David Lord, who is schizophrenic, lost his wife who was bipolar, after emergency room doctors dismissed her abdominal pain as intestinal flu. She died a week later of an ovarian tumour.
Published in The Toronto Star, April, 2010.
David Lord bears no malice toward the doctor who casually dismissed his bipolar wife’s ovarian tumour as intestinal flu and sent the couple home.
He harbours no anger toward the nurse who turned to him with contempt and asked, “Is she always like this?” when Leslie couldn’t contain her agony and cried out in pain in the hospital emergency room.
There is no fury, even though, one week, after the emergency visit, the woman he had been married to for only three months, died in his arms from an undiagnosed tumour that had twisted into itself, cutting off her blood flow and killing her at 42.
But Lord does have a message he’d like to convey to all health-care professionals when it comes to helping the mentally ill.
“I want them to see the person first,” said the soft-spoken widower who suffers from schizophrenia, himself.
“Don’t see the person as a collection of symptoms. They are more than the sum of their symptoms. They have a lot to offer personally, and we’re worth knowing. We’re valuable people.”
Stigmatizing the mentally ill is a widespread problem that the Mental Health Commission of Canada (www.mentalhealthcommission.ca/) is aiming to shatter in its 10-year, anti-stigma plan “Opening Minds.”
One of the most alarming and consistent findings from its focus groups across the country is that the very people they turn to in their darkest hours, those working on medicine’s front lines, are responsible for some of the worst discrimination shown toward them.
“Health-care workers often think that they’re immune to stigma, that we don’t hold stigmatized views,” said Arla Hamer, chair of the Mental Health and Addictions Network Education Work Group. “But the reality is, we do.”
Patients who sought emergency help reported being victims of disrespectful language, mandatory undressing and segregation from other patients. They’re often pushed to the back of the line and doctors tend to stop treating their physical symptoms once psychiatric conditions are revealed, Hamer said.
“As a result, people often don’t seek treatment. Stigma is a real barrier.”
Over the last year, Hamer’s group, conducted out of the Central Local Health Integration Network (LHIN) regional health authority in Markham, delivered anti-stigma workshops to hundreds of health-care providers who work in hospital emergency rooms, community health and access centres in the region. It’s a kind of sensitivity training for frontline medical staff.
“A little kindness goes a long way,” she said.
It’s a program the commission lauds for strategically bringing in people with mental illness to talk about their experience with discrimination, a powerful tool that forces people to confront their prejudices, said Micheal Pietrus, spokesman for the Mental Health Commission of Canada.
“It gives staff an opportunity to deal with someone who isn’t in crisis, so they can see that when they’re on their meds, they’re just like anyone else,” he said. “It changes people’s perceptions and makes a huge difference.”
Lord, for instance, is a gentle-mannered, soft-spoken man whose conversation is articulate, thoughtful and intelligent. In the absence of anger, however, is a palpable sorrow marked in both his slow, methodical words and a sombre, faraway gaze.
“The doctor didn’t pay any attention to us. He didn’t ask her one question. They didn’t give her proper care or attention,” he said softly. “They didn’t separate the mental illness from the physical illness. And that’s a big mistake.”
A week after being sent home, the couple sat down to lunch and Leslie’s breathing became shallow. Lord walked over behind her, rubbing her shoulders in an attempt to comfort her. Her breathing stopped. She died half an hour or so later.
Though Leslie had complained of abdominal pain months before her death, she refused to seek help because she was afraid of hospitals.
“Doctors and nurses do make mistakes, like everyone, but unfortunately, when they do, it can mean the difference between life and death,” he said.
It’s been seven years since his wife died and Lord, who lives in East York, is now an active member of Progress Place Rehabilitation Centre at Wellesley and Church Sts. downtown, a recovery centre for people with mental illnesses.
Progress Place is set to rollout its own anti-stigma educational curriculum to health-care providers within the University Health Network in the summer. The community-based centre focuses on streaming people back into society through employment, education and housing programs and members are involved in running every aspect of the centre.
“We’re trying to get everyone to recognize that people can recover and become productive members of their community,” Pietrus said.
Among health-care providers, stigma isn’t just reserved for people suffering from mental illness. It’s also endemic within the medical profession, itself, says Micheal Pietrus, spokesman for the Mental Health Commission of Canada, based in Calgary.
“Psychiatrists are often discriminated against by their colleagues,” he said.
Medical students have reported being dissuaded from specializing in psychiatry as it’s not viewed as “real” medicine, as fixing a heart or a broken leg is.
“The medical system has separated the head from the body.”
According to its interim report released in March, the standing committee on mental health and addictions at Queen’s Park pointed out there’s a widespread shortage of psychiatrists in the province, and fewer than 500 child and youth psychiatrists in the country.
The Mental Health Commission of Canada reports that only one in six children diagnosed with a mental illness will get help. Not every child is diagnosed, Pietrus points out.
The ratio of practising psychiatrists for every 10,000 Ontarians decreased by 2.4 per cent between 2002 and 2007.