Like a puzzle whose pieces continue to be assembled to reveal a larger picture, the brain divulges more and more of its secrets over time. Back when he was in medical school, the mind-body connection was not as well understood as it is today, said 66-year-old Dr. Sam Ozersky.
Today we know that mental illnesses, such as bipolar disorder, depression, schizophrenia and post-traumatic stress disorder can affect the physiology of the brain, in some cases shrinking its volume, as revealed in MRI scans. But it’s also been learned that early treatment can help reverse that effect.
“The brain can recover,” said Ozersky, a psychiatrist and senior consultant in mood disorders at the University Health Network (UHN). “The brain can heal itself within limits either through medication or certain forms of brain activity such as psychotherapy, physical exercise and brain exercise such as puzzles, Sudoko and crosswords.
“Yes, you can renovate your brain, provided it is not a ‘tear down’ situation and renovation is not extensive,” he said.
The key is early intervention and that’s where “Feeling Better Now” (FBN) comes in.
FBN is a web-based, mobile-ready early identification system developed by Mensante Inc., a company Ozersky founded in 2006.
It provides the user with a web-based platform that assesses an individual’s mental health and recommends a course of action best suited to address the maladies people are suffering from.
“We’re like a GPS to the best available care, whether self care, care by others such as counsellors and therapists, and care by medical practitioners,” Ozersky said.
It’s a service that’s badly needed.
“Our experience over the past decade indicates that employees suffering mental health problems may not always turn to a doctor first. They may confide in their partners and families, seek out counselling through Employee Assistance Programs (EAP) and student counselling services, or choose to pursue options in self-directed care,” he said.
“There is absolutely a need for a system to optimize mental health care delivery that is inexpensive and medically approved, Ozersky added.
With Feeling Better Now, which was updated earlier this year as FBN2, prospective patients take a test on their computers or mobile device. Their answers to the questions posed by FBN help the program diagnose the patient, assign different levels of risk and offer recommendations for treatment.
Assessments can take as little as 15-20 minutes to complete, even for those experiencing several mental health issues, which can include major depression, generalized anxiety, eating disorders and substance abuse.
“We don’t do anything that isn’t supported by the scientific literature,” Ozersky said, noting that the College of Family Physicians of Canada has endorsed FBN as a practice tool and that the Ontario Medical Association has approved the program for its members’ personal use.
“We tell them how to make contact with people who can help them explain what they should do. We provide a checklist of functions that the caregiver should be providing according to the best science.”
The website also offers a “toolbox” of resources approved by Mensante’s clinical advisory board. Among there are stress reduction tools, online and mobile cognitive behaviour therapy, Smartphone and tablet apps for mental health management and downloadable PDF workbooks to manage symptoms of poor mental health.
The upshot of that approach is that it gives the patient greater control over their own care.
“The website is driven by the patient,” Ozersky said. “It helps the patient, care- givers and family members optimize the prevention, early diagnosis and treatment of mental disorders according to the best scientific evidence.
“We promote engagement by making them the centre of the care and letting them choose what suits them best.”
Another benefit of the online tool is that it helps users avoid the stigma that can be attached to mental illness, and that can increase the chances the patient will seek help, he added.
So far, a number of large enterprises have made FBN available to their employees. Among them are TD Bank Financial Group, ArcelorMittal Dofasco, Healthcare Benefit Trust, Fraser Health Authority in British Columbia, University of British Columbia faculty of medicine, Kingston General Hospital and the Ontario Teachers Insurance Plan.
These groups recognize the serious financial implications that can be caused by untreated mental illness, Ozersky said.
He cites research by Ron Kessler, a mental health economist at Harvard University, who estimates that healthcare costs of mental health disorders in the United States reach $3,000 per employee per year. Add on lost productivity and the costs balloon up to $6,000 per employee per year.
Though the Feeling Better Now system is currently available to about 1 million Canadians, Ozersky hopes to see its scope expand. He’d like the Ontario government to adopt it and he is proposing to test the updated version of Feeling Better Now (FBN2) as part of the British health system’s NHS Test Beds Program.