Monday, November 30, 2009

The Mental Health Commission of Canada Announces a Framework for a Mental Health Strategy for Canada

An email received today from the Mental Health Commission of Canada:

We are extremely pleased to provide you with a link to the Mental Health Commission of Canada document Toward Recovery and Wellbeing: A Framework for a Mental Health Strategy for Canada.

The framework is truly the product of a remarkable amount of input from all corners of Canada over the past year and half. It draws on the wide diversity of experiences, voices and thinking of thousands of people like you or your organization for what a mental health strategy for Canada must achieve. It has also built on the efforts undertaken by so many over the years to champion the importance of a mental health strategy for Canada.

Seven interconnected goals are presented to point the way to a comprehensive and person-centred mental health system for our country: one that both promotes the recovery of people living with mental health problems and illnesses, and fosters the mental health and well-being of everyone living in Canada.

This document is not yet a strategy - it is the framework to help us create one. The ongoing input from people like you from every part of the country will be essential to the success of the next phase of developing a Mental Health Strategy for Canada. We are confident that working together we will be able to define practical solutions and develop action plans to achieve our shared vision for the long awaited mental health strategy for Canada.

In the coming months we will be communicating more details about how the next phase of our work will be structured.

Also see:

Mental Health Commission releases framework for mental health strategy

Voices of Recovery

From the Center for Psychiatric Rehabilitation website:

Voices of Recovery consists of two different types of “voices.” The first “voice” is a selection of recovery stories that were published in the Coping With column of the Psychiatric Rehabilitation Journal from the years 2000 through 2008. The second “voice” is a collection of PhotoVoice projects, which includes a photograph and a short narrative explaining the personal meaning behind the picture from the photographer’s point of view. These inspirational contributions remind us that recovery is not only possible--recovery is real!

Table of Contents
  • Preface
  • Chapter 1: Recovery
  • Chapter 2: Increasing Knowledge and Control
  • Chapter 3: Managing Life's Stresses
  • Chapter 4: Enhancing Personal Meaning
  • Chapter 5: Building Personal Support
  • Chapter 6: Setting Personal Goals

Citation: McNamara, S. (Ed). (2009). Voices of recovery. Boston: Boston University, Center for Psychiatric Rehabilitation.

Also see:

The Recovery Workbook

Saturday, November 28, 2009

Lunenburg County Chapter - Christmas Bake Sale

Linda Dagley selling wares at the Lunenburg County Chapter's Christmas Bake Sale

The Lunenburg County Chapter of the Schizophrenia Society of Nova Scotia held its annual Christmas Bake Sale on November 27th at the Bridgewater Mall. This year a draw was held on a gingerbread house made by a Chapter member. Many thanks to all Chapter members and friends who donated the yummy baked goods and warm, cozy toques and mittens; making this the most successful Christmas bake sale ever!

Photograph by Jan House. Please click on the photograph to enlarge it.

Thursday, November 26, 2009

Information sharing and mental health

From the NHS Evidence - mental health website:
This Department of Health [U.K.] guidance sets out some of the issues relating to the exchange of information between mental health trusts and outside organisations and individuals. It sets out when, why and how information can safely be exchanged for the benefit of the individual and the public.

To download the entire document, please click here (PDF).

Also see:

Carers and confidentiality in mental health: Issues involved in information-sharing

Wednesday, November 25, 2009

Three years old!

This weblog was created three years ago today. Since that time there have been more than 890 postings and over 64,000 visits.

Thank you to everyone who has showed an interest in what is posted here. And thank you to each and every person who has contributed so much to the pages of this weblog.

Image by Morburre. This image is used under the Creative Commons Attribution 3.0 Unported License.

Blood tests may reveal psychosis

An article posted today by the Los Angeles Times:
By Shari Roan

Scientists are moving closer to developing blood tests that can diagnose serious mental disorders, according to a study published this week in the journal Molecular Psychiatry.

A consortium of researchers showed they could identify blood biomarkers for two key psychotic symptoms: hallucinations and delusions. They relied on a technique termed convergent functional genomics that integrates several independent lines of evidence from human and animal models to identify and prioritize findings. The same approach has been used to look for genes and gene pathways linked to bipolar disorder, alcoholism and schizophrenia. Last year, the researchers published blood biomarkers for mood disorders.

Much more work will be required in order for such blood tests to be used for diagnosing and treating mental illnesses. However, the technology would be a milestone because psychiatric disorders now are diagnosed -- often with a great deal of uncertainty -- by evaluating symptoms. And there are few good ways to measure, biologically, how a medication is working. The study was conducted at the Indiana University School of Medicine and Roudebush VA Medical Center; Scripps Research Institute at UC San Diego; and State University of New York, Syracuse.

"Objective blood biomarkers for illness state and treatment responses would make a significant difference in our ability to assess and treat patients with psychiatric disorders, eliminating subjectivity and reliance on patient's self-report of symptoms," the authors wrote in the paper.

Perhaps such tests would even prevent health insurance companies from refusing to pay for treatments for mental illness.

Photo credit: Mark Boster / Los Angeles Times

Also see:

Blood Tests For Hallucinations, Delusions May Be Available In Future, Indiana University Researchers Predict

Tuesday, November 24, 2009

Dr Crippen: Why we have to watch our language

An article published in today's edition of The Guardian:
Human beings should not be defined by their illness

My wife and I helped our children learn to read with the help of Biff, Chip, Kipper and friends who starred in the Oxford Reading Tree books. We could not help but smile at how racially correct the books were, with people of all colours and creeds. And quite right too. The children, of course, took the ethnic origins of the characters for granted. Again, quite right too.

We smiled because we thought back to the books we were brought up with. Little Black Sambo; Noddy always being chased by golliwogs and so on. We also took it all for granted but it was not quite right. It was not right at all; engrained stereotypes, the thoughtless use of words and pictures with their subtle, insidious undertones.

It still happens, particularly in medicine, where the thoughtless use of words may indicate an underlying iceberg of prejudice and misunderstanding. I was taken to task a few days ago by a psychiatrist colleague for using the word "schizophrenic" as a noun.

"It is not a noun, and schizophrenics are people," he said. Technically the psychiatrist is wrong. Like "diabetic" and "asthmatic", schizophrenic was always meant to be an adjective, but common usage has made it a noun.

Technical point scored, perhaps, but the issue is more profound than grammatical pedantry. The psychiatrist meant that a fellow human being should not be defined by an illness. It's not right to talk about "diabetics" and "asthmatics" either but doing so does not seem to cause as much offence. And as a doctor I can't keep writing "patients with diabetes" all the time. I need one word.

But mental illness carries a stigma and schizophrenia is the saddest of illnesses, bringing with it separation from society, social and intellectual decay and, worst of all, loneliness. Human beings with schizophrenia are human beings with schizophrenia. They should not be defined by their illness.

It would never happen in Biff and Chip's world. And quite right too.

Dr Crippen is a pseudonym for a long-serving GP.

Image credit

Monday, November 23, 2009

MHCC Launches National Research Project to Find Sustainable Solutions for People With Mental Health Issues Who Are Homeless

A news release distributed today by the Mental Health Commission of Canada:
Study will investigate 'Housing First' approach

TORONTO, Nov. 23 /CNW Telbec/ - The Mental Health Commission of Canada (MHCC) has implemented a ground-breaking national research project in five cities to find the best way to provide housing and services to people who are living with mental illness and homelessness. Using a 'Housing First' approach, the research project focuses on first providing people who are homeless with a place to live, and then the other assistance and services they require. The goal is to see if this approach is better than traditional 'care as usual.'

A total of 2,285 people who are homeless and living with a mental illness will participate in the study. Of these, 1,325 participants in the research project will be given a place to live and offered a range of housing, health and social support services over the course of the research initiative. These supports include help with maintaining a home, undertaking routine tasks like shopping or getting to a doctor's appointment or securing opportunities for education, volunteering and employment. The rest of the participants will receive the services that are currently available in the five test sites. Both groups will be compared to see which approach works best.

"The study will produce evidence on whether providing a place, plus services, will better support reintegration into functional, meaningful living," said Dr. Jayne Barker, Director, At Home/Chez Soi Project. "Another research question is cost. Will it cost less to house and provide services than it would if these marginalized individuals were in hospitals, prisons and shelters?" said Dr. Paula Goering, Research Lead, At Home/Chez Soi Project.

The At Home/Chez Soi project is the largest of its kind in Canada. The research will help make Canada a world leader in providing better services to people living with homelessness and mental illness. Each test site will focus on a specific target population within the overall study group.

Toronto's project will provide specialized services for people from diverse ethno-cultural backgrounds. Moncton will examine the shortages of services for Anglophones and Francophones, and Montreal will focus on the outcomes related to social housing, as well as helping people to return to the workplace. In Winnipeg, the needs of urban Aboriginal people will be highlighted, while Vancouver's project is aimed at people with addictions and substance abuse problems.

The MHCC is working closely with many partners on this project, including provincial and municipal levels of government, researchers, many local service providers and individuals who have experienced homelessness and mental illness. "This research initiative is meant to represent a significant step forward in understanding and reducing the incidence of homelessness in Canada," said the Honourable Michael Kirby, Chair of the MHCC.

In Toronto, services will be provided in eight different languages and approximately 57 per cent of the participants will come from immigrant and ethno-racial groups. 300 participants in the Toronto research group will get housing units within a number of different locations across the city, including apartments, where they can stay for the duration of the project.

Participants in the Housing First model will have to pay a portion of their rent, will meet with program staff once a week, and will be encouraged to make use of the support services. 260 participants in the non-Housing First group will meet with an interviewer every three months.

A unique focus of the Toronto project will be the development and evaluation of a Housing First ethno-racial intensive case management model for people who are homeless from different ethno-racial groups. One hundred participants will be served by this innovative program, and will have access to holistic, culturally appropriate and linguistically competent services and supports.

Key partners in the Toronto demonstration project include: the Government of Canada, COTA Health, Across Boundaries, the Centre for Research on Inner City Health - St. Michael's Hospital, Toronto North Support Services, the City of Toronto, and Housing Connections.

"A recent survey found more than 5,000 people are homeless each night in the City of Toronto. Our hope is that this project will help us find best practices and long-term solutions for all people in this city with homelessness and mental health issues, as well as Canadians in similar circumstances in communities right across the country," said Faye More, Toronto Site Coordinator.

Previous related research suggests that the provision of housing and support services may be effective. For example, a joint report by Simon Fraser University, the University of British Columbia and the University of Calgary found each person who is homeless in B.C. costs taxpayers $55,000 a year in health, corrections and social services. The report concluded that if housing and support were offered to these people, it would cost the system much less -- $37,000 a year -- a savings of $18,000, or 33 per cent per person per year. According to Corrections Canada, the cost of incarceration in a federal prison averages $90,000 per year, per inmate.

The Mental Health Commission of Canada is a non-profit organization created to focus national attention on mental health issues and to work to improve the health and social outcomes of people living with mental illness. In February 2008, the federal government allocated $110 million to the MHCC to find ways to help the growing number of people who are homeless and have a mental illness. Updates on the study will be posted on the MHCC website at

For further information: or to arrange an interview, please contact:

Micheal Pietrus, Director of Communications, MHCC, (O) (403) 255-5808, (O) (403) 385-4037,;

Nujma Bond, At Home/Chez Soi Communications, MHCC, (O) (403) 385-4033, (C) (403) 826-3942,;

Charmain Emerson, Strategic Communications Inc. for MHCC, (O) (416) 588-8514, (C) (416) 857-9401,;

Susan King, Strategic Communications Inc. for MHCC, (O) (613) 744-8282, (C) (613) 725-5901,

Also see:

Housing first for mentally ill homeless

Sunday, November 22, 2009

Thanks -- by Ashley at Overcoming Schizophrenia

Posted today on Overcoming Schizophrenia:
I ended one of my groups the other day by going around the room and letting people share what they are thankful for. (I lead closed groups, not open to the public, at various facilities.)

I am thankful that I am able to function well, organize, research, and to lead groups. As you probably already know, if you follow this blog regularly, I have come a long way to get to where I am now. In the past, schizophrenia tried to hinder me, take away my speech, make it hard for me to recognize family, and almost kill me by my excessive paranoia and determination not to eat or drink. But now, I have hold on my brain disorder; I take my medication regularly, I continue to learn more about different mental illnesses, and I have support of family, friends, and health professionals.

What are you thankful for?

If you have a mental health concern such as schizophrenia, you are not alone, I can understand you. If you are a caregiver, family member, or friend of someone living with a mental illness believe that recovery is possible and that your special someone can get better. I am living proof that people living with a mental illness do come back and live productive, independent lives!

For those of you learning what schizophrenia is for the first time, it is a thought disorder that is difficult to treat but is treatable. There is no cure for it, yet, however with a combination of medication and support people living with schizophrenia can lead fulfilling lives. I am one of them.

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

Thanks for writing this post, Ashley!

Thursday, November 19, 2009

Media Advisory - Canada's Mental Health Commission at Forefront of Research on Mental Health and Homelessness

A media advisory issued today by the Mental Health Commission of Canada:
OTTAWA, Nov. 19 /CNW Telbec/ - A series of news conferences will be held on Monday, November 23rd, to officially launch "At Home/Chez Soi", a ground breaking national research demonstration project that will help us understand and reduce the incidence of homelessness in Canada. The purpose is to find the best mix of housing and support for homeless people who have a mental illness. Research tells us homelessness and mental illness is closely linked.

Participating in the news conferences will be experts in the field of mental health, social housing and research, as well as individuals who have experienced mental illness and homelessness.

The news conferences will occur, (all times are local) in:
  • Moncton, New Brunswick, First United Baptist Church, 157 Queen Street, 11:00 am;
  • Montréal, Quebec, Le Chaînon, 4373 ave de l'Esplanade, 10:00 am;
  • Toronto, Ontario, Enoch Turner School House, 106 Trinity St., 10:00 am;
  • Winnipeg, Manitoba, Thunderbird House, 715 Main St., 10:00 am; and
  • Vancouver, British Columbia, Coast Clubhouse, 295 East 11th Ave., 10:00 am.

For further information: or to arrange an interview, please contact:

Susan King, Strategic Communications Inc. for MHCC, (O) (613) 744-8282, (C) (613) 725-5901,;

Nujma Bond, At Home/Chez Soi Communications, MHCC; (O) (403) 385-4033, (C) (403) 826-3942,;

Charmain Emerson, Strategic Communications Inc. for MHCC, (O) (416) 588-8514, (C) (416) 857-9401,

Also see:

Major homelessness initiative will be launched next week

Searching the stage for a solution

‘Simple’ film tackles complex condition

An article posted November 18th on
By Jonathan Bullington

Her uncle’s charge was clear: create a film that would make sense of the disease – not just for him, but for those like him who watch helplessly as a loved one suffers.

That film will be put to the test at the Skokie Theatre Sunday, Nov. 22 when local filmmaker Kamelya Alexan [pictured] premiers her short film, “One Simple Life.”

The 21-minute film tells the story of Mark, a young man diagnosed with paranoid schizophrenia who wrestles with the illness while trying to function in society.

The movie is largely based on the real-life story of Marcel, Alexan’s 25-year-old cousin currently undergoing treatment for schizophrenia at a clinic in California. She said her family struggled to understand what was happening to Marcel as he increasingly displayed common schizophrenic symptoms—paranoia, delusions and hallucinations—in the years before his diagnosis.

“Coming from a very small Middle Eastern culture, we don’t really understand mental illness and mental health,” Alexan said. “So people just assumed there was something either behaviorally wrong with him, or something else.”

Alexan and her partner Brian Soszynski, who plays the role of Mark and wrote the film's screenplay, spent close to a year making the movie. They were assisted by a 50-person cast and crew—mostly volunteers—and a paltry budget of $3,000—mostly from Alexan’s work as a production assistant for director Christopher Nolan’s 2008 Batman sequel, “The Dark Knight.” The film is one of 25 projects she’s worked on while studying film at Chicago’s Columbia College.

“I was one of the lucky ones,” she said of watching Nolan direct. “He knew exactly what style and what look he wanted. He knew exactly how to control the environment.”

Her admiration for Nolan’s assertiveness should come as no surprise given her upbringing. Born in Tehran, Iran, Alexan’s parents fled the violence of their home for America when she was 5 years old. Entranced by movies from an early age, by the time she was 15, the Niles North sophomore wrote her first script, which she pitched to a Hollywood producer while attending an Assyrian cultural convention in Los Angeles.

“My passion started out of boredom, and wanting to prove I could do something that was impossible,” she said. “I come from a culture that’s pretty much extinct, so to have a filmmaker come out and to be a woman—it’s very different. My culture doesn’t really know how to handle it.”

At Columbia, Alexan’s determination drew the attention of her peers, including Soszynski. Although the pair knew each other before Columbia, their relationship didn’t turn professional until Soszynski’s first acting role, a part in a silent film directed by Alexan for a class project.

Born and raised in Chicago, Soszynski spent his youth pursuing various creative outlets—poetry, art, music; he studied acting and directing at Columbia, but he said he prefers to act.

“I like the creative aspects of an actor,” he said.

Soszynski committed himself to learning all he could about schizophrenia before stepping into the role of Mark. He joined Alexan on a trip to visit Marcel’s clinic, where he spoke with physicians and with Marcel about the day-to-day effects of the illness.

“The more I talked with Marcel, the more I wanted to play the part and for people to see what this disease does to people,” Soszynski said.

With the film’s premier already sold out, the Skokie Theatre, 7924 N. Lincoln Ave., will host another screening of “One Simple Life” at 7 p.m. Feb. 28. Tickets can be purchased online at or at

Report backs development of peer support worker role

A news release issued today by the Scottish Recovery Network:
An independent evaluation of peer support worker pilot schemes in five Health Board areas has recommended further roll out of the role at the same time as making recommendations for future implementation.

The research report, which was commissioned by the Scottish Government and carried out by the Scottish Development Centre for Mental Health in partnership with the Universities of Edinburgh and Stirling, includes a number of key findings:
  • The peer worker role was successfully piloted in a number of settings but worked best where services were open to recovery focused working.
  • Peer workers were welcomed by service users who reported high levels of satisfaction.
  • There were challenges for peer workers in adapting to their new roles.
  • Peer workers were able to bridge the ‘them and us’ divide between service users and professionals.
  • Peer workers roles complement mental health teams with new skills and knowledge.
Recommendations include:
  • Peer support workers should be treated the same as any other employee in relation to terms and conditions.
  • Standardisation of a core peer support worker job description.
  • Peer support workers should be formally trained.
  • Workers should only be placed in supportive environments as a way to enhance, but not introduce, recovery.
  • Room should be left for peer support workers and their colleagues to develop the role gradually but systematically.
  • Providing guidance that can be used by local employers to raise awareness of the role.
The pilot schemes were developed as a result of a commitment in Delivering for Mental Health. The Scottish Recovery Network has been supporting the development of the peer support role and will continue to play a role in its promotion and implementation.

As part of our commitment we are working with the Scottish Qualifications Authority (SQA) to develop accredited awards and learning materials to further support the training of future peer support workers. We will also be working to develop guidelines to support the implementation of peer worker roles.

Summary of Evaluation of the Delivering for Mental Health Peer Support Worker Pilot Scheme (94.84 kB)

Evaluation of the Delivering for Mental Health Peer Support Worker Pilot Scheme (666.04 kB)

Saturday, November 14, 2009

Psychosocial Treatments to Promote Functional Recovery in Schizophrenia

The abstract of an article published in the March 2009 edition of Schizophrenia Bulletin:

By Robert S. Kern (1–3), Shirley M. Glynn (2,3), William P. Horan (2,3), and Stephen R. Marder (2,3)

(1) To whom correspondence should be addressed; Veterans Affairs Greater Los Angeles Healthcare System (MIRECC 210 A), Building 210, Room 116, 11301 Wilshire Boulevard, Los Angeles, CA 90073; tel: 310-478-3711 ext. 49229, fax: 310-268-4056, e-mail:

(2) Department of Psychiatry and Biobehavioral Sciences, Geffen
School of Medicine at University of California Los Angeles, Los
Angeles, CA

(3) Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA

A number of psychosocial treatments are available for persons with schizophrenia that include social skills training, cognitive behavioral therapy, cognitive remediation, and social cognition training. These treatments are reviewed and discussed in terms of how they address key components of functional recovery such as symptom stability, independent living, work functioning, and social functioning. We also review findings on the interaction between pharmacological and psychosocial treatments and discuss future directions in pharmacological treatment of schizophrenia.

Overall, these treatments provide a range of promising approaches to helping patients achieve better outcomes far beyond symptom stabilization.

Key words: recovery / social skills training / cognitive behavioral therapy / cognitive remediation / social cognition / schizophrenia

To download the entire article, please click here (PDF).

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

Also see:

New Possibilities in Cognition Enhancement for Schizophrenia

Friday, November 13, 2009

Schizophrenia is overcome by Saltaire woman

An article published in today's edition of The Telegraph & Argus:
By Tanya O'Rourke

A young Bradford woman who used her experience of paranoid schizophrenia to help others and achieved a first-class degree last night won a Yorkshire Young Achievers award.

Eleanor Longden [pictured], 27, of Saltaire, was diagnosed with the condition at the age of 18. She was bullied by other students and began to harm herself.

She overcame her problems and graduated with the highest first-class degree in psychology to be awarded by the University of Leeds.

For the past four years she has worked for Bradford’s Early Intervention in Psychosis team and in 2006 she helped to establish the Bradford Self-Injury Service which provides treatment, support and advice to people who self-harm.

Miss Longden, who grew up in Bradford and attended Salt Grammar School, has contributed to several mental health textbooks and spoken at national and international conferences.

She is now studying for an MSc and plans to start a PhD next year.

She was named joint winner of the Achievement in Education Award for overcoming her problems to achieve academic success and making a huge contribution to the understanding of mental illness.

The awards, sponsored by McCormicks Solicitors of Harrogate, were announced at a ceremony at the Leeds United Conference and Exhibition Centre.

Peter McCormick, senior partner at McCormicks Solicitors, said: “Even after 17 years’ experience, the judging just goes on getting tougher and tougher.

“The nominations are always both inspiring and heart-rending and the stories of the winners are incredible.”

The awards scheme has so far raised more than £750,000 for Action for Children for projects in Yorkshire.

Tuesday, November 10, 2009

Dual diagnosis: Why treat one and not the other?

An article published in today's edition of The Chronicle Herald:
By Christine Stapleton [pictured]

I HOPE we can put an end to the pesky debate about alcoholism.

Alcoholism is an illness — a real illness. The American Medical Association accepted alcoholism as an illness in 1957 and for about as long the American Psychiatric Association has included alcoholism in its Diagnostic and Statistical Manual — the Bible for diagnosing mental disorders.

Alcoholism and drug addiction are more than just a lack of self-restraint and discipline. Just ask anyone who knows me. I have run marathons and countless triathlons. I have held the same job for 23 years, and I contribute to my company pension plan. I have resisted doughnut-day-Friday and the lure of expensive high-heeled, pointy-toed shoes, which certainly would have improved my love life.

I am not an aberration. In fact, many, many alcoholics are like me. We are high-functioning alcoholics who managed to hang on to our careers, cars and homes. We did not live under bridges and we did not panhandle.

Why is this important? Because I believe that dual-diagnosis is the biggest mental health problem today, yet most people do not even know what it is. Dual diagnosis is the coupling of substance abuse with another mental illness. I am talking about people like me who have alcoholism and depression or are addicted to crack and have bipolar disorder.

As I see it, the problem is that we — including the medical community and criminal justice system — do not accept and treat alcoholism as a real illness. Nor do they understand and appreciate how futile it is to treat one illness but not the other. Everyday addicts and alcoholics seek treatment for substance abuse but no one bothers to screen them for a companion mental illness. Likewise, doctors prescribe antidepressants to their patients without screening them for substance abuse.

The addict/alcoholic whose depression is not treated will continue to self-medicate with drugs and alcohol or fail at the attempt to get clean and sober. Those with depression whose substance abuse is not detected will get sicker because alcohol is a depressant and with every sip they are throwing gasoline on their simmering depression or bipolar.

No one knows how many dual-diagnosed alcoholics/addicts are out there but experts believe at least one of every three alcoholics/addicts has another mental illness. They are the most tragic and costliest of the mentally ill. Very often they commit crimes or suicide. They abuse their wives/husbands and children. Police answer their 911 calls and foster parents take in their kids. The dual diagnosed often become homeless and clog our emergency rooms.

So if you want to go on believing that addicts and alcoholics are weak-willed and you have no compassion for them, please have mercy on your wallet. Your ignorance is costing all of us.

Christine Stapleton writes for The Palm Beach Post, West Palm Beach, Fla.

I have changed the headline of this story to the one that appeared in the The Palm Beach Post.

Also see:

Schizophrenia and Substance Use

Concurrent Disorder

Sunday, November 8, 2009

‘I've gone through a metamorphosis'

An article published in yesterday's edition of The Globe and Mail:
Stability is the key to managing mental illness, experts suggest. André Picard looks at a Montreal project that puts housing first, providing troubled homeless people a stable home of their own

By André Picard

Ricardo Maddalena has lived in many places over the past four decades: fleabag apartments, a psychiatric hospital, prison, rooming houses and on the streets.

Four years ago, he finally found a home.

The 58-year-old, who suffers from severe schizophrenia and has struggled with alcoholism since his teens, moved into an innovative housing project in downtown Montreal that is operated by Chambreclerc, a non-profit group in the city that offers housing to long-time homeless men and women with severe psychiatric disabilities.

“Since I moved here, I've gone through a metamorphosis,” Mr. Maddalena says.

To read the entire article, please click here.

Also see:

Homelessness: By the numbers

Harm reduction: Contentious, but experts say it works

Photo Credit: John Morstad for The Globe and Mail

Friday, November 6, 2009

The Schizophrenia Society of Canada Supports Appropriate Treatment of Inmates Living with a Mental Illness

A November 5th news release from the Schizophrenia Society of Canada:
WINNIPEG, MANITOBA--(Marketwire - Nov. 5, 2009) - The Schizophrenia Society of Canada ("SSC") welcomes the 2008/09 Annual Report of the Office of the Correctional Investigator ("OCI") tabled November 2, 2009 in Parliament. Commenting on the Report, SSC President Jim Adamson says: "It is commendable and most appropriate that four of the 19 key recommendations address the treatment and support of inmates who live with a mental illness within Canada's federal prison system."

According to the OCI Annual Report, mental health services in federal penitentiaries are woefully deficient. Across the country, prisoners are denied treatment because of a shortage of clinical staff and inadequate mental health facilities for the prison population. The Schizophrenia Society of Canada along with its provincial schizophrenia societies has maintained that the treatment and support of inmates who are mentally ill in Canadian prisons is sub-standard, and sometimes almost non-existent.

Howard Sapers, Correctional Investigator of Canada says in his annual report: "Federal correctional mental health care services are under extreme duress - there are deficiencies in terms of capacity, quality, standards and responsiveness of care. Criminalizing and then warehousing the mentally ill burdens our justice system and does nothing to improve public safety. The demands in this area of corrections are increasing dramatically; the unmet needs are immediate and troubling. The overall situation of offenders with mental health disorders has not significantly improved since my Office first reported on this troubling situation back in 2004."

The prevalence of offenders with significant mental health issues upon admission has doubled in the past five years. Eleven percent of federal offenders have a significant mental health diagnosis and over 20% are taking a prescribed medication for a psychiatric condition; just over 6% were receiving outpatient services prior to admission. (1)

The Correctional Investigator's report highlights the seriousness of the conclusion that our prisons have become warehouses for the mentally ill. Over the past three decades Canada has moved toward a community and outpatient system of "de-institutionalizing" the mentally ill from provincial facilities, to "re-institutionalizing" them as prisoners.

"Criminalization of those with mental illness is unethical. If these inmates do not receive hospital-standard psychiatric care, their chances of rehabilitation are extremely low and their risk of re-offending remains high. Allowing inmates to go without comprehensive treatment services for their mental illness is a failure of the Correctional Service to address mental health needs of offenders on many levels," says Chris Summerville, CEO of the Schizophrenia Society of Canada.

(1) Public Safety Canada, Corrections and Conditional Release Statistical Overview: Annual Report 2008, December 2008.

For more information, please contact:

Schizophrenia Society of Canada
Chris Summerville
Chief Executive Officer
Office: (204) 786-1616 or Mobile: (204) 223-9158

Also see:

Report: Prisoners lack mental health support

Mental Health Commission of Canada responds on Correctional Investigator's Report

Mental health court takes first cases

An article published in today's edition of The Chronicle Herald:
'It’s not about the crime, it’s about the person'

By Davene Jeffrey

The first sitting of the province’s mental health court wrapped up quickly Thursday afternoon in Halifax.

With just five cases on the docket, the session was over in just 15 minutes. And unlike in other courts, most of the participants seemed happy to be there.

"The docket will grow," said legal aid defence lawyer Kelly Rowlett. "There are a lot of mentally ill people who have filtered through the criminal court and forensic system."

Ms. Rowlett is one of two lawyers who will defend people who appear in the mental health court.

In the inaugural session Thursday, three men and two women facing charges ranging from assault with a weapon to mischief appeared in the court. Four of the five were eager to have the mental health court handle their cases.

One woman said she wanted time to review information on the program before deciding.

A team including a nurse and social worker will now interview the four and determine whether they are eligible for the program.

The atmosphere in the mental health court is meant to be collaborative rather than adversarial, said Crown attorney Sandi MacKinnon. The clients must acknowledge their guilt and sign a form stating they are entering the program voluntarily.

"It’s not about the crime, it’s about the person," Ms. Rowlett said.

And while the court is designed to be a better fit for people with mental health issues, it is also a good situation for Ms. Rowlett and Ms. MacKinnon, they said.

"In a previous life, I worked with individuals with disabilities and I was a community advocate," Ms. MacKinnon said.

That’s what led her to become a lawyer.

"It’s almost like coming full circle for me," she said.

Ms. Rowlett used to work in insurance litigation before she began to represent mentally ill clients.

"It’s kind of nice to make a difference every once in a while," she said.

Ms. Rowlett said her clients "are really wonderful, caring people who appreciate the assistance."

The mental health court has been in the works for two years.

Ms. MacKinnon said a lot of mental health services are available, but the job of the court and its team of workers will be to co-ordinate those services in developing programs for the people who come through the courtroom doors.

After a program has been set up for a client, he or she will be required to return to court so the judge can assess whether progress is being made.

In many cases, the criminal charges will eventually be stayed, Ms. MacKinnon said.

She said cases involving people who are found to be not criminally responsible for their actions will remain in the regular court system.

Ms. MacKinnon said the purpose of the mental health court is not to avoid criminal convictions for clients but to provide the supports they need to avoid coming into conflict with the law repeatedly. In that way, the public is protected, she said.

The Crown does anticipate some glitches as the new court gets underway.

For instance, Ms. MacKinnon said, few resources are available to help people who have experienced brain injuries.

"This segment of the population is going to be somewhat challenging," she said.

The court’s second session will be next Thursday.

Also see:

Youth Mental Health and the Criminal Justice System

London's Mental Health Court

Reading List: Mental Health Diversion Courts

Wednesday, November 4, 2009

Mental-health program for Digby schools gains national attention

An article published in today's edition of The Chronicle Herald:
By Brian Medel, Yarmouth Bureau

Digby County proponents of an adolescent mental-health curriculum being included in area high schools have received national attention.

The Mental Health Commission of Canada has asked if they can use a local program in a new national anti-stigma campaign.

"We’re very excited about being part of this campaign," John Roswell, the co-ordinator of the Digby Clare Mental Health Volunteers, said Tuesday.

"Our mandate is to promote the mental health of Digby County residents and we are trying to overcome the prejudice and discrimination faced by people with mental illness in our community.

"We have been focusing on adolescent mental health in particular and this is one of the areas the commission is concentrating on."

Mr. Roswell said his group has been working for several months to introduce information about mental health and illness into the curriculum of Digby County high schools. It now looks like the program will begin during the 2010-2011 school year.

"The (Canadian) Mental Health Commission will be helping us measure the effectiveness of our program," said Mr. Roswell.

The Digby County group has also joined forces with the Sun Life Financial Chair of Adolescent Mental Health at Dalhousie University and the IWK Health Centre to help with their project.

Dr. Stan Kutcher, an adolescent mental health expert at Dalhousie University’s school of medicine, spoke to Digby County teachers Tuesday, providing information on mental health and disease.

Mr. Roswell said 80 per cent of all psychiatric disorders emerge in adolescence and it would be good for people to have some understanding of them.

"Mental illnesses affect more people, directly or indirectly, than any physical illness," he said, adding that 83 per cent of Digby County high school students surveyed by his association recently said they knew someone with a mental illness.

And yet mental illness is something people don’t like to talk about, said Mr. Roswell.

"We’re trying to overcome that by creating a dialogue in our community. We’re trying to help people see that it’s OK to admit that you might have a mental illness."

Flu program delays deal for psychiatrists — minister

An article published in today's edition of The Chronicle Herald:
By David Jackson, Provincial Reporter

Health Minister Maureen MacDonald [pictured] said Tuesday her department’s focus on swine flu has delayed a new deal for metro-area psychiatrists.

Half a dozen doctors were at Province House to draw attention to the department missing an Oct. 31 deadline for an agreement.

Dr. Nick Delva, the Capital district health authority’s chief of psychiatry and the head of Dalhousie medical school’s psychiatry department, said he thinks a deal could get done in a week to 10 days.

But with the biggest immunization program in provincial history underway, that’s not a time frame Ms. MacDonald is looking at.

"I think it’s pretty clear what I’m looking at in the next 10 days, and it’s not sitting down and doing collective bargaining, sadly," said Ms. MacDonald, who has been under opposition fire for the government’s handling of the H1N1 vaccine rollout.

"We will get to this issue as soon as we can, but we are dealing with a public health emergency in the province, and that’s where our focus has to be for the time being."

The psychiatrists had a memorandum of understanding with the previous government and Doctors Nova Scotia to get an agreement, called an academic funding plan, done by the end of October. The last one expired more than three years ago.

Dr. Delva said the new arrangement would add about $3 million in annual costs to about a $20-million budget. That covered 70 full-time-equivalent positions at 1,840 hours each per year, but Dr. Delva said psychiatrists have done a lot of work for free.

"We were providing far, far more hours (of) clinical work and far more hours (of) academic work than this," he said. "We did it for free for a number of years, and it was an unsustainable situation."

Aileen Brunet, a forensic psychiatrist and president of the Nova Scotia Psychiatric Association, said doctors won’t support the province’s new mental health court until an agreement is done.

The court starts sitting Thursday, with four cases scheduled. The Justice Department plans to pay for a private psychiatrist, if necessary, before an agreement is finalized. Dr. Brunet said psychiatrists would never withdraw services they are already providing, but they won’t be offering new ones until the deal is in place.

Premier Darrell Dexter said in question period that he expects a new deal to be done soon.

Liberal Leader Stephen McNeil said the Dexter government doesn’t seem to have a plan for mental health services.

"Clearly, what happened here today is the premier said one thing on the floor of the House, and the minister said something quite different outside. They’re not on the same page. Who’s telling the truth?"

Also see:

Psychiatrists threaten to skip mental health court

Tuesday, November 3, 2009

Nova Scotia's Mental Health Court Program

From the Nova Scotia Department of Justice website:
A specialized Mental Health Court, the first of its kind in Nova Scotia, will hold its first seating on November 5, 2009. The new court will hear cases which have been recommended by a mental health court team as being eligible for the program, and 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 goal of this new court is to treat Nova Scotians with mental disorders, who commit criminal offences, fairly and compassionately, and to help them improve their mental health to reduce the risk to public safety.

For more information, please see:

Mental Health Court: Overview (PDF)

Mental Health Court: Mission (PDF)

Mental Health Court: FAQ (PDF)