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Why people with mental illness shouldn’t have access to medically assisted death

Mark Henick, a mental-health advocate in Toronto, says we should be focusing on suicide prevention and long-term solutions for mental health.

DERMOT CLEARY

Mark Henick, 29, is a mental-health advocate in Toronto. In the lead up to the introduction of Bill C-14, Henick launched a petition and wrote a letter to Prime Minister Justin Trudeau, making his case for why people with mental illness should be excluded from medically assisted death. Here, he explains his position.

To read a different take on the issue, click here for Adam Maier-Clayton's position.

I started experiencing symptoms of anxiety and depression as early as late elementary school, and I really started making suicide attempts in early junior high school.

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I didn't have the language to call it that at the time. I didn't know what I was experiencing. But there were multiple, escalating attempts over the course of years and I was getting closer and closer to taking my life until one night, I found myself on the wrong side of the railing of a bridge when I was 15. I let go of the railing and started to fall, but somebody reached out and grabbed me and pulled me back over the railing.

I didn't experience some miraculous recovery overnight or anything like that. But it was that moment, when I was really faced with the choice of what I wanted to do with my life, and I decided to be like that person who reached out and saved my life to try to help others in their darkest times.

Most Canadians support assisted dying in the traditional sense: Somebody is at the end of their life, they've exhausted all the treatment options for their condition and they're objectively suffering. It can be easy to make that analogy with mental-health problems as well. People do suffer grievously with mental-health problems such as depression, bipolar disorder, schizophrenia.

The difference, however, is that a significant reason people suffer with mental-health problems is not necessarily because of the symptoms themselves, but because of the stigma, because of the disorganization of the system and the inaccessibility of treatment and support.

Someone with end-stage cancer may have gone through their full course of treatment and determined that nothing else can be done. But somebody with a severe and persistent mental-health problem likely didn't receive that kind of care at any point in their journey.

And on top of that, mental illnesses attack your perception. They attack your ability to hope and to see changes in the future and to conceptualize your recovery. So that makes it difficult to actually think you could lead a normal – whatever that means– and happy life in recovery.

In the vast majority of situations, people with mental-health problems or illnesses are fully capable of making decisions. Informed consent in the mental-health sector is and must continue to be sacrosanct. It speaks to the intrinsic rights of the individual, but it is also a factor in effective treatment and intervention outcomes. Simply put, people recover better when they are actively involved in the decisions and approaches that are engaged to help them do so.

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Even though most people don't seek out help for a mental-health problem, when they do, we know that we can help. Most people can recover from mental-health problems when they actually get the services that they need.

So we need to be focusing on suicide prevention for people who have mental-health problems because there's absolutely no reason that they should die, first of all, and to suffer as much as we, as a society, are letting them suffer.

I bounced in and out of hospitals many, many times. I received treatment in several in-patient wards as well as outpatient services with social workers, psychiatrists, medication and my general practitioner. But even after every discharge, the follow-up care was not very good. Why should somebody have to suffer like this in a system that isn't designed to care for them?

Recovery doesn't always mean cure. And I think that's an important point. I consider myself fully recovered, but my depression still relapses at least once a year and I still experience anxiety fairly regularly. So recovery means learning how to manage it, how to manage those symptoms, manage what you're going through in a more effective way, so you can lead a fulfilling life. It doesn't necessarily mean to be asymptomatic.

But in the cases of treatment-resistant mental-health problems and severe and persistent mental-health problems, that's largely because we don't yet understand and we definitely don't have a health-care system or a social-care system to support people with these kinds of disorders. Many people, for example, who are actively symptomatic and experiencing schizophrenia, very often end up in prisons, in hospitals, homeless and unemployed. That's not right.

So I think we could be making much more progress in finding true cures and also helping people improve their quality of life if we were to actually pay better attention to helping them recover and building support systems that they need.

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If we were to offer assisted dying to people who have mental-health disorders, I feel like we'd be giving up on them. It's as if policy-makers would be saying, "Look, we're not willing to help you get better, but at least we're willing to help you die." That doesn't make any sense to me.

As told to Wency Leung.

This interview has been condensed and edited.

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