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Doctor tells of benefits of pro-active health care may lead to substance abuse By Janice Becker Citizen staff For social workers, mental health professionals. public health nurses. recreational directors and others, listening to Dr. Gina Browne gave credence to theories and experiences long held to be true. Dr. Browne, founder and director of system-link research on health and social service utilization at McMaster. University, spoke to dozens of health care professionals- at the Huron County Health Unit last Thursday. Simply put, Browne's studies show that a proactive approach to both physical and mental health, particularly for those receiving social services support, is more cost effective with the same or improved results than treating a problem. Her studies go far beyond just looking at the costs such as what would be involved in providing mental health counselling and job training to a single mother compared to her draw on the welfare system. The studies go into detail to determine the domino effect of that mother staying on welfare such as the cost to the health care system because of ongoing depression, an inability to support her children and any problems which then may arise for them. In one of the most easily displayed results, Browne found that by providing recreational or child care facilities for families there was a 50 per cent reduction in the use of Children's Aid services, 50 per cent reduction in the need for psychologists, 10 per cent reduction in the need for social workers, 10 per cent reduction in the use of probation officers, 50 per cent drop in the use of 911 emergency services, 50 per cent reduction in the use of specialists, 25 per cent reduction in the use of occupational therapists, 33 per cent drop in the use of physiotherapists and a SO per cent drop in the use of chiropractors. She told one story which clearly demonstrated how a less expensive or invasive method could be used to alleviate distress. An elderly woman arrived at the emergency room after calling 911 with chest pains. The doctors then administered tests for heart problems, respiratory difficulties and several other physical ailments which might explain the tightness in her chest. like this. "I lost my husband last year and my cat just died yesterday. I am so lonely and my heart is broken." When Browne asked those in attendance if they had witnessed such a response to loss, many hands were raised. Interaction from a home care worker may have prevented the need for a costly hospital visit, it was suggested. In her study of welfare mothers, she found that many were seriously depressed, with 60 per cent having two or more mental health issues. Forty per cent of the mothers had physical pain and 33 per cent of the children were hyperactive or had behavioral difficulties. For patients dealing with mental health issues, Browne determined total health care and societal costs to be two and a half times as great for those who were not assisted in adjusting to their illness. Some of those costs included loss of income for the patient and others impacted by the patient's inability to work,mediCations, babysitting, transportation and parking. These would be on top of actual medical care costs required to improve coping skills compared to those of dealing with ongoing difficulties. There was also an impact on the occurrences of other illnesses when mental health issues were not addressed. When youths were studied, Browne found that 52 per cent of the teens had a psychiatric disorder and many had overlapping issues. "There is a co-morbidity in adolescent disorders. When a child has a substance abuse problem, it • could be because of an anxiety disorder," she said. It was determined that there is a five-fold increase in expenses for those youths because they use all services more. "It is not good to cut counselling out of the schools," Browne said. "If there is a disorder, (adolescents) are more likely to participate in risky behaviours. We will be treating the injury caused by the behaviour, but not the mental health issues (which ,may have caused it)." The provision of recreation lessens the use of food banks (snacks are often included), nervous problems are decreased as are phobia and other disorders. The interaction with others increase social support systems, she said. By introducing a recreational program to a welfare family, it may also open lines of communication so that other family needs can be met. There is less stigma in having a recreational director visit a home to set up programs, than for a social worker to stop by, said Browne, She noted the success realized by Peel Region after council put more money into recreational programs. "They had a 33 per cent exit rate from the (social services) system," she said. Browne noted it was also important to know who does not need extra services. In a study which looked at the emotional health of adolescents enrolled in a school-based program, those not accepted into the program had an 81 per cent rating. Those who graduated reached 76 per cent and 56 per cent if they attended a follow- up session. Students still waiting had an emotional health quotient of just 25 per cent. In her study of seniors, she found that what might empower one group would not work for another. In younger seniors, giving them responsibility for their health care records empowered them while it only added more worry and stress for older adults. A senior's ability to cope with illness was also impacted by their living arrangement whether at home with a spouse to provide care, living alone or in a seniors' residence. Browne found that cultural sensitivity training for social workers helped improve the health of clients. This training looks at the values and preferences of the person. In discussion with the professionals in the room, they agreed that is necessary for all branches involved in social services to work together. Browne agreed saying that someone from a different field may "discover not a new landscape, but see things with new eyes." It is important to focus on a different aspect of health, said Browne. It would be the difference between restoration and repair, empowerment and supplement, holistic care to specialized specific services, proactive to on-demand service or health instead of health care. "We must look at the whole picture of the family," she said. Others spoke of the difficulties faced by rural counties where mental health . facilities are closing and there is not transportation to the nearest location. Diane Peacock with Perth County services said there is also empowerment in the telling (of problems). Browne agreed, saying that allowing those with difficulties to discuss them freely allows them to problem solve, a vital component to improved mental health. When asked how the system and services could be improved, Browne said workers and residents must get the government involved. "More money must be returned to the municipalities." "I think that will happen when people sit up and take notice," said Joan Van den Broeck of the Huron County Children's Aid Society. "We need a wellspring of interest from the community." Dave Urlin, deputy-mayor of South Huron, the only municipal leader in attendance at the morning session, suggested a presentation be made to county council so "we could get 18 people yelling" at the government. In summing up her message, Browne stressed. "It is more effective and less expensive to help people." Browne presented results from more than a dozen studies in support of proactive social services. All the reports are available through the Huron County Health Unit. As she sat waiting for the Anxiety results, a nurse asked her how she was feeling. The answer went something Business Directory Help for Today. Hope for Tomorrow. Today, I in 13 Canadians over 65 is affected by Alzheimer Disease and related dementias: For more information, contact your local Alzheimer Society or visit our Web site at www.alzheimecca AlzheimerSociety • Camila Study of liaskb