Thursday, July 24, 2008

The Ottawa Citizen: Mental illness a crisis with no end in sight

Donna Jacobs

The Ottawa Citizen

A Canadian authority on mental health in the workplace tells people it's time to put down their BlackBerries -- and their cellphones, too. And leave them down for a few days.

"Turn your back on the e-mail system for a particular part of the day," Bill Wilkerson advises.

"Leave it to tomorrow. Next time you want to e-mail somebody, think twice. Consider going to their office."

BlackBerries, he says, are ruining business protocols by being "an incredibly cryptic and sometimes insulting short form of communicating."

They bypass human contact with its crucial body language, they isolate people and, he says simply, "isolation predicts depression."

People are increasingly isolated, he says, even in crowded rooms, in big buildings full of people.

Under the bombardment of random requests, he says, "risk aversion has turned into responsibility aversion."

He says that nearly one in four Canadians will have a period of mental illness at some point -- well above the global average -- a medical condition dominated by depression.

Mental illness is a national crisis, he says: a disabling or killing disease with rates rising exponentially and no containment strategy in sight.

Mr. Wilkerson is at home with crises.

He has served as business manager for the NHL and CFL and for the Toronto Blue Jays, executive assistant to the minister of energy, mines and resources; adviser to the Ontario minister of industry and trade; chief of staff to former Toronto mayor Art Eggleton and as former president/CEO of Liberty Health insurance.

He now serves as special adviser on neuroeconomics for the Institute of Mental Health at McGill University and works with policing agencies, Canadian Forces and Veterans Affairs on mental health matters.

"The locus of mental illness is an intensified assault on the brain -- from five-second TV advertisements, from immediacy of information, from expectation of instantaneous results on the job, in investments, in lifestyle changes, in fast-track learning," he says. "We have turned the world upside down."

Are we frying our brains? "Absolutely. We are putting our resilience on the line and once we do that, there is no fall-back position. Frustration and rumination -- seething -- are the two major social effects of chronic job stress. They are a prelude to depression."

During the course of his work, Mr. Wilkerson has been instrumental in convincing Canada's CEOs (and, most recently, Prime Minister Stephen Harper) to tackle the growing incidence of mental illness that costs Canadians more than $50 billion a year.

Public servants are asking for sick time and disability time, or struggling on the job, in steeply rising numbers, he says.

These days, he is meeting with federal deputy ministers and RCMP Commissioner William Elliott to set strategy for the Mental Health Commission of Canada.

"The real question for the federal workplace," Mr. Wilkerson says, "is this: 'Is it difficult or hopeless in your mind to get routine things done routinely?'

"If everything is tough, then your workplace is too crowded with too much stuff.

"You've got to understand the migratory sequence between stress, burnout and depression. Chronic stress makes everything urgent and everything a priority. Burnout is the graduation to another level where nothing is a priority and frankly you've begun to tune out. That can lead to a brain response which produces symptoms of depression.

"Depression is the emptying out of our sense of control, our sense of place. It undermines our immune systems. It excretes hormones in hugely excessive volumes and it attacks our cardiovascular health."

What is the solution in the workplace?

"The solution is the cornerstone of good old-fashioned management, which is based on human decency, clear thinking, open communications. The other cornerstone is clarity of purpose and function. When those two things go missing, bad practices replace them."

This year is the 10th anniversary of the Global Business and Economic Roundtable on Addiction and Mental Health, a non-profit think-tank he co-founded with former finance minister Michael Wilson, now Canada's ambassador to the U.S. and Roundtable chairman.

Mr. Wilkerson and Mr. Wilson have lost family to mental illness. Mr. Wilson's 29-year-old son, Cameron, took his life in 1995. Mr. Wilkerson's father, James Earl Wilkerson, was hospitalized several times with paranoia.

Mr. Wilkerson once put his loss starkly in one of hundreds of speeches he's given around the world.

"Depression killed two members of my family," he said. "One with a blood clot, the other, a gun.

"In 2004, my older brother, Bob, died alone at home. Official cause of death: heart failure. More to the point, he was killed by his depressed mood. Having recently lost his wife to cancer, he abandoned his blood thinners and anti-depressant medication.

"In 1979, my ex-wife used a small revolver her brother gave her for protection against the night to put a bullet in her brain -- while she was stirring a pot of spaghetti sauce, her specialty. Separated, not divorced, we were still close.

"Depression and other forms of mental illness are not invisible, impossible to diagnose or -- as some popular mythology would have it -- imaginary.

"Imagination didn't kill my brother or my wife. With a blood clot and a gun, depression did that."

Last week, in this interview, Mr. Wilkerson set out Canada's two most compelling mental illness demographics.

The most vulnerable are children, he said, who are susceptible because their brains are still forming. They're especially vulnerable to those stronger than they are. They're soaking up impressions, pressures and, sadly, the effects of being neglected, abused, treated inhumanely.

The average age for anxiety onset in Canadian children is 12, for depression it's 21 and for substance abuse it's 18, he says.

The second demographic is people in their 20s, 30s and 40s -- "men and women in their absolute prime working and earning and living years.

"You've got teachers who are at a higher-than-national-average rate of depression and stress-related absence. And you have parents who are taking stress-related absence from work in record numbers.

"The kids get it at both ends of their day."

How the country responds is, he says, "a challenge to the integrity of Canadian values, the Canadian health care system and our sense of right and wrong. It's that fundamental."

He says that friendship, family support and basic human love are just as important as medical treatment to a mentally ill person's survival and recovery.

His advice to those distressed? "Don't suffer alone. Reach out."

And his advice to the spouse, relative, co-worker: "Reach back."

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