In a just-released book, two reformers of the American justice system advocate “gradualism,” an approach to public policy that supports smaller policies rolled out in stages to effect significant change in society.
Among the arguments supporting their position is the idea that this approach leads to a priori non-existent consensus across the political spectrum as the changes are rolled out. But this approach does not apply to all contexts. The Dubé reform testifies to this; when the boat is sinking, time is running out, and we must act with determination and boldness.
Can we afford a gradualist approach to mental health as we have observed for several years? Of course not. Not only does the boat sink, but the system never had its head above water. And there is indeed a consensus among the various political parties and in society: the situation is untenable.
For lack of adequate care, the condition of some seriously ill people deteriorates. Hundreds of people take their own lives in silence and anonymity every year, leaving loved ones devastated by the thousands. Despite “unprecedented” investments by the government, the waiting lists have not changed one bit.
I was hospitalized in my late twenties and now help young people who are hospitalized in my role as a peer support worker. As a patient partner, I experienced the shortcomings of the system and, as a worker, I see that they still exist. I fell on the answering machine of a helpline. It’s a symptom of a broken system.
On both sides of the curtain, we therefore see the same reality which must change. Last week, a 14-year-old boy suffering from psychosis wanted to go play basketball in the hospital gymnasium to get out of his room. Not enough staff to accompany him.
make history
Many observers argue that what matters most to politicians is the mark they will leave on history. And history, for its part, is written in moments of crisis. What could be better than a pandemic that has made whole sections of society vulnerable to leave its mark?
Moreover, major reforms, such as the one desired for mental health, have as a common denominator the restoration of dignity to individuals: saving the language of an oppressed people, nationalizing a resource held hostage by special interests, setting up a childcare system that allows women to fully participate in the labor market. The Laurins, Lévesques and Marois have indeed left their mark in the history book by performing feats that have deflected the trajectory of Quebec.
There are countless articles on the opinion pages about mental health that are sounding the alarm. Columnist Patrick Lagacé argued, four years ago now, that things would really change when society was angry. Aren’t we already there?
Not being able to substantially reverse the tide with outrage alone, should we adopt a different tone? Something like considering the immense feat that would be a truly saving reform, Minister of Social Services, Lionel Carmant? What an accomplishment it would be to finally bring mental health care into modernity in Quebec! One would say of the “Carmant reform” that it would have put an end to the insufficiency of the care which perpetuates the suffering and undermines the dignity of the sick. She would save lives. We would teach it at university. She would be the envy of the world.
It is high time that people were once again convinced that politics is capable of great things and has the power to change lives. Let’s dream for a moment… why not aim, as the Quebec Association for the Prevention of Suicide does, for a society without suicide? Welcoming hospitals that give people in serious distress the comfort and healing they need? An eradication of waiting lists? Put an end to the exodus of psychologists from the public to the private sector?
The glory of a politician is matched only by the audacity and ambition of the policies he pushes through. It is this type of individuals that history remembers, Monsieur Carmant. Up to you.