Should we fix child and youth mental health first?
Posted on 18/03/2010 | 0 Comments
The Province of Nova Scotia spends about 3.8 percent of its health care budget on mental health services. Well below the minimum recommended by the World Health Organization. A small proportion of this goes to child and youth mental health. As the week long series in the Chronicle Herald (March 8 to March 12) pointed out – the entire provincial mental health system is very broken. In my opinion, we have to tear it down and start again. If we had a blank slate there is no way that we would build a mental health system in the way we currently have it.
So, where do we start. Tearing and building will take a bit of creative thought and a bit of time, not to mention some very difficult slogging to move out of current rigidities and the control of vested interests. What should we do now?
Well, I wrote about three ideas on this http://thechronicleherald.ca/Letters/1172666.html and the first was focusing on child and youth mental health.
Most mental disorders begin before age 25 years. Most of these are life-long. Most of these respond quite well to the evidence based treatments that we have. Early intervention with effective care has the potential to decrease short term morbidity and improve long term outcomes. The most effective way to decrease suicide rates is to identify and treat mental disorders. And the list goes on and on.
Yet we persist in back end investment. Lets stop this foolishness now. Of course we need to provide better care and services for post-youth and vulnerable populations (such as refugees, first nations, the economically and socially disadvantaged, etc), but we need to really ramp up our investment at the front end. So while we work on transforming the entire system we should immediately increase our investment in providing the best evidence based care with the best human resources we can allocate to children, youth and their families. And we should do it now!
--Stan
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This is a great set of comments and rings very true.
I totally agree that scientists (just like everyone else) have their biases and foibles. After all, scientists are human beings too! But science is different than scientists.
The scientific method is the most objective frame that we have by which to evaluate and predict. Science is not about finding truth. It is only about being less wrong most of the time. The scientific method (experimental design and mathematics) gives us the ability to test what we believe. The scientific method is not used to prove something is correct, on the contrary, the scientific method is designed to prove that something is not correct! It is designed to test what is called the “null hypothesis”. It takes ideas that come out of left field (or wherever else they come from) and puts those ideas to an independent test.
t does not drive our beliefs. It does however challenge our beliefs. In that way it is self-correcting. Of course scientific inquiry and understanding lives within a wider social context. That is one of the great features of science.
But gravity is gravity, social context notwithstanding. And thus it is nasty, brutish and long. As Brecht said, (something like this) - the purpose of science is to save us from everlasting error.
By Christina Carew on May 11th
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