Wednesday, March 31, 2010

Call for Abstracts: 2010 Canadian Association for Suicide Prevention Conference



An email received by the SSNS on March 31st:
The Canadian Mental Health Association – NS Division & NS Department of Health Promotion & Protection, hosts of the 2010 Canadian Association for Suicide Prevention Conference: Communities Addressing Suicide Together, are pleased to announce that the Call for Abstracts is now open!

We invite communities, survivors, community-based practitioners, clinicians, researchers and policy-makers to submit an abstract that focuses on innovative and promising practice in addressing suicide. The guidelines and submission form for the Call for Abstracts are available on the conference website at www.suicideprevention.ca/2010.

The conference will take place at the Alderney Landing Cultural Convention Centre on the Dartmouth waterfront in Halifax, Nova Scotia from October 5-7, 2010. Registration will open on Tuesday, April 6, 2010. Please note that seats are limited – we encourage you to register early!

Looking forward to seeing you in Nova Scotia!

Angela Davis & Julian Young
Conference Co-Chairs

1-877-466-6606
Casp2010@eastlink.ca

Tuesday, March 30, 2010

Act to ensure rights of the incapacitated


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

By Davene Jeffrey

Nova Scotians will soon be able to retain more autonomy should they become incapacitated.

The province’s new Personal Directives Act becomes law on Thursday, replacing the Medical Consent Act, which gives people the right to name a proxy to make health-care decisions on their behalf.

Health Minister Maureen MacDonald said the new legislation goes beyond instructions for health care.

She said people will be able to assign someone to make sure their wishes for personal needs such as recreation and hygiene are followed.

"It means that people, and particularly, I imagine, people who are older or persons with disabilities, with perhaps some kind of a condition that has a degenerative element, would have the security of knowing that how they wish to be treated will be respected."

As of Thursday, forms will be available through the Justice Department website or through Service Nova Scotia offices, said Health Department spokesman Ryan Van Horne.

There will be two forms, one to appoint a delegate and the other to outline details of expected care and treatment. A booklet explaining the act also will be available.

"The Personal Directives Act covers a wide range of things, including personal-care decisions," Van Horne said.

"For example, if you are admitted to a nursing home and you are a vegetarian, you could ensure that you get a vegetarian diet or that you got fresh air for an hour a day."

The directives will have to be reasonable and legal, Van Horne said.

For instance, anyone living in a nursing home could not expect to receive treatment that the home could not offer to other residents, he said.

"If you want to ask for something that they do provide to everybody else, then you’ll get it," Van Horne said. "If you want something that they don’t provide to everybody else, then you need to make some other type of arrangement."

The act was passed in May 2008 after it was introduced by Cecil Clarke, who was then the justice minister in the Conservative government. MacDonald couldn’t say why it has taken almost two years for the act to take effect, but she said regulations had to be written and staff in health-care settings and elsewhere had to be trained in the new rules.

Van Horne said officials had hoped to bring the act into force last fall but it got sidelined by the H1N1 crisis.

With David Jackson, provincial reporter.

Also see:

Powers of Attorney and Health Care Directives (Nova Scotia)

Friday, March 26, 2010

Tough decisions must be made


An article published in today's edition of The Chronicle Herald:
Mental health strategy will include eating disorder help

By Michael Lightstone

Access to eating disorder pro­grams in Nova Scotia is likely to be addressed in the province’s new mental health strategy, Health Minister Maureen MacDonald [pictured]said Thursday.

Though the plan is in its in­fancy — it was announced in the Dexter government’s throne speech at Province House in Ha­lifax — she hinted it could in­clude some sort of expansion of the province’s existing program. “We have a small eating disor­der treatment program for young people here in the metro area," MacDonald said after the speech. “So, people from other parts of the province . . . have to come here, and the wait lists are long." MacDonald cited the size of the program and its waiting list as examples of “some weaknesses, perhaps, in the (mental health) system that need to be examin­ed."

She was short on details, how­ever, and couldn’t provide a cost estimate for the NDP’s mental health blueprint. The govern­ment is projecting a $525-million deficit for the 2009-10 budget year.

“We will have something in the near future, and we will be look­ing forward to having a compo­nent that will allow for public in­put in the development" of the strategy, MacDonald said in an interview.

Part of that consultation ele­ment, she said, will be a regional conference in Halifax this fall to be hosted by the provincial gov­ernment.

Although MacDonald didn’t provide specifics, she acknow­ledged the province-wide strate­gy won’t be note-perfect or all-en­compassing.

“I’m not prepared to wait as minister of health until we have some perfect strategy developed before we take action," she said. “We already know that there are some things that are needed."

Critics of Nova Scotia’s mental health system have long com­plained there are deficiencies.

And a recent Chronicle Herald investigation found resources for treating the mentally ill are thin in some areas of the prov­ince and non-existent in others.

Asked about the stigma many people still attach to mental ill­ness, MacDonald said public opinion of those with emotional problems or in a treatment pro­gram has changed.

“There’s a lot less stigma today than there has been in the past," she said. “So, I’m hopeful. I don’t think that changing attitudes is an impossible thing, but I don’t think that it’s something that will be solved quickly."

Photo credit

Thursday, March 25, 2010

Speech from the Throne 2010



An excerpt from today's Speech from the Throne:
My government will undertake a new Mental Health Strategy to revamp mental health and addiction services. And the provincial Mental Health Court is already helping to ensure that those who suffer with mental illness are treated with the respect and care they deserve, while ensuring that the justice system is also well served.

To download the entire Speech from the Throne 2010, please click here (PDF)

Please click on the image to enlarge it.

Wednesday, March 24, 2010

Mental health clinics work


A letter to the editor published in today's edition of The Chronicle Herald:
By Dr. Ian Slayter

While we agree mental health services are under-resourced in Nova Scotia, we disagree with this paper’s criticism of the direction taken by our community mental health clinics. Through these clinics we try to provide the best fit between the mental health needs of individuals living in the Capital Health district and the skills and training of teams of health professionals. One article focused on the model of care at the Bayers Road Community Mental Health Clinic. The same model is followed at each of our other community mental health clinics in Dartmouth, Lower Sackville, Cole Harbour, and Windsor.

We are pleased with the direction followed by all five clinics. The clinics have difficulty meeting the high demand for service, nevertheless they do a very good job in the circumstances.

Each clinic works as a team. Priority is given to people with more serious mental illness. Individuals see one or two clinicians — a nurse, social worker, occupational therapist, intensive case manager, or psychologist — and a consultant psychiatrist. Patients with milder mental illness, for example, an adjustment reaction to a stressful situation, usually do not need a team approach. Not everyone needs to see a psychiatrist.

The different professionals offer a wide variety of knowledge and skills. Some skills overlap, some are unique to a particular discipline. For example, only an occupational therapist can do an assessment of someone’s functional level, only a psychiatrist can prescribe psychiatric medication. It might be noted at this point that the community mental health teams work closely with family physicians and that they too can assess, follow, treat, and prescribe medications for persons with psychiatric problems.

Patients are usually referred by family physicians. These referrals are reviewed by a member of the team and the patient may receive a call to ask for further details. Patients are not assessed by phone. The initial assessment is done face-to-face to determine what services the patient needs. Sometimes the person doing the assessment will refer the individual to another clinician as we try to match the needs of the patient with a clinician who has the skills needed.

Our clinicians work within their scope of practice. This means that they assess and treat within the boundaries of their knowledge and skill, as determined by their training, experience, and the guidelines of their profession.

We consider it our responsibility to see the patients as soon as reasonably possible. To provide timely care to those in greatest need, we discharge patients from our service who are ready in order to see those who are waiting and whose needs are more urgent. For the best care of our patients, and not because of management dictates, we do work to see new referrals within the target times set by the Department of Health: urgent patients within one to seven days, semi-urgent patients within 28 days, and non-urgent patients within 90 days.

This team model of care, where the psychiatrist acts primarily as a consultant to the other clinicians, is the standard model followed by public clinics in Canada, the United States, Australia, and elsewhere.

We are looking at newer ways to make our care more effective and efficient to better serve our patients.

As with other conditions, many people’s mental illnesses can be managed successfully in the community with the assistance of a variety of health professionals. However, this model is not for everyone. Depending on the nature and severity of their illnesses, some people require acute inpatient or specialized care, periodically or over the long term.

Could we do better with more resources? Certainly. And every part of the health care system would say so. Through Community Mental Health Clinics such as the one at Bayers Road, we succeed in providing effective, evidence-based care throughout our district in a responsible and efficient manner.

Ian Slayter, MD (Psychiatrist), is clinical director of General Psychiatric Services for Capital Health.

Friday, March 19, 2010

Society must rethink delivering of mental health care


A letter to the editor published in the March 17th edition of the Whig-Standard:
Re: "Patients fear loss of program," March 2, 2010, Whig-Standard.

Bravo to Ken Mitchell and Gary Mustard for getting their voices heard. The purported philosophy of care at Providence Care Mental Health Services is the recovery model, a client-centred, client-directed treatment model. One of the central tenets of the model is "nothing about me without me," yet one doesn't get the sense that Mr. Mitchell and Mr. Mustard were consulted or involved in the decision to cut the recreation staff from the outpatient teams at Providence Care's Montreal Street Clinic.

If outpatient teams needed restructuring, one would have hoped that clients affected by the changes would have been involved in the decision-making process to determine which aspects of care were most important to them.

Instead, as Mr. Mitchell stated, he and other Montreal Street clients are being faced with the removal of services they deem to be "essential to their well being." This isn't the recovery model and indeed it is not consistent with any good model of mental health care.

The availability of services for people with mental-health problems is a huge issue, not only locally, but nationally. It is tragic that at the same time that the Mental Health Commission of Canada is working to address systems issues, stigma issues, issues of homelessness and issues of insufficient resources, there are hospitals like Providence Care eliminating jobs and reducing services.

While the hospital administration may arbitrarily distinguish between losing jobs and eliminating positions, the fact is that there will be fewer people to provide services.

In the mental-health arena, we are long past the days of doing more with less. We have passed through doing the same with less and now we are doing less with less. People with mental illnesses are getting less care, are more prone to being criminalized and are increasingly living on the streets.

Without access to the necessary range of services, people with mental illnesses do not recover well. Providence Care is no doubt caught in a bind. To be sure, they have to balance their budget. But the striking lack of public interest in the cutbacks, the elimination of front-line positions rather than management positions and the lack of consultation with the people who use and need the services all speak to the general disregard that society has for people with mental illnesses. And those people are us.

One in five Canadians will experience a mental illness in their lifetime. All of us have family and friends with mental illnesses. Providence Care needs to think again about the cutbacks. The funding agencies of the government need to think again. We, as a society, need to think again about how we provide care for people with mental illnesses. After all, they are us.

Dorothy Cotton [pictured], Psychologist

Dorothy Cotton is a member of the Mental Health and the Law Advisory Committee of the Mental Health Commission of Canada

Photo credit

Thursday, March 18, 2010

Troubled times for mental health: What can we do right now?


A letter to the editor published in today's edition of The Chronicle Herald:
By Stan Kutcher [pictured]

The recent series in The Chronicle Herald about the crisis in mental health highlighted a number of issues that are not new or unique to Nova Scotia. However, the question facing us in this province is: What are we going to do about it right now? Here are three immediate solutions to our problem that we could put into place quickly.

Focus on children and youth:

We know that approximately 70 per cent of mental disorders begin prior to age 25. We also know that early identification and effective treatment of these disorders is likely to lead to substantially better outcomes and may lead to long-term health cost containment.

So what can we do about this? First, we need to provide effective support to parents and communities so children receive the best early start they can. Then we need to train our teachers and all those who work with young people to learn how to identify children and youth who may be in the early stages of a mental disorder and provide seamless access to effective interventions.

This will require enhancement of human resources, of course, but this should be first developed in this age group. It is my impression that a modest increase in investment in child and youth mental health could lead to immediate short-term improvements with an additional long-term gain. The simple immediate solution: add additional human resources to child and youth mental health services.

Increase mental health care in primary health care:

The primary care sector is the foundation of our health care system. This is where the mental health needs of people are first brought for care. Yet our primary care sector is not set up to deal with such needs. Physicians require better training in the diagnosis and treatment of mental disorders, and primary care practices need to be supported with health providers who have the skills to provide ongoing psychological care. These providers do not need to be at the highest rank of the professional ladder. Rather, they need to have the competencies to counsel and support those who require mental health interventions.

Effective primary sector mental health care will not only address issues of access to care, but will also decrease the demand on specialty mental health services, leaving them more able to provide care for individuals who require more intensive interventions. The simple immediate solution: add counsellors and other trained therapists to primary care practices.

Stop investing in things that do not work:

Mental health care has long historical roots in many types of interventions for which there is little or no evidence of effectiveness or economic value. It is essential that we stop investing in things that we know do not work or for which there is little compelling evidence that they work.

While we have been moving towards greater awareness of the necessity for evidence-based care, we need to hasten progress in that domain and begin to provide funding on the basis of solid scientific evidence. If the evidence does not yet exist, then the funding could be provisional for a period of time until those who champion the intervention or program have had the opportunity to impartially determine its effect and value.

At the very least, no new programs or interventions should be applied without good, independent and most substantial evidence of their effectiveness and economic value. And all existing programs must be evaluated on what they achieve (their outcomes) not on what they do (their activities).

The simple immediate solution: base funding of mental health programs and interventions at least in part on substantive evidence of their effectiveness and cost-effectiveness and continue funding based on outcomes evaluation.

These three simple solutions may be a good place to start. Concurrently, there needs to be immediate and substantial structural change addressing how mental health services are conceptualized and how mental health care is delivered.

We need to stand back and critically and innovatively create a new system that meets the needs of people, provides care and not just services. It must be based on our national and community values and human rights, and be delivered using the best available scientific evidence by those providers best trained to provide care.

We need to also create a framework that can work alongside (but outside) the current health and mental health domains. This may be best realized by creating a Provincial Mental Health Commission (PMHC) that reports directly to the minister of health and that has as its one mandate the development of a provincial mental health strategy that is population needs-driven, innovative and based on best scientific evidence applied within values and principles that define us as caring, compassionate and considerate human beings.

The PMHC should have a sunset clause: five years. If we cannot do this in five years, we are not doing what needs to be done.


Dr. Stan Kutcher is Sun Life Financial Chair in Adolescent Mental Health and director, World Health Organization Collaborating Centre in Mental Health Policy and Training, Dalhousie University and the IWK Health Centre.

Tuesday, March 16, 2010

Mental health report focuses on multicultural groups


A March 15th news release from the Mental Health Commission of Canada:
CALGARY, March 15 /CNW Telbec/ - Statistics Canada is predicting that 1 in 3 Canadians will belong to a visible minority by 2031. The Mental Health Commission of Canada has released a report addressing the needs of multicultural, immigrant and refugee groups. The study is part of its mandate to improve mental healthcare across all areas of Canadian society.

"These groups face unique challenges and are more exposed to factors that promote mental health problems and illnesses," says Steve Lurie [pictured], Chair of the Commission's Service Systems Advisory Committee.

The document, titled 'Improving Mental Health Services for Immigrant, Refugee, Ethno-cultural and Racialized (IRER) Groups,' outlines factors that policy makers and service providers may want to consider when working to improve mental health services for these groups.

"Migration, discrimination, language barriers and lack of awareness of services have an impact on mental health," says Lurie. "Trust in services, cultural competence, targeted health promotion, and stigma can all delay access to treatment."

The 16 recommendations in the report are firmly rooted in the goals of the Mental Health Strategy for Canada. The recommendations fit into one of three main areas, including:
  • Better coordination of policy, knowledge and accountability
  • The Involvement of communities, families, and people with lived experience
  • More appropriate and improved services
The report was prepared by the Diversity Task Group, a subcommittee of the Commission's Service Systems Advisory Group. For more details on the recommendations, see the ... backgrounder [below]. To read the report, please [click here (PDF)].

The Mental Health Commission of Canada is a non-profit organization created to focus national attention on mental health issues. The MHCC does not provide services, but rather acts as a catalyst for action. The Service Systems Advisory Committee is one of eight MHCC committees tasked with making a difference in targeted areas. The other seven are: Child and Youth; Mental Health and the Law; Seniors; First Nations, Inuit and M├ętis; Workforce; Family Caregivers; and Science.

BACKGROUNDER

Improving mental health services for immigrant, refugee, ethno-cultural and racialized groups: Issues and options for service improvement

The report was prepared by the Diversity Task Group, a subcommittee of the Commission's Service Systems Advisory Committee and the Social Equity and Health Research department of the Centre for Addiction and Mental Health (CAMH), Ontario.

The report's plan is firmly rooted in the Commission's development of a Mental Health Strategy for Canada.

There are five groups of actions required to improve mental health services for IRER groups:
  1. Changed focus - an increased emphasis on prevention and promotion

  2. Improvement within services - organisational and individual cultural competence

  3. Improved diversity of treatment - diversity of providers, evaluation of treatment options

  4. Linguistic competence - improved communication plans and actions to meet Canada's diverse needs

  5. Needs linked to expertise - plans to offer support by people and services with expertise to areas with lower IRER populations so they can offer high quality care

Sixteen specific recommendations have been made:
------------------------------------------------

CATEGORY 1: Co-ordination of policy, knowledge and accountability
  1. Each province and territory should include strategies and performance measures in their mental health plans to address the needs of immigrant, refugee, ethno-cultural, and racialized (IRER) groups.

  2. Each province should gather data on the size and the mental health needs of their IRER populations. They should plan their services based on this population data.

  3. The mental health strategy of each province should consider a cross-sectoral plan for improving the social determinants of mental health problems and illness for IRER groups.

  4. A virtual national centre for research into the mental health and mental health problems and illness in IRER groups should be developed. The Centre could perform a regular one-day mental health census of mental health care service use and a community needs survey sampled by province.

  5. Health Canada, Canadian Institutes of Health Research and the provinces and territories should produce a research and development fund for studies aimed at answering strategic policy and practice questions for IRER groups' mental health and service provision. For instance there is an urgent need for Canadian research into the identification and evaluation of culturally appropriate systems of care for immigrant children and youth.
CATEGORY 2: The involvement of communities, families and consumers
  1. A central part of each provincial and regional plan to improve the
    mental health of immigrant, refugee, ethno-cultural and racialized groups
    must include the involvement of IRER communities, consumers, and families
    in planning, decision-making, implementation, and evaluation.
CATEGORY 3: More appropriate and improved services
  1. Health funders should require that service providers take steps to
    attract a more diverse workforce and that there is a monitoring of the
    workforce to assess how it reflects the communities being served.

  2. Service provider organizations and provincial ministries should
    develop strategies to enable good candidates from IRER groups to advance
    into appropriate leadership positions within their organizations.

  3. Each service provider should have an organizational cultural
    competence strategy.

  4. Cultural competence training should be made available to all who have
    direct contact with clients and should be provided to existing staff in
    all service organizations.

  5. Cultural competence training should become a standard part of the
    training of all professional care staff. This should be insured through
    standards of accreditation of training programs and institutions and
    licensing professions.

  6. Provinces and territories should encourage diversity in the
    organizations that provide care, the models of care used, and the sites
    at which care is offered in order to meet the mental health needs of IRER
    groups.

  7. A knowledge transfer strategy for promising practices in the delivery
    of care to IRER groups developed and implemented so that the most
    effective models are known to and can be deployed by providers.

  8. A linguistic competence strategy should be mandatory for local/
    regional service providers and funding for this should be provided by
    their funders.

  9. A virtual centre of excellence in the treatment and support of
    immigrant and IRER groups should be developed.

  10. The MHCC could develop a project similar to the national homelessness
    demonstration project to plan, document and evaluate promising practice
    in the development of diversity strategies in at least five communities
    across the country.

To read the full report, please [click here (PDF)].

For further information: Karleena Suppiah, Communications Specialist, (403) 385-4050 or (403) 370-3835 (cell), ksuppiah@mentalhealthcommission.ca

Photo credit

Sunday, March 14, 2010

Positive news helps remove stigma of mental illness


A letter to the editor published in today's edition of the Des Moines Register:
Newspapers have the job of reporting the news - the good and the bad. It was a pleasure to read a positive article such as the one in the March 7 Register regarding mental illness, and schizophrenia in particular, "Crimes Distort Disease's Reality."

The article emphasized that mental illness is treatable. As in other illnesses, early diagnosis is imperative for health to improve. Diagnosis, therapy and medication, and sometimes hospitalization, are all components essential to a person with schizophrenia, not unlike other illnesses.

Positive journalism regarding schizophrenia is a welcome window for family members who are living with a stigma that still permeates. More positive knowledge might improve that stigma.

- Patricia Schafer, Ankeny

Friday, March 12, 2010

MENTAL HEALTH: SPECIAL REPORT


From the March 8th edition of The Chronicle Herald:




Is the mental health system broken? Find out, starting in Tuesday’s edition of The Chronicle Herald.


The Articles and Videos

Addressing mental health malaise difficult in tough times, but necessary (March 12th)

Desperate measures (March 12th)

Reaching the breaking point (March 12th)

Getting help instead of being put behind bars (March 12th)

Taking treatment to kids (March 11th)

Payment scheme keeps patient numbers down (March 11th)

Balancing treatment, research (March 11th)

Much work to do (March 10th)

VIDEO: Health Minister Maureen MacDonald says mental health care is a priority (March 10th)

Real success or just a mirage? (March 10th)

Integrated care in community best, cheapest (March 10th)

Help just down the hallway (March 10th)

When an option is denied (March 10th)

Mental health: Is our province’s system hurting or helping? (March 9th)

Desperately seeking help for Donnie (March 9th)

The long road to mental health (March 9th)

Mental illness problems common among homeless (March 9th)


Also see:


Success stories

Involuntary Psychiatric Treatment Act (Nova Scotia)

Nova Scotia's Mental Health Court Program

Spring Lake Ranch

Home on the farm: Working therapeutic farm communities (An article from the fall 2007 edition of Schizophrenia Magazine, PDF)


Letters to the editor:


March 24th
Mental health clinics work


Awareness key

I would like to thank The Chronicle Herald for exploring the challenges facing mental health services in Nova Scotia. It is a difficult topic to cover thoroughly, as issues of confidentiality often prevent mental health professionals from disclosing details of illness and treatment in specific cases. Mental illness is difficult for patients and families, as well as for treating physicians. As in other medical conditions, many psychiatric illnesses have poor prognosis and the best treatments sometimes prove ineffective.

As a medical student, I am learning the importance of advocating for patients. Treatments available in Nova Scotia are top-notch but most mental illnesses are chronic conditions requiring many resources to optimize outcomes. Growing strains on the health-care system and limited resources add another dimension to the challenges of treatment. I am in the process of completing a six-week psychiatry rotation at the QEII and have seen first-hand both the difficulties faced by patients as well as the dedication and compassion of members of the mental health team.

Increased public awareness of the need for further supports is a great step toward ensuring these patients have the necessary resources.

Blair Williams, Halifax

March 19th
Don’t discount positives

In response to the March 12 article "Reaching the breaking point," I would like to share that I have been a mental health consumer under the care of Dr. David Mulhall since 1997. The care I have received from Valley Regional Hospital’s mental health unit and its staff has been paramount in my recovery. Please don’t discount the fact that numerous consumers have received and are receiving proper care from the hospital and its range of services.

It may not be a perfect system, and it’s not black and white, but I agree with Dr. John Campbell, who says he has "confidence in the people who work within our system."

Barbara Martin, Wolfville


Research topics

Regarding the Capital District Health Authority: Hats off to Dr. William O. McCormick, psychiatrist, for his March 12 letter "Hospital open and active." He stated the facts about the Nova Scotia Hospital not being closed, and about its Allied Sites.

People should not comment in public before they fully research their topics.

Emmalee Hopkins, Halifax

March 18th

Troubled times for mental health: What can we do right now?


March 17th
Unique contribution

Mental health is certainly everybody’s business and it is imperative that the public has adequate knowledge and education in order to make informed decisions about individual needs.

The March 10 article "Real success or just a mirage?" contains some comments that could lead to a misconception about the qualifications of psychologists and their role in mental health. An understanding of the unique contribution that psychologists make in the provision of mental health services plays an integral part of public education and informed decision-making.

Registered psychologists in Nova Scotia are uniquely qualified to diagnose and provide treatment for a spectrum of mental health disorders. Psychologists are involved across the continuum of care — from prevention, diagnosis and intervention to the treatment of acutely ill individuals. Ultimately, working toward an environment where individuals can be offered services from an interdisciplinary team of professionals is an advantage to the client or patient.

On another note, it was wrong for the title of your series on mental health services in Nova Scotia to contain the words "Broken minds," with a graphic of a head with a shattered hole in it against a backdrop of machine cogs. This image promotes a stereotype of mental illness.

Dean Perry, R.Psych., Public Education Co-ordinator,
Association of Psychologists of N.S.

March 14th
Real progress made every day

IN LIGHT of The Chronicle Herald’s special report on mental health last week, I thought it was the right opportunity to shine a light on some of the positive work being done for mental health care right here in our community.

This past week, we have heard about the holes in the province’s health care system, the disparity of funding allocated to mental health care and heart-wrenching stories of families and individuals affected by mental illness.

While these are all important stories to tell, perhaps the real message here is about awareness.

In last Wednesday’s article titled "Much work to do," Health Minister Maureen MacDonald was quoted as saying, "We won’t fix the mental health system, but we will make some real progress."

Let us be reminded that real progress is being made every day.

Yes, there are funding limitations, a provincial deficit and poor distribution of health care funds. But each day, we are more impressed by our community’s willingness to give their time and effort to help raise awareness about the prevalence of mental illness.

In April, the Mental Health Foundation of Nova Scotia will launch our first-ever capital campaign in support of mental health, Opening Minds. This groundbreaking campaign aims to raise $3 million to improve mental health care services for individuals who are affected by mental illness.

Anyone can support this campaign, whether it’s by making a financial contribution, volunteering their time or spreading the word throughout their community about the need for support.

While there is still much work to be done, the Foundation has made major strides in changing the way people think about mental illness — and you, too, can help make a difference.

Fred MacGillivray, Chair, Board of Trustees, Mental Health Foundation of Nova Scotia

March 12th
Hospital open and active

We who are mental health professionals are following with interest the articles this week. It is very disappointing that the March 10 front-page article "Much work to do" contained misleading information. Outlining our health minister’s experience, the article stated: "She … worked at Dalhousie Legal Aid and the Nova Scotia Hospital before it was closed in favour of a community-based mental health model."

It is no more true that the Nova Scotia Hospital has been closed than to say that the Victoria General Hospital or the Halifax Infirmary has been closed because they are now part of the Capital District Health Authority (CDHA). At the Nova Scotia Hospital, we have the following: the only in-patient unit for the seniors’ mental health service of CDHA; the only in-patient unit in the province for those with dual diagnoses of mental illness and developmental delay; two rehabilitation units for persons with very severe and persistent mental illness; one of the three acute in-patient units in CDHA mental health program.

A number of other programs which, along with the parent hospital, we refer to as "the Nova Scotia Hospital and Allied Sites" are, indeed, community-based, including three of the five out-patient clinics in CDHA.

I am proud to be just three weeks short of completing 21 years association with this important Dalhousie University department of psychiatry teaching hospital.

William O. McCormick, psychiatrist, Mental Health Services
Bedford/Sackville

March 10th
Signs of hope

We appreciate the initiative you have taken in focusing on mental health in Nova Scotia. In Tuesday’s paper, you highlight a few shortcomings. There are also signs of hope. More staff and money may not be the total solution.

First: There are talented and committed professionals seeking to make a difference. There is the early intervention program, with mental health professionals working with school staff to identify young people who could develop mental illness. We could back them up with volunteers for support groups and provide activities for those at risk.

Second: Family members are available to supplement professional treatment. In many instances, they provide the majority of the care, at no cost to the Department of Health. They need to be welcomed, valued and integrated into the total package.

Third: Those who "consume" mental health services for themselves and who are on the recovery journey from their illness are a valuable resource. They can be the sympathetic ear and a model/partner for others who are ill.

We shall read the subsequent issues of The Chronicle Herald with interest.

Rev. Roger Cann, New Minas

Tuesday, March 9, 2010

Strengthening Families Together: Kentville



Ongoing!

FREE!



Do you have a relative or friend with a serious mental illness?

Would you like to learn more about his or her illness?


Delivered by family members who have direct experience with the psychiatric illness of a loved one, and enhanced by invited speakers with topical expertise, Strengthening Families Together is a Canadian-based educational program for families and friends which provides information, skill-building, and support. The program is FREE and open to all family members and friends of those living with a serious mental illness.

You will learn about:
  • Early intervention and recovery
  • Treatments and supports
  • Coping with challenges of daily living
  • Navigating the mental health system
  • The importance of taking care of yourself, too
The Kings County Chapter of the SSNS will deliver Strengthening Families Together at the CMHA Kings County Branch office, 49 Cornwallis Street, Suite 109, Kentville, Nova Scotia, beginning on Tuesday, March 16th, from 7:00 pm to 9:00 pm, and continuing for nine consecutive weeks.

For an outline of the Strengthening Families Together program, please click here.

Registration

To register for this 10-week session of Strengthening Families Together, please contact Pat at (902) 678-8458 or Penni at (902) 678-1229.

Quotes from participants of previous Strengthening Families Together sessions:

“I would like to say thank you so very much for taking the time and effort to have this program on Thursday nights. It has been a wonderful experience and I am sad to see it end.”

“This has been a blessing to me. I am very satisfied with my experience with the group, and my understanding of the health care options and support available to us has greatly increased. I would highly recommend Strengthening Families Together to any who will listen! Thanks.”

“Some solid strategies and ideas on how to help our son.”

“I feel this program is a wonderful launching pad; it equips us to participate in community events and gives us connections to others who are equally passionate about understanding mental illness. It’s a valuable resource.”

Sunday, March 7, 2010

Centre to study mental health, addiction, inequality


A posting from the Simon Fraser University website:

How do the intersections of gender, race, poverty and other social factors affect services and outcomes for people with mental health and addiction issues?

That’s one of the questions SFU’s new Vancouver campus Centre for the Study of Gender, Social Inequities and Mental Health plans to address.

The centre will investigate why there is unequal access to services and health outcomes for people with mental illness and substance-use problems.

It will also help develop programs, policies and interventions to resolve these issues, with the goal of improving adult mental health both in Canada and abroad.

SFU health scientists Marina Morrow [pictured] and Elliot Goldner and the Mental Health Commission of Canada’s Howard Chodos will lead the centre, which will include more than 30 national and international co-investigators and collaborators.

Morrow, a community psychologist, specializes in research related to gender and mental health and mental-health reform.

"I would say women are still under-served—most services don’t take gender into account," she says.

"Yet within the female population, women are more at risk of sexual exploitation and violence, particularly if they suffer from mental health issues."

Centre activities will focus on mental health reform; recovery and housing; reproductive mental health; violence, mental health and substance use; and the criminal justice system, mental health and substance use.

"The centre has three main functions," explains Morrow. "To foster research in the key priority areas, to develop knowledge exchange that will encourage implementation of our research findings, and to mentor and train students and community-based researchers who can build capacity in the field of social inequities and mental health."

"There’s a pressing need for this centre," she says, "because there has been very little attention to the ways in which social and structural determinants affect people with mental health issues."

The centre is being funded with nearly $2 million from the Institute of Gender and Health, part of the Canadian Institutes of Health Research.

Photo credit

Thursday, March 4, 2010

This Valley Life: Student speakers advocate for change


An article published in the March 4th edition of the Contra Costa Times:

By Jim Ott

Earlier this week, Dublin High School senior Annie Arcuri stood in front of more than 90 people at a regional Rotary breakfast in Livermore and shared a story about her older brother, Louis.

"I lost my older brother to schizophrenia," she said into the microphone, stepping away from the safety of the lectern. "He had been a straight-A student, a star athlete, but he became lost to an illness that no one wants to talk about."

To read the entire article, please click here.

Tuesday, March 2, 2010

Scientists identify age-associated defects in schizophrenia


A March 1st news release from The Scripps Research Institute:
Gene network-based analysis reveals unexpected results

LA JOLLA, CA – March 1, 2010 –The underlying causes of the debilitating psychiatric disorder schizophrenia remain poorly understood. In a new study published online in Genome Research March 2, 2010, however, scientists report that a powerful gene network analysis has revealed surprising new insights into how gene regulation and age play a role in schizophrenia.

Researchers are actively working to identify the direct cause of schizophrenia, likely rooted in interactions between genes and the environment resulting in abnormal gene expression in the central nervous system. Scientists have been studying expression changes in schizophrenia on an individual gene basis, yet this strategy has explained only a portion of the genetic risk.

In the new work, a team of researchers led by Associate Professor Elizabeth Thomas [pictured] of The Scripps Research Institute has taken a novel approach to this problem, performing a gene network-based analysis that revealed surprising insight into schizophrenia development.

The group analyzed gene expression data from the prefrontal cortex, a region of the brain associated with schizophrenia, sampled post-mortem from normal individuals and schizophrenia patients ranging from 19 to 81 years old. However, instead of just looking at genes individually, Thomas and colleagues at the Scripps Translational Science Institute, Nicholas Schork and Ali Torkamani, considered interactions between genes, as well as groups of genes that showed similar patterns of expression, to identify dysfunctional cellular pathways in schizophrenia.

"Once gene co-expression networks are identified," said Thomas, "we can then ask how they are affected by factors such as age or drug treatment, or if they are associated with particular cell types in the brain."

The gene network analysis suggested that normal individuals and schizophrenia patients have an unexpectedly similar connectivity between genes, but the most surprising finding was a significant link between aging and gene expression patterns in schizophrenia. The team identified several groups of co-expressed genes that behaved differently in schizophrenia patients compared to normal subjects when age was considered.

A particularly striking age-related difference in co-expression was found in a group of 30 genes related to developmental processes of the nervous system. Normally these genes are turned off as a person ages, but in schizophrenia patients the genes remain active. This critical finding strongly suggests that age-related aberrant regulation of genes important for development can explain at least part of the manifestation of schizophrenia.

Thomas explained that these findings help to refine the developmental hypothesis of schizophrenia, which states that one or more pathogenic "triggers" occur during critical periods of development to increase risk of the disease. Specifically, this work indicates that abnormal gene expression in developmentally related genes might be a significant pathogenic trigger, occurring over a broader time-scale than expected.

"Rather than a pathological trigger occurring at a critical developmental time point," said Thomas, "the trigger is ongoing throughout development and aging."

Furthermore, Thomas noted that the new study supports early intervention and treatment of schizophrenia. Treatment approaches aimed at averting gene expression changes and altering the course of the disease could be specifically tailored to the age of the patient.

###

In addition to Thomas, Torkamani, and Schork, authors of the study, "Coexpression network analysis of neural tissue reveals perturbations in developmental processes in schizophrenia," include Brian Dean of the Mental Health Research Institute (Australia). See Genome Res doi:10.1101/gr.101956.109.

This work was supported by the Scripps Translational Science Institute Clinical Translational Science Award, the National Institutes of Health, and a Scripps Dickinson Fellowship.

Interested reporters may obtain copies of the manuscript from Peggy Calicchia, Editorial Secretary, Genome Research (calicchi@cshl.edu; +1-516-422-4012).


About The Scripps Research Institute


The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Scripps Florida is located in Jupiter, Florida.

Contact: Keith McKeown
kmckeown@scripps.edu
858-784-8134
Scripps Research Institute


About Genome Research


Launched in 1995, Genome Research (www.genome.org) is an international, continuously published, peer-reviewed journal that focuses on research that provides novel insights into the genome biology of all organisms, including advances in genomic medicine. Among the topics considered by the journal are genome structure and function, comparative genomics, molecular evolution, genome-scale quantitative and population genetics, proteomics, epigenomics, and systems biology. The journal also features exciting gene discoveries and reports of cutting-edge computational biology and high-throughput methodologies.


About Cold Spring Harbor Laboratory Press


Cold Spring Harbor Laboratory is a private, nonprofit institution in New York that conducts research in cancer and other life sciences and has a variety of educational programs. Its press, originating in 1933, is the largest of the laboratory's five education divisions and is a publisher of books, journals, and electronic media for scientists, students, and the general public.

Photo by Dana Neibert.