Saturday, April 30, 2011

Nova Scotia candidates questioned


A letter to the editor published in today's edition of The Chronicle Herald:
The Mental Health Coalition of Nova Scotia emailed all federal election candidates in the province the following questions:
  1. Can you please tell us your party’s platform as it pertains to mental health and addictions?

  2. Less than five per cent of total health care spending in Canada goes to mental health and in Nova Scotia, less than four per cent. The World Health Organization estimates the disease burden at 15 per cent. How will you and your party address this inequity?

  3. In 2014, the Health Accord is up for renewal. What strategy will you and your party adopt to ensure that mental health and addiction issues are addressed in the Health Accord negotiations?

  4. The Canadian Psychiatric Association states: "One in three inmates suffer with a mental disorder." What plans do you and your party have to address: a) prevention programs in the community and b) community-based treatment options for individuals currently involved in the criminal justice system?

  5. What will you and your party do to address the current states of poverty and homelessness in Canada?
Responses from the candidates can be viewed at www.mentalhealthcoalitionns.info.

Gail Gardiner, Co-Chair,

Mental Health Coalition of N.S.

Thursday, April 28, 2011

Mental health care: Are our rights to privacy being eroded?


An opinion piece published in today's edition of The Chronicle Herald:
By Aileen McGinty

One in five Canadians are likely to experience mental illness within their lifetime. Statistically, this means that about 80,000 people in the Halifax area could be affected by new guidelines on disclosure of information being developed by Capital District Health Authority’s Mental Health Program.

The Mental Health Program was advised, rightly or wrongly, last year during a visit by the Meriden Programme from England that collaborative mental health care in Nova Scotia is restricted more than in most other places in the world by the emphasis on confidentiality.

Capital Health’s response to this is to develop new disclosure guidelines together with "champions of disclosure" in their various teams. What the Mental Health Program does not appear to appreciate is that you cannot get around existing legislation simply by introducing new policy. If legislation is required to be changed, there is an appropriate process to be followed. The danger with the direction taken by Capital Health is that the new policies may not be in compliance with legislation, leaving the organization open to challenge.

The draft disclosure guidelines prioritize the rights of family members of those with mental illness over the rights of the individuals living with mental illness. ("Family" is defined as those whom the patient identifies as supportive.) Families play an extremely important role in the lives of many of those with mental illness; however, the rights, dignity and respect owed to the individuals concerned must take priority.

These rights cannot be ignored as they are enshrined in the UN Convention of the Rights of Persons with Disabilities. On a provincial level, the Freedom of Information and Protection of Privacy Act provides that all public bodies are obliged to ensure the protection of an individual’s personal information.

In essence, the draft guidelines as written advocate manipulation and obfuscation of people who are vulnerable and likely to be in distress. In any discussion, clarity is paramount, but especially so when that discussion involves someone who may be distressed, confused or anxious.

These draft guidelines advise professionals not to ask someone whether they want their personal information kept confidential, but rather assume consent and ask only which information can be disclosed and to whom. Many people with mental illness as well as human rights professionals, both in Nova Scotia and other provinces, are finding this extremely disturbing. It is essential to inform someone that they have a right to keep their personal information confidential.

It is unlikely that any other health-care information would be treated with such a cavalier attitude and it may be possible that CHDA Mental Health Program could be setting itself up for complaints of discrimination on this basis.

Collaborative care is an important factor in the treatment of any illness. I am a great supporter of collaborative care generally, and am presenting on this very topic at the 12th Canadian Collaborative Mental Health Care Conference to be held in Halifax in June this year. However, research on collaborative care is quite specific about which particular circumstances lead to improved patient outcomes. It is simplistic to state (as in the draft guidelines) that "research shows that good supports improve patient outcomes," especially without referencing that statement.

My aim in highlighting this issue is not to be dismissive of collaborative care. My concern is to ensure that the individual’s right to privacy of personal information is not eroded.

The consultation period for this document was very short and the deadline for comments has passed. However, given the importance of this matter to so many people, I am sure that CDHA Mental Health Program would still be open to listening to the views of the public and other relevant bodies before completing the final document.

Aileen McGinty is a member of the Mental Health and Law Advisory Committee of the Mental Health Commission of Canada.

Also see:

Personal Directives in Nova Scotia

Personal Directives Act

Personal Directives Regulations

Personal Health Information Act (not proclaimed in force)

Carers and confidentiality in mental health - The Royal College of Psychiatrists (2010)

Rethink Policy Statement 27: Confidentiality and information sharing

SDO briefing paper – Information Sharing

Confidentiality and Information Sharing Reference List

Thursday, April 21, 2011

Mental health early intervention projects offer 'outstanding value'



Please click on the image to magnify it.

An article posted on April 20th by Children & Young People Now:
Having early intervention psychosis teams work with young people experiencing their first episode of schizophrenia or bipolar disorder can save as much as £18 for every £1 spent.

By Joe Lepper

Taxpayers save £8 for every £1 spent on parenting programmes, according to the latest study into the value of early intervention mental health projects.

The study by the Department of Health, London School of Economics and Political Science, the Centre for Mental Health and Institute of Psychiatry found savings increased as the mental health support became more specialised.

It is estimated that £18 is saved for every £1 spent on deploying early intervention psychosis teams to work with young people experiencing their first episode of schizophrenia or bipolar disorder.

Suicide training for GPs saves £44 and alcohol misuse schemes save £12 for every £1 spent.

Called Mental Health Promotion and Mental Illness Prevention: the Economic Case, the study puts the economic and social cost of mental health problems, through factors such as offending rates and benefit payments, at £105bn a year.

Care services minister Paul Burstow said: "Mental health is not a matter of them and us, it’s about all of us. At some point one in four of us will suffer a mental health problem.

"PCTs and GP Consortia should take a careful look at this study and use it to commission better mental health services."

The research team looked at 15 different mental health projects. Team leader Professor Martin Knapp said they all offer "outstandingly good value for money".

He added: "Most are low in cost and many become self-financing over time, saving public expenditure as well as radically improving the quality of people’s lives."

Also see:

What’s it worth now?

Thursday, April 14, 2011

Public to get say on Nova Scotia's mental health system


An article published in today's edition of The Chronicle Herald:
By John McPhee, Health Reporter

The committee charged with creating the province’s long-awaited mental health and addictions strategy will embark on a series of public meetings next week.

The provincial advisory committee will hold the first of six meetings Monday in Greenwood to get feedback on how programs and services can be improved.

The NDP government first announced its intention to create a strategy last spring. The committee co-chairpersons — Michael Ungar [pictured], a professor of social work at Dalhousie University, and Joyce McDonald of [The Empowerment Connection] — were announced in June and the rest of the committee in the fall.

It is composed of 12 health experts, researchers, mental health clinicians and people living with or affected by mental illness.

The committee kept a low profile since that time, but it has been holding consultations with health-care providers and advocacy organizations, said a spokeswoman from the Health and Wellness Department.

"We’re just letting them do their work and we don’t want to complicate that or distract them," Patricia Murray, acting executive director of mental health and addictions, said in an interview. "It’s a huge job they’re doing and we’re just anxiously anticipating the end result that they’re able to submit."

The committee has met with about 50 groups and more meetings are planned, a recent Health and Wellness Department news release said.

The move to revamp the system has been sparked by concerns about long waiting lists for treatment and how mentally ill people are treated in the justice system, as highlighted by Judge Anne Derrick’s report in December 2010 on the death of Howard Hyde. Hyde died Nov. 22, 2007, after a violent conflict with jail guards at the Central Nova Scotia Correctional Facility in Dartmouth.

Mental health advocate Stephen Ayer of Halifax has criticized the province for being too slow in dealing with the problems in the mental health system. Ayer, the executive director of the Schizophrenia Society of Nova Scotia, welcomed the consultations.

One committee member and staff from the Nova Scotia Health Research Foundation met with the society about three weeks ago. "It was very useful," Ayer said in an interview.

But he is concerned the consultation thus far has been with the people who provide the services, not with those who use the services. At his urging, the committee will meet with people with mental illnesses next month.

As for the strategy, "we are looking forward to seeing some movement in terms of improvements in access to services," he said.

Besides the public meetings, people can also provide input online or through the mail. For more information, go to www.nshrf.ca/mentalhealthandaddictionsstrategy or call 424-4043.

The committee is expected to submit its recommendations to Health and Wellness Minister Maureen MacDonald in the fall.


SCHEDULE

Schedule of public meetings on the province’s mental health strategy:
  • April 18: Greenwood, 8 a.m. to noon, 14 Wing Greenwood, Birchall Training Centre, Chamber Room
  • April 26: Amherst, 8 a.m. to noon, Tantramar Theatre, 98 Victoria St. E.
  • April 27: Sydney, 8 a.m. to noon, Cape Breton University, 1250 Grand Lake Rd., multi-purpose rooms A and B
  • May 3: Halifax, 1 to 5 p.m., Saint Mary’s University, Burke Building, Burke Theatre B (entrance off Inglis Street)
  • May 5: Bridgewater, 9 a.m. to 12:30 p.m., South Shore Regional Hospital, lecture rooms 1 to 3 (third floor)
  • May 16: Halifax, 8 a.m. to noon, Universite Sainte-Anne, Campus de Halifax, 1589 Walnut St. It will also be broadcast to campuses in Tusket, Petit de Grat, Church Point and Grand Etang.

Image credit

Sunday, April 10, 2011

Schizophrenia Society of Canada - Annual Awards 2011


From the Schizophrenia Society of Canada website:
Our schizophrenia societies depend upon the perseverance, skill and devotion of dedicated volunteers, practitioners and staff members who help us to achieve our mission of promoting a quality of life for those affected by schizophrenia and psychosis. Without their dedicated efforts, we would be missing the leadership and direction essential for our organizations.

Each year, the Schizophrenia Society of Canada recognizes individuals and initiatives/programs within the schizophrenia community that are helping to fulfill our mission through the presentation of our Annual Awards.

Do you know someone who has made an outstanding contribution to our mission? Here is your chance to celebrate his or her achievements with a nomination for a 2011 Annual Award. A nomination form, along with the description and criteria for each award, is listed below.

If you require further information email info@schizophrenia.ca.

Nominations Deadline: July 31, 2011


Awards and Criteria:

Please note: Each endorser should also submit as a separate attachment, details on the activities of the individual or initiative/program and how the activities relate to the award criteria.

Image credit

Wednesday, April 6, 2011

Experiences of psychosis - website



From healthtalkonline.org:
This module is about people’s experiences of psychosis. Many of the people we interviewed had, at some point in their lives, received a diagnosis of schizophrenia. However there were a number of people we spoke to who had never received this diagnosis but who had experienced psychosis i.e. hearing or seeing things or holding unusual beliefs which other people don’t see or share. We interviewed 34 people (31 people with direct experience and three carers) about their experiences.

To visit the website, please click here.


Image credit

Saturday, April 2, 2011

NAMI launches new schizophrenia website and brochure


An article posted on April 1st by News-Medical.net:
The National Alliance on Mental Illness (NAMI) has launched a new website on schizophrenia and published a new brochure on the medical condition which affects more than 2.4 million American adults each year.

Onset of schizophrenia often strikes men in their late teens or early twenties, while appearing in women in their late twenties or early thirties. The cause and course of treatment are different for each individual.

"NAMI has launched the new schizophrenia website and published the new schizophrenia brochure to provide up-to-date information to individuals, families and others," said NAMI Executive Director Michael Fitzpatrick.

"Everyone should know the nature of schizophrenia and its symptoms. Everyone should know the latest medical thinking on prevention, triggers and treatment."

The schizophrenia brochure can be downloaded from the website at www.nami.org/schizophrenia or ordered in packets of 25 copies each for local groups, physician offices, health fairs, conferences or workplace education.

The website highlights two areas of recent research relating to onset of schizophrenia:
  • "Fish oil" supplements may help prevent psychosis during critical years of brain development. Further studies are needed, but NAMI Medical Director Ken Duckworth advises individuals in their teens or twenties with early symptoms of psychosis to take Omega-3 fatty acids—available in supermarkets and pharmacies. There appear to be few risks compared to the potential benefit.
  • Smoking marijuana is increasingly seen as a causal factor that can trigger onset of schizophrenia in some people. NAMI cites three studies published in February and March 2011. As an environmental factor, marijuana is believed to "trigger" genetic factors, increasing the risk of psychotic incidents and ongoing experiences.
The schizophrenia web site includes discussion of anosognosia, more commonly known as a lack of insight. Individuals may lack awareness of their own illness—believed to be the result of problems with neurological processes in the frontal lobe of the brain. The condition can lead to tension within families and complicate treatment.

NAMI offers education and support programs to individuals and families confronting schizophrenia.

SOURCE: National Alliance on Mental Illness

Should state mental health institutions close?



An article published in the March 18th edition of the Asbury Park Press
By Valerie Fox

Recently I read a lengthy editorial from a mental health advocate who stated strongly that institutions should close and have all mentally ill people treated in the community. The writer works for a large mental health community provider, which has probably influenced her opinion. In this editorial, no thought was given for people who cannot live in the community, but instead need the shelter of a long-term care facility.

Having been involved in direct care in the mental health system as a consumer-provider and having visited many people in institutions and in the community while serving on boards and committees, it is my opinion that, unfortunately, not all mentally ill people have responded to medication. For some, a number of meds are tried, but none give freedom from serious symptoms to be able to seek and live a good quality of life.

I have met other people who do not have insight into their illnesses and the need to take medication. These people are very vulnerable to becoming victims or victimizing others because they are not living in reality, but instead are living in the grip of voices and delusions.

For myself, after living homeless for approximately two years, I initiated being sent to an institution. I did not know I was ill, but I did know enough that going to a community hospital would not help me. I would be treated very well but, once I was stabilized, I would be returned to the community as I had been a few times while homeless. For me, this short hospitalization was not enough time for healing to take a firm hold on me.

When in long-term care, I had more time to think about my life and where it had gone, and how to get back the good life I had known prior to homelessness; I had been very traumatized by homelessness, and I was given the chance to slowly adjust to re-entering the community with strong linkage, especially housing options.

I am happy that many people can live in the community while living with mental illness. However, I don't think we should lose sight that not all people can and will need sheltered care for some period of time, whether long-term or a few months.

Let us keep the option of long-term care for those who need it; and let us continue building innovative community programs. Both are needed in my opinion to continue to meet the needs of people living with mental illness in New Jersey.


Valerie Fox of Parsippany is founder and president of the Morris County Mental Health Coalition. She is in recovery, having lived with schizophrenia for many years. She is a mental health advocate and writes on mental health topics.

Also see:

Personal Accounts: Schizophrenia and Socialization