TABLE OF CONTENTS

Executive Summary 1

The Onslaught of Mental Illness 2

Suicide: The Final Word 3

Social and Family Burdens 4

Current Psychiatric Practice 5

Relapse in Spite of Medications 6

Rising Drug Costs: a Major Threat to Health Programming 7

Psychiatric Medications: Panacea or Pandora 8

Defining a New Model For The Care of The Mentally Ill 14

Footnote References 17

Executive Summary…

Mental disorders place a significant burden on families, government, society, and the health care system. Annual increases in the prevalence of mental disorders are staggering. Provincial government insurance and support programs are reeling under the burden. This report reviews government reports and the scientific literature, to demonstrate the following:

· The cost of mental illness to families, society, and government is enormous. In any given year, at least one out of every five adults has a diagnosable mental disorder.

· Neuropsychiatric conditions account for the greatest amount of disability worldwide, seven times as much as cardiovascular disease.

· Globally, a million people commit suicide every year. In Canada, there is one suicide every two hours.

· Psychiatric illness is increasing worldwide. Canadian figures showed a 36% increase in people seeking treatment for mood disorders in 2000 compared to 1995.

· Current medical treatment consists of psychiatric medication, which is far superior to the older methods of institutionalization and confinement. Unfortunately, the 5-year relapse rate seems to be well over 50% in spite of optimal pharmacological treatment.

· Of great concern is the growing evidence that many psychiatric medications raise the risk of cancer, addiction, and suicide. For instance, a woman taking certain psychiatric medications more than doubles her risk of ovarian cancer. Indeed, the use of one antidepressant (Paxil) is a greater risk factor for cancer than is smoking.

· There is a new way to conceptualize and treat mental illness, one that does not harm the health of the patients, and which offers true hope for wellness, for the very first time in human history. This novel treatment consists of nutritional supplementation, and it is based on over 80 years of solid scientific knowledge.

· There are hundreds of studies in the scientific literature showing that nutrient deficiencies are linked to mental disorders.

· New research since 2000 has begun to demonstrate that it is possible to reverse the symptoms of mental illness with nutritional supplementation.

Onslaught of Mental Illness…

Depression in the year 2000 was the fastest growing cause of physician visits in Canada, reported Intercontinental Marketing Services (IMS) Health, a group that specializes in collecting and analyzing health care information for the pharmaceutical industry.¹ IMS reported that in the year 2000 doctor visits for mood disorders in Canada had escalated 36% over the previous five years, resulting in over 7.8 million consultations for depression.¹ These consultations did not include other psychiatric problems such as schizophrenia or anxiety disorder. IMS figures also showed a 63% increase over the previous four years in the number of prescriptions filled to treat mood disorders such as depression. Physicians wrote over 3 million prescriptions for Paxil (paroxetine) alone, one of the most commonly prescribed medications for depression. Paxil sales in the year 2000 increased by 19% over the 1999 marketing statistics.[1]

In spite of newer antidepressants coming to market, the number of people suffering from depression continues to increase every year in Canada and throughout the world.
A recent monograph on “The Global Burden of Disease” (GBD) provided a comprehensive assessment of worldwide disabilities.² Produced by Harvard University and the World Health Organization, this book indicated the immensity of depression. The report summarized health data gathered from nations having “developed” health care systems. Neuropsychiatric conditions accounted for the largest sector of the disabilities evaluated: they were 43.9%, compared to cardiovascular diseases, for instance, which accounted for only 6.5%. [2]

In his December 2000 report, the U.S. Surgeon General detailed the U.S. situation with the following statements³:

Adults: “The surveys estimate that during a 1-year period, about one in five American adults — or 44 million people — have diagnosable mental disorders, according to reliable, established criteria. To be more specific, 19% of the adult U.S. population have a mental disorder alone.” [3]^{[4] [5]}

Children: Almost 21% of U.S. children aged 9 to 17 years had a diagnosable mental disorder or addictive disorder associated with at least minimum impairment.3 [6]

Globally, studies have identified mental illness to be a significant problem for both children and adolescents. The following table provides data from seven countries:[7]

Table 1: Prevalence of child and adolescent mental disorders, selected studies

Country	Age (yrs)	Prevalence (%)
Ethiopia[8]	1-15	17.7
Germany[9]	12-15	20.7
India[10]	1-16	12.8
Japan[11]	12-15	15.0
Spain[12]	8,11,15	21.7
Switzerland[13]	1-15	22.5
USA6	1-15	21.0

The recent publication of the “2001 World Heath Report” produced by the World Health Organization (WHO) added that “mental and behavioural disorders are common, affecting more than 25% of all people at some time during their lives”.7

In her opening message to the world, the Director General of WHO, Dr. Gro Harlem Brundtland, stated “initial estimates suggest that about 450 million people alive today suffer from mental or neurological disorders… Major depression is now the leading cause of disability globally.”⁷

Surveys conducted in both developed and developing countries have shown that, during their entire lifetime, more than 25% of the population develops one or more mental or behavioural disorders.[14] [15]^[16]

Summary:

Worldwide, in both developed and undeveloped nations, the prevalence of mental disorders is increasing. More people suffer from neuropsychiatric conditions (43.9%) than from any other type of disability. More than 25% of individuals develop one or more mental or behavioural disorders in their lifetime. It is evident that mental disorders are a worldwide burden.

Suicide: The Final Word…

One of the particularly tragic outcomes of a mood disorder is suicide. Over 90 percent of suicide victims have a significant psychiatric illness at the time of their death. These are often undiagnosed, untreated, or both. Mood disorders and substance abuse are the two most common.[17]^{[18]
[19]
[20]
[21]}Around 15-20% of depressed patients end their lives by committing suicide. ⁷^[22]

“Suicide is now a major public health problem. Using an average for 53 countries for which complete data are available, the age-standardized suicide rate for 1996 was 15.1 per 100,000. The rate for males was 24.0 per 100,000 and for females 6.8 per 100,000. The rate of suicide is almost universally higher among men compared to women by an aggregate ratio of 3.5 to 1.”⁷

Suicide is one of the top three causes of death for young adults aged 15-34 years. This represents a massive loss to society, as young persons in their productive years of life die prematurely. Data on suicide attempts are available from only a few countries: they indicate that the number of suicide attempts may be up to 20 times higher than the number of completed suicides.

Canadian Data: A total of 3,681 people committed suicide in 1997.[23] Suicide is the fifth leading cause of death in Canada, with approximately one death every two hours. According to hospital records for 1998/99, females were hospitalized for attempted suicide at one and a half times the rate of males. About 9% of people who were hospitalized for a suicide attempt had previously been discharged more than once following a suicide attempt in that same year.[24]

Worldwide data: “A million people (globally) commit suicide every year.”7 Standing shoulder to shoulder, they would create a line of people approximately 700 kilometers in length. Between 10 and 20 million people attempt suicide annually.

As Table 2 demonstrates, suicide is the number three cause of death in the U.S. for males 35-49 years of age. It is more common than diabetes, AIDS, or motor vehicle accidents.

Table 2
Major Causes of Death*, Males with Age-Group, U.S., 1998

Rank	35-49 years	50-64 years
1	Diseases of heart (64.7)	Diseases of heart (322.9)
2	Other injury (unintentional) (28.7)	Lung cancer (123.1)
3	Suicide (23.9)	Stroke (38.5)
4	Motor vehicle accident (21.3)	Chronic obstructive pulmonary disease (34.0)
5	AIDS/HIV (19.5)	Diabetes mellitus (32.9)
6	Chronic liver disease (14.6)	Colorectal cancer (32.1)
7	Lung cancer (12.4)	Chronic liver disease (31.4)
8	Homicide (10.8)	Other injury (unintentional) (24.9)
9	Stroke (8.7)	Suicide (21.6)
10	Diabetes mellitus (7.1)	Motor vehicle accident (20.4)

*All crude death rates are per 100,000 people.

Includes cirrhosis. Note: Bolded text denotes chronic diseases and conditions. Source: Vital Statistics Mortality Data, National Center for Health Statistics, CDC.

Summary:

According to the World Health Organization one million people commit suicide every year. It is a major cause of death worldwide in the 15-34 age groups. Between 10 and 20 million people attempt suicide annually.

Social and Family Burdens…

Mental and behavioural disorders cause massive disruption in the lives of those who are affected and their families.7

“The burden of mental illness on families includes economic difficulties, emotional reactions to the illness, stress of coping with disturbed behavior, disruption of household routine, and the restriction of social activities. The single most important barrier to overcome in the community is the stigma and associated discrimination towards persons suffering from mental and behavioral disorders.”[25]

Many studies from industrialized countries have estimated the high aggregate economic costs of mental disorders.[26] The annual cost in the United States has been estimated to be 2.5% of the gross national product.7

In a recent 14-country study on disability associated with physical and mental conditions, active psychosis was ranked by the general population as the third most disabling condition, higher than paraplegia and blindness.[27]

The economic cost of schizophrenia to society is also high. It has been estimated that the cost of schizophrenia to the United States in 1991 was US$19 billion in direct expenditure and US$46 billion in lost productivity.7

The Bloody Aftermath of Mental Illness

Student Ryan Atteberry is helped to a waiting ambulance outside

Thurston High School in Springfield, Ore., May 21, 1998, after

another student suffering with mental illness and who was

expelled for bringing a gun to class, opened fire with a semiautomatic

rifle in a high school cafeteria, killing at least one person and

critically wounding seven others. The student shot and killed his

parents the day before.

Summary:

Mental illness disrupts the emotional and financial well-being of families. The burden on federal and provincial health care systems is enormous.

Current Psychiatric Practice…

Not until the mid-1950s did psychotropic medication become available to psychiatrists in a sufficient number to have an impact on clinical care. Since then, the number of psychiatric medications has increased with every passing year.

Prior to the advent of these medications, patients were commonly institutionalized, detained, and confined. In some underdeveloped countries these practices still continue. It was recently reported that, “Human Rights Commissions found ‘appalling and unacce