28): Sure, Snoop Dogg owes Hannah Sung an apology, but don't overlook MuchMusic. If anything, it owes her a bigger one. As a prominent and leading source of media exposure for Canadian youth, shame on MuchMusic for not having explored gender and sexuality in a more responsible way.

Was I one of those youth rapping along to Snoop back in the day? Probably, but fortunately with age, experience and education, I have come to re-examine such ideas and rely on more varied media exposure.

Rabiya Jalil, Calgary

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