Kiwis more accepting of mental health sufferers

From the December 31st edition of The New Zealand Herald:

More New Zealanders feel they could be supportive of someone with a mental illness, according to research issued yesterday.

The research, conducted periodically on behalf of the Ministry of Health's Like Minds, Like Mine programme by Phoenix Research, has tracked changes in New Zealanders' attitudes to mental illness since 1997.

Significant improvements had been made over the past decade, but the Mental Health Foundation was particularly pleased that 71 per cent of people in the latest survey reported that they knew how they could be supportive of someone experiencing mental illness, an increase of 10 per cent over the last survey in 2007.

To read the entire article, click here.

Photograph courtesy of Like Minds, Like Mine.

Schizophrenia: Medicine's Mystery - Society's Shame (Paperback, 2008)

From Amazon.com:

Written by a medical writer and family member of someone suffering from schizophrenia, this book outlines all of the issues involved with schizophrenia and its treatment including stigma, history, causes, physiological changes in the brain, and best treatments. It is an ideal reference and support for family members and others interested in this disease. It is also suitable as supplementary reading for students in health care fields (including medicine and nursing), psychology, social work and any occupation that needs solid information about schizophrenia. The book is recommended by the World Fellowship for Schizophrenia and Allied Disorders on its website.

Click on the image to enlarge it.

Nation Builder 2008: The Finalists - Casting a light on mental illness

From the December 26th edition of The Globe and Mail:

Michael Kirby wants a revolution in the way we regard diseases of the mind, and has established a unique charity to bring it about

By Erin Anderssen

OTTAWA -- As a math student at Dalhousie University, Michael Kirby [pictured] would spend long afternoons sitting in the "Roost," the top floor of his fraternity house, working through differential equations.

On occasion, he would know the answer after a quick glance at the problem.

"I realize it's going to take two hours to figure it out," he would say. "But I can just tell by looking that the answer is x=2."

And usually, recalls his fraternity brother George Cooper, now a prominent Halifax lawyer, he was right.

"He could just pierce through the central core," says Mr. Cooper, "and tell you the answer before he had actually done the heavy lifting to actually be able to prove it."

The ability to know the answer before others have even framed the question has marked Mr. Kirby's tenure as the first chair of the Mental Health Commission of Canada.

To read the entire article, click here.

Also see:

Mental Health Commission Chair Michael Kirby named to Order of Canada (December 30th, 2008).

Photograph by Ashley Fraser.

150 years of healing, serving

An article published in today's edition of The Chronicle Herald:

The Nova Scotia Hospital marks a century and a half of helping patients with mental illness

By John Gillis, Health Reporter

WHEN IT WAS OPENED, the vast Mount Hope Hospital stood on the Dartmouth waterfront off Asylum Road.

Today that route is called Pleasant Street and the Nova Scotia Hospital is a collection of smaller but still imposing buildings. The site will remain a centre of psychiatric care, but years from now a passerby might be hard-pressed to imagine its institutional past.

The first patient was admitted to what was then known as a lunatic asylum 150 years ago today, A.H. MacDonald notes in his Mount Hope Then and Now: A History of the Nova Scotia Hospital.

The evolution of the facility reflects the history of modern psychiatry, Dr. Nick Delva, chief of psychiatry for the Capital district health authority, said in the hospital’s health sciences library recently.

The original hospital, the first of its kind in Nova Scotia, was founded by former Halifax mayor Hugh Bell [pictured], whose push for such a facility was backed by American advocate Dorothea Dix.

It was mainly a place to hold people with mental illnesses, rather than treat them, Dr. Delva said. A stay of two years would have been considered a short one.

He said the approach to the care of patients would likely have been centred on the idea of healthy living.

The hospital was deliberately located away from busy Halifax. Patients would be given good food and treated humanely. The hospital operated a farm across the road, partly so that it would be self-sustaining and also to give able patients an occupation.

A minority of patients would fare well enough to be discharged.

"Through just the natural courses of the illnesses, people would recover," Dr. Delva said, noting people with depression and even acute psychoses may go through cycles or "burn themselves out."

An 1876 hospital record book notes reasons for admission, including intemperance, "change of life" for a 47-year-old woman, sunstroke and measles.

Other people who would clearly be recognized as having mental illnesses today might never have seen the hospital in those days, said Dr. Alistair Munro, who worked at the Nova Scotia Hospital from 1983 to 1999 and is a former chief of psychiatry.

"Insanity was a disgrace," he said. Many people would have been kept at home, despite their illnesses, to avoid shaming their families.

There would have been some drugs available to treat mental illnesses at that time, but the fact the brain is a collection of separate cells — fundamental to current therapies — was not known until the turn of the 20th century.

The hospital grew in size, eventually holding more than 700 people. In 1918, 270 people were admitted, bringing the number under care to 746.

A letter from that year describes a patient of Dr. Lewis Thomas:

"This is to certify that Miss Mary O went insane in 1918 and died at the Nova Scotia Hospital Nov. 18, 1918. I first began to treat her on Feb. 6 for nervousness. This nervousness gradually developed into insanity. I consider that the explosion of Dec. 6, 1917 [pictured], had a good deal to do in causing this mental condition to develop."

There were major advances in the 20th century in the drugs available to treat mental illnesses, helping to drive a major shift in the approach to care.

"The expectation is that most people will live in a non-institutional setting," Dr. Delva said.

Several smaller buildings were constructed on the hospital grounds and the large original Mount Hope building eventually came down.

Those newer buildings are also destined to come down. Simpson Hall, built in 1964 as a residence for students of the hospital’s long-running nurse training program, will be demolished in the coming year to make way for four 10-bedroom houses for people getting ready to live in the community.

Plans are for the 50-year-old red-brick Purdy building, itself a waterfront icon, to fall in time.

In mid-December, there were a total of 116 in-patients at Nova Scotia Hospital buildings.

Among the artifacts on display in the library is a 1950s-era electro-convulsive therapy machine. So-called "shock treatments" may be thought of as outmoded, thanks in part to our "cultural memory" of the therapy gleaned from sources like the Oscar-winning film One Flew Over the Cuckoo’s Nest, Dr. Munro said.

He called the 1975 film, based on a 1962 novel, "dishonest," depicting conditions and approaches that were already very dated by that time.

Electro-convulsive therapy is still a treatment given at the Nova Scotia Hospital, but it’s a far cry from the punitive and traumatic treatment many might imagine. Dr. Delva said all kinds of medical evidence supports its effectiveness in treating persistent depression. It’s given under anesthetic and patients receive muscle relaxants that eliminate violent seizures. Dr. Delva said a person can’t drive home afterward because of the anesthetic but otherwise should have no physical effects.

A majority of mental issues are now handled by family doctors in co-operation with a variety of other health practitioners.

Some psychiatric patients still spend long periods in hospital. Some are seniors with dementia, some have intellectual disabilities as well as psychiatric illnesses and there are rehabilitation services for people who need significant help getting ready to live in the community.

Between those people whose illnesses can be managed by family doctors and those who require long hospitalization are a group of patients who need a complex system of care, Dr. Delva said.

Many can still live in the community with supports and medications, though for people whose illnesses impair their understanding of how well or sick they are, contact from mental health care providers sometimes needs to be assertive.

"That means you’ve got to get out there, be their memory, be their support," Dr. Delva said. "Those are people that would have been in institutional settings for sure their whole life in the olden days."

Today, mental illness may not always be viewed as the social disgrace it once was, but a real stigma remains.

Dr. Munro attributes much of that to the terrible conditions and failure to help patients in underfunded and overcrowded psychiatric hospitals of the middle part of the 20th century.

Dr. Munro and Dr. Delva agreed funding for mental health care is still not where it needs to be. But Dr. Delva said he’s optimistic Nova Scotia is moving in the right direction.

"Good care, good facilities will remove the stigma," he said.

Photograph of the Halifax Explosion from Wikipedia.

Photograph of the Nova Scotia Hospital by rwkphotos (used under Creative Commons License).

Playing For Change: Song Around the World - "Stand By Me"

Text with the video:

From the award-winning documentary, "Playing For Change: Peace Through Music", comes the first of many "songs around the world" being released independently. Featured is a cover of the Ben E. King classic by musicians around the world adding their part to the song as it travelled the globe.

WHO Proposes Plan to Close Major MH Treatment Gap

An article published in the December 19th edition of Psychiatric News:

By Aaron Levin

The World Health Organization pushes governments and organizations around the globe to boost services for mental, neurological, and substance abuse disorders.

The "huge treatment gap" in the developing the world for psychiatric, neurological, and substance use disorders can be narrowed if governments and donors can increase funding, expand mental health services, and integrate the latter into primary care settings, said the World Health Organization (WHO) in announcing its Mental Health Gap Action Program (mhGAP) in October.

The plan seeks to strengthen commitments by governments and international organizations to put more human and financial resources into treating these disorders and expand access to targeted interventions in low-income and lower-middle-income countries.

"We have in hand, right now, all the evidence, solutions, and lines of action we need to address the global burden of morbidity and premature mortality caused by these disorders," said Margaret Chan, director general of WHO, at a news conference in Geneva. "But have no illusions.... Having evidence and a well-designed package of interventions are not enough. We will not see progress in mental health without political commitment."

To read the entire article, click here.

Margaret Chan [pictured]: "Having evidence and a well-designed package of interventions are not enough. We will not see progress in mental health without political commitment."

Credit: World Health Organization

Also see:

Mental Health Gap Action Programme (mhGAP): Scaling Up Care for Mental, Neurological, and Substance Use Disorders (PDF)

MHCC NEWS: Winter 2008-2009

To download the complete newsletter, click here (PDF).

Mental Health Stamp

From Canada Post:

In 2008, Canada Post adopted Mental Health as its chosen cause with a commitment to raise awareness for what is sometimes referred to as the “Invisible Disease.” This PERMANENT™ domestic rate (52¢) stamp has been issued as a semi-postal stamp, which means that the cost of the stamp includes a surcharge in addition to the face value. In this case, proceeds from the 10-cent surcharge will go towards mental health research and patient support.

Booklet of 10 stamps. Price: $6.20

To purchase the stamp, click here.

Click on the image to enlarge it.

Semantics matter in schizophrenia

A letter to the editor published in the December 19th edition of the Vancouver Courier:

To the editor:

Re: "Hitting the High Notes," Dec. 10.

Thank you for your informative profile of musician/activist Earle Peach.

I have just one criticism. In the article, writer Lenore Rowntree referred to her sister as "schizophrenic"--a common error that a lot of people make. Perhaps she meant that her sister has schizophrenia. That makes more sense since schizophrenia is a mood disorder that often comes and goes, not a religion.

Besides that, calling people "schizophrenic" or "bipolar" pigeonholes them as walking chemical disasters. As someone who works in the mental health community, I am constantly blown away by the talented, perceptive and compassionate people around me. Many have a diagnosis like schizophrenia but can and do run circles around so-called "normal people" in the greater community. Ironically a great number of journalists are thought to have some form of bipolar disorder.

It's time for us to stand up for ourselves, be accurate and make sure that all journalists in print, radio and television are as well.

Cassandra Freeman, Vancouver

Family of man who died in Taser incident says he was ill, not violent

An article published in the December 20th edition of Mercury News (San Jose, California):

By John Woolfolk

The family of a man who died Friday after repeated Taser jolts dispute police accounts and say he already was pinned under several deputies, handcuffed and not fighting back when another officer used his stun gun.

Rather than the "strenuous, intense physical altercation" that police described, the family of 26-year-old Edwin Rodriguez [pictured] said he was confused but not combative with officers that night. They also said Rodriguez suffered from schizophrenia, a chronic mental illness that can cause hallucinations.

"He wasn't violent at any point," said Emilia Centeno, 35, a cousin whose brother and mother witnessed the incident. They have cell-phone photos showing several officers on top of Rodriguez that they say they took before the officer used the Taser.

"That is what we don't understand. Why would you use it on him more than one time when there were so many officers already on top of him and he couldn't move and wasn't fighting back?"

To read the entire article, click here.

BOOK REVIEW: 'Soloist' examines human side of mental illness, friendships

Posted on December 18th by TheStarPress.com:

By Ivy Farguheson

If a friend or family member has been diagnosed with schizophrenia and you're at your wits end trying to figure out what to do for them, here's a suggestion. Read The Soloist: A Lost Dream, an Unlikely Friendship and the Redemptive Power of Music by journalist Steve Lopez, and breathe.

Nathaniel Ayers is a homeless man Lopez sees playing the violin near his office at the Los Angeles Times. A regular columnist for the newspaper, he decides to talk to Ayers, in hopes of coming up with his latest column.

He then enters into the complex world of mental illness, homelessness and media responsibility, opening his eyes to his own narcissistic behaviors and the beauty of freedom and music.

Ayers suffers from paranoid schizophrenia, something readers and Lopez discover early on. Through continual conversations with him, Lopez discovers that he has an impressive musical knowledge and spent time in his 20s as a student at Julliard.

With each meeting, Lopez becomes more intrigued with the community services for the homeless in Los Angeles and the struggles of truly caring for someone with schizophrenia. He continues to write columns about what he discovers in his city, but begins to wonder if he is exploiting Ayers for his own celebrity.

The Soloist is an excellent book, not because of its subject matter or the author's writing style, but because of its raw honesty. Ayers is homeless and does not wish to take medication or stay in shelters. He prefers to stay on the street, playing his music, experiencing what he believes to be true freedom.

And Lopez is a middle-class professional with his own ideas about how life should be lived and what should be done to save those who need community services.

In this work, these two men show the power of friendship and its ability to change each of us in ways we are unaware of every day. Whether Ayers moves inside or begins to take his medication is not the point of this journey. Nor is the path Lopez takes to see how he is pushing his own ideas on someone with an illness unknown to him.

The message of living and learning from the world around us is the paramount lesson in this work. Similar to A Beautiful Mind, this work certainly opens readers' minds to those living with schizophrenia. But more importantly, it opens the hearts of those who judge others for various reasons.

The Soloist won't solve anyone's problems or answer those questioning the world of mental illness, but it will encourage readers to take a breath, slow down and love those who enter their lives.

Artist fights stigma of schizophrenia

From the December 16th edition of the Times Union:

By Lori Cullen

Amber Christian Osterhout uses her artwork to raise awareness of the stigmas and discrimination people with mental illness can suffer.

To read the entire article, click here.

The above image is by Luanne M. Ferris of the Times Union.



The above poster is by Amber Christian Osterhout (click on the poster to enlarge it).

Targeted funding misses core areas

From the December 15th edition of the Times Colonist:

It would be a great loss if valuable agencies such as the B.C. Schizophrenia Society had to slash services -- or even close -- as an unintended consequence of a provincial government funding policy and the economic downturn.

One of the Liberal government's policy shifts after the 2001 election was a move from block funding to non-profits across the province to targeted program funding.

Where the government had reviewed an organization's overall operations and decided on an appropriate level of public funding, it adopted a new approach.

Non-profits could apply for money to cover the direct costs of specific programs. For anything else, they were on their own.

There are merits to the approach. The government has more control on how the money is used and can assess value for money spent more directly. It can set priorities, rather than leaving it up to the local non-profit to assess community needs. And ministries know where their contribution is being spent.

But the shift also created problems. Non-profits' core expenses -- rent, basic administration staff, fundraising, newsletters and programs not covered by the province -- were no longer funded. The expenses were necessary to maintain the organization, but the funding formulas didn't acknowledge that reality.

And the agencies lost the flexibility that allowed them to react to emerging needs by shuffling funding. If there was a spike in the need for services for seniors suffering from schizophrenia, for example, in the past the society could have shifted money from another program. That was no longer allowed by government.

Most rose to the challenge by seeking donations or holding fundraisers to cover core expenses. That was difficult, because donors -- like government -- respond more enthusiastically to appeals for money to support specific programs.

To read the entire article, click here.

Also see:

Sinking into debt, health care non-profits fight for survival

Image courtesy of the British Columbia Schizophrenia Society (click on the image to enlarge it).

New Report: Poverty line is being cracked, but not broken

Cross-Canada action needed as economy worsens, National Council of Welfare says


A December 10th press release from the National Council of Welfare:

Toronto, December 10 – While incomes for most Canadians on welfare were stuck far below the poverty line, some cracked that line in 2007, the newest report by the National Council of Welfare says. But tough economic times mean it will be tough to really break through, unless comprehensive, nationwide action is taken, says the advisory body to the federal government.

Welfare Incomes, 2006 and 2007 looked at the circumstances of Canadians on welfare in all provinces and territories. The study by the National Council of Welfare found that in the case of the lone parent with a pre-school age child living in Quebec, welfare income for 2007 reached 100 per cent of the Market Basket Measure (MBM), a poverty line measurement that takes into account the cost of meeting basic needs in different parts of Canada.

In the case of the lone parent with a pre-schooler in Newfoundland and Labrador, welfare income slightly surpassed the MBM, at 103 per cent.

“This information is considered significant because welfare incomes in Canada have historically been only a fraction of the real costs of survival and far below the poverty line”, said John Rook, Chair of the Council. “This means that lone-parent incomes, which include social assistance and federal child benefits, have reached a level that begins to give these families a reasonable chance in life. Even more encouraging, Quebec and Newfoundland and Labrador have poverty reduction strategies in place where social assistance is part of a larger, integrated framework with links to child care, health, education, and labour market policies. This can truly help people to get ahead.”

At the same time, however, the report found that single employable people receive welfare incomes at less than half of the MBM in most provinces, far below any measure of poverty or decency.

These incomes range from a low of 27 per cent of the MBM to a mere 67 per cent even in the best of cases. The Council is also concerned about the maze of rules and regulations that can trap welfare recipients and often discourages or even prohibits them from helping themselves out of poverty.

For example, people on welfare can keep little or none of their earnings if they can find some employment, which can discourage them from looking for work. Administrative rules vary throughout the country, but the new report details consistently how qualifying for welfare is a complicated, cumbersome and stigmatizing process.

As the economy deteriorates, the National Council of Welfare is concerned that the number of Canadians facing hardship will likely grow. In addition to welfare recipients, there are people who manage to leave the welfare system on their own, and others who can’t qualify, have been cut off or won’t sacrifice their assets or dignity to apply, Rook noted. While some may get ahead, others may be trading one form of poverty for another, and that is not good news for Canada anytime, especially not now.

“A comprehensive, pan-Canadian strategy to solve poverty is needed”, Rook added. “It should have targets and timelines, a plan of action, accountability and measurable indicators.” Many partners must be involved. Canada is not unique. “For any nation to solve poverty or foster prosperity there must be government action, political will and a real recognition of the human face of poverty.”

Media contact:
Carrie Breckenridge (613) 552-3527

The report and additional documentation are available at www.ncwcnbes.net.

For hard copies of the report, contact:
The National Council of Welfare
112 Kent Street, 9th Floor
Place de Ville, Tower B
Ottawa, Ontario K1A 0J9

Telephone: (613) 957-2961
Fax: (613) 957-0680

The National Council of Welfare is an independent body established to advise the federal government on issues related to poverty and social development.

Welfare Incomes, 2006 and 2007 estimates total welfare incomes in the 13 provinces and territories for four types of households: a single employable person; a single person with a disability; a lone parent with a two-year old child, and; a two-parent family with two children aged 10 and 15. There are 53 scenarios in all because Alberta has an additional program for persons with disabilities. The NCW has produced similar estimates since 1986.

Click on the image to magnify it.

Also see:

2007 Provincial Welfare Rates Compared to the MBM (National Council of Welfare Fact Sheet)

Governments must 'step up’ on poverty

Welfare recipients poorer than Canadians imagine: report

Economy hits poor hardest

Welfare inadequate to meet needs: report

Negative feedback gets positive results

A news article posted on December 5th by Rice University:

Rice grad student’s discovery may be clue to epilepsy, autism, schizophrenia

By Mike Williams

Taking an unplanned detour from neurofibromatosis research, Eric Howlett [pictured] found something interesting: a potential clue to the roots of epilepsy, autism, schizophrenia and other neurological disorders.

The Rice University doctoral student had his “Aha!” moment while studying the peripheral nerves of the Drosophila, aka the fruit fly. That’s where he found an unanticipated connection between glutamate -- an amino acid and neurotransmitter found in much of the food we eat -- and phosphoinositide 3-kinase (PI3K), an enzyme that, Howlett found, regulates the activity of neurons.

To read the entire article, click here.

Photograph courtesy of Rice University.

Manulife invests $500,000 in Nova Scotia mental health projects

A December 9th press release from Manulife Financial Corporation:

Nova Scotians living with a mental illness will benefit from a $500,000 donation announced today by Manulife Financial to support early intervention programs and community-focused living residences.

"The costs for mental illness is in the billions of dollars for the Canadian economy each year; therefore businesses have a part to play in recognizing and investing in good mental health," said Paul Rooney, President and CEO, Manulife Canada.

"It's also important that we continue to improve the way mental illness is perceived in our society so that those experiencing mental illness and their families receive the same high level of care, support and hope as those dealing with other illnesses."

"Manulife's investment will play a part in helping us achieve our vision of making sure the people of Nova Scotia are healthy, especially our youngest Nova Scotians," said Premier Rodney MacDonald. "This is so much more than treating illness. It's about making healthy lifestyles a lifelong commitment for people, providing support for those who need it, and changing the circumstances that cause so much harm."

Manulife Financial has committed $250,000 of the money to the Canadian Mental Health Association's Nova Scotia Division for a prevention program for children and a peer support program for youth.

"Mental Health affects us all one way or another. Between 15 percent and 25 per cent of our children and youth suffer at least one mental health problem or illness. Fear, embarrassment, peer pressure and stigma are all barriers to children and youth talking about mental health or asking for help," said Charles Bruce, CMHA Nova Scotia's chair. "Manulife's investment will go a long way towards teaching children and youth about mental illness and how to talk about it with their friends, siblings and families in a way that reduces stigma."

Manulife also announced that the other $250,000 contribution will go to the Mental Health Foundation of Nova Scotia for the construction of residences for patients at the Nova Scotia Hospital who are making a transition back into the community.

"When you consider the cost of supporting someone with serious mental illness in the hospital is $170,000 a year, compared to the $35,000 it costs to support that same person in the community, Manulife's investment in the residences makes good financial sense," said Robert Hunt, the Foundation's chair. "Manulife's investment is an excellent start towards our Foundation's $2 million fundraising goal in order to make these residences a reality for Nova Scotians recovering from a mental illness."

Mental illness is the leading cause of employee disability in the workplace, affecting both absenteeism and productivity. More than 30 per cent of Manulife Financial's long-term disability claims administered on behalf of clients are related to mental illness. Industry studies estimate that mental illness costs the Canadian economy more than $51 billion a year in lost productivity, direct medical costs and reductions in health-related quality of life.

Media contacts:

Manulife Financial
Tom Nunn
(519) 594-8578
tom_nunn@manulife.com

Mental Health Foundation of Nova Scotia
Catherine Kieran
(902) 464-5994/233-3298
catherine.kieran@cdha.nshealth.ca;

Canadian Mental Health Association - Nova Scotia Division
Carol Tooton
1-877-466-6606
tootonc@eastlink.ca

Capital Health - Mental Health Services Satisfaction Survey 2007

To view this document, click here.

From the Preamble:

The Mental Health Services Satisfaction Survey was distributed within Capital Health between November 1st and 30th, 2007. This is the third year the survey has been distributed to people who utilize Mental Health Services within Capital Health.

Quote for Today

"According to reports published in the Journal of the American Medical Association, roughly 50% of individuals with personality disorders are affected by substance abuse, and 37% of alcohol abusers suffer from some form of mental illness. Individuals with schizophrenia or bipolar disorder are four or five times more likely, respectively, to suffer from substance abuse than the general population."

Source

For help, visit:

Schizophrenia & Substance Use

Addiction Services (Nova Scotia)

Alcoholics Anonymous (Nova Scotia)

Narcotics Anonymous (Nova Scotia)

Some tested Tasers fire stronger current than company says: CBC/Radio-Canada probe

An article posted December 4th on CBCnews.ca:

Some Tasers deliver a higher level of electricity than the manufacturer promises, reveals a series of tests on 41 stun guns that was commissioned by CBC News and Radio-Canada.

The abnormal X26 model Tasers were manufactured before 2005, prompting some scientists to suggest police should stop using any older versions of the stun guns until they can be tested.

Of the 41 Tasers tested, four delivered significantly more current than Taser International says is possible. In some cases, the current was up to 50 per cent stronger than specified on the devices.

To read the entire article, click here.

The photograph shows three of the X26 Tasers tested by U.S.-based lab National Technical Systems as part of a CBC/Radio-Canada investigation into the devices. (Photograph courtesy of CBCnews.ca)

New drug for schizophrenia offers relief from weight gain

Posted on December 1st by 3news.co.nz:

An alternative antipsychotic drug which causes less weight gain than older treatments has been funded for those with schizophrenic disorders by New Zealand’s drug buying agency Pharmac.

Patients would be able to get the drug, amisulpride (Solian) [molecular structure illustrated], from today, which has been funded without restrictions.

Pharmac’s medical director Peter Moodie said increasing the range of treatments [for schizophrenia] had benefits for a condition that was difficult to treat.

"Over recent years some of the older antipsychotic treatments have been discontinued and so increasing the choice of medicines is an advantage," he said.

He also confirmed amisulpride was less likely to cause weight gain than other antipsychotics.

The agreement also saw injection and suppository formulations of the antinausea treatment prochlorperazine (Stemetil) becoming fully funded.

Antipsychotic drugs cost Pharmac more than $60 million a year, one of the agency’s highest expenditure groups.

Suicide risk in schizophrenia: learning from the past to change the future

The abstract of a review paper published in the March 16, 2007, edition of Annals of General Psychiatry:

By Maurizio Pompili, Xavier F. Amador, Paolo Girardi1, Jill Harkavy-Friedman, Martin Harrow, Kalman Kaplan, Michael Krausz, David Lester, Herbert Y Meltzer, Jiri Modestin, Lori P. Montross, Preben Bo Mortensen, Povl Munk-Jørgensen, Jimmi Nielsen, Merete Nordentoft, Pirjo Irmeli Saarinen, Sidney Zisook, Scott T Wilson and Roberto Tatarelli

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of [individuals living with schizophrenia] die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that [people living with schizophrenia] who [are] more likely to commit suicide [are] young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal [individuals with schizophrenia] usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal patients with schizophrenia, yet some researchers argue that insight into the illness does not increase suicide risk.

Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening [these individuals] for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures.

This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as
well as the development of a set of guidelines for reducing suicide risk among schizophenia patients.

I have taken the liberty to edit the abstract to remove the word schizophrenic.

To read the entire paper, click here (PDF).

Thanks go to the Lancashire Care Library & Information Service for bringing this paper to my attention.

Freedom to be sick leaves families feeling chained

From today's edition of The Globe and Mail:

Caregivers who can't get mentally ill loved ones to seek help grapple with laws designed to protect civil rights

By André Picard

Mary Liz Greene [pictured] was in the midst of an animated conversation with her son when he suddenly lunged, grabbed her by the neck with two hands, then pushed his thumbs into the soft flesh of her throat, using the full force of his 6-foot, 200-pound frame.

Gasping for air, she felt the pressure let up for an instant, shoved him with all her might and fled to a neighbouring apartment to call 911.

“I'm lucky to be alive,” Ms. Greene said later, “although sometimes I doubt that.”

Her son, 24-year-old John Candow, suffers from severe bipolar disorder and, when untreated, is consumed by the delusion that he is Tony Soprano, the TV mobster. He has been living with his mother and, since he was diagnosed three years ago, has thrown knives at her, burned her with cigarettes, punched and kicked her repeatedly.

Last week's incident was the most violent yet. When police arrived, they were confronted with a psychotic young man holding a knife to his throat threatening suicide. They tasered, subdued and arrested him – and found 10 more knives in his knapsack.

When Ms. Greene, a Halifax social worker, visited her son at the East Coast Forensic Hospital a few days later, he reminded her, matter-of-factly, that he plans to kill her and chop her body to pieces.

“When John's not sick, when he's being treated, he's very loving. He's a sweet, beautiful boy,” Ms. Greene says tearfully.

But the central fact of the sordid tale is this: Mr. Candow refuses to get treatment, as is his right under Canadian law.

That right presents a dilemma for countless caregivers across the country whose loved ones have such severe mental illnesses as schizophrenia, bipolar disorder and addictions, especially when they also suffer from anosognosia – an inability to recognize they are sick.

To read the entire article, click here.

Photograph by Sandor Fizli for The Globe and Mail.

The loneliness of the psych ward

From today's edition of The Globe and Mail:

By Erin Anderssen

Ben Robinson [pictured] spent long months during his hospital stays pacing the halls alone, hoping someone would visit.

Hardly anyone did, except for his mother, even though he phoned friends specifically to ask for company. The people who eventually braved the locked ward at the Clarke Institute never stayed long. “Where are the white padded rooms?” they joked.

“It was a bit of freak show kind of thing,” says Mr. Robinson, a 24-year-old part-time student in Toronto who has been diagnosed with schizo-affective disorder – a condition defined by symptoms of both a mood disorder, such as depression, and schizophrenia. “Like, ‘Whoo, let's go see my friend in the mental hospital.' ”

Even so, those visits made all the difference, he remembers – a few moments to feel “semi-normal,” to talk to someone from the outside and forget that he wasn't free to leave. The nurses, he says, were too busy to spend much time on chit-chat; the patients didn't mix much except to watch TV in silence. Other than a daily 30-minute appointment with his psychiatrist and taking a few workshops, he spent most of his time drinking tea and walking. “It's incredibly lonely and boring in the hospital,” he says. “I needed people to be there as much as possible.”

Mr. Robinson was lucky to get any visitors: Studies suggest that as many as 40 per cent of psychiatric patients never see a family member or friend at their bedside. According to a recent survey conducted at Toronto's Centre for Addiction and Mental Health, one-third of hospitalized patients in the mood and anxiety program received no family visits – and 20 per cent were visited only once or twice. Friends were even less in evidence: More than 70 per cent of the people surveyed said they received no more than two visits, and the majority didn't see a single friend.

There's a reason why psychiatric hospitals don't usually have gift shops: Nobody buys gifts for their patients. “You go into any ward in any hospital, and you will see cards, a balloon or two, flowers, teddy bears,” says Karen Liberman, executive director of the Mood Disorders Association of Ontario. “The psych ward is virtually the only place where you see nothing and nobody.”

To read the entire article, click here.

Photograph by Deborah Baic of The Globe and Mail.

Psychiatry: A specialty relegated to the basement

An article published in the today's edition of The Globe and Mail:

By Carolyn Abraham

Jai Shah [pictured] could have been any sort of doctor he wished. Even before he graduated with honours from the University of Toronto's medical school, the 30-year-old Edmonton native had earned a master's degree in international health policy from the London School of Economics, published papers and worked for the Canadian Institutes of Health Research.

Praise follows him wherever he goes. Except for last fall – when he decided to specialize in psychiatry.

“A psychiatrist?” some of his supervisors said, “But you're smart! … You're taking the easy way out … Your patients will make your life hell … Your patients will make you depressed … What a waste of talent!”

Dr. Shah knew mentally ill people battle both their disorders and the social stigma their conditions carry. But it surprised him that psychiatrists confront a certain stigma, too.

“I'm sure the feedback has discouraged some young doctors from choosing this as their career,” said Dr. Shah, now at the Harvard Longwood Psychiatry Residency Training Program in Boston.

In fact, Susan Abbey, who heads the U of T first-year residency program in psychiatry, said the disparaging comments are “ubiquitous.”

“I don't think there's one of our incoming residents who hasn't been exposed to negative comments from family or friends or academic supervisors,” Dr. Abbey said.

Just as lawyers can face a barrage of bottom-feeder jokes, psychiatrists, both in film and real life, have long been seen as doctors of a lesser science. Even their own physician colleagues can view their patients as difficult and time-consuming. The negativity, experts say, is contributing to a national shortage of psychiatrists and shoddy care for mentally ill people.

To read the entire article, click here.

Photograph by Jodi Hilton for The Globe and Mail.

Membership Involvement is Required to Bring About Change

Click on the image to enlarge it.

Schizophrenia study puts patients in charge

Posted November 21st on StoneyCreekNews.com:

Hearing [Our] Voices sheds light on control, medication challenges

By Richard Leitner, News Staff

Barbara Schneider [pictured] recalls her shock at her eldest son’s reaction to his being diagnosed with schizophrenia at 23. They had stopped for a breather during a bike ride and she had expected him to agree with her observation that he’d had a tough year.

“He said, ‘Oh, no. No, since my diagnosis I think that it’s so much better,’ ” Ms. Schneider recounted at a recent forum hosted by St. Joseph’s Healthcare Hamilton.

“He was referring to the fact that he’d received a diagnosis that helped him make sense of his very frightening experiences and that he was taking medication to help him cope better with life in general.

“It’s not too strong to say that I was completely stunned by the difference in our perspectives.”

The revelation prompted the University of Calgary communications professor to spearhead a groundbreaking study that took a unique look at the struggles faced by people diagnosed with schizophrenia: it put the patients in charge.

To read the entire article, click here.

Also see:
callhome.ucalgary.ca

Photograph of Dr. Barbara Schneider courtesy of the University of Calgary.

$9.8 Million Grant to Map “Epigenome” of Schizophrenia

A November 21st press release from Johns Hopkins Medicine:

Researchers at the Johns Hopkins University School of Medicine and four other academic medical centers have been awarded a $9.8 million grant from the National Institutes of Mental Health to pin down inherited changes that occur outside a cell’s DNA sequence in people with schizophrenia. Unlike changes or mutations in the DNA sequence itself, epigenetic marks or alterations can be affected by a lifetime of exposure to the environment in which cells operate.

“A comprehensive understanding of a disease’s epigenome can provide hidden and valuable clues to the role of diet, chemicals, infections and behaviors in genetic predisposition to diseases,” says Andrew Feinberg [pictured], M.D., professor of medicine and director of Hopkins’ Center for Epigenetics in its Institute of Basic Biomedical Sciences. Because a significant indicator of epigenetic change is our body chemistry’s addition of so-called methyl groups to DNA at specific sites, the research will focus on identifying changes in “methylated” sites in the epigenome that are associated with schizophrenia.

The research team is comprised of scientists at Hopkins, University of Pennsylvania, University of Alabama at Birmingham, University of Pittsburgh, and University of California San Diego. "The NIMH is very excited about funding this team of world-class scientists to look into epigenetic factors as possible causes for schizophrenia," says Thomas Lehner Ph.D., M.P.H., chief of the genomics research branch and the associate director of the division of neuroscience and basic behavioral science at the National Institute of Mental Health.

“Many researchers have identified genetic alterations associated with schizophrenia, but so far they do not account for a large proportion of schizophrenia patients,” says Feinberg, who is leading the multi-institutional effort. “Our work can identify differences in methylation patterns seen in blood samples or brain tissue samples from patients with and without schizophrenia to fill out the whole picture of both epigenetic and genetic contributions to this disabling disorder.”

The scientists will take advantage of DNA samples from the National Institutes of Mental Health genetics repository. They will analyze the methylation patterns at nearly ten thousand sites throughout the genomes of several thousand samples and controls, choose the 50 most prominent sites, and map the locations of the methylation marks to identify and analyze the activity of nearby genes.

“These studies will provide the first comprehensive evaluation of the epigenetics of schizophrenia and allow for unprecedented integration of genetic and environmental information about schizophrenia,” says Feinberg.

Because epigenetic changes — unlike nuclear DNA changes — are potentially reversible, “these studies may also lead to exciting new avenues for schizophrenia therapy,” Feinberg notes.

Stephen Desiderio, M.D., Ph.D., director of the Institute for Basic Biomedical Sciences at Hopkins, says the collaborative nature of the epigenome investigation “promises to add quickly and richly to the growing body of knowledge about schizophrenia,” which affects an estimated 2 million adults in the United States alone.

On the Web:
www.hopkinsmedicine.org/ibbs/research/epigenetics

Media Contacts:
Audrey Huang; 410-614-5105; audrey@jhmi.edu
Maryalice Yakutchik; 443-287-2251; myakutc1@jhmi.edu

Photograph of Dr. Feinberg courtesy of Johns Hopkins Medicine.

Costas Halavrezos interviews the executive director of the SSNS

From the November 19th edition of CBC Radio's Maritime Noon:

Donnie Harvey is from Bridgewater, Nova Scotia. His family tried to get him help for what they believed were his psychotic episodes, but couldn't - until he threatened his mother with a knife, and she involved the police.

Since 2007, psychiatrists in Nova Scotia have had a tool that could prevent such attacks. It's called the Involuntary Psychiatric Treatment Act. It allows mental health professionals to force someone into treatment if they determine the person is a danger to others or themselves.

Stephen Ayer [pictured] is the executive director of the Schizophrenia Society of Nova Scotia and he says it's a powerful tool that isn't being consistently used, and that endangers many families.

To listen to Costas Halavrezos interview Stephen Ayer, click here (RealPlayer).

Photograph by Denton Conrad.

Laing House is all about healing

From the November 13th edition of the Community Herald Halifax:

Unique facility helps teens, young adults deal with mental health issues

By Pat Lee, Staff Reporter

Early November is a sad time of year for Hans [pictured] and Dani Himmelman. It’s the time of year when their 23-year-old daughter Genna took her own life.

But the couple have found a way to channel some of their grief by becoming avid supporters of Laing House, the only centre of its kind in Canada offering critical support to teens and young adults dealing with serious mental health issues.

"It’s very rewarding for us to be involved with Laing House," Hans said recently.

"It’s a way for us to deal with our own grief and to help other kids."

Along with being active volunteers at the house — Dani works with parents, and Hans is the incoming chairman of the board — they were involved with the home’s annual fundraiser UnMasked Mental Health Masquerade, held just a few weeks ago.

Last year, the event raised $150,000 for Laing House.

Hans, a 30-year employee at CIBC Wood Gundy, got people in his workplace involved and secured $16,000 for the cause, half from the investment firm and the other half from seven colleagues.

"Our Halifax office has been a major supporter," he said.

Hans said that although his daughter lost her struggle with mental illness four years ago, it’s been healing to see the success stories that happen at Laing House every day.

"She was one of the few who didn’t make it through," he said of his daughter’s struggle with schizophrenia and depression from about the age of 12.

"But Laing House was instrumental in getting her back on her feet."

Located in a Victorian house on Barrington Street, the centre was established in 2001 by his friends Keith and Rosemary Hamilton in honour of Rosemary’s mentally ill mother and a child of their own with mental illness. The centre offers a wide range of programs and supports for teens, young adults and their families.

Hans said that through Laing House, Genna was able to find jobs and activities she enjoyed.

"There’s a real void in our mental health system that doesn’t provide for peer support or the support that Laing House provides," he said.

"When kids are recovering from, or living with, a mental illness, they need to know that they’re not in isolation."

Next fall, the Himmelmans and four other couples will climb Mount Kilimanjaro to raise money for the house.

Photograph by Christian Laforce of the Community Herald Halifax.

Activists demand action against poverty

From the November 16th edition of The Chronicle Herald:

Province not giving enough support, rally told

By Tom Peters, Staff Reporter

Anti-poverty activists and support organizations took their cause to the streets of downtown Halifax on Saturday, demanding that the provincial government take action to assist poor people.

About 100 people, including young and old representing a variety of community groups, organizations and service agencies, chanted slogans, beat on drums and carried signs that bore messages such as Economic crisis not new to us, Stop the war on the poor, Child in poverty and Daycare for kids not bailouts for banks.

Their demands focused on increased social assistance, a raise in the minimum wage, increased access to employment insurance, affordable housing, universal childcare and affordable post-secondary education.

After a brief rally in Victoria Park, the activists marched to Province House, where speakers called for government action. There were no politicians at the House on Saturday.

Wayne MacNaughton, an advocate for the homeless, told the gathering in the park that politicians need to be held accountable for the things they are not doing. He said politicians demand report after report on poverty issues "yet they have known for years what needs to be done because every report always says the same thing," he said.

Mr. MacNaughton was critical of the lack of funds for Pendleton Place, a Halifax shelter for the homeless that won’t reopen this winter.

He said that was "appalling since government has done absolutely nothing to address the underlying issue, which is more affordable housing and more community supports for people suffering from mental illness and addictions. They have done nothing on either of those things."

To read the entire article, click here.

Also see:

Protestors call for end to the 'war on the poor'

Photograph by Ingrid Bulmer, The Chronicle Herald.

In a Novel Theory of Mental Disorders, Parents’ Genes Are in Competition

An article published in the November 10th edition of The New York Times:

By Benedict Carey

Two scientists, drawing on their own powers of observation and a creative reading of recent genetic findings, have published a sweeping theory of brain development that would change the way mental disorders like autism and schizophrenia are understood.

The theory emerged in part from thinking about events other than mutations that can change gene behavior. And it suggests entirely new avenues of research, which, even if they prove the theory to be flawed, are likely to provide new insights into the biology of mental disease.

At a time when the search for the genetic glitches behind brain disorders has become mired in uncertain and complex findings, the new idea provides psychiatry with perhaps its grandest working theory since Freud, and one that is grounded in work at the forefront of science. The two researchers — Bernard Crespi [pictured], a biologist at Simon Fraser University in Canada, and Christopher Badcock, a sociologist at the London School of Economics, who are both outsiders to the field of behavior genetics — have spelled out their theory in a series of recent journal articles.

“The reality, and I think both of the authors would agree, is that many of the details of their theory are going to be wrong; and it is, at this point, just a theory,” said Dr. Matthew Belmonte, a neuroscientist at Cornell University. “But the idea is plausible. And it gives researchers a great opportunity for hypothesis generation, which I think can shake up the field in good ways.”

Their idea is, in broad outline, straightforward. Dr. Crespi and Dr. Badcock propose that an evolutionary tug of war between genes from the father’s sperm and the mother’s egg can, in effect, tip brain development in one of two ways. A strong bias toward the father pushes a developing brain along the autistic spectrum, toward a fascination with objects, patterns, mechanical systems, at the expense of social development. A bias toward the mother moves the growing brain along what the researchers call the psychotic spectrum, toward hypersensitivity to mood, their own and others’. This, according to the theory, increases a child’s risk of developing schizophrenia later on, as well as mood problems like bipolar disorder and depression.

In short: autism and schizophrenia represent opposite ends of a spectrum that includes most, if not all, psychiatric and developmental brain disorders. The theory has no use for psychiatry’s many separate categories for disorders, and it would give genetic findings an entirely new dimension.

To read the entire article, click here.

Also see:

Psychosis and autism as diametrical disorders of the social brain

Photograph by Annie Marie Musselman for The New York Times.

Families helping families

An October 9th news release from SANE Australia:

SANE Australia today launches a new DVD that offers first-hand insight on dealing with mental illness in your family.

For Jo Buchanan, her family have been her greatest teachers. From helping her sister following a diagnosis of schizophrenia to becoming a carer for her son Miles when he discovered he had bipolar disorder, Jo has discovered many things.

One of the main things she learnt and is keen to pass on to others is the importance of learning how to cope.

‘When my sister first showed signs of schizophrenia, I had no idea what was happening as I had to deal with it alone. When Miles became unwell, I was able to recognise the symptoms, which meant I could find help from the right people immediately,’ Jo said.

‘Education and information about mental illness are so helpful when it comes to working out how to cope with the many changes it brings in a family’s life.’

Jo and Miles have joined others in sharing their experiences on a 30-minute DVD produced by SANE Australia in partnership with highly regarded production company RealTime Health.

The DVD is part of a kit, which includes the SANE Guide to Families ¬– offering practical advice on how to cope with the impact mental illness can have on a family. On the DVD, Jo talks about the challenges she’s faced as a carer and the many ways they have helped her to grow.

‘Through my experience as a carer, I have accessed strengths I didn’t know existed; strengths developed through surviving circumstances for which I was totally unprepared and untrained. I have learned about courage, hope, faith and humility,’ she said.

SANE Australia’s Paul Morgan says the Families DVD and guide are invaluable tools in helping families learn more about mental illness from people with first-hand experience.

‘Around one in five Australians will experience a mental illness at some time, and for every one of those there will be a ‘ripple effect’ on family and friends. Hearing from people who deal with mental illness on a daily basis can help those in similar situations,’ Dr Morgan said.

Tips from the DVD kit include:

• Coming to terms with caring for someone with a mental illness

• Finding support options for the whole family

• Learning skills

• Planning for the future

The Families and Mental Illness DVD Kit is available from SANE Australia, as well as many other resources on mental illness. Visit www.sane.org or phone the SANE Helpline on 1800 18 SANE (7263).

To arrange an interview with Paul Morgan or Jo Buchanan, contact Cathy Heycock on 03) 9682 5933 or 0414 427 291.

Thanks go to Chris Summerville for bringing this news release to my attention.

Predictors of general quality of life and the mediating role of health related quality of life in patients with schizophrenia

An abstract published online on October 30th in Social Psychiatry and Psychiatric Epidemiology:

Carin J. Meijer (1), Maarten W. J. Koeter (1), Mirjam A. G. Sprangers (2) and Aart H. Schene (1)

(1) Dept. of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

(2) Dept. of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

INTRODUCTION: The concept 'quality of life' (QoL) has become increasingly important as an outcome measure in the evaluation of services and in clinical trials of people with schizophrenia. This study examines the mediating role of health related quality of life (HRQoL) in the prediction of general quality of life (GQoL).

METHOD: QoL and other patient- and illness characteristics (psychopathology, overall functioning, illness history, self-esteem and social integration) were measured in a group of 143 outpatients with schizophrenia. GQoL was measured by the Lancashire Quality of Life Profile and HRQoL was measured by the MOS SF-36. To test the temporal stability of our findings, assessments were performed twice with an 18-month interval.

RESULTS: We found that patient's GQoL is predicted mainly by anxiety and depression and self-esteem and to a lesser extent by global functioning and social integration. At both time intervals HRQoL appeared to be a significant mediator of the relationship between anxiety and depression and self esteem versus patient's GQoL.

CONCLUSIONS: The results of this study are important for mental health professionals, as these provide more insight in the mechanisms by which they could improve the GQoL of their patients with schizophrenia. The results confirm that diagnosis and treatment of anxiety and depression in outpatients with schizophrenia deserves careful attention of clinicians. Also strategies and specific interventions to improve self-esteem of patients with schizophrenia are very important to maximise patient's QoL.