Mental health advocate raises concerns about Icelandic model

While the province's new focus on mental health seems to come with a distinctly Nordic flavour, one researcher cautions against adopting the model wholesale.

Yesterday, Health Minister Dorothy Shephard announced the province's five year plan to increase mental health services.

This includes implementing "a guiding document for population health promotion and prevention" which the province said would be based on the Icelandic Prevention Model.

But Julia Woodhall-Melnik, director of the laboratory for housing and mental health at UNB Saint John, doesn't think the Icelandic model would fit the province's demographics.

"The Icelandic model is great for a middle class family, but I don't think it's going to work for our most vulnerable in society and it's those vulnerable individuals that I'm the most worried about," said Woodhall-Melnik.

The Icelandic model

The Icelandic Prevention Model was introduced in the small island nation in the 90s as alcohol, drug and tobacco use increased among the nation's youth.

The model includes raising the legal age to buy alcohol and tobacco, promoting after school sports and other extracurricular activities, asking parents to spend more quality time with their children and implementing curfews for youth.

The 2008 scientific article "Substance use prevention for adolescents: the Icelandic Model" published in Health Promotion International cited a study indicating that in 1995, 25 per cent of Icelandic 10th graders had become drunk 10 or more times in a 12 month period.

By 2003 that number had dropped to 14 per cent.

But Woodhall-Melnik said there's a couple things that would make the model impractical in New Brunswick.

"In Iceland, individuals experience a lot more equity in terms of income," said Woodhall-Melnik.

"We have a much higher rate of poverty in New Brunswick than they experience in Iceland."

'Very conservative'

Woodhall-Melnik said she understands what would attract the province to this model, calling it a "very conservative mandate" that focuses on strong parenting and behavioural change.

But that mandate starts to break down outside the traditional nuclear family that have two parents with 9-5 jobs.

"It's all well to say, 'OK, we're going to have a committee of parents policing the street at 10 o'clock at night after curfew to take home any kids that they find out wandering,'" said Woodhall-Melnik.

"If I'm a little Jill, let's say and I'm 15 years old, I'm out after curfew, but my mom's working the night shift somewhere and … my other parent is not in the picture. You know, there's nobody for me to come home to necessarily."

She said parent to child contracts forbidding drug and alcohol use, which was part of the Icelandic model, may work for middle class families, but those families are less likely to be at risk of substance abuse.

"Middle class kids, they tend to, you know, try some alcohol, try some drugs, they dabble in this," said Woodhall-Melnik.

"Usually when we look at general population trends and don't look at the individual specific family case, we see that children from lower income backgrounds and children who experience large amounts of trauma are actually the children that are more likely to grow up to use substances problematically."

Change needed

Still Woodhall-Melnik said she was happy to hear the province announce a plan, even one with potential flaws, because change is needed urgently.

"Our mental health system here is far behind other provinces in Canada," said Woodhall-Melnik.

"I'm a not so recent ... immigrant from Ontario and the mental health system there is much more well developed than here."