Expert panels are on the endangered species list, a rare form of deliberative democracy not yet crushed by Harper's Conservatives.
So, crazy as it sounds, the Mental Health Commission of Canada has been allowed to table the country's first-ever psychological health strategy. And stranger still, it has received respectful attention from the Conservatives despite its $4 billion prescriptions.
Of course, we don't know what it will amount to in the end, but Changing Directions, Changing Lives, set up in 2007 by the Tories, calls for sweeping changes. And, in the tradition of such commissions, it could spark informed civic dialogue preparatory to smart legislation.
Relish the breakthroughs.
The report normalizes what's standard for all other diseases: a focus on prevention, treatment and recovery, not isolation, marginalization and shaming. No one says "Get over your cancer" or "Let's not waste money trying to find a cure or prevention," and the same should hold for mental disorders.
Prevention has a hard time getting attention in general, as heart disease shows, but the vascular organ's got it easy compared to the brain and mind. Only one in four children with mental health problems seeks treatment, the report says. And when people hospitalized for depression leave, there is less than a one-third chance of follow-up by trained physicians. There's a screw loose in the medical model.
Politicians responsible for austerity budgets, please take note. The report stresses the connection between mental well-being, physical health, economic prosperity and school performance, and argues that "mental health can be promoted in policies and practices in all areas of social and economic life."
The commissioners identify investments to reduce child poverty and homelessness as "protective measures" that reduce the damaging effects of well-known "risk factors." They also classify anti-gay, anti-woman and racist behaviour as "underlying risk factors" for mental health problems.
When it comes to safeguarding the mind and brain, settling for mere health is setting the bar too low, the report says. We should strive for health, well-being and thriving, the last a term we use for newborns but forget about quickly as the focus shifts to preparing the child for life in the cruel world.
The report presents a priority-changing paradigm but forgets itself when it comes to recommendations. It doesn't propose, for example, to end the monopoly of tax-supported treatment by medical professionals.
That's the mental health equivalent of putting chiropractors, naturopaths, osteopaths, physiotherapists and massage therapists beyond the pale of a publicly supported system. No social workers, case workers, psychologists or psychotherapists, let alone nutrition therapists, need apply. How does that square with wellness and thriving?
The other obvious area of neglect is nutrition. The writers apparently haven't heard of research on the crucial role omega-3 "healthy fats" and vitamin D can play in resisting depression and other mental problems.
Catherine Mah - head of the newly created food policy research initiative at U of T and the Centre for Addiction and Mental Health - thinks there's a policy blind spot when it comes to food. Since food and food security are such low priorities for the medical professions, there are no standard screening questions, such as "Did you ever go without food as a child?" or even "What have you eaten today?" Don't ask, don't tell is no way to run a diagnostic system.
As well, the commissioners make no mention of the healthful impact of urban green space or natural environments - a disastrous omission at a time of super-tall buildings, over-the-top density and potential agoraphobia epidemics.
The report estimates that mental problems and illnesses cost Canada over $50 billion a year, in large part due to lost productivity. Almost half of disability claims and absenteeism are attributable to mental problems.
If austerity is more than a mythology designed to create a false sense of scarcity and is actually about saving governments money, the 2 per cent increase in both medical and social spending proposed by this report is really a way to save on spending, as well as enrich lives.