What patients think about involuntary treatment

Posted on February 26th by Mental Health Update:

All over the world large numbers of people are admitted to psychiatric hospitals. The laws governing this are controversial and in the U.K. are governed by the 2007 Mental Health Act. Most laws are based on the assumption that people who are compulsorily admitted to hospital do not recognise their need for care at the time so research has tended to concentrate on whether - looking back on things - people think it was a good idea that they received treatment. A team of researchers, led by Stefan Priebe [pictured] from Newham Centre for Mental Health, London led a study of 1,613 people in 11 different countries. They were interviewed within a week of admission and again after a month and three months. The number of people who were happy with the decision to involuntarily treat them varied a lot between the different countries and ranged from 71% in Italy to 39% in Lithuania after a month and from 46% in Sweden to 86% in Italy after three months. (The figures for England were 47% and 54% respectively.) Women, people living alone and people with schizophrenia were more likely to be unhappy with their admissions.

Priebe, Stefan ... [et al] - Patients' views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries. British Journal of Psychiatry. March 2010, 196(3), 179-185.

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McGorry urges mental health overhaul

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

By Julia Medew

The Australian of the Year, Patrick McGorry [pictured], has called for a massive overhaul of the mental health system to direct funds away from acute hospital services to more community-based care.

Only weeks after accepting his award, Professor McGorry has moved to capitalise on his role by asking the federal Health Minister, Nicola Roxon, for at least $200 million in new services this year.

On top of his list is a significant expansion of specialised treatment facilities for young people aged 15 to 24 who are experiencing early psychosis and other serious mental health disorders such as schizophrenia.

He said the only such facility in Australia, Orygen Youth Health, should be used as a model for 10 new centres in other cities this year, with a commitment to another 10 in regional hubs over the next five years.

The rollout would cost $100 million this year, he said, with recurrent spending rising to about $250 million a year when all 21 centres are operating.

"This investment will be recouped three times over because early intervention is highly cost-effective and rapidly shrinks the need for care in the medium to long term," he said.

"This will free up resources for the long-term disabled cases and the broader range of mental disorders. The health economics case is unassailable."

Professor McGorry, who directs Orygen Youth Health, said he had also asked for 60 new "headspace" centres, which currently provide mental health, education, employment and drug and alcohol services to young people aged 12 to 25 at 30 sites across the country.

He said this expansion, which would cost $100 million to set up and the same in recurrent spending, would make headspace centres the first port of call for young people showing signs of mental illness, who could then be referred on to the specialised treatment facilities if need be.

"This is a low-risk reform strategy with rapid and dramatic benefits in health gain and cost savings. Failure to invest in early psychosis reform will result in another lost generation of young Australians consigned to unnecessary disability as well as premature death from suicide and cardiovascular disease," he said.

Professor McGorry said he wanted to see the centre of gravity of mental health services shifted away from hospitals to community-based facilities because the sector had suffered enormously from being moved out of "asylums" and into hospitals in the 1990s. He said the transition was like "boarding a sinking ship" for mental health professionals who had struggled to work with scarce funds ever since.

''The acute pressure [on the hospital system] has made mental health budgets very vulnerable,'' he said. ''The mental health system needs to be scaled up significantly now. It needs to double in size and the states can't do it alone.''

Professor McGorry said that after consulting widely in recent weeks, he also hoped federal and state and territory governments would fund more mobile treatment teams for people with delayed recovery and persistent conditions so they were not forced to go to hospital emergency departments during crises.

"We need to disinvest in emergency departments as the place for acute and crisis care. EDs are the wrong places for people with mental health problems to be treated," he said.

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MHCC receives major grant from City of Vancouver

A February 19th news release from the Mental Health Commission of Canada:

CALGARY, Feb. 19 /CNW Telbec/ - The Mental Health Commission of Canada (MHCC) has received a $500,000 grant from the City of Vancouver. The funds will help operate part of a research demonstration project on mental health and homelessness at a downtown hotel.

The 100-unit Bosman Hotel is being converted into supportive housing for some of the participants in the Vancouver At Home/Chez Soi project. It is part of the MHCC's four-year national research initiative.

The initiative is taking a 'Housing First' approach to finding the best ways to help homeless people who also live with a mental illness. Similar projects are being carried out in Winnipeg, Toronto, Montreal and Moncton. 2285 homeless people living with a mental illness will participate nationally and 1,325 people from within that group will be given a place to live.

"This is terrific news," said Mr. Michael Kirby, Chair of the MHCC. "It is wonderful to see such a strong commitment and we look forward to working with the City of Vancouver and other partners over the course of this initiative."

This latest grant is in addition to a 1.1 million dollar contribution to the project previously made by Vancouver's "Streetohome Foundation" (www.streetohome.org). That donation included a $275,000 grant from the "Vancouver Foundation" (www.vancouverfoundation.bc.ca). Both organizations are helping tackle homelessness in Vancouver.

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.


For further information:

Nujma Bond, Mental Health Commission of Canada, (403) 385-4033

Catharine Hume, Vancouver At Home/Chez Soi project, (604) 688-2204

Also see:

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

Gratitude as an Action Plan

A February 17th webinar, conducted by Carol Bailey Floyd (pictured), which was sponsored by the Copeland Center for Wellness and Recovery and Essential Learning:

Gratitude can serve to heal and help us move forward in positive ways. A daily acknowledgment of what is right in our lives can create the groundwork for mindfulness, confidence, self-esteem, and empowerment. Active recognition of the optimistic force of gratitude is a powerful approach to living. This presentation includes remarkable research findings about the benefits of using this simple, safe and uplifting wellness tool.

Carol Bailey Floyd, Director of Programs for Mental Health Recovery & WRAP, is a certified WRAP facilitator and trainer of facilitators. Well-known in the mental health field, she was the Project Coordinator for the University of Illinois at Chicago's WRAP Research Project in Ohio.


Downloads Available

PowerPoint Slides for Gratitude as an Action Plan

Recording of Gratitude as an Action Plan

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Much more must be done

A letter to the editor published in yesterday's edition of The Chronicle Herald:

The Feb. 9 story "Family tried to get teen murder suspect psychiatric help" reports that the family of the young man charged tried to obtain psychiatric care prior to the tragic event. It is often the shocking that draws attention to the commonplace. We need to do more, much more.

Parents, youth and health providers have known for a long time now that rapid, efficent access to effective, high-quality mental health care is a problem. We need to do much better to ensure that those who need care immediately receive high-quality care immediately. That may mean redesigning our health system. That may mean addressing mental health literacy in schools and in the community. That may mean better training in the diagnosis and treatment of mental disorders for all health providers.

One in five young people has a mental disorder requiring professional treatment. If the prevalence of heart disease in youth was that high, would there not be a heart clinic on every corner? Yet those in most need of mental health care do not receive it. What is wrong with this picture? Enough is enough. It is time to fix the problem!

Dr. Stan Kutcher [pictured]
Sun Life Financial Chair in Adolescent Mental Health
Dalhousie University

Family had been trying for months to get teen murder suspect psychiatric help

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

By Steve Bruce, Court Reporter

The family of a 17-year-old Middle Sackville boy charged with murdering a woman last Friday had been trying to get him psychiatric help for months, The Chronicle Herald has learned.

They had finally managed to get him an appointment for a psychiatric assessment at the IWK Health Centre in Halifax [pictured] on Monday, sources close to the family said.

But something allegedly went horribly wrong before the boy could be assessed.

Last Friday at about 12:15 p.m., RCMP found the body of Joyann Wright, 49, in her home on Hewer Crescent in Middle Sackville.

Police haven’t released the cause of death, but sources say Wright was stabbed and that the boy tried to kill himself after he fled the scene in her vehicle.

The teenager, whose identity is protected by the Youth Criminal Justice Act, was naked when he was arrested on a Lower Sackville street.

Police believe he was involved in a string of motor vehicle collisions after the killing.

A Saturn Astra owned by the victim crashed into a postal van on Rossing Drive, about 50 metres from Hewer Crescent. The vehicle also crashed into the back of a dump truck that was parked on Millwood Drive.

Then the boy was involved in a minor car-pedestrian accident on Sackville Drive after apparently throwing himself in front of a vehicle.

He received treatment for his physical injuries at the Cobequid Community Health Centre in Lower Sackville before he was transferred to the mental health unit at the IWK.

The boy wasn’t able to make it to Halifax youth court Monday morning from the hospital.

Defence lawyer Stan MacDonald appeared in court on the boy’s behalf.

Judge Pam Williams granted MacDonald’s request to have the matter adjourned until Friday.

The teenager will remain in custody at the IWK.

A Crown attorney will be brought in from Sydney to prosecute the case, court was told.

MacDonald refused to comment on his client’s mental health history when contacted by this newspaper Monday afternoon.

Outside court earlier in the day, the boy’s lawyer said the IWK unit "is the appropriate place for him right now."

"At this point, what I would like to say is to convey that his family is very appreciative of how the police dealt with the matter and very appreciative of the treatment that he received at the Cobequid centre and at the IWK," MacDonald told reporters.

The boy has one conviction for theft. He pleaded guilty in January and is due to be sentenced in April.

(sbruce@herald.ca)

Also see:

System is in chaos, mental health advocates say

Three cheers for outspoken health bureaucrat

Mental Health Advocate (IWK Health Centre)

Mental Health Mobile Crisis Team (PDF)

Photograph of the IWK Health Centre courtesy of the Department of Pediatrics, Faculty of Medicine, Dalhousie University.

Her life story goes from fearful to awesome

An article published in today's edition of The Province:

By Lora Grindlay

For the 11th year, Coast Mental Health will present six people with Courage to Come Back awards for overcoming injury, illness and adversity and for inspiring those around them while doing so. Recipients will be celebrated at a gala dinner at Vancouver's Hyatt Regency hotel on April 30. Today we profile the recipient in the mental-health category. Find more at coastmentalhealth.com

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No longer is Tina Tomashiro's life ruled by fear.

Her days are now measured in achievement and accomplishment: Three years since she last used crack cocaine; four courses of the 11 she needs to be a paralegal completed; a full-time job as office manager of Pivot Legal Society; the correct medication and the self-awareness to control her depression and paranoid schizophrenia; mastering the art of doing perfect circles on her rollerblades.

And now a Courage to Come Back award -- a testament to her willingness and determination to change the life she once lived. It was the life of a homeless, drug-addicted woman with an untreated mental illness suffering severe trauma following a violent assault in 2002.

"I was totally unemployable four years ago because of my mental health, because of self-esteem. I had low self-worth, very little support," said Tomashiro, 39 (pictured).

Tomashiro struggled with mental illness for years and was diagnosed with depression in 1999 and with schizophrenia in 2005.

In the years between the diagnoses she was the victim of a violent attack at the hands of someone she thought she knew.

"I'm a little too trusting, a little too nice," she said. "I actually thought I was going to die that night."

Tomashiro believes the attack triggered something inside her.

"I started being scared all the time," she said. "I think that somehow I snapped."

Following the attack, she lost her job of over two years at BCIT, began using crack cocaine and moved to Calgary where, when she wasn't living on the streets, she was in the psychiatric ward of a hospital.

Tomashiro returned to Vancouver in late 2004 and moved into the Stanley Hotel, a supported-housing program in the Downtown Eastside operated by the Portland Hotel Society. It was there that she reached rock bottom with a suicide attempt, but it's also where she started her comeback.

Dr. Bill MacEwan, a psychiatrist familiar to many in the Downtown Eastside, got her stabilized on medication. And she quit crack.

"Everything that happened from when I was assaulted, I just lived for fear," she said. "I used to use [crack] and it made me really scared. I just reached a point where I was tired of being scared. I was scared that I was going to wake up scared again."

Tomashiro now lives at the Portland's Pennsylvania Hotel in the Downtown Eastside, has renewed contact with her 17-year-old daughter and credits the Portland Hotel Society, Pivot Legal Society and MacEwan for investing in her life.

She's renovated and painted her single-occupancy room, repaired clothes for her neighbours, secured a $500-grant to plant a community garden, and threw a barbeque for the neighbourhood.

Tomashiro started an art program at the Carnegie Centre, promoted Pivot's Hope in Shadows calendar and has spoken publicly about her struggles with mental illness.

"I've changed so much in the last few years," she said.

Photograph by Nick Procaylo, The Province.

Learning to cope

An article published in the January 29th edition of The Truro Daily News:

Educating yourself key to dealing with mental illness

By Monique Chiasson

TRURO – Martha Rodler (pictured) has come to expect people uttering “stupid” or “crazy” under their breath within her earshot.

She doesn’t approve of such rude actions, but she deals with it in a positive way.
“I feel bad for them because it’s their problem and they are looking for a reaction so I don’t give it to them,” said the North River resident who has learned how to deal with mental illness issues in a healthy way. Her mother and brother were both diagnosed with schizophrenia many years ago and while she has had to learn how to cope with their illness, she has also had to educate herself on how to handle society’s ignorance and intolerance of mental illness.

“There’s still a stigma that someone with mental illness is stupid and it can be shameful for some ... but you can’t let what other people think affect you,” said Rodler. “You need to see there’s a person beyond the illness and it wasn’t their choice to have it. It’s a challenge that has made me a stronger person.”

Before Rodler educated herself on understanding mental illness and enforcing healthy boundaries, she often felt “stress, resentment and anger.”

She said as important as it was for her to learn how to accept, understand and deal with other people’s mental illness, it is also vital the community becomes more understanding and tolerant as well.

“If a person with mental health (issues) has learned to live with it why can’t we (as a society)? It’s time to break the cycle of stigma,” said Rodler.

There are many ways of getting help, she said, including searching for information online, self help groups, therapy, books and tapes and through the local Canadian Mental Health Association.

The association hosted Wine, Women and Wellness at the Marigold Thursday night. The event was the first of its kind in Truro with the goal of bringing women together to become closer, share their experiences and help raise awareness about mental health. “It’s great,” said Rodler. “Women are very strong but we need each other.”

The association’s executive director, Crystal Hill, said such events are vital to the community.

“Everybody is affected by mental health and it’s important to recognize the importance of talking about it ... so people know there are resources available,” said Hill.

Also see:

Learning about Schizophrenia: Rays of Hope - A Reference Manual for Families & Caregivers (PDF)

Symptoms of Psychosis & Schizophrenia (PDF)

Photograph by Monique Chiasson, Truro Daily News.

Doctors and dentists who 'substance abuse' helped

An article posted on January 28th by BBC News:

A pilot project giving special help to doctors and dentists with health problems has treated 184 people in its first year.

By Jane Dreaper, Health Correspondent, BBC News

62% of them had mental health problems, while 36% were battling drink or drug addiction.

Of the 78 who weren't working when they came into contact with the scheme, 46% returned to work.

The medical director of the project said she had been surprised at the extent of substance misuse.

The project has been hailed a success and there are plans to expand it.

A third of the medics contacted the service because they were already involved in disciplinary proceedings.

Depression was the mental health problem most commonly diagnosed by the NHS Practitioner Health Programme (PHP) - but the service also uncovered six cases of psychosis that hadn't previously been treated.

Of the 67 doctors and dentists who attended the service with addiction problems, 51 were drinking too much alcohol while 16 were abusing a range of drugs - including heroin, ketamine and cocaine.

'Embarrassed'

The PHP was set up because NHS clinicians are often embarrassed to seek help for these sorts of problems.

It also has to ensure that patients aren't put at risk by doctors and dentists who are unwell.

Five of the scheme's patients removed themselves from their duties after being told they should do so - and on two occasions, the PHP contacted the regulators to express concern about its patients.

Psychiatrists, anaesthetists and paediatricians were the specialties most commonly attending the service.

The PHP's medical director, Dr Clare Gerada, said: "This has been a real eye-opener.

"I thought at first we'd see a bit of stress and burn-out. But it soon became apparent how troubled some of these doctors and dentists were.

"I've been surprised at the degree and extent of substance misuse that we've seen.

"They're not the easiest patients in the world - and behind them are patients who could potentially be harmed.

"They tend to present at a late stage, but very few dropped out of treatment, and most of them tend to do well."

'Abstinent'

More than 80% of the doctors and dentists who were treated for addiction were shown to have stayed abstinent afterwards - compared with about 10% of the general population.

The service tests their hair and blood for evidence of alcohol or substance abuse.

PHP has so far operated in Greater London. Talks have begun to set up similar NHS services in Newcastle and Avon.

The chief medical officer for England, Sir Liam Donaldson, had the idea for the service.

He said: "The problem is there in all medical workplaces around the world.

"Previously, doctors found it extremely difficult to access appropriate and confidential care.

"From the number of patients accessing PHP during its first year, it's clear there is a need for this highly specialised service."

Photograph courtesy of the Practitioner Health Programme.

Blood test for schizophrenia could be ready this year

A January 20th media release from the American Chemical Society:

A blood test for diagnosing schizophrenia — the most serious form of mental illness — could be available this year, according to an article in the current issue of Chemical & Engineering News, ACS' weekly newsmagazine. The disorder, with symptoms that can include hallucinations and delusional thoughts, affects more than two million people in the United States and millions more worldwide.

C&EN Senior Editor Celia Henry Arnaud mentions the test as one part of a much broader discussion of how scientists are using non-brain cells to study schizophrenia in an attempt to speed the identification of biomarkers of the disease and develop new diagnostic tests. She notes that schizophrenia does not just involve the brain, but also abnormal levels of certain proteins that appear in other parts of the body. The article highlights groundbreaking research by a group of scientists in the United Kingdom indicating that 40 percent of the chemical changes in the brains of schizophrenia patients also occur in other body parts. The U.K. scientists are studying these biomarkers in the skin, immune cells, and blood of patients to provide a real-time picture of the disease. Most previous studies, in contrast, were done with brain tissue taken from patients after death, the article notes.

The scientists have already identified several schizophrenia biomarkers in the blood and are working with a company that plans to launch a blood test for diagnosing schizophrenia in 2010. The test could help confirm diagnoses made on the basis of psychiatric evaluations and allow earlier diagnosis so that patients can be treated earlier.

###

ARTICLE FOR IMMEDIATE RELEASE
"A Systemic Look at Schizophrenia"

This story is available at http://pubs.acs.org/cen/science/88/8803sci1.html

Contact
Michael Bernstein
Email: m_bernstein@acs.org
Phone: 202-872-6042

Also see:

Expression Profiling of Fibroblasts Identifies Cell Cycle Abnormalities in Schizophrenia

Photograph courtesy of the American Chemical Society.

Industry-Academic Consortium Set Up to Bolster Schizophrenia and Depression R&D

An article posted today by Genetic Engineering and Biotechnology News:

A newly established international industry-academic consortium is to receive funding from the Innovative Medicines Initiative (IMI) to develop new models and methods for the discovery of treatments for schizophrenia and depression. Led by H. Lundbeck and Kings College London, the NEWMEDS (novel methods leading to new medications in depression and schizophrenia) project plans on partnering with major academic institutions in Europe and Israel as well as global pharma companies like AstraZeneca, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutica, Novartis, Orion, Pfizer, Roche, Servier, and Wyeth.

The research will focus on developing new animal models for the identification of treatments for schizophrenia. It will also examine how genetic variations influence drug response. Additionally, the project aims to develop new approaches that will allow shorter and more efficient clinical trials.

The consortium believes there are currently a number of major bottlenecks preventing the translation of knowledge and research findings relating to schizophrenia and depression to the clinic. These include a lack of accurate animal models for drug discovery, a scarcity of tools and tests in healthy volunteers to provide early efficacy data, and the reliance in clinical trials on symptom-based diagnostic and statistical manual categories.

“While the biology of psychiatry has made remarkable progress, we have been slow in converting that into innovative and new medications,” points out Shitij Kapur, M.D. (pictured), at King’s College London’s Institute of Psychiatry. “This is a joint challenge for academia and industry. NEWMEDS is a joint response. It is not only scientifically innovative, but it is also an innovation in creating a cluster of nearly 50 scientists from both sides to work together to achieve a common goal of better, safer, and more effective medicines more quickly.”

Tine Bryan Stensbl, M.D., divisional director for discovery pharmacology research at Lundbeck, adds, “NEWMEDS embodies a novel collaborative effort where companies join forces and together with academia answer scientific questions in a precompetitive environment that will form the basis of tomorrow’s medicines. This joint effort will provide novel insights that undoubtedly will be to the benefit of the patients suffering from schizophrenia and depression.”

The IMI, which will provide funding to NEWMEDS, is public-private partnership between the pharma industry’s European Federation of Pharmaceutical Industries and Associations and the EU. The initiative’s goal is to promote and support Europe’s position in drug discovery and development. The IMI’s overall funding scheme has a budget of €2 billion, half of which will be provided by the EU’s Seventh Framework Programme and half by EFPIA member companies.

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

Photo credit

Understanding What Causes Schizophrenia: A Developmental Perspective

An editorial published in the January 2010 edition of the American Journal of Psychiatry:

By John H. Gilmore, M.D.

Understanding what causes schizophrenia is becoming harder and harder. We know that schizophrenia has genetic causes, since the most significant risk factor is having a first-degree relative with schizophrenia. However, most people with schizophrenia do not have an affected relative, and while the overall genetic contribution to schizophrenia may be large, the contribution of specific genes is very small. Candidate gene studies and more recent genome-wide association studies have had inconsistent results and indicate, at best, individual genes increase risk by less than 2 times—from an average population rate of 1 in 100 to 1.5 in 100. Pre- and perinatal complications and environmental exposures appear to have somewhat stronger effects than individual genes, as prenatal exposure to infection or hypoxia increases risk of schizophrenia from 1 in 100 to 2–4 in 100 (1). Schizophrenia is likely the result of an interaction between genetic risk and environmental exposures, and recent studies have attempted to describe that interaction.

To read the entire editorial, please click here.

I thank Dr. David Whitehorn for bringing this article to my attention.

Coping Tips and Other Helpful Tidbits

A January 9th posting on the blog, Suicidal No More: Choosing to Live with Schizophrenia:

I've received some emails recently, from people who have read this blog, asking me for input and suggestions one what to do about their own battle with Schizophrenia or their family member's dealings with it. From time to time, over the past few years that I've been writing here, I have been asked questions, or, sometimes, told that things I've written were helpful to those readers who were new to this illness and sometimes had little hope. If I can inspire anyone to have hope, that is perhaps the greatest gift I could create with this blog. So, I thought I'd write some tips and pointers, for the uninitiated, and even for those who, like me, have been dealing with this illness for a very long time, but may have lost heart and are not sure what to do to cope.

To read the entire post, please click here.

Teaching police officers about mental illness..why?

The Top Ten Reasons To Make Sure Everybody’s Got Basic Training For Working With Individuals With Mental Illness

To read this article by Dr. Dorothy Cotton (pictured), please click here and scroll up to the top of the webpage that appears.



Also see:

The Police / Mental Health Liaison Website

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safeTALK - Suicide Alertness for Everyone

Friday, February 12th!

An email recieved on December 23rd, 2009, from Keith Brumwell, Co-Manager, Canadian Mental Health Association, Halifax-Dartmouth Branch:

Learn four basic steps to recognize persons with thoughts of suicide and connect them with suicide helping resources. safeTALK three-hour training can help you make a difference.


Why come to safeTALK?

Most people with thoughts of suicide invite help. Often these opportunities are missed, dismissed, or avoided — leaving people more alone and at greater risk. safeTALK training prepares you to help by using TALK (Tell, Ask, Listen and KeepSafe) to identify and engage people with thoughts of suicide and to connect them with further help and care.


Who should attend safeTALK?

safeTALK is for everyone who wants to help prevent suicide: front line workers, clergy, volunteers, parents, youth*, teachers, law enforcement, … anyone who wants to be a suicide alert helper. safeTALK is brief, affordable and internationally recognized. safeTALK is for anyone age 15 and older. This is an excellent course and is a life skill anyone can use.

*Younger persons may attend with the consent of parents or guardian.

How can I get safeTALK training?

There will be a course held on Friday, February 12th, at the Bloomfield Center, 2786 Agricola Street, Halifax, from 1:00 pm to 4:00 pm, and the same course repeated from 6:00 pm to 9:00 pm.

The cost of the course is $30. Certificates are given to those completing this training.

The facilitator will be Keith Brumwell, a registered trainer with Livingworks, a safeTALK trainer, and a Master Trainer who has facilitated over forty ASIST (Applied Suicide Intervention Skills Training) courses. Keith works with individuals living with mental illness, he has extensive experience in suicide intervention, and working with persons at risk for suicide.

Please contact Keith at brumwell@ns.sympatico.ca if you are interested and he will provide you with registration information.

You may also get further information on safeTALK by visiting www.livingworks.net.

I took the liberty to edit the email a bit.

The Lunenburg County Chapter's Annual Christmas Party

The Lunenburg County Chapter of the Schizophrenia Society of Nova Scotia's Annual Christmas Party was held on December 16th, 2009. A total of 46 members and guests enjoyed a meal FIT for the Lunenburg County Chapter as prepared its members.

The winning ticket from the raffle of an original painting by Richard Balser, held in support of the Lunenburg County Chapter's Education and Community Access Fund, was drawn by Cassidy Eisnor. The holder of the winning ticket was Sandy Conrad, one of the guests at the Annual Christmas Party.


Richard Balser, a member of the Lunenburg County Chapter, presenting his artwork to Sandy Conrad.


Rita and Jennifer, winners the Best Elf Contest.


Kaye Joudrey, Santa's favourite elf, helps Santa (a.k.a. Linda Dagley) hand out some early Christmas gifts.


Jean Covert and Denton Conrad elfing it up!


Please click on any photograph to enlarge it.

All photographs by Jan House.

Self-stigma and the “why try” effect: impact on life goals and evidence-based practices

The abstract of an article published in the June 2009 edition of World Psychiatry:

By Patrick W. Corrigan, Jonathon E. Larson, and Nicolas Rüsch

Illinois Institute of Technology, Chicago, IL 60616, USA

Many individuals with mental illnesses are troubled by self-stigma and the subsequent processes that accompany this stigma: low self-esteem and self-efficacy. “Why try” is the overarching phenomenon of interest here, encompassing self-stigma, mediating processes, and their effect on goal-related behavior. In this paper, the literature that explains “why try” is reviewed, with special focus on social psychological models. Self-stigma comprises three steps: awareness of the stereotype, agreement with it, and applying it to one’s self. As a result of these processes, people suffer reduced self-esteem and self-efficacy. People are dissuaded from pursuing the kind of opportunities that are fundamental to achieving life goals because of diminished self-esteem and self-efficacy. People may also avoid accessing and using evidence-based practices that help achieve these goals. The effects of self-stigma and the “why try” effect can be diminished by services that promote consumer empowerment.

Keywords: Self-stigma, mental illness, public stigma, self-esteem, self-efficacy, empowerment

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

Posting of this abstract is for the purposes of research into mental illness and self-stigma.

NAMI Applauds New Report on Caregiving

A December 17th news release from the National Alliance on Mental Illness (NAMI):

Arlington, VA — The National Alliance on Mental Illness (NAMI) praises a new report, Caregiving in the U.S. 2009, which offers a revealing portrait of the nearly one-in-three American adults who serve as a family caregiver.

The study is based on interviews with 1,480 caregivers chosen at random and offers a national profile of people caring for adults, the elderly and children with special needs. It follows similar studies conducted in 2004 and 1997, but for the first time, caregivers for children, as well as those caring for adults over the age of 18, were surveyed.

The report echoes the findings of NAMI’s own depression survey and schizophrenia survey, which include the perspective of caregivers for people living with these serious mental illnesses. All these reports suggest that caregivers face daily stresses that can impact their own health and other relationships. For example, NAMI’s depression survey, released in November, found that while almost one-half (48 percent) of caregivers for people with depression have been diagnosed with depression themselves, only about 25 percent were engaged in treatment at the time of the survey.

“We know from our own studies that caregivers make significant sacrifices to care for their loved ones living with mental illness,” said Michael Fitzpatrick, NAMI executive director. “The findings of this new report will help us anticipate the needs of caregivers so that we can improve NAMI’s education and support programs.”

NAMI offers a variety of peer education and support programs, including those specifically for caregivers.

Family-to-Family is a free, twelve-week course for family caregivers of individuals with severe mental illnesses. The course is taught by trained family members and more than 115,000 family members have graduated from this national program. The course is also available in Spanish.

NAMI Basics is an education program for parents and other caregivers of children and adolescents living with mental illnesses. The course is taught by trained teachers who are the parent or other caregivers of individuals who developed the symptoms of mental illness prior to the age of 13 years.


About NAMI:

The National Alliance on Mental Illness is a non-partisan organization with 1100 state and local affiliates, dedicated to improving the lives of individuals and families affected by mental illness. Dedication, steadfast commitment and unceasing belief in NAMI's mission by grassroots advocates have produced profound changes.

http://www.nami.org/
http://twitter.com/namicommunicate
http://www.facebook.com/pages/NAMI/85273022315

Putting the sibling back into the family

A December 8th news story from the University of Alberta’s Faculty of Rehabilitation Medicine:

By Laurie Wang

The role of brothers and sisters is often overlooked when it comes to family support for those with mental illness.

“When people think of family, they often think of the parents, not the siblings,” said Liz Taylor, professor of occupational therapy at the University of Alberta’s Faculty of Rehabilitation Medicine. “There’s a lifelong impact on the healthy sibling living with the ill sibling—something we often forget.”

The researcher conducted a narrative study on women who had a sibling with schizophrenia. She also spoke on the topic at the University of Alberta Calgary Centre Rehabilitation Seminar Series in mid November.

“The siblings wanted to be involved, but never got to be. Perhaps the parents were trying to protect them, but they told me they felt left out of the medical education the parents received,” Taylor said. “And then when they’re older, their parents are aging so they are the ones being asked to be caregivers, but they don’t have all the information.”

It is also common for the parents to focus on the child with mental illness over the others. Taylor explained that from the people she interviewed, a majority reported that they would feel left out so they’d cope by having achievements outside the home.

“Leisurely activities became a form of escape. The women in the study were highly successful and well-educated. They perceived themselves as helpers—some were health-care professionals themselves,” Taylor said. “But they always felt they had to be even more successful and needed to achieve more.”

An underlying theme was the inability to enjoy time with family.

“They felt they were unable to celebrate and that they had to put on an act that they were happy. One woman said to me, ‘I feel like a fraud with my own children,’” she explained.

All of the women in the study were willing to accept that they would need to be caregivers to their siblings. “It wasn’t a matter of ‘I don’t want to’; it was a matter of ‘I don’t know how to.’ They just felt like they were doing it without any information,” said Taylor.
She stressed the importance of letting the healthy sibling be involved early on, even at a young age.

“Health-care professionals need to know that family is more than just mom and dad. Everyone in the family needs to learn how to give support,” she said. “As an occupational therapist working with families, I need to remind myself to include the siblings when I talk to families too.”

Taylor is teaching her occupational therapy students how to be more inclusive in their future practice and get the whole family involved.

“I’d also like to see the future generation of parents demanding that all their children are involved. Teachers should also encourage healthy siblings to take part in being part of the support and solution,” she continued.

Taylor says that the Schizophrenia Society of Canada and other organizations have played a positive role in educating people and providing information, but that teachers, parents, health-care workers and friends need to provide support for the sibling too.

“There needs to be more support groups for the siblings. We need to encourage them to get the information and education they need,” Taylor said. “The more you understand, the more you can give support and be a part of the team.”

Links:

• Download PDF of story published in Edmonton Journal

About the University of Alberta Faculty of Rehabilitation Medicine

As the only free standing faculty of rehabilitation in Canada, the University of Alberta Faculty of Rehabilitation Medicine balances its activities among learning, discovery and citizenship (including clinical practice). A research leader in musculoskeletal health, spinal cord injuries and common spinal disorders (back pain), the Faculty of Rehabilitation Medicine aims to improve the quality of life of citizens in our community. The three departments, Occupational Therapy (OT), Physical Therapy (PT) and Speech Pathology and Audiology (SPA) offer professional entry programs. The Faculty offers thesis-based MSc and PhD programs in Rehabilitation Science, attracting students from a variety of disciplines including OT, PT, SLP, psychology, physical education, medicine and engineering.

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Research shows schizophrenia most stigmatised

A December 10th media release from SANE Australia:

New research by SANE Australia finds that schizophrenia is the most stigmatised mental illness.

An analysis of complaints made by the public to SANE’s StigmaWatch program about media reporting of mental illness has found that nearly 1 in 4 relate to schizophrenia. By comparison, only 1 in 50 complaints are about the irresponsible media reporting of depression.

‘We are beginning to see the positive impact of depression awareness campaigns in the media, which is very encouraging. Unfortunately, schizophrenia continues to be one of the most misrepresented and misunderstood illnesses in the community,’ says SANE Australia Executive Director Barbara Hocking.

The report, SANE Research Bulletin 10: Stigma, the media and mental illness, found that 23 per cent of the complaints made about schizophrenia involved sensationalised media reporting. Many of these complaints related to media reports that perpetuate violent or dangerous stereotypes, or incite community fear about the illness.

The number of media reports about schizophrenia that emphasise violence or threatening behaviour misrepresent the actual statistics: one in one hundred people will experience schizophrenia but the lifetime risk of someone with schizophrenia seriously harming or killing another person is calculated to be just .005%.

‘It is certainly alarming that many media representations of schizophrenia are sensationalised, suggesting the risk is far greater than in reality,’ Ms Hocking said. ‘Such irresponsible media reporting causes unnecessary distress to the majority of people with schizophrenia who lead peaceful lives, having a negative effect on how they feel about themselves and how well they are accepted by others.

‘SANE would like to see more stories about the real, every day experience of living with schizophrenia and less sensationalised reporting positioning those affected as violent or incompetent outcasts.’

Encouragingly, there has been a significant increase in responsible and accurate media reporting of depression, with nearly 1 in 3 nominations for positive media coverage focussing on the illness. According to Ms Hocking, the ‘coming out’ of many high profile figures experiencing depression has had a large role to play in community understanding and acceptance of the illness.

‘The combination of awareness campaigns and responsible media reporting of depression has encouraged people to start talking, seek help and feel less excluded.’ Ms Hocking said.

‘SANE encourages the media to extend responsible reporting to all mental illnesses; the sad reality for people living with schizophrenia is that the stigma they experience can be just as distressing as the symptoms themselves. Media have a major role to play in helping to improve this situation so that any person with a mental illness feels understood and accepted by the community.’


Kylie’s story

‘I was diagnosed with schizophrenia a decade ago and in my search to understand my new illness, the media offered me a skewed vantage point where it appeared schizophrenia was simply a licence for bad behaviour. Now, on the inside looking out, I recognise what an inaccurate portrayal this is, the exception rather than the rule. Like many living with schizophrenia, I was a victim of violence and abuse rather than the perpetrator.

There are so many people like me out there succeeding, living, working, raising families and contributing. Stigma stops these same people from putting their hand up to say they are living meaningful, purposeful lives. This is to the detriment of those newly diagnosed with schizophrenia seeking hope for recovery and society at large. The media’s power to do good becomes evident when we see community attitudes towards depression improve through proper reporting and education.’

Kylie Griffin was diagnosed with schizophrenia at 28. Kylie is a mother of two and works as a client support worker in mental health and lives in West Wodonga.


Cameron’s story

‘Much of the pain that I suffered from schizophrenia resulted not from the illness itself, but from the fear that I felt once I was diagnosed. I was afraid to tell people what I was dealing with because I was scared of being painted with the same brush as those I saw in the media. It was this fear of being outcast, of being labelled, and of being seen as a psychopath, that stopped me from seeking the help that I needed.

The media plays a pivotal role in improving the lives of those suffering from a mental illness, and hold the key to changing community attitudes. If the media will take the initiative and tell the real stories, present the real people, and show the community that people living with mental illness are just like everyone else, then the change we seek is not far away.’

Cameron was diagnosed with schizophrenia when he was 24. He is a PhD academic at Melbourne University and runs his own website and Foundation for young people affected by mental illness - peoplelikeyou.com.au


Jo’s story

‘As a carer, I get hurt when I see remarks that label people who are mentally ill with names such as 'fruitcake', 'nutter' or 'psycho.' Don't they realise that this is my son they are talking about? There are times when carers feel forced to lie to avoid facing the possibility of demeaning reactions or remarks. This is degrading, especially when as a general rule in life, you make it a point not to lie. As if it's not bad enough for someone to have a mental illness, to be punished for it by being the victim of stigmatising comments is like kicking a man when he's down.

I believe editors and producers have a moral responsibility to avoid cruel discriminatory words. They hold the power to influence children as well as adults. It would be great if the media made conscious decisions to use their power to promote compassion, understanding and education about mental illness. This would help to eliminate fear which, along with ignorance, is one of the primary causes of stigma.’

Jo Buchanan is a published author and mother of three living in Melbourne. Her son Miles has been living with bipolar disorder for 20 years.



SANE’s StigmaWatch program monitors the Australian media to ensure accurate and respectful representation of mental illness. Complaints are submitted by community members concerned about media reports which stigmatise mental illness or promote self-harm and suicide. The program also provides positive feedback to the media about accurate and responsible portrayals of mental illness, based on nominations from the public.


Note to editors

• Download SANE Research Bulletin 10: Stigma, the media and mental illness
• SANE Executive Director Barbara Hocking is available for interview
• Kylie Griffin, Cameron Ralph and Jo Buchanan are available for interview
• Examples of irresponsible media reporting are available
• Media reporting guidelines on mental illness and suicide are available from Mindframe

SANE media contact

Briony Walker
03 9682 5933
0414 427 291
briony.walker@sane.org

All photographs courtesy of SANE Australia.

Phase III Study Demonstrates INVEGA® SUSTENNA(TM) Statistically Similar to RISPERDAL® CONSTA® Long-Acting Injection

A December 10th news release from PR Newswire:

TITUSVILLE, N.J., Dec. 10 /PRNewswire/ -- Treatment with once-monthly INVEGA® SUSTENNA(TM) is not inferior to treatment with bi-weekly RISPERDAL® CONSTA®, according to new data from a comparative study of both treatments in patients with schizophrenia. Results of the 13-week clinical trial were released this week.

To read the entire news release, please click here

In From the Margins: A Call to Action on Poverty, Housing and Homelessness

A December 8th media release from the Senate of Canada:

Ottawa (December 8, 2009) – A major Senate report tabled today is declaring that Canada’s system for lifting people out of poverty is substantially broken and must be overhauled.

“We began this study by focusing on the most vulnerable city-dwellers in the country, those whose lives are marginalized by poverty, housing challenges and homelessness.” stated Senator Art Eggleton, Chair of the Standing Senate Committee on Social Affairs, Science and Technology’s Subcommittee on Cities. “As our research evolved, so too did our frustration and concern as we repeatedly heard accounts of policies and programs only making living in poverty more manageable – which essentially entraps people."

The recommendations in the report, In From the Margins: A Call to Action on Poverty, Housing and Homelessness, are the summation of a two-year cross-country study. Committee members heard testimony from more than 170 witnesses, including people living in poverty, several of them homeless, as well as universities, think tanks, provincial and local governments and community organizations.

Based on the findings of this extensive study, the Committee’s first and fundamental recommendation is that Canada and all provinces and territories adopt the goal of lifting people out of poverty. Included among the vast range of measures recommended by the Committee to realize this core goal are the coordination of a nationwide federal-provincial initiative on early childhood education; the development of a national housing and homelessness strategy; and the creation of a basic income floor for all Canadians who are severely disabled.

The Working Income Tax Benefit (WITB) is an existing government program that the report highlights as bearing real promise because it gives people the pure incentive to get a job. To strengthen the WITB’s capacity to help Canada’s poor, the report recommends that the federal government commit to a schedule of long-term planned increases to bring recipients to the Low Income Cut-off line – as opposed to managing in poverty.

“According to 2007 numbers from Statistics Canada, we spend $150 billion dollars each year in federal and provincial transfer payments to individuals, excluding education and health care costs. So how is it that there are still millions of Canadians weighed down by poverty?” asked Senator Hugh Segal, Deputy Chair of the Subcommittee. “The Committee’s recommendations demonstrate the crucial difference between spending, and spending wisely. By breaking the cycle of poverty once and for all, we will be investing in human empowerment – which will drive the health and prosperity of our cities and yield benefits for all of us.”

The report and more information about the Committee is available at: http://senate-senat.ca/cities-villes-e.asp.


Contact Information

Elizabeth La Forest
Media Relations
613-944-9162
Toll-free: 1-800-267-7362
lafore@sen.parl.gc.ca

Keli Hogan
Committee Clerk
613-993-9021
Toll-free: 1-800-267-7362
Hogank@sen.parl.gc.ca

The Hidden Business Cost of Mental Illness

An article posted December 3rd on blogs.harvardbusiness.org:

By Stew Friedman (pictured)

It's hard to focus on your work when your child is hallucinating.

One of the least discussed yet quite salient issues for American business in this year of health care reform is an important yet hidden cost associated with mental illness: the drain on productive work endured by family members struggling to support loved ones who suffer from such diseases. The good news for business leaders is that it's not hard to do something to help and thus feel good while improving company culture and morale, as well as your bottom line.

Mental illness comes in a staggering array of forms, and affects a broad swath of our general population. According to the National Institute of Mental Health, an "estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year."

Awareness and understanding of mental illness has grown in recent years; still, it's often not taken seriously or treated as a legitimate medical disease either by businesses, by the health care system, or by our society. Indeed, too many people remain reluctant to get the help they need because of the stigma associated with mental illness. The website bringchange2mind.org (with a powerful new public service video by film director Ron Howard) asserts that "for many, the stigma associated with the illness can be as great a challenge as the disease itself."

This stigma extends beyond those directly stricken to family members. Parents of children with mental illness are often viewed as guilty by association, unfairly perceived as the cause of the illness — the source of harmful child-rearing practices — when the origin is mainly biological. Parents and other family members feel shame and a sense of failure. I know because one of my adult children suffers from a toxic combination of schizophrenia (a thought disorder) and bipolar illness (a mood disorder).

There are real costs associated with employees having to carry this heavy weight of worry and responsibility, especially if they feel they must do so without the understanding and support of their organization. There is stress, unwanted social isolation in the workplace, and the feeling that they must find clandestine ways of responding to urgent demands for their attention. All of this undermines productivity by causing burn-out, unplanned absences, distractions from focused effort on tasks, and poor confidence in being able to contribute to the team.

As a leader in your organization, you can reduce these costs and inspire greater performance from valued employees. You can enable them to feel freer to ask for the help they need in supporting their families by changing how you think , how you talk, and how you act. In turn, they are bound to repay you with extraordinary effort and commitment to your goals and to your company.

Mind your attitude. Changing your attitude toward one of greater understanding and acceptance requires education (see, for example, this recent Harris survey on schizophrenia). If an employee with dependent care responsibilities born of a physical abnormality or illness needs to bring a loved one to a doctor's visit, no one judges him harshly. Indeed, this is likely to evoke sympathy. On the other hand, if he has to disrupt his work schedule to care for a family member, who — for reasons difficult to grasp and explain — cannot be left alone for fear of hearing voices or of some other dread psychological symptom, then he might well be reluctant to risk letting others know why he needs the time because they might look askance or even question his own mental stability. Your attitude can make all the difference. By taking mental illness as seriously as any physical illness, you convey emotional support and encourage employees to get the help they need to cope with the strains of caring for their sick loved one.

Watch your words. The words you use, and the way you use them, convey your attitude. Here's a tip from bringchange2mind.org: "Refrain from using terms like 'crazy,' 'nuts,' 'psycho' and 'lunatic.' While there may be times when it is too challenging or simply not possible to politely correct someone else's insensitive use of language, you can always try to watch your own." To combat harmful stereotypes and demonstrate understanding, it's better to say, for example, that someone "has schizophrenia" than to call that person a "schizophrenic" — the illness is not the person.

Model behavior. The kinds of actions that show genuine support are the same ones you'd want to show all your employees in treating them as whole people, with important aspects of life playing out beyond the bounds of work: Initiate and encourage dialogue with an open mind, address the individual needs of each employee, respect confidentiality, and be flexible and willing to engage in joint problem-solving while focusing on results that matter to you and to them.

Change the culture. As a business leader you are in a position to have a positive influence on the culture of your organization which, in turn affects all your employees as well as other stakeholders — clients and customers, suppliers, community members, and so on. Your supportive attitude about those who are forced to live with mental illness — with the words and deeds to reinforce it — can shape your company's values and the behavior in it that determine whether or not all your people get the help they need to both contribute fully to your business and lead productive lives.

What else can be done to make it easier for parents and other loved ones of those who live with mental illness to perform well at work? Please comment and share your stories, advice, and resources.


Stewart D. Friedman is Practice Professor of Management at the University of Pennsylvania’s Wharton School in Philadelphia. He is the founding director of Wharton’s Leadership Program and of its Work/Life Integration Project, and the former head of Ford Motor’s Leadership Development Center. He is the author of numerous books and articles on leadership development, work/life integration, and the dynamics of change, including the bestselling Total Leadership: Be a Better Leader, Have a Richer Life, from Harvard Business Press. For more, please visit www.totalleadership.org.

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Also see:

Work, Recovery and Inclusion: Employment support for people in contact with secondary mental health services (U.K.)

What would it take to destigmatize schizophrenia?

Posted December 2nd on the blog Shrink Rap:

The current podcast in Radio 4’s great series ‘All in the Mind’ looks at whether a new name would be the solution for destigmatizing schizophrenia.

Listen to podcast (30 minutes)


Source: BBC Radio 4

Skunk users face greater risk of psychosis, researchers warn

An article published in today's edition of The Guardian:

By Sarah Boseley, health editor

Skunk, the powerful form of cannabis dominating the street drug market, is seven times more likely to cause psychosis than ordinary cannabis, scientists say.

Dr Marta Di Forti and Prof Robin Murray, who are among the authors of today's paper published in the British Journal of Psychiatry, say skunk is now the same price as ordinary cannabis on the streets of south London, where the study was carried out, and is now the one that is easiest for young people to obtain.

The researchers at the Institute of Psychiatry in London analysed the cannabis consumption of 280 people who were admitted with a first episode of psychosis to the South London and Maudsley NHS Foundation Trust, and compared them with 174 healthy people from the area. Those who used skunk were almost seven times more likely than ordinary cannabis users to develop psychotic illnesses such as schizophrenia, they found.

"In the last five to six years it has been established that there is a link between heavy cannabis consumption and psychosis, but there is a lot of argument about how important it is," said Murray.

Most cannabis users remain healthy, he said, but he pointed to the growing takeover in the street markets of skunk, which contain 18% THC, the substance thought to trigger psychosis, compared with about 4% in cannabis resin (hash).

Forti said 80% of the cannabis sold on the streets of south-east London was now skunk. People who use skunk do not necessarily appreciate its toxicity, she said.

Those in the study had an average age of 25. Those who had psychotic attacks heard voices and had paranoid illusions, such as a conviction that neighbours or family were conspiring against them.

About 1% of the population suffer psychosis at some time in their life. Studies have shown the risk of psychosis doubles in those who use cannabis a few times.

Photograph: Floris Leeuwenberg/Corbis