Centre intégré universitaire de santé et de services sociaux de l’Ouest-de-l’Île-de-Montréal
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Ask the expert

As a mental health specialist, do you believe that more people are developing mental illnesses?

I think that some illnesses rise and fall. For instance, depression goes down during wartime because people are too busy worrying about what is happening around them. But after the war is over, the rates go up again. So I think that depression and suicide rates can vary. I believe that suicide rates have actually increased in certain parts of the world—most likely because society in changing. I think that there are specific mental illnesses like schizophrenia, bipolar disorder, and major depression whose rates have stayed about the same.

Do people who show up late want to be noticed?

Do they do it because they want to be noticed? Or because they're disorganized? Or because they believe their time is so important, they don't mind making everybody else wait? Is this really a problem? If it is done to the extreme and affects a broad area of their lives, it is a disorder. Otherwise, it is just unacceptable behaviour. We all do things that irritate other people? That's why I've said that everyone is going to recognize themselves in all of the descriptions of disorders. But problem behaviours are only disorders when they are pervasive and serious, and have been that way for a long time.

Would the success of certain famous people with mental illness (Jim Morrison or Robin Williams) have been possible without their illness?

An undergraduate student was doing a research study on creativity in people suffering from OCD. The hypothesis was that, because people who have obsessive-compulsive disorder are so ordered and focused, and sort of compelled to do what they feel they have to do, their degree of creativity is going to be reduced relative to the normal population. It is really a question of channelling your talents or abilities into your prospective career. This is what counsellors do. They take your abilities and try to channel them into the most appropriate productive career. Why don’t we do the same thing for people who have mental illness? Because we do not think we can; but we can – we just have to know how to do it.

-Joseph Rochford, PhD, Mini Psych School 2009

What is being done for the homeless who are mentally ill?

Not enough! I would like to be able to tell you that we have big projects. However, we do not. There are challenges in helping certain homeless people. Some of them represent a category of mentally ill people who don't like institutions. They prefer the freedom of the streets. I'm not saying this in a sarcastic way. They do not want boundaries. We need to develop ways of helping them without putting them in institutions and locking them up. A lot of them have substance abuse problems that they're not ready to give up. They want to have the freedom to go out for a drink and come back. It's a challenge for us to find better ways of reaching out to these people, because they do suffer and they might be helped. However, we have to go to them. We cannot expect them to come to us.
-Mimi Israel, Mini-Psych School 2006

Are mental illnesses less frequent in "primitive societies"?

In primitive societies, the prevalence of schizophrenia and bipolar disorders is believed to have been the same as it is today. However, in some primitive societies people with severe mental disorders are better integrated into the community; they often remain in their homes. Suicide varies greatly from country to country. I would say that it is less prevalent in underdeveloped countries than in westernized countries. Anorexia is found all over the world, but some countries and ethnic groups are spared. For example, there's a lower incidence among black people. We don't know why. It's not just a question of cultural influence. True anorexia seems to have a fixed incidence in populations and but is not found in certain parts of the world, like in Inuit communities and in some Middle Eastern countries.
- Mimi Israël, MD, FRCPC, Mini-Psych School 2006

Is being transgender/homosexual a mental illness?

When it comes to sexual aspects, psychiatry has not had a brilliant history. Homosexuality was considered a disease up to the 1970’s, and it even used to be a classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM).Despite this awful history, there are people who nevertheless have sexual delusions, and that’s why it’s very important to get an opinion from psychiatrists and sexologists to determine whether the person has a delusion or whether this is actually part of their identity. Schizophrenia can affect a person’s basic identity, so we can say that sexuality has some impact if it affects identity. Delusion can also manifest as sexual ideas, so it’s very important to be careful when it comes to sexual identity and how it relates to delusions.
- Ridha Joober, MD, PhD, Mini-Psych School 2012

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