Friday, July 30, 2010

Survey focuses on public perceptions of mental illness in the criminal justice system


An article posted on July 22nd by the CMHA - Ontario Division:

The Federal Government has released a preliminary report of its 2009 Annual National Justice Survey, which focuses on mental health issues. Introduced by the Department of Justice in 2007, the survey collects in-depth, timely and policy-relevant public opinion on current issues. The 2009 survey is a first of its kind, as public opinion research has never been carried out on the topic of mental health and the criminal justice system.

The survey results, which consist of 4,008 respondents from a telephone sample and 1,000 respondents from an online sample, provide an understanding of the Canadian public's perspective of justice and mental health issues. According to the survey, more than three-quarters of respondents agreed that it is important for the court to take the mental health needs of victims who testify into account, and that is it essential that people charged with a crime are able to understand what is going on and are able to communicate with their lawyers. As well, about three-quarters of respondents agreed that it is important for the court to consider the mental competency of people charged with a crime at the time the crime was committed.

More than one-third of respondents agreed that people should not be convicted of a crime if their mental competency prevented them from knowing what they were doing or that it was wrong, whereas more than one-third of respondents disagreed. While almost three-quarters of respondents agreed that there should be alternatives to the regular criminal court process for people charged with non-violent crimes who have mental health or developmental disorders, for violent crimes, only about half of respondents agreed that there should be alternatives to the regular court process.

More than three-quarters of respondents agreed that people who are found Unfit to Stand Trial (UST) or Not Criminally Responsible on Account of Mental Disorder (NCRMD) for both violent and non-violent crimes should remain under the supervision of the justice or mental health systems indefinitely, if necessary, for public safety reasons. However, approximately two-thirds of respondents agreed that people who are found UST or NCRMD for a non-violent crime and are detained in a hospital should be reintegrated back into society when detention in a hospital is no longer necessary for public safety reasons. This figure was significantly lower (approximately one-third) for those charged with violent crimes.

A full report of the survey will be released later this year.

See National Justice Survey 2009: Mental Health Disorders in the Criminal Justice System, Department of Justice Canada, 2010, available by clicking here.

Saturday, July 17, 2010

Largest effort to find gene-environment interactions underlying schizophrenia risk



An article posted on July 16th by news-medical.net:
At the 23rd ECNP Congress 2010 in Amsterdam, Professor Dr. Jim van Os, Chairman of the Department of Psychiatry and Neuropsychology at Maastricht University Medical Centre, The Netherlands, will present the EU-GEI project, involving more than 7,500 patients and their families, which brings together a multidisciplinary research team from 15 countries in the largest effort to date to find gene-environment interactions underlying schizophrenia risk. In particular, he will explain the development of tools that will make it possible to monitor, and possibly modify, vulnerability at the behavioural level, thus preventing transition to overt illness.

Schizophrenia and related psychotic disorders are the most mysterious and costliest of mental disorders in terms of human suffering and societal expenditure, representing a major challenge to scientists. Until recently, researchers had relatively few starting points in trying to unravel the causes of psychosis and to identify better treatments. While epidemiological research has characterised powerful environmental effects on schizophrenia risk, twin and family studies have established that more than half of the vulnerability for schizophrenia is of genetic origin. However, despite enormous investments, it has proven extremely difficult to identify molecular genetic variants underlying schizophrenia liability. According to the model of gene-environment interaction, genes influencing schizophrenia risk may do so indirectly by making individuals more sensitive to the effects of causal environmental risk factors (e.g. urbanisation, migration, cannabis use, childhood trauma). Now, for the first time, a focused scientific collaboration has been organised in Europe in order to elucidate the causes of schizophrenia, focussing on both genes and environments in the same research project.

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Thursday, July 15, 2010

Directory of Self-Help Groups in Nova Scotia 2010



An email received today from the Self-Help Connection:
We are happy to announce that the 2010 edition of the Self-Help Connection’s Directory of Self-Help Groups in Nova Scotia is now available for purchase. The directory contains a listing of self-help groups, support groups and supporting organizations throughout Nova Scotia. Topics range from Abuse & Violence, Cancer, Family & Parenting, Heart & Stroke, Mental Health to Youth Organizations.

This year we have given you the option of either purchasing a hard copy of the directory or a PDF file download (1.69 MB in size) with a "click and find" feature.

Whether you are someone looking for a particular group to meet your specific needs, a professional seeking an appropriate referral point for a client, or a researcher looking for self-help group contacts or information about a certain topic, we hope you will find this document to be an informative and user-friendly resource.

The directory can be purchased for $30 by any of the following methods:
  • Calling us at 466-2011 if you would like a directory mailed to you. Please note that there is a $5.00 postage and handling fee applied to mail out orders.
We would like to thank you for your continued support and look forward to hearing from you. Please do not hesitate to call me if you have any questions.

Self-Help Connection
Email: selfhelp@eastlink.ca
Tel: (902) 404-7800 Ext.#14
Fax: (902) 404-3205

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Thursday, July 8, 2010

Address the real barriers


A letter to the editor published in today's edition of The Globe and Mail:
Untreated mental illness is a major risk for suicide: The rate of suicide for people with schizophrenia is 50 times higher than the general population, and 15 to 30 times higher for people with bipolar disorder (Suicide Barriers Fail To Address Root Of Problem – July 7). Suicide is the leading cause of death for 15- to 24-year-olds.

In Canada, only three in 10 adults access mental health care; the situation is worse for children and youth. While stigma may be a factor, the biggest problem is the lack of accessible mental health services and a lack of focus on early intervention. It is ironic that the share of health spending on mental health continues to decline, even though we know recessions lead to increased demands for mental-health services.

Provincial governments have an opportunity to use the increase in federal health transfers between now and 2014 to reverse this trend and focus on early intervention.

Steve Lurie [pictured], executive director, CMHA Toronto Branch

Also see:

Effect of a barrier at Bloor Street Viaduct on suicide rates in Toronto: natural experiment

Suicide barrier on Bloor Viaduct worked, but jumpers went elsewhere: study


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Wednesday, July 7, 2010

Some With Psychosis Decide Social Life Not Worth It


An article published in the July 2nd edition of Psychiatric News:
By Joan Arehart-Treichel

If people with schizophrenia function poorly in social settings, it may be because they have developed negative beliefs about social functioning, perhaps to protect themselves from rejection.

“Get a life!” people sometimes quip.

“Well, that's not easy to do if you've got schizophrenia,” an individual with this illness might respond.

But it might still be possible. The reason? Negative beliefs about a social life seem to be the major reason why individuals with schizophrenia don't have a social life, a new study has found. And if that is the case, then changing those beliefs might help them “get a life.”

The study was conducted by Paul Grant, Ph.D., a research assistant professor of psychology in psychiatry at the University of Pennsylvania, and Aaron Beck, M.D., [pictured] University Professor Emeritus of Psychiatry at the University of Pennsylvania. Beck is also considered “the father of cognitive therapy.” Results were published in the May 15 Psychiatry Research.

People with schizophrenia tend to isolate themselves from others, yet at the same time they say that they would like to have friends, get a job, and perhaps have a family. What is the explanation for this discrepancy? Could it be negative beliefs and expectations rather than the illness itself? Grant and Beck conducted a study to find out.

The study sample included 123 adults with an average age of 39 who had been diagnosed with schizophrenia or schizoaffective disorder. Various scales were used to evaluate subjects on social functioning, neurocognition, emotion perception, positive symptoms, negative symptoms, depression, anxiety, and negative beliefs about social functioning.

Negative beliefs about a social life were determined with 15 statements from the Revised Social Anhedonia Scale. Several of the statements, for example, were “People are usually better off if they stay aloof from emotional involvement with others,” “Making new friends isn't worth the effort it takes,” and “Having close friends is not as important as most people say.” For each statement, subjects answered yes or no. Subjects' responses were summed into a total score of 0-15, with higher scores indicating more negative beliefs about a social life.

The researchers then used correlational analysis to see whether there were any orderly, predictable relationships between subjects' social functioning scores and their scores on the other measures. None could be found between their social functioning scores and their neurocognition, emotion perception, positive symptoms, and anxiety scores. But such a link could be found between their social functioning scores and their negative symptoms, depression, and scores indicating negative beliefs about the value of a social life.

And most striking, high scores on negative beliefs about a social life were associated with poor social functioning scores.

The researchers then determined the relative contribution to social functioning of neurocognition, emotion perception, negative symptoms, depression, and negative beliefs about social function. They found that neurocognition and emotion perception contributed a negligible amount—a finding that surprised them—but they also found that negative symptoms and depression accounted for somewhat more, and that negative beliefs about a social life accounted for the largest contribution to social functioning.

Finally, they conducted a longitudinal analysis of 13 of the subjects to see whether negative beliefs about social functioning at baseline significantly predicted social withdrawal a year later, or whether social withdrawal at baseline predicted negative beliefs about social function a year later. The former was the case.

Putting all these results together, it looks as if negative beliefs about a social life may be a major reason why people with schizophrenia don't relish social interactions, the researchers concluded. “We propose that the patients' asocial beliefs trump their need for social acceptance,” they wrote.

And, if that is the case, would certain interventions help individuals with schizophrenia change such beliefs and thus improve their social lives? The researchers think that they might.

For example, “encouraging the patient to engage in social contact can expose the dysfunctional beliefs, which can then be the target for cognitive restructuring. Various behavioral techniques such as social-skills training and assertiveness training can facilitate social engagement and demonstrate to the patient the positive consequences of social engagement.... Modifying beliefs that maintain depression, which is also linked to poor social functioning, can further motivate the patient to socialize productively.”

The study was funded by the Foundation for Cognitive Therapy and Research, NARSAD, and the Heinz Foundation.

Also see:

Asocial beliefs as predictors of asocial behavior in schizophrenia


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Friday, July 2, 2010

New blood-test to aid in schizophrenia diagnosis



A July 1st news release from the University of Cambridge:
A new blood-test resulting from research at Cambridge University could aid in the early diagnosis of recent-onset schizophrenia – complementing the traditional patient interview-based diagnosis.

VeriPsych, developed by Professor Sabine Bahn, Director of the Cambridge Centre for Neuropsychiatric Research, and collaborators at Psynova Neurotech and Rules-Based Medicine, is based upon a blood-based biomarker test - where characteristics are objectively measured and evaluated as an indicator of the presence of disease.

Professor Sabine Bahn, said: "Schizophrenia is a complicated and challenging disease, yet current diagnostic approaches continue to be based on patient interviews and a subjective assessment of clinical symptoms. We expect VeriPsych to be used as an aid to this current process, and we hope it will provide the psychiatrist with additional confidence in their evaluation, as well as speed up the process."

Schizophrenia is a disease that typically begins in early adulthood; between the ages of 15 and 25, affecting 51 million people worldwide with more than 250,000 cases in Britain. Current diagnosis of Schizophrenia is conducted through interviews by a psychiatrist, who follows structured guidelines such as The Diagnostic and Statistical Manual of Mental Disorders, a process that can take several months.

During VeriPsych's developmental stage, researchers analysed 200 biomarker candidates individually and in combination to assess their connection to schizophrenia. They discovered a set of 51 biomarkers with linkages to schizophrenia and to various biochemical pathways, including inflammation, metabolism and cell-to-cell signaling. In a subsequent study, the 51 biomarkers were validated in combination with a mathematical process to separate schizophrenia patients from normal controls. The study included analysis of more than 800 well-characterised blood samples collected by leading psychiatric hospitals.

The research was published in the online journal Biomarker Insights. Commercial rights resulting from this research are held by Psynova Neurotech Ltd., which was launched by Cambridge Enterprise in 2005 and is now majority-owned by Rules-Based Medicine, Inc. Professor Bahn is the Co-Founder, Director, and Chief Scientific Officer of Psynova.

Also see:

Validation of a Blood-Based Laboratory Test to Aid in the Confirmation of a Diagnosis of Schizophrenia (PDF)


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Thursday, July 1, 2010

National project aims to highlight human rights issues for persons with mental illness


A June 28th media release from the Canadian Mental Health Association - Winnipeg Region, Public Interest Law Centre of Legal Aid Manitoba, and the Mental Health Commission of Canada:
Mental Health Commission of Canada (MHCC) funds national project to examine issues of equality, dignity and inclusion for people with mental illness

The Canadian Mental Health Association – Winnipeg office (CMHA) in partnership with the Public Interest Law Centre of Legal Aid Manitoba have been engaged by the Mental Health Commission of Canada’s (MHCC) Mental Health and the Law Advisory Committee to conduct research related to mental health, human rights, and relevant law, policies, and service standards. One of the Committee’s mandates is to examine Canada’s legal framework as it relates to persons with mental illness, including legislation, regulations, and policies.

“This is a very exciting year to engage in this work, with Canada’s recent ratification of the UN Convention on the Rights of Persons with Disabilities we can see there is a real spotlight now on how we protect these rights throughout Canada.” Nicole Chammartin, Executive Director, CMHA Winnipeg adds, “CMHA has been a long standing advocate for human rights for people experiencing mental health issues, and we know Canadians value human rights as being a core part of the Canadian experience, but unfortunately that is not always the case for everyone.”

A key component to this project will be the work of a consultative group of persons who have experienced mental health issues that will guide the research and development of an evaluative framework for national and provincial mental health related laws and policies, as well as the development of a draft set of core service standards.

Six individuals representing the pre-determined pilot jurisdictions of Manitoba, Nova Scotia, British Columbia have been selected as members of the consultative group as well as one individual each from Quebec and the Northwest Territories. Lindsay Evangelista, a consultative group member from BC shares, "I knew something needed to be done when I first entered the assessment unit at one of the hospitals. The staff seemed totally disinterested in my care and I had one nurse tell me that I was faking all my symptoms and called me the equivalent of a female dog. Needless to say, it was the worst experience of my life.”

This 18-month project is now underway with an anticipated completion date of September 2011. For more information on this project please visit www.cmhawpg.mb.ca for a project description, information on the consultative group and updates on progress throughout this project. In addition, the project research team is aiming to consult with other stakeholders in each of the pilot jurisdictions and there is an opportunity to indicate your interest in being involved when you visit
the site.

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Media inquiries may be directed to Nicole Chammartin, CMHA Winnipeg Region, at (204) 982-6103.

Class action settlement in drug for schizophrenia


An article published in the June 30th edition of The Toronto Star:
Some users of antipsychotic drug say they were not warned of risk of diabetes

By Theresa Boyle, Health Reporter

Canadian courts have approved a $17.6 million settlement in a class-action lawsuit launched by individuals who became diabetic after taking an antipsychotic drug.

The settlement with Eli Lilly, manufacturer of Zyprexa, was announced Wednesday. It stems from allegations that the drug giant failed to warn about risks of severe weight gain, diabetes, hyperglycemia and pancreatitis.

Zyprexa is used for treatment of schizophrenia and bipolar disorder.

Eli Lilly denies any wrongdoing and the allegations have not been proved in court.

“While we believe the allegations are without merit, Lilly is taking this difficult step because we believe it is in the best interest of the company as well as the Canadian health care professionals who depend on this important medication,” John Rudolph, legal counsel for Eli Lilly, said in a written statement.

The drug continues to be used, but changes have since been made to its label to include warnings of diabetes.

The class action was filed on behalf of 11 people from Ontario, British Columbia and Quebec and approved by the superior courts of those provinces.

“We acknowledge that Eli Lilly has done the right thing,” said Harvin Pitch, counsel for Stevensons LLP, which represented some of the plaintiffs. “We encourage all users of Zyprexa who qualify to apply for their benefits.”

To receive a settlement payment, an individual must have started taking the drug prior to June 6, 2007 and then been diagnosed with diabetes, hyperglycemia, ketoacidosis or pancreatitis. The size of each payment will depend upon severity of illness and the total number of approved claims.

The settlement was based on an estimate that there would be 1,450 claims, though it is possible that the actual number may be higher, Pitch said.

The total number of prescriptions filled in 2009 in Canadian retail pharmacies for Zyprexa and its generic equivalents was 2,493,081. It is the third most prescribed antipsychotic on the Canadian market.

Further information is available at classaction.ca, from lawyer Daniel McConville at Stevensons LLP: (866) 940-8329, or from lawyer Matthew Baer at Siskinds LLP: (800) 461-6166 x 7782.

Note:

The claims deadline is October 28th, 2010.

Also see:

Notice of Settlement Approval (long version) [PDF Document]

Claim form [PDF Document]

Press Release – June 30, 2010 [PDF Document]