If our society is increasingly aware of the realities of depression and anxiety, it further stigmatizes people with schizophrenia, laments the president of the Association of Psychiatrists of Quebec (AMPQ), Claire Gamache.
“People who suffer from psychosis, schizophrenia. We are more afraid of these people than before,” said M.me Gamache in an end-of-year interview at Duty. “And there, it is certain that with homelessness and drug consumption, it is likely to increase. »
Paradoxically, “we have greatly reduced the stigma for anxiety disorders and depression,” she notes.
According to a study conducted between 1996 and 2018 in the United States, people feel less and less the need to distance themselves from depressed people. The investigation led by Professor Bernice A. Pescosolido of Indiana University, on the other hand, indicates that in 20 years, this need to distance oneself has not diminished from people suffering from schizophrenia, the perception of dangerousness associated with this illness having even increased.
In Quebec, the president of the AMPQ notes that, when a tragedy occurs, politicians and commentators are too quick to conflate violence and mental health. “We saw a lot of elected officials mention it in public saying: “It must be a mental health problem.” »
However, “90% of people who have mental illnesses will never be violent”, underlines Mme Gamache. “I offered to go and explain to the mayors of the cities to pay attention to the speech. We must undo these amalgams. You are much more likely to be killed by someone drunk than by a psychotic. »
“Ill” or “in distress”
When it is pointed out to her that, in fact, we see violent tragedies committed by unstable or disturbed people multiplying in the media, Claire Gamache retorts that a person can be “in distress” without suffering from a mental disorder.
The case of the tragedy at Polytechnique constitutes a good example, she continues. It was said of Marc Lépine “that he was crazy”. However, “he was a guy who was in distress, who had a hatred of women because he felt rejected. But he wasn’t sick.”
The president of the Association of Psychiatrists adds that there are also people suffering from mental disorders who commit crimes that are not caused by their illness.
In this regard, she says she looks forward to reading coroner Géhane Kamel’s report on Abdulla Shaikh, the man who killed three people at random in the summer of 2022 before being himself shot dead by the police during an operation.
Mr Shaikh had already been diagnosed with schizophrenia years before the attack. However, during the coroner’s hearings, experts argued that illness was not necessarily the cause of the murders he had committed.
“We really have to be careful with these amalgams,” repeats Claire Gamache. Because people with schizophrenia are much more at risk of being victims of violence than of causing it. »
A Santé Québec in mental health
However, when we talk about “distress”, is the lack of resources to blame? The issue was raised during the coroner’s hearings in the Shaikh case.
Questioned on this, Mme Gamache responds that this is why the future Santé Québec agency must have a parallel “branch” dedicated to mental health and social services.
Until now, the Minister of Health, Christian Dubé, has refused to review the organization chart of Santé Québec in this sense.
The president of the AMPQ also believes that the plan developed by Minister Lionel Carmant for mental health is “very good” (the 2022-2026 Interministerial Action Plan). “He deals a lot with young people and 75% of mental illnesses begin before the age of 18,” she mentions.
When it was pointed out to her that despite this “very good” plan, progress was slow in terms of waiting times, she replied that the lack of staff weighed heavily.
As for services aimed at psychotic, schizophrenic or bipolar people, they are increasingly better “structured,” says M.me Gamache. She estimates that psychiatrists devote a total of 80% of their resources to these heavier cases. “We created a lot of things for them,” she said. And there, we should perhaps see what more we can do for the population in general. »