MAID and mental health: Does ending the suffering of mental illness mean supporting death or supporting higher lives?

Recent headlines have highlighted debates amongst federal parties over the proposal to extend Medical Assistance in Dying (MAID) to people suffering solely with mental illness.

Proponents of expanding Bill C-7 to mental illness claim that delays to accomplish that are based on stigma and stereotypes promoting the assumption that a mental disorder renders someone incapable of constructing a rational selection to die. Those that advocate for delaying an expansion suggest that more work is required to ensure appropriate safeguards are in place to tell apart requests for MAID from illness-induced suicidal ideation.

The recent announcement that including mental illness in MAID will probably be delayed until 2027 gives provincial and territorial health-care systems more time to organize for implementation.

Putting access to MAID in context

People living with long-term mental illness must have the choice to think about MAID, like others facing chronic, debilitating illnesses. However, access to MAID is a small part of a bigger conversation we must be having about how the health-care system can provide supports and services that empower individuals with mental health disorders to navigate the long journey of mental illness with dignity and resilience. Extending support to the families that look after them needs to be considered key.

As the Centre for Addiction and Mental Health (CAMH) reportsmental illness is the leading reason for disability in Canada, and wait lists for services are far too long. For everybody with a debilitating mental illness, there are members of the family — biological, legal or chosen — doing their best to offer support and care. But who supports these families as they navigate the challenges of persistent mental illness?

Despite a long time of research demonstrating the importance of family caregivers for supporting individuals with severe mental illness, and the helpful outcomes for all members of the family when families are supported, vital support services have declined throughout Canada. Families which can be racialized, poor or newcomers are getting even less support in a depleted family support service system.

Examples of evidence-based family-focused supports that might help include family psychoeducation, peer supportand community-based, culturally-acceptable services that give attention to whole families.

Supporting patients and families

In addition to asking health-care systems to organize to finish the suffering of mental illness by facilitating death, we needs to be asking legislators and policymakers to construct a health-care system that supports higher lives for individuals with mental disorders and their families.

Families manage mental illness out of sight of those leaders and society at large; their suffering is seen as a personal matter that isn’t any one else’s business. But the numbers tell us that ending affected by mental illness is everyone’s business. It requires networks of support for many who have been diagnosed and caregivers. Ignoring the families that support individuals with mental illness has ramifications for everybody’s health.

My research exploring the experiences of Ontario families affected by mental illness has shown there are gaps within the system in relation to family support. Conversations with families reveal that, whether one is a caregiver or someone who has been diagnosed, those living with mental illness often feel isolated, alone and overwhelmed.

Family members who don’t fall into the definition of “traditional family” often report challenges throughout the care process. Families which can be a part of marginalized or lower-income groups face additional challenges to getting help and supportoften as a consequence of financial barriers, language and cultural barriers, or other social determinants that correspond to inequities in access to health care.

The failure to construct proper supports and services that meet the needs of families could worsen an already growing mental health crisis. If the family is stressed, that stress will impact everyone inside itcaregivers and other people battling a mental illness alike. This is suffering that may last for a long time. The well-being of whole families affected by mental illness should be recognized as a difficulty of urgent concern.

Caring for individuals with long-term mental illness

Education and training are needed to make sure health professionals have the knowledge they need to raised support families. At the identical time, more work should be done to advertise most people’s understanding of mental illness and reduce stigma, so people don’t feel ashamed about asking for help.

My work with the Family Caregiving Project to develop free online educational resources is a start. These resources help health-care professionals, educators and community groups higher understand and discuss the experiences of families battling mental health issues.

But Canada’s families require government support as well. We have to make sure that our health-care system provides essential services for families. Last 12 months, we called on the Ontario government to fund targeted support for families living with serious and protracted mental illnesses, collecting nearly 1,500 signatures from individuals who agree family support must be a priority.

Living with a recurrent mental illness and having hopes rise and fall when treatments fail is a source of profound suffering for families throughout Canada. People diagnosed with mental illness have to be a part of the dialogue surrounding MAID eligibility because long-term mental illness will be devastating. At the identical time, we have now a health-care system that is targeted on the short term of crisis and hospitalization, with little thought or investment for the months and years over which individuals and their families must find ways to hold on.

We have to offer greater than assistance to death. We have to offer adequate resources and services that may get people help when needed, and support the mental health and well-being of all members of the family over the long run.