Introduction

Summarize the primary source

Write a thesis statement for the essay

Response Paragraph 1 -First claim with framework critiquing the main source

• Textual evidence from primary source; textual evidence from secondary sources

Response Paragraph 2 -Second claim with framework critiquing the main source

• Textual evidence from primary source; textual evidence from secondary sources

Conclusion

• Restatement of the thesis; new questions; memorable statement, concluding statement based upon the beloew article

• MAID and mental health: Does ending the suffering of mental illness mean supporting death or supporting betterlives?Published: March 4, 2024 3.58pm ESTAuthor

1. Charmaine C. Williams

Dean and Professor of Social Work, University of Toronto

Disclosure statement

Charmaine C. Williams receives funding from the Social Sciences and Humanities Research Council (SSHRC). In the past she has received funding from the Canadian Institutes of Health Research (CIHR), the International Development Research Council (IDRC), the Ontario HIV Treatment Network, and the Ministry of Health and Long-Term Care.

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Recent headlines havehighlighted debatesamong federal parties over the proposal toextend Medical Assistance in Dying(MAID) to people suffering solely with mental illness.

Proponents ofexpanding Bill C-7 to mental illness claimthat delays to do so are based on stigma and stereotypes promoting the belief that a mental disorder renders someone incapable of making a rational choice to die. Those that advocate for delaying an expansion suggest that more work is needed toensure appropriate safeguardsare in place to distinguish requests for MAID from illness-induced suicidal ideation.

The recent announcement that including mental illness in MAID will bedelayed until 2027gives provincial and territorial health-care systems more time to prepare for implementation.

Putting access to MAID in context

People living with long-term mental illness should have the option to consider MAID, like others facing chronic, debilitating illnesses. However, access to MAID is a small part of a larger conversation we ought to be having about how the health-care system can provide supports and services that empower people with mental health disorders to navigate the long journey of mental illness with dignity and resilience. Extending support to the families that care for them should be considered key.

Get your news from people who know what they're talking about.Sign up for newsletterHealth Minister Mark Holland, left, looks on as Justice Minister and Attorney General of Canada Arif Virani speaks about assisted dying legislation on Feb. 1, 2024 in Ottawa.THE CANADIAN PRESS/Adrian Wyld

As the Centre for Addiction and Mental Health (CAMH) reports, mental illness is the leading cause of disability in Canada, and wait lists for services are far too long. For each person with a debilitating mental illness, there are family members biological, legal or chosen doing their best to provide support and care. But who supports these families as they navigate the challenges of persistent mental illness?

Despite decades of research demonstrating theimportance of family caregiversfor supporting people with severe mental illness, and thebeneficial outcomesfor all family members when families are supported, vital support services havedeclined throughout Canada. Families that are racialized, poor or newcomers aregetting even less supportin a depleted family support service system.

Examples of evidence-based family-focused supports that would help includefamily psychoeducation,peer support, andcommunity-based, culturally-acceptable servicesthat focus on whole families.

Supporting patients and families

In addition to asking health-care systems to prepare to end the suffering of mental illness by facilitating death, we should be asking legislators and policymakers to build a health-care system that supports better lives for people with mental disorders and their families.

Families manage mental illnessout of sightof these leaders and society at large; their suffering is seen as apersonal matterthat is no one else's business. But the numbers tell us that ending suffering from mental illness is everyone's business. It requiresnetworks of supportfor those who have been diagnosed and caregivers. Ignoring the families that support individuals with mental illness hasramifications for everyone's health.

My research exploring the experiences of Ontario families affected by mental illness has shown there aregaps in the systemwhen it comes to family support. Conversations with families reveal that, whether one is a caregiver or someone who has been diagnosed, those living with mental illness often feelisolated, alone and overwhelmed.

In a video from the Family Caregiving Project, family members describe difficult interactions with the health-care system.

Family members whodon't fall into the definition of "traditional family"often report challenges throughout the care process. Families that are part of marginalized or lower-income groups face additionalchallenges to getting help and support, often due to financial barriers, language and cultural barriers, or other social determinants that correspond to inequities in access to health care.

The failure to build proper supports and services that meet the needs of families could worsen an already growing mental health crisis. If the family is stressed, thatstress will impact everyone within it, caregivers and people struggling with a mental illness alike. This is suffering that can last for decades. The well-being of whole families affected by mental illness must be recognized as an issue of urgent concern.

Caring for people with long-term mental illness

Education and training are needed to ensure health professionals have the information they need to better support families. At the same time, more work must be done to promote the general public's understanding of mental illness and reduce stigma, so people don't feel ashamed about asking for help.

My work with the Family Caregiving Project to developfree online educational resourcesis a start. These resources help health-care professionals, educators and community groups better understand and discuss the experiences of families struggling with mental health issues.

Read more:Medical assistance in dying for mental illness ignores safeguards for vulnerable people

But Canada's families require government support as well. We need to ensure that our health-care system provides necessary services for families. Last year, we called on the Ontario government to fund targeted support for families living with serious and persistent mental illnesses,collecting nearly 1,500 signatures from people who agree family support needs to be a priority.

Living with a recurrent mental illness and having hopes rise and fall when treatments fail is a source of profound suffering for families all over Canada. People diagnosed with mental illness need to be part of the dialogue surrounding MAID eligibility because long-term mental illness can be devastating. At the same time, we have a health-care system that is focused on the short term of crisis and hospitalization, with little thought or investment for the months and years over which individuals and their families must find ways to carry on.

We need to offer more than assistance to death. We need to offer adequate resources and services that will get people help when needed, and support the mental health and well-being of all family members over the long term.

• Mental health
• Mental illness
• Stigma
• Families
• Caregiving
• Assisted dying
• Health-care system
• MAID
• access to care

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