Mental health

Introduction

Effective treatment of depression requires early detection. Depression can be difficult to identify among subgroups of patients with co-morbid medical illnesses, substance abuse disorders, mental retardation, brain injury, and dementia, or those who are at either end of the age spectrum. This article addresses risk factors and unique aspects of presentation in the young and the old. 

The numbers associated with depression are staggering: 1.4 million people in Canada afflicted at any given time; over $3 billion in direct medical costs; 40 000 person-years lost from work and over $1 billion in economic costs; the second leading cause of long-term disability among workers, number one among white-collar workers; the fourth leading cause of global burden of disease, projected to be the second leading cause by 2020.[1,2]

Introduction

Workers with injuries that have a mental health component can be complex to diagnose, treat, and assist toward a successful return to work. Unique clinical challenges include understanding mental job demands, establishing reasonable work expectations, designing modified duties, and providing needed job accommodations. WorkSafeBC case management teams can help.

A few years ago I made an important mental-health maintenance decision. I decided to get off the emotional roller-coaster ride our politicians love to take us on whenever the BC electorate decides to give the incumbent majority a royal butt-kicking. The new group, flushed with their sense of importance and newfound power, grasping their list of election promises in upraised, victorious mitts, have always driven my optimism and almost carnal desire for change to new heights. However, reality quickly dampens the enthusiasm of novice health ministers within a few heartbeats.