Friday, April 30, 2010

First symptoms of psychosis evident in 12-year-olds


An article posted today by Lab Spaces:
Children normally experience flights of fancy, including imaginary friends and conversations with stuffed animals, but some of them are also having hallucinations and delusions which might be the early signs of psychosis.

A study of British 12-year-olds that asked whether they had ever seen things or heard voices that weren't really there, and then asked careful follow-up questions, has found that nearly 6 percent may be showing at least one definite symptom of psychosis.

To read the entire article, please click here.

I thank Terri Vernon for bringing this article to my attention.

Also see:


Etiological and Clinical Features of Childhood Psychotic Symptoms: Results From a Birth Cohort

Childhood Psychotic Symptoms: Etiologic and Clinical Features

Thursday, April 29, 2010

Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001—05: an epidemiological survey


The abstract of an article published in the June 13th, 2009, edition of The Lancet:
By Prof. Michael R. Phillips, MD; Prof. Jingxuan Zhang, MMed; Qichang Shi, BMed; Zhiqiang Song, BMed; Zhijie Ding, BMed; Shutao Pang, MMed; Xianyun Li, MMed; Yali Zhang, MD; and Zhiqing Wang, BMed

Background

In China and other middle-income countries, neuropsychiatric conditions are the most important cause of ill health in men and women, but efforts to scale up mental health services have been hampered by the absence of high-quality, country-specific data for the prevalence, treatment, and associated disability of different types of mental disorders. We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China.

Methods

We used multistage stratified random sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China; the sampling frame of 113 million individuals aged 18 years or older included 12% of the adult population in China. 63 004 individuals, identified with simple random selection methods at the sampling sites, were screened with an expanded version of the General Health Questionnaire and 16 577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.

Findings

The adjusted 1-month prevalence of any mental disorder was 17·5% (95% CI 16·6—18·5). The prevalence of mood disorders was 6·1% (5·7—6·6), anxiety disorders was 5·6% (5·0—6·3), substance abuse disorders was 5·9% (5·3—6·5), and psychotic disorders was 1·0% (0·8—1·1). Mood disorders and anxiety disorders were more prevalent in women than in men, and in individuals 40 years and older than in those younger than 40 years. Alcohol use disorders were 48 times more prevalent in men than in women. Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents. Among individuals with a diagnosable mental illness, 24% were moderately or severely disabled by their illness, 8% had ever sought professional help, and 5% had ever seen a mental health professional.

Interpretation

Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.

Funding

China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health.

Bold emphasis in the text of the abstract is mine.

Posting of this abstract on the weblog is for the purposes of research into the prevalence and treatment of mental disorders in China.

Also see:

Mental disorders in China underestimated

Media Advisory - Story opportunities during Mental Health Week



A media advisory from the Mental Health Commission of Canada:
CALGARY, April 28 /CNW Telbec/ - Next week is Mental Health Week (May 3 -9, 2010). You can speak with the Mental Health Commission of Canada (MHCC) for a national perspective on mental health issues and to find out more about its initiatives. Here are some of the issues the MHCC is tackling:

More than one thousand off the streets

In February 2008 the Federal government allocated $110million to the MHCC to undertake a 4 year research demonstration project looking at mental health and homelessness, called At Home/Chez Soi. The initiative is working in 5 cities across Canada (Vancouver, Winnipeg, Toronto, Montreal, Moncton) to find ways to more effectively help people with mental illness who are homeless.

It is estimated that 25-50% of people who are homeless have a mental illness. Homelessness also costs the system up to $6 billion per year for health, criminal justice and social services.

Stigma: still the biggest barrier

Opening Minds is the MHCC's 10-year anti-stigma/anti-discrimination initiative designed to change the attitudes and behaviours of Canadians towards those living with mental illness. Launched in October 2009, the initiative is the largest systematic effort to reduce the stigma of mental illness in Canadian history. Opening Minds is focusing on three target groups: Youth (early intervention can make an enormous difference in reducing stigma), health care workers (stigma is mostly experienced on the medical front lines) and workforce (many employees choose to go untreated then risk being labeled by their employer).

The stigma of mental illness is one of the key reasons people with mental health issues report they would not seek help. Since more than seven million people will experience mental health problems this year alone in Canada, this is a significant issue.

Developing first Mental Health Strategy for Canadaever Mental Health Strategy for Canada

The MHCC is developing Canada's first ever mental health strategy. After an extensive national public consultation, the Commission released the document Toward Recovery and Well-Being in November 2009, which introduces the Commission's vision for change and the actions needed to address the mental health needs of Canadians. This document forms the framework for what will become Canada's first ever mental health strategy.


The MHCC is a non-profit organization created to focus national attention on mental health issues. It is funded by the federal government but operates at arm's length from all levels of government. The Commission's objective is to enhance the health and social outcomes for Canadians living with mental health problems and illnesses. www.mentalhealthcommission.ca

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

Friday, April 23, 2010

Cartoonists should be careful how they portray mental health


An article published in today's edition of The Guardian:
It's not political correctness gone mad. Some things really should be unsayable

By Beatrice Bray [pictured]

Newspaper cartoons can be great. They can say the unsayable. They have licence to push the boundaries of taste. Their images can resonate for years. But Martin Rowson's cartoon "Dressing-up box" (Comment & Debate, 29 March) overstepped the mark.

Rowson had fun depicting different Conservative politicians in fancy dress. They are shown like kids in the playroom. But as one Tory lifts Mrs Thatcher's moth-eaten blue dress, he shouts: "Hey everybody! This is the 'psychotic yet tough union basher' cozzie!"

The use of the word "psychotic" was offensive. You may think this political correctness gone mad, but if you are ill, or have been, you need words to describe your experience to yourself and to others. If for you these words are negative, you will hate yourself. Language can make or break your happiness.

That is why mental health activists do not like psychiatric terms being used as abuse. We want to show the public how to use terms like "schizophrenia", "psychosis" and "bipolar" in the correct way.

For starters, do not use the word "schizophrenia" when you don't mean mental illness – as when, a few years ago, an MP on a Commons committee claimed there was "schizophrenia" within the BBC.

And please allow individuals an identity apart from their illness, so always say "a person with schizophrenia" rather than "a schizophrenic".

In general usage the word "paranoia" means an undue sense of suspicion. It does not mean illness. The psychiatric term "paranoia" involves an extreme sense of persecution.

"Psychosis" is another escapee into the fashionable world. In the street sense it implies wackiness, but some of us need it to report distressing symptoms to doctors in life-threatening crises. We are not always believed.

There are attempts to banish such ambiguity. "Bipolar" is a new term which was introduced to replace the stigmatised "manic depression". This creates a chance to reinvent the illness, but already the new label is becoming tarnished. You cannot separate words from their popular meanings. You have to change attitudes and behaviours as well as words.

Rowson's cartoon is testament to this, even though he does not sound like the kind of man who would want to disfranchise those of us with severe mental health problems.

We were not Rowson's target: Margaret Thatcher was. But just to complicate matters we are now championing the honour of Thatcher even though some of us are leftwingers. We do not think that Thatcher, a dementia sufferer, should face misused words of abuse.

In the mental health world we try not to offend. At conferences we agree to avoid insulting each other with derogatory terms. We are glad that the main party leaders have copied us. All three have signed a compact, drafted by the all-party parliamentary mental health group, on the use of language. This is the first time such an agreement has been reached. It would be appropriate if journalists and cartoonists were to respect this compact.

Photo credit

Monday, April 19, 2010

Help for the body and mind


An article published in the April 16th edition of The Record:
Centre NuHaB to add mental health programs to their services

By Corrinna Pole

For nearly fifteen years the Life Skills Development program at Centre NuHaB in Ascot Corner has offered non-traditional therapy focusing primarily on addictions.
This year, the centre anticipates an addition to its service, focusing on mental health, with the opening of a “Therapeutic Recover/Healing Ranch” called the Ranch de Cantons.

NuHaB founder André Rochon [pictured] and his wife Cindy have embarked on a mammoth venture to purchase a multifunctional property that will address multiple aspects of mental health issues in a non-institutional setting, helping “humans to find their human being.”

“We’ve been working in addictions for years… I’ve seen more and more addictions and mental health (issues) and I’m getting more and more calls from hospitals and institutions and support groups to work with their mental health clientele,” said André. “I’ve noticed there are fewer organizations dedicated to a complete approach to mental health issues, which is much more than giving them medication and putting them on a ward with papers and crayons. There is much more needed; it’s a big job.”

The Rochons envision an ecofriendly, self-sustained community dedicated to helping individuals suffering from a wide range of psychological and emotional disorders reconnect with themselves by focusing on six aspects - the mind, body, spirit, interdependence, independence and realization.

Although therapeutic ranches have been in existence since the early 1900’s, the Ranch de Cantons would be the first of its kind in the province. It would respond to the seven strategic goals that have been outlined by the Mental Health Commission of Canada that would enable everyone in the country to attain the best possible mental health and wellbeing.

The goals include support, prevention, responding to diverse needs, recognizing and supporting the family’s role in care, offering access to useful treatments and supports, advancing research and taking action using the best evidence from multiple sources of knowledge, and lastly valuing those living with mental health problems and illnesses.

To read the entire article, please click here.

Photo credit

Thursday, April 15, 2010

Gene linked to schizophrenia: Canadian study


An article posted on April 13th by AFP:
MONTREAL — People with a specific mutated gene may be prone to schizophrenia, according to a Canadian study published Monday in a US scientific journal.

The study led by University of Montreal researchers found new mutations in the so-called "SHANK3 gene" in [schizophrenia] patients.

"That these new mutations occur in schizophrenia is rather unexpected and may explain why the identification of the genes linked to this disease has been so difficult," senior author Guy Rouleau [pictured] said in a statement.

"Our findings show that a significant number of schizophrenia cases are the result of new genetic mutations in the SHANK3 gene," he said in the study published in the US Proceedings of the National Academy of Science.

Schizophrenia is a mental disorder that affects about one percent of people worldwide. It is most commonly manifested as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking.

It often leads to significant social or occupational dysfunction.

SHANK3 proteins are involved in maintaining the physical structure of nerve cells, and mutations in the gene result in specific abnormalities in cell shapes.

These deformations have been observed in schizophrenia patients.

Lead study author Julie Gauthier said the SHANK3 gene had "previously been linked to autism," which suggests "a molecular genetic link between these two neurodevelopmental disorders."

It also means that SHANK3 "may have a role in other brain disorders," she said.

Posting of this article is for the purposes of research into schizophrenia.

Saturday, April 10, 2010

Stick to facts on mental illness


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

Although I have only lived in this country for nine weeks, I cannot let the March 28 letter by Elizabeth Azuya go without response. I hope the views expressed do not reflect those of the wider Canadian community.

While the incident referred to — the stabbing to death of eight children in China — is indeed a tragedy, some of the statements in the letter are inaccurate and are particularly disappointing, following on as they do from the recent focus on mental health in The Chronicle Herald.

Ms. Azuya states, "The fact that people suffering from mental illnesses are mostly the ones blamed for such offences should change the ways in which such people are treated anywhere they go." Fact: The majority of people who are violent do not suffer from a mental illness. People with mental illnesses have the same basic human rights as anyone else and they should not be treated any differently. I wonder how Ms. Azuya thinks they should be treated.

"Leaving them to wander around could turn into a huge social problem." If I presume that "them" are individuals with a mental illness, the idea that "they" all wander around causing social problems is farcical. Fact: People with mental illness are 2.5 times more likely to be victims of violence than to be perpetrators of violence.

Does Ms. Azuya realize the large numbers of "them" who are wandering around anyway? Fact: In Canada, one in five people will experience a mental illness at some time in their life. Does this mean that 20 per cent of the people in this land should somehow be seen as posing such a risk to society that the streets are unsafe to walk on, as the letter suggests?

Ms. Azuya might like to know that statistically, the incidence of mental illness is actually less in China, at 17.5 per cent, although she may be relieved she does not live in Scotland where it is 25 per cent!

The fact that the suspect in the incident in China was once a "medical worker" is irrelevant. Given the incidence of mental illness, health service providers will undoubtedly have people working for them who have experienced mental illness at some point, and quite rightly so. Is it any wonder that while some people still hold outdated ideas about mental illness, individuals may not feel comfortable sharing that information, especially within the workplace?

I did wonder if this letter was a joke, but sadly, I fear it is not. And yes, Ms. Azuya, I am one of "them," but I am also a qualified lawyer (Scottish), psychologist (U.K.), teacher (U.K.) and music therapist (Canadian). I have spent many years working in the health care sector, have a very successful career and three thriving children, so please do not be afraid that I am "coming to stab (you) to death."

Aileen McGinty lives in Hammonds Plains.

Photo credit

Friday, April 9, 2010

Workplace Mental Health Resources



Please click on the image to magnify it.

National Call to Action: Identifying the Need for Specialized Treatment and Care of Concurrent Mental Health and Substance Use Disorders



An April 9th news release from the Canadian Centre on Substance Abuse:
Ottawa, April 9, 2010 – The Canadian Centre on Substance Abuse (CCSA) — Canada’s non-governmental organization dedicated to reducing the harms associated with alcohol and drugs — today announced the release of Substance Abuse in Canada: Concurrent Disorders, the third in a series of biennial publications that highlight key contemporary substance abuse issues in Canada and identifies areas where action is needed.

Written by members of CCSA’s Scientific Advisory Council — a group of Canada’s leading biomedical, neuroscience and clinical experts — and other leading clinicians and academics in the field, Concurrent Disorders takes an in-depth look at the state of concurrent disorders and provides a call to action to address this significant health issue.

Concurrent disorders — cases in which individuals have both a mental health problem and a substance use problem — are currently poorly understood by the public and inadequately addressed by either Canada’s primary healthcare system or specialized mental health and addiction services.

"Concurrent disorders are generally seen as unlinked and separate as a result of mental health and addiction systems that are compartmentalized and largely independent of each other. The result is that clients are often being treated for one of their disorders but not the other," said Rita Notarandrea, CCSA’s Deputy Chief Executive Officer. "As this report indicates, treating each problem separately leads to poor client outcomes that are characterized by frequent relapses and crises, placing undue strain on the healthcare system and its professionals. Concurrent Disorders is a significant first step towards identifying the actions we must take to effectively address this public health issue."

The publication takes an in-depth look at six areas within the field of concurrent disorders, including the interplay between substance use and anxiety, stress and trauma, impulsivity, mood, and psychosis.

"The rationale for considering concurrent disorders a topic of special significance is in many ways self-evident: the two disorders frequently coexist; they often share common biological, psychological and social roots; and these co-occurring disorders represent a major health challenge," said Dr. Franco Vaccarino, Professor of Psychology and Psychiatry at the University of Toronto and Chair of CCSA’s Scientific Advisory Council. "The limited ability of our parallel substance use and mental health clinical and community programs to approach concurrent disorders in a coordinated, integrated manner represents a significant barrier to effectively treating those affected."

The cost of substance abuse and mental health to Canadians is considerable. In a 2002 study by CCSA, substance abuse disorders were estimated to cost Canada more than $40 billion annually. In addition, a 2001 Public Health Agency of Canada study estimated the price tag of mental health problems in Canada to be $14.4 billion annually. Collectively, substance abuse and mental health issues account for more than $54 billion in costs to Canadian society each year and exact an immeasurable toll on individuals, their family and friends.

The percentage of costs that can be attributed to those with concurrent disorders is currently unknown. However, findings within Concurrent Disorders suggest that these individuals likely account for a large portion of the total, as they have a limited ability to cope with everyday challenges, experience higher unemployment, and at the extreme, can become homeless, socially marginalized or criminally involved.

A Call to Action

Concurrent Disorders identifies the critical need for Canada to address the issue of concurrent disorders through:
  • Policy makers, educators, researchers and health professionals acknowledging that specialized treatment for those with concurrent disorders is a major priority for Canada;
  • Increased scientific programs that provide a better understanding of the processes and mechanisms underlying concurrent disorders, and that address current gaps in research and research funding;
  • Increased community addiction programs that are better equipped to deal with clients with concurrent disorders;
  • Integration of clinical practice guidelines in the substance use disorder and mental health fields that reflects a unified national approach to treatment and care;
  • An educational platform that increases the number of trained professionals with a common understanding of concurrent disorders and treatment practices;
  • A focus on youth and early detection, as concurrent disorders often have an onset during adolescence and are best treated early; and
  • The development of prevention and treatment strategies that focus on life stressors and trauma as significant risk factors in the development and recurrence of concurrent disorders.
To read the full Concurrent Disorders publication or the Highlights report, please click here.

–30–

About CCSA:

With a legislated mandate to reduce alcohol- and other drug-related harms, the Canadian Centre on Substance Abuse (CCSA) provides leadership on national priorities, fosters knowledge translation within the field and creates sustainable partnerships that maximize collective efforts. CCSA receives funding support from Health Canada.


For further information, please contact:

Annie Boucher, Fuse Communications
Tel.: (613) 863-3702
Email: boucher@fusecommunications.ca

Also see:

National approach needed on care for mentally ill who abuse substances: report

Tuesday, April 6, 2010

Community Mental Health Groups - Capital Health District



Please click on the image to magnify it.

A video from the 2009 Canadian Federation of Mental Health Nurses Conference


A video made up of photographs taken during the Canadian Federation of Mental Health Nurses Conference held in Halifax on October 21-23, 2009.

Look closely, you might see some people you recognize!



To look at a larger version of this video, please click here.

Monday, April 5, 2010

Drug ads still stigmatise mental illness


An April 3rd news item from the University of Cambridge:
The way that drugs used to treat mental illness are advertised to doctors could be helping to perpetuate – rather than break down – the stigma still attached to mental health problems.

Over the space of a year, Dr Juliet Foster [pictured] analysed 96 different drug advertisements carried in the British Medical Journal and the British Journal of Psychiatry. She discovered stark differences in the way that psychiatric and non-psychiatric drugs are advertised to health professionals.

Whereas adverts for "physical" diseases such as pain and blood pressure medication usually picture people as happy and active, either in work settings or enjoying their leisure time, psychiatric drugs such as those used to treat depression and Alzheimer's disease are more likely to show troubled or inactive individuals.

According to Dr Foster: "The negative images of distressed, disturbed and often deviant individuals used in advertisements for psychiatric medication contrast sharply with advertisements for non-psychiatric medication which focus on happy smiling people engaged in healthy activity, and perpetuate links between mental health problems and abnormality, fear and otherness."

As well as looking at images, Dr Foster analysed the text used in the drug advertisements. She found that while adverts for non-psychiatric drugs majored on medically-related information on the drug itself, adverts for psychiatric drugs included less text and text that is focussed on narrative description or case studies.

The differences have important implications for the stigma still attached to mental illness, says Dr Foster.

"It is hard to argue that the general public should see mental health problems in the same light as any other health problem when it seems clear that this is not always happening in the health industry," she says.

"It would be wrong to deny that health problems don't cause suffering: people who experience mental health problems obviously do report very high levels of distress and unhappiness at their experiences. But to maintain a distinction between mental health and other health problems, and in particular to portray mental ill health more in terms of chaos, deviance, fear and otherness risks perpetuating stigma that professionals, and service users may strive so hard to dismantle in other areas."

The paper is published in the Journal of Mental Health

I thank John Devlin for bringing this article to my attention.

Also see:

Mental health research in The Lancet: A case study">Mental health research in The Lancet: A case study

Laing House Family Support Group


The Laing House Family Support Group is a self-help group for family/friends of an adolescent or young adult up to the age of 30 who has a mental illness (not restricted to any one illness in particular). Since January 2008, the Laing House Family Support Group has operated as a stand-alone group, at arm's length from Laing House, but with Laing House's support.

Because the Laing House Family Support Group it is now run BY family members FOR family/friends, it is meant to be inclusive rather than exclusive and there is no requirement for the youth themselves to be members of Laing House or for families to have the youth's permission to attend.

The goal of the Laing House Family Support Group is to provide support and education according to the needs determined by the Support Group members. Meetings always include a time for sharing and support amongst the Group and we invite speakers when a specific interest is identified by the Group.

The Laing House Family Support Group meets on the first Monday evening of each month at 6:30 pm.

There is no commitment to attend group meetings beyond what families find is helpful or convenient. Laing House is located at 1225 Barrington Street, Halifax, Nova Scotia.

Contacts:

Dani Himmelman, parent facilitator: phone (902) 826-224 or email dhimmelman@eastlink.ca.

Judy Bell, Team Leader, Laing House: phone (902) 473-7743.

Saturday, April 3, 2010

Facts don’t concur


A letter to the editor published in today's edition of The Chronicle Herald:
In his March 24 opinion piece, "Mental health clinics work," Dr. Ian Slayter states, "priority is given to people with more serious mental illness."

Dr. Slayter’s statement is inconsistent with the facts for the Dartmouth Community Mental Health Clinic. Of the 137 new referrals to the Dartmouth Community Mental Health Clinic in January 2010, the most recent month where data is publicly available, none were seen as "urgent/rapid follow-up."

In November 2009, the next most recent month, 94 people were referred to the same clinic and none were seen as "urgent/rapid follow-up." In October 2009, none of the 92 new referrals were seen as "urgent/rapid follow-up."

In total, of the 323 new referrals to the Dartmouth Community Mental Health Clinic over a four-month period, excluding December 2009 because the data are not publicly available, none were seen as "urgent/rapid follow-up."

Wait-time data for the five community mental health clinics in the Capital Health district can be accessed by visiting its website (www.cdha.nshealth.ca), clicking on "Accountability" and selecting "Mental Health Community Team Wait Times." A dash means there were zero people in a category.

Stephen W. Ayer, executive director, Schizophrenia Society of N.S.

Thursday, April 1, 2010

Spring 2010 issue of CrossCurrents


A note from the editor published in the Spring 2010 issue of CrossCurrents:
This is an issue of CrossCurrents that you may not want to read. It forces us to confront our own contributions as health care providers in perpetuating stigma and discrimination against people with mental illness and addiction. We may think we are immune; after all, we work in this sector because we want to help people. Many health care providers I spoke with told me, “We don’t have that problem here.”

Yet consumers tell a different story. We solicited input from people with mental health and addiction issues. What became clear from the many submissions we received was the pervasiveness of stigma and discrimination in the health care system. People told us again and again that stigma is the single most important barrier to their quality of life, more so than the illness itself.

Stories like these describe the experience of stigma, but we know little about what interventions work in reducing it. This issue of CrossCurrents focuses on action. We hear first about Opening Minds, the 10-year anti-stigma campaign of the Mental Health Commission of Canada that in its first year is targeting stigma and discrimination among health care professionals, with the goal of developing promising practices. Next, Anne Ptasznik spends time with a group of psychiatry residents and consumers that meets informally in non-clinical settings, providing the valuable contact and context needed to combat stigma.

Social worker Cheryl Peever’s personal story shows that clinical knowledge does not always translate into effective workplace practices when mental illness or addiction is a workplace issue. Ned Morgan examines how the stigma that extends to those who work with people with mental health and addiction issues is perpetuated through film portrayals of mental health nurses. Other stories look at stigma in the emergency department and the black mark of borderline personality disorder. In her Last Word column, Jan Wallcraft asks whether public anti-stigma campaigns developed by psychiatrists do more harm than good. Visit the Last Word column to have your say.

Hema Zbogar
tel 416 595-6714
hema_zbogar@camh.net

Club Friday - Spring 2010 Schedule



Please click on the image to magnify it.

Also see:

Healthy Minds Cooperative