OPA 2015 Annual Conference
"To affect the quality of the day, that is the highest of arts"
Henry David Thoreau
Many of us have entered medicine and psychiatry to positively affect the days and lives of our individual patients. In “The Physician as Health Advocate: Translating the Quest for Social Responsibility Into Medical Education and Practice” Dharamsi et al. eloquently argue that “Medical systems that tend to focus largely on the individual relationship between the physician and the patient, with little attention to the doctor’s role and responsibility to society, will face difficulty serving vulnerable groups”. Therefore, in addition to being devoted to the best interests of each individual patient, it is our professional responsibility to respond to the mental health care needs of society, especially the needs of our most vulnerable and underserved population. It is our responsibility to be socially engaged and accountable.
We need to champion social justice efforts aimed at addressing social determinants of health. As the healthy communities are the foundation of a healthy society, we need to strive to be involved in public advocacy efforts directed at improving conditions that positively impact the well-being of our patients. Our patients and the people of Ontario need affordable housing, income security, and supported employment opportunities. They need to live in an environment free of neglect, abuse, violence and discrimination based on race, gender, and sex orientation. They need to be able to live in an environment that is supportive and does not stigmatize them because of their illness. They need equitable access to high quality mental health care regardless of their diagnosis and regardless of whether they live in an affluent part of Toronto or in one of Ontario’s rural communities or remote First Nations communities or whether they are in a correctional facility.
We need to practice culturally competent and evidence-based psychiatry, commit to address the needs of the most disadvantaged and ensure that limited health care resources are put to their best use. Our focus needs to be not only on decreasing the burden of mental illness but also on enabling the future where the most disadvantaged and vulnerable groups will be served and have equitable access to services and where the mental health of the population will be a priority. I am convinced that a health care system that is proactive in supporting wellness and building or strengthening resilience is more equitable and sustainable then the one focusing solely on alleviation of illness.
Self-awareness, mindfulness and the reflective capacity that we harness as psychiatrists will give us the necessary ability to widen the lens and broaden our field of vision. This vision will include both equitable care of the mentally ill and promotion of mental health for all. It will include not only care and advocacy for the individual patient, but also care and advocacy for vulnerable communities.
To bring this vision to reality, we need to continue listening to our patients as well as our partners in the health care sector. We need to strengthen existing partnerships and look for and embrace new partnerships outside of the health care sector.
We need to dance the collaborative dance that also includes asking to be listened to so that we could provide the best access and care for our most vulnerable population and work towards mental health for all.
This is how we can enlarge our impact.
Dr. Diana Kljenak