Book Review: André Picard, Matters of Life and Death: Public Health Issues in Canada

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Review written by Adam Montgomery

André Picard is the health columnist at The Globe and Mail and one of Canada’s top public policy writers. Link:

In the 21st century, Canadians are more concerned with their health than ever before, and for good reason. We’re living longer, are constantly “connected,” and unfortunately, falling prey to the fast-paced, sound-bite lifestyle that technology brings in its wake. André Picard’s latest book is a refreshing and unreserved look at what governments and the Canadian medical system are doing right – and wrong – as they try to keep up with Canadians’ evolving health needs.

Policy & Politics

Matters of Life and Death provides numerous snapshots of major health issues in Canada, largely based on Picard’s reporting for the Globe and Mail. What makes this book particularly important and timely is that unlike most articles and academic journals, Picard focuses on health policy and health politics, and how patient experiences are affected by them. It’s not enough to talk about “patient-centred care,” we have to make sure we are actually achieving it, and, as Picard states on several occasions, we have a long way yet to go. One of the biggest problems, he writes, is that Canadian Medicare lacks vision and goals, has a dearth of leadership, and despite much talk about how great our system is, lags “on the practical side.”[1]


Data collection is not the solution

Perhaps nowhere are these statements more accurate than when it comes to Canadian mental healthcare, and here Picard has much to say. One tough subject he raises is suicide. Given the stark reality that Canada has roughly 3,900 suicides a year – six for every homicide – it is not enough for us to “content ourselves with mopping up the blood, patching the wounds and mending the broken hearts;” we need to invest in preventive measures.[2] Sadly, as with other aspects of the Canadian medical system, we have “become adept at collecting data on depression and suicide,” but have “done little that is concrete to offer help and invest in prevention.”[3] Canada still has no suicide prevention strategy, demonstrating the author’s point that we have become all talk, no action when it comes to mental health matters.

Helpful Adjuncts Like Peer Support

So who or what is to blame for why we allow this public health crisis to go on year after year? For that answer, we must circle back to Picard’s overall assessment of Canadian Medicare. Innovation is, he states, “hampered by policy gridlock.”[4] Worse still, the managers of the system are “largely powerless and beholden to the whims of politicians,” and with few exceptions are “profoundly mistrusting of entrepreneurship and pathologically risk-averse.”[5] This is especially true when it comes to mental health, where helpful adjuncts like peer support are still viewed with mistrust by many doctors and policy makers, despite growing evidence that they work.

Risk & Reward

One of the most important messages Canadians must take from this book is that “If you don’t take risks, you will never innovate.”[6] In this 21st century world, when the mental health of our nation continues to deteriorate while our politicians and policy makers promise much but deliver little, that message is more important than ever. Matters of Life and Death is an important book that speaks to some crucial issues we must face, and overcome, if we are to stop trying the same stale methods and expect a different result.

Picard’s book adds to a growing chorus of individuals who are tired of seeing our politicians and medical system stifled by outdated thinking, turf wars, studies of studies, all yielding few tangible innovations. Enough talk. The time to act is now.

Adam Montgomery is the Amazon bestselling author of “The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan”. He is also the co-author of  After the War: Surviving PTSD and Changing Mental Health Culture.

1 Page 17.
Page 57.
3 Page 62.
4 Page 40.
5 Page 40.
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