Saturday, August 29, 2009

How Can I Support Someone with Persecution Delusions


An August 24th post on the weblog, Overcoming Schizophrenia:
Recently, a reader asked how to support, or what to say to someone who has persecutory delusions and confides in them. I thought this question was profound. By investigating this question it could help so many people maintain or develop a trusting relationship with their relative, friend, or client, etc. I asked the opinion of my therapist, and she gave some pointers and asked me to remember a time when I was psychotic and what could someone have said to me to make me feel more comfortable...

When I was at my peak of psychosis everything was a sign from God - that truck making a U-turn meant go back, that taxi cab driver telling me to stay out of trouble meant he was in on it too. While I was psychotic I heard conflicting voices. When I would ask someone a question on the phone the voices would give different information. I was extremely paranoid. And almost everyone was a threat. I couldn't confide in relatives because they would tell my secrets, I couldn't trust friends because they wouldn't believe me. I couldn't keep a journal because someone would find it and read it. I was mentally trapped. I remember trying to escape from family, for reasons that I cannot make sense out of, but the belief was that they were after me, and I was scared.

Wondering about the city I spotted a man with a bike, (I thought to myself I could take his bike and escape from everyone), I asked this man questions about his bike. It was early in the morning and I wore a short sleeve top, he asked me if I was cold and gave me his sweater. I took the sweater then eye-balled his newspaper, I was anxious to know what day it was. He asked me if I wanted it and I said no (I don't know why I didn't take the newspaper). By this time I re-evaluated taking his bike, (this man must be an angel- he gave me his sweater because he knew I was cold, and offered his newspaper when I really wanted it, to know the date). We talked about nothing, I asked him random questions like if he was married with children. He told me he was divorced. I asked why didn't he have children, and he replied because his wife was on birth control. I felt at peace with this man. Finally, I told him I had to go and went my separate way.

If he had known I was psychotic and offered support I would have wanted him to say what my therapist suggested: "What can I do to let you feel more safe?" My therapist also suggested that an individual ask the person experiencing psychosis if there was another explanation for their situation, such as why the FBI would be following them or why their family or anyone would try to harm them.

It is important to show empathy by telling the person with psychosis that "I understand you feel like everyone is after you (or whatever the scenario)..." DO NOT PROMISE to keep information confidential because if that individual who confides in you is a danger to them self or to others I would strongly recommend that you contact a professional ASAP.

My therapist also said to try to maintain neutral facial expressions and tone of voice to not come off as threatening. The man that spoke to me was very kind, warm, and concerned for my well being. Also, do not encourage the delusions. Instead, remind them that it must be scary for whatever they are experiencing, but just show your concern for them and how you are there to support them.

I hope this post gave you some insight into how someone feels when psychosis takes over and what you can do to support them. I appreciate you for reading my posts and would love to hear from you- whether it be a question, comment, or simple "hello".

If you would like to learn more information about schizophrenia visit the National Alliance on Mental Illness (NAMI), or Schizophrenia Society of Nova Scotia (Canada).

Thanks for this excellent posting Ashley!

Mental health court long overdue


An opinion piece published in today's edition of The Chronicle Herald:
By Marilla Stephenson [pictured]

THE TORIES MAY have promised it, the NDP may have delivered it and the Liberals may have backed it. But credit for this week’s announcement that Nova Scotia will finally establish a mental health court goes to the many justice system officials who have pushed for years, and then finally said enough is enough.

Remember the story of Jean Roberts, the 70-year-old Dartmouth woman who ended up in court for setting fire to her own apartment?

She was unable to properly care for herself, could not be cared for in a traditional nursing home and found herself in trouble with the law. She had been in and out of jail over an 18-month period after what her family described as a slow slide into dementia and mental health problems.

Sadly, during a court appearance, Roberts had asked to be returned to jail because she had nowhere else to go. But is jail really the right place for people like Jean Roberts?

In 2006, Judge Bill MacDonald said no, it was not. After releasing her from custody on a series of relatively minor charges, he ordered sheriff’s deputies to delivery her to the Health Department and to leave her in their care.

"Why should the criminal justice system have to come up with all the options?" the judge asked at the time.

"I don’t want to take the responsibility of putting her out in the parking lot. There needs to be a facility in our society to deal with people like Jean."

Since then, the previous Tory government did move to establish a transition shelter for people with mental health problems, though with just a handful of beds I doubt it is able to accommodate the needs that exist. Still, it was a start.

More recently, Nova Scotians have heard the disturbing testimony at the inquiry into the death of Howard Hyde, the Dartmouth man who died in custody in 2007 after police shocked him with a stun gun.

He suffered from paranoid schizophrenia, but was not sent for a mental health assessment as one doctor had requested after he had been taken into custody on a domestic assault charge.

But the long-promised mental health court has been slower to materialize.

The Tories had finally promised to have it in place April 1 of this year, but a delay was soon announced. Summer or fall was the new target. Of course, an election and a change in government soon followed.

Finally this week, Justice Minister Ross Landry, under the new NDP government, announced that it will open in Dartmouth in November.

Once a week — guess who? — Judge Bill MacDonald will hear cases that are recommended by a provincial mental health court team.

They will be diverted from the regular provincial court case stream, but will not include more serious crimes such as murder or sexual assault.

Landry says the new court will help to balance public protection requirements and the needs of those who suffer from mental illness and find themselves in trouble with the law.

"It ensures public safety, and at the same time ensures the accused’s health needs are met," said Landry.

The court will not hold regular trials. Those who appear in the mental health court will have given either an admission of guilt prior to a regular trial, or have received a guilty verdict in a regular court.

The intent will be to work out treatment options, and in some cases, charges could be withdrawn once treatment is complete, says Landry.

With the closures in past years of mental health residential facilities, more people have found themselves without the care options they need.

For some folks, this had led to life on the streets and an absence of needed medications. Landing in court on charges, followed by jail, should not be the only option our society can offer.

The new court is a long-awaited initiative that will require offenders to be responsible for their crimes, while offering a helping hand to those with mental illnesses so they can get on the road to better health.

Also see:

Mental health court: Delivering on Tory promise

Friday, August 28, 2009

New Mental Health Court to Open in Dartmouth


From the Nova Scotia Department of Justice website:


Justice Minister Ross Landry (left) tours the construction site of the new Mental Health Court which will open in Dartmouth, Nov. 2. He is joined by Stephen Ayer, Executive Director of the Schizophrenia Society of Nova Scotia. Minister Landry said the new court will help people who are in greater need of counselling and treatment instead of being held in custody or put in situations that may lead to confrontations.


Photograph courtesy of the Nova Scotia Department of Justice.

Nova Scotia sets up mental health court


An article published in today's edition of The Chronicle Herald:
Service intended to divert those who need help into treatment

By Michael Tutton, The Canadian Press

Nova Scotia is setting up a special court to divert some of the province’s mentally ill away from the criminal justice system and into treatment programs.

Justice Minister Ross Landry, standing in the gleaming new courtroom Thursday, said the new mental health court would balance the needs of the public and the mentally ill.

"It ensures public safety, and at the same time ensures the accused’s health needs are met," said Landry.

The once-a-week sitting at the court will not hold trials, but rather will serve as a setting where the court can work out alternatives to jail sentences and set up treatment programs, Landry explained.

Under the system, which begins Nov. 2, provincial court Judge Bill MacDonald will take cases recommended by a mental health court team.

The cases would include crimes normally brought to provincial court, like thefts and assaults, but not more serious acts such as murder and sexual assault.

The person being tried must either admit to the crime prior to appearing in the mental health court, or have been found guilty in a regular court and then referred.

In some instances, the mentally ill would have criminal charges against them withdrawn if they successfully complete their treatment program and fulfil the court’s conditions, Landry said.

The province’s handling of the mentally ill has come under scrutiny during the public inquiry into the death of Howard Hyde, who had a long history of schizophrenia and involvement with the courts.

Hyde died in jail on Nov. 21, 2007, about 30 hours after he was arrested for an alleged assault and Tasered during a struggle inside a Halifax police station.

Landry said he couldn’t say whether a mental health court system would have helped Hyde avoid his conflict with the law. But he said he believes that overall, it will improve the chances of treatment of mentally ill people who come before the courts.

He said a mental health court in Saint John, N.B., that has operated for over eight years has had positive results.

Statistics kept by that court for last year indicate that almost nine in 10 people using the court complete their treatment programs, and 86 per cent avoid further conflicts with the law.

However, during Thursday’s news conference the mother of a mentally ill man posed questions to Landry about whether the new court would be likely to accept people who have trouble recognizing their own illness.

Mary Elizabeth Greene, a Halifax-area social worker, told the minister her son has psychotic episodes and can’t recognize when he has done something wrong.

"He doesn’t believe he has a mental illness and he wouldn’t choose to go to a mental health court and there are many like my son who don’t have insight," she said.

The minister invited the woman to come to his office and talk, and said they would consult with medical experts. He said he hoped that once a mentally ill person receives treatment following a psychiatric assessment, he or she would agree to use the new court.

Greene said in addition to the courts, the province badly needs better group homes where her 24-year-old son could be monitored more often and treated.



Mary Elizabeth Greene watches as Justice Minister Ross Landry announces the province’s first court to help those with mental health issues during a news conference in Dartmouth on Thursday. Ms. Green’s son John Can­dow is in the mental health system as a patient.

Photograph by Eric Wynne, The Chronicle Herald.

Also see:

Hyde’s sister doubts mental health court would have helped

Thursday, August 27, 2009

Justice Minister Announces Opening of Mental Health Court


A news release circulated today by the Nova Scotia Department of Justice:

The province's first court to help people with mental health illnesses will open in Dartmouth on Nov. 2.

The court was set up to help people who are in greater need of counselling and treatment instead of being held in custody or put in situations that may lead to confrontations.

"The government is seeking new ways to help those offenders who have mental health issues," said Attorney General and Justice Minister Ross Landry, today, Aug. 27.

"This court will look at the person and their illness, not just their crime when it comes to administering justice."

Two years of planning of the made-in-Nova Scotia court included input from representatives from police agencies, RCMP, Public Prosecution Service, legal aid, judiciary and several government departments.

The specialized court will sit one day a week at the provincial court building. Judge Bill MacDonald will hear the cases which have been recommended by the mental health court team as being eligible for the program. A team of mental health clinicians and lawyers will be at the courthouse to assess potential clients and assist with their needs through counselling and other support.

The mental health court program is based on the best practices of other jurisdictions, and is tailored to meet the needs of Nova Scotians.

FOR BROADCAST USE:

The province's first court to help people with mental health illnesses will open in Dartmouth on November 2nd.

The court was set up to help people who are in greater need of counselling and treatment instead of being held in custody or put in situations that may lead to confrontations.

Attorney General and Justice Minister Ross Landry says the government is seeking new ways to help those offenders who have mental health issues.

He says this court will look at the person and their illness, not just their crime when it comes to administering justice.

The court will sit one day a week at the provincial court building.

-30-

Media Contact:

Sherri Aikenhead
Department of Justice
902-424-3313
E-mail: aikenhsl@gov.ns.ca

Federal study to give homeless places to live


An article published in the August 25th edition of the Ottawa Citizen:

By Tiffany Crawford

A new federal project will look at helping homeless people with mental illness in five cities across Canada reintegrate into society by giving hundreds of them places to live.

The study, by the Mental Health Commission of Canada, will monitor a total of 2,225 homeless people living with a mental illness in Moncton, N.B., Montreal, Toronto, Vancouver and Winnipeg over four years.

Of that number, 1,325 homeless Canadians will be given a place to live, including apartments and group homes, and will be offered psychological and social support to assist them over the four years.

The remaining participants will receive normal services, such as counselling and emergency shelters that are currently available in the five cities.

The participants will be selected next month, said research lead Dr. Paula Goering, who is also head of the Health Systems Research and Consulting Unit at the Centre for Addiction and Mental Health in Toronto.

"It is a very exciting chance to learn. We have never done anything like this in Canada before," she said.

Goering said the budget from Health Canada is $110 million.

Candidates will get to choose from several options where to live, and be visited at least once a week by program staff. The researchers aim to prove that by giving homeless people a stable place to live, they will be able to reintegrate into society.

"If it's an apartment we offer rent supplements. But they might prefer to live in a group home," said Goering. "It's important to note that we aren't placing people, we are helping people with their problems."

The study will compare how much money the federal government spends on services for the people who have been given accommodation, compared to those using the regular services, for example policing costs, emergency room visits and shelter beds.

Goering said there will be no requirement for participants to give up drugs.

"Many of the individuals will have mental illness and addictions. We won't put restrictions on people to be dry or stop using and we will still house them and then offer them help with their problems."

Data from this kind of extensive research does not currently exist in Canada, according to the commission.

The research projects will end in 2013, and will produce a body of evidence to help Canada develop services to homeless people living with a mental illness, said Goering.

Photograph by Arlen Redekop, The Province (please click on the photograph to enlarge it).

Sunday, August 23, 2009

Lunenburg County Chapter's Annual Barbeque



On Saturday, August 22nd, the Lunenburg County Chapter of the Schizophrenia Society of Nova Scotia held their annual summer barbeque at Big Mushamush Lake. Many thanks to Aubrey Zinck and Kaye Joudrey for hosting this year's barbecue!



Barbeque Masters - Dachia Joudrey (left) and Aubrey Zinck.


Please click on the photographs to enlarge them.


Photographs by Jan House

A step in the right direction



An article published in the August 21st edition of The News:
By Jennifer Vardy Little

STELLARTON – For Dale Robinson, a new directory to mental health services in the county is a dream come true.

Robinson is the president of the local branch of the Canadian Mental Health Association. More and more frequently, Robinson picks up the phone and finds someone on the other end who needs to know where to turn.

Now, the answers will be at his fingertips.

“The questions I get most often from people looking for services is where do I go and how can I access what’s available,” Robinson said.

“Now I have a tool to make finding those answers easier. I know my copy will be permanently on my desk.”

Robinson is talking about The Compass, a new mental health resource and directory developed by the Pictou County Health Authority in conjunction with the two community health boards.

The book features information about mental health, like how to recognize depression in teens, understanding seniors’ mental health, addictions and differentiating between sadness and depression.

It also features a complete directory of the services available in the county.

The book is the last of seven initiatives suggested by the community health boards in the community health plan released in 2006.

The book has undergone several revisions and was presented to local groups to get feedback on what the book should include. Thanks to those sessions, the book was further expanded to include topics like post-partum depression.

Carolyn Hemmings, a member of the Pictou West Community Health Board, says she feels blessed to have been involved with the project.

“This book is going to mean a lot to a lot of different people,” she said during the launch of the book at the Nova Scotia Community College on Thursday.

“People can go to the directory and know exactly where to turn to to get help.”

The book is free and will be available at doctors’ offices, pharmacies and departments at the health authority. People can call 752-7600, ext. 3316, to get their own copy of the directory.

Friday, August 21, 2009

Implementing Evidence-Based Practices for People With Schizophrenia


An abstract published in the July 2009 edition of Schizophrenia Bulletin:
By Robert E. Drake (1,2), Gary R. Bond (3), and Susan M. Essock (4)
  1. To whom correspondence should be addressed; Psychiatric Research Center, 2 Whipple Place, Lebanon, NH 03766, tel: 603-448-0263, fax: 603-448-3976, e-mail: Robert.E.Drake@dartmouth.edu
  2. Dartmouth Psychiatric Research Center, Dartmouth Medical School, Lebanon, NH
  3. Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN
  4. Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, NY

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions.

Keywords: evidence-based practices / schizophrenia / implementation research

To read the entire article, please click here (free Medscape registration is required).

Posting of this abstract is for the purposes of research into schizophrenia and recovery.

Thursday, August 20, 2009

Cannibis smokers have a seven-fold schizophrenia risk


Harper government devotes funds to studying the link between marijuana use and mental illness

An article published in yesterday's edition of The Toronto Star:
WINNIPEG – The Harper government is putting up $550,000 to gather research on marijuana use and mental illness.

The Schizophrenia Society of Canada will use the money to further research the links between cannabis and early psychosis as well as develop promotional materials warning youth about the dangers of smoking pot.

The money is part of Ottawa's $30 million national anti-drug strategy announced in 2007.

Chris Summerville, CEO of the Schizophrenia Society, said the public doesn't realize that cannabis users have a seven-fold increase in risk of developing schizophrenia.

He pointed to recent research out of Victoria, B.C., linking pot smoking and mental illness.

As part of the society's research, some 30 youths who have experienced psychosis will be trained to gather information about the reasons their peers use cannabis.

The results will be used to develop educational materials aimed at decreasing the use of illicit drugs among young people.

Winnipeg Conservative MP Joy Smith said Tuesday that while the public regards marijuana as a soft drug, there may be very serious consequences for young pot smokers who have a predisposition to mental illness.

"Science has shown that cannabis may actually trigger the onset of psychosis and may also intensify the symptoms for those who already have a psychotic illness," Smith said in announcing the grant.

"It has been suggested that up to 80 per cent of youth who have had a psychotic episode were using cannabis. And that's pretty shocking," said Smith, who was filling in for Health Minister Leona Aglukkaq at news conference.

Photograph by Rotbuche.

Sunday, August 16, 2009

Climbers to scale African peak to benefit Laing House


An article published in the August 9th edition of The Chronicle Herald:
A group of six Nova Scotians is on its way to Africa to climb Mount Kilimanjaro as part of a fundraising effort for Laing House.

The group — Henry and Rena Demone, Hans and Dani Himmelman, and David Kirkpatrick and Paula Taylor — is paying all its own expenses so that all of the more than $60,000 that’s been raised will help support youth living with mental illness.

The idea for the climb was born at the Laing House masquerade ball fundraising event in 2007. Each member of the group has had a friend, family member or colleague experience mental illness and wanted to come up with a unique way to support Laing House.

The house is a peer support organization for youth with mental illness. It opened in Halifax in 2001 and has helped hundreds of young people. It’s the only organization of its kind in Canada.

Kilimanjaro, the highest peak in Africa, is the world’s highest free standing, snow-covered equatorial mountain. The climb will begin on Sept. 11. To learn more, visit www.lainghouse.org.

Photograph by Paul Shaffner. Photograph used under Creative Commons Attribution 2.0 License

Saturday, August 15, 2009

System failing mentally ill in jails: experts


An article published in today's edition of The National Post:

Phase one of inquiry into Taser death ends

By Megan O'Toole

Phase one of an inquiry into the death of a Nova Scotia man who was Tasered while in police custody ended yesterday, and experts say the process has underscored a dire need for changes in the treatment of mentally-ill prisoners.

After five weeks of testimony and a number of controversial witnesses, including officers involved in the struggle to subdue Howard Hyde of Dartmouth, N. S., the inquiry has been adjourned for two months.

Testimony to date has shown a number of systemic flaws, observers say, including a severe lack of co-ordination between police and health-care services.

"There were a lot of balls dropped," said Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, noting the case underscores the need for police to be better trained in how to handle mentally-ill prisoners. "Right from the get-go, police didn't give Howard a fair shake."

The paranoid schizophrenic, who reportedly harboured a deep fear of police, was initially arrested for assault after an argument with his girlfriend, who told authorities Mr. Hyde had not been taking his medication.

At that point, Mr. Hyde should have been taken to hospital for assessment and treatment, Mr. Ayer said, but instead he was taken to the Halifax police detachment. Rambling and in a psychotic state, Mr. Hyde apparently attempted to flee after a booking officer took out a knife to cut the drawstring off his shorts.

That prompted a violent struggle, captured on surveillance video and shown during the inquiry, in which a shirtless and frantic Mr. Hyde screams and struggles to escape. Police say they were concerned he would reach for a knife from a nearby drawer of weapons, and shocked him with the Taser to regain control. He collapsed and was taken to hospital.

The use of a Taser on a paranoid schizophrenic person, as an aggressive act, "could have a tendency to make things worse, to have the issue escalate out of control," noted University of Alberta psychiatrist Patrick White.

While hearing testimony from a couple of the officers involved in the scuffle, the inquiry learned -- contrary to earlier official reports -- that Mr. Hyde had not been asked to co-operate as officers struggled to handcuff him, nor was he warned the Taser would be deployed.

Chris Summerville of the Schizophrenia Society of Canada said a better technique would have been attempting to talk Mr. Hyde down from his psychotic state, then handcuffing him once he had calmed down. Police should be trained for such situations, Mr. Summerville said, but in many cases they are not.

Mr. Hyde's girlfriend, Karen Ellet, has said he "was treated as a prisoner, not as a mental-health patient."

After doctors cleared Mr. Hyde to leave the hospital, they requested he have a follow-up psychiatric examination after his morning court hearing, or that he be returned to the emergency room -- something the officers were not authorized to do.

Neither happened, and Mr. Hyde ended up back in his jail cell, where he died about 30 hours after receiving the initial Taser jolt. Nova Scotia's medical examiner pegged the cause of death as "excited delirium" linked to his mental illness.

Carol Tooton, executive director of the Canadian Mental Health Association's Nova Scotia division, says the case could have ended differently had Mr. Hyde received proper treatment for his schizophrenic condition. The inquiry, she noted, has underscored a staggering lack of co-ordination between police, mental-health workers, courts and hospital staff -- resulting in a failure to properly deal with a man travelling between those systems.

"We often talk about working in silos," Ms. Tooton said. "It seems that [those] systems really do operate independent of one another."

The inquiry resumes in October, with recommendations from Judge Anne Derrick expected next year.

Monday, August 10, 2009

Zyprexa (Olanzapine) Class Action - Notice of Class Certification


The Schizophrenia Society of Nova Scotia suggests to its members that they should seek legal advice immediately so that they may be properly apprised of their rights, particularly because of the limited time within which a potential claimant may "opt out".



To view a high resolution PDF of the above document, please click here.

From the above document:

...


This notice does not constitute medical advice. Patients who have been prescribed Zyprexa should consult with their physicians if they have any questions with respect to their medical condition and should not stop taking Zyprexa without consulting with their health care professional.

...


IF YOU WISH TO EXCLUDE YOURSELF FROM THE CLASS PROCEEDING (“opt out”) you must deliver a written notice to one of the solicitors for the parties ... specifying your desire to opt out of the class proceedings. Notice of your decision to opt out must be received by either one of the solicitors by October 16, 2009.

ANY JUDGMENT OBTAINED ON THE COMMON ISSUES IN THE ACTION, WHETHER FAVOURABLE OR NOT, WILL BIND ALL CLASS MEMBERS WHO DO NOT OPT OUT OF THIS ACTION.

...


For further information, please click here.

Films attack mental health stigma


Posted online yesterday by BBC News:

To view one of the videos, please click here (the video appears after an advertisement).

To read the entire article, please click here.

Saturday, August 8, 2009

Mental health experts target ‘huge mismatch’ in funding


An article published in yesterday's edition of The Ottawa Citizen:
Stigma is diverting money for research, doctors say

By Tony Spears

The stigma of mental illness is diverting research money from a multibillion-dollar economic problem, Ottawa’s leading mental health experts say.

Mental illness affects one in five Canadians and is the leading cause of workplace disability. According to a Senate report, the Canadian economy takes an $8.1-billion hit from productivity lost to mental illness, and the cost balloons to $33 billion if substance abuse is included.

The World Health Organization did an assessment showing the global burden of mental illness was second only cardiovascular illnesses, said Dr. Zul Merali, head of the Institute of Mental Health Research at the University of Ottawa. Mental illness is the No. 1 reason for workplace disability.

Lacking the “sex appeal” of heart-disease and cancer, mental illness research funding is languishing and accounts for less than five per cent of health research in Canada, Royal Ottawa Mental Health Centre data show.

To read the entire article, please click here.