International mental health conference opens today in Sydney, Nova Scotia

An article published in today's edition of the Cape Breton Post:

SYDNEY — For the past few weeks, Linda Alderson [pictured] has been working long hours to make sure an international conference on mental health goes off without a hitch.

As manager of rehabilitation services with the Cape Breton District Health Authority’s Mental Health Services, Alderson helped organize the district-sponsored annual conference of Psychosocial Rehabilitation Canada, a national association of individuals and organizations committed to the provision and growth of psychosocial rehabilitation services to support the recovery of persons with serious mental health issues.

Enhancing Recovery: Community, Culture and Family is the theme of the conference, which takes place from today until Thursday at the Membertou Trade and Convention Centre. Participants from across Canada as well as the United States, Sweden, United Arab Emirates and Singapore are taking part in the conference.

“The conference is not only a wonderful opportunity to network and share information,” says Alderson, “but it also allows people from Cape Breton to attend a high-quality event that features the latest research and advancements in the field.”

The conference is open to Cape Breton District Health Authority staff, anyone with mental illness and their families, community agencies and employers who have staff with mental illness.

Bursaries to help with registration are available for district staff, people with mental illness and/or their families. So far, fundraising efforts have managed to raise enough money to allow more than 30 Cape Bretoners to attend the conference who normally wouldn’t have the resources to pay the $350 needed for the entire registration package.

“We are really good at fundraising,” she says. “We were committed to giving the general public a chance to attend the conference.”

About 250 people are expected to take in the conference, a number which Alderson says reflects well on Cape Bretoners.

“That’s a statement in itself,” she says. “At last year’s conference in Ottawa, they had the same number of participants. Here we are, attracting the same number as in a major centre.”

The first full day of sessions on Tuesday begins with a presentation from Keith Anderson, a local lawyer who will discuss his journey through depression. Louise Bradley, president and CEO of the Mental Health Commission of Canada, will give an update on the commission. Concurrent presentations and workshops will take place throughout the afternoon.

Ambassador Awards will also be given out that day, including one to Alderson herself. Alderson will receive an Ambassador Award for making Cape Breton a leader in psychosocial rehabilitation in Nova Scotia. She is founding member of PSR Canada, past member of PSR Canada’s board of directors and past-president of PSR Nova Scotia. Alderson also currently sits on the PSR policy committee as well as several other committees and boards, locally, provincially and nationally.

“I’m quite humbled to be receiving this award,” she says. “I’ve been in the the mental health field for more than 30 years. My passion is in supporting people to live better and have more fulfilling lives. To receive an award like this is fabulous.”

Dr. John Higenbottam, clinical associate professor in the schizophrenia division of the University of British Columbia, will receive the other Ambassador Award.

The second day of the conference on Wednesday features presentations, concurrent sessions and workshops.

The final day of the conference on Thursday is a half-day session that features Sheila Morrison’s presentation “Lessons I Have Learned — A Mother’s Story.” In her presentation, Morrison will talk about how she helped and encouraged her daughter to move forward following treatment for a difficult psychosis. Jocelyn Greene from St John’s, N.L., will discuss social enterprise and building a community where those with mental illness are included. There will also be a presentation from the First Nations culture perspective.

Conference sponsors are include Addiction Services, Mental Health Services, Department of Psychiatry-Cape Breton District Health Authority, Family Working Group and the Department of Psychiatry-Capital Health/Dalhousie University.

If you are attending this conference, be sure to visit the Schizophrenia Society of Nova Scotia's Information Booth!


Photo credit

The Schizophrenia Society of Nova Scotia - 2011 Annual General Meeting

The Schizophrenia Society of Nova Scotia’s 2011 Annual General Meeting was held in Springhill, Nova Scotia, on Saturday, September 24th, 2011.

Please click on any photograph to enlarge it.

Cecilia McRae, president of the Schizophrenia Society of Nova Scotia, delivers her President's Report

Phil Rogers, treasurer of the Schizophrenia Society of Nova Scotia, delivers his Treasurer's Report.

Hilary Thorne, the SSNS's project coordinator, speaks about the growth of the Schizophrenia Society of Nova Scotia.

Frank Allen, president of the Cumberland County Chapter of the SSNS introduces the guest speaker, Dr. Pippa Moss.

Dr. Pippa Moss, Chief of Psychiatry, Cumberland Health District, talks about strategies to reduce the stigma and discrimination so often encountered by people who have experienced mental illness, as well as by those who love them. To view Dr. Moss' PowerPoint slides, please click here (PDF).

Rev. Dr. Roger Cann, president of the Kings County Chapter of the SSNS, speaks about the activities of the Kings County Chapter.

Donna Methot, president of the HRM Chapter of the SSNS, speaks about the activities of the HRM Chapter.

Photographs by Stephen Ayer

Michael Kimber at the University of King's College media symposium

From the YouTube posting by the Mental Health Commission of Canada:

Michael Kimber, a King's College graduate, speaks about his personal experience with mental illness at the King's College media symposium.

Michael Kimber suffers from intense anxiety and isn't afraid to tell anyone. He writes about his experience in a personal, heart-felt and riveting blog and receives thousands of hits daily. Today Michael is still blogging, writing a book, and continuing to attract attention on the impact of stigma and mental health.

Schizophrenia: A Recovery

Recovery and Respect - Dr. Frank Shelp

Text accompanying the video:

Respect and recovery from a mental illness are inextricably linked, said Dr. Frank Shelp, Georgia's Commissioner of Behavioral Health and Developmental Disabilities. Dr. Shelp was addressing the 20th annual conference of the Georgia Mental Health Consumer Network at St. Simons Island, August 2011.

Also see:

RESPECT International: Joel Slack

RESPECT International

The History of the Georgia Mental Health Consumer Network: Larry Fricks

Peer-Run Employment Supports - Benefits, Roles, and Opportunities: George Brice

Visions for the Georgia Department of Behavioral Health and Developmental Disabilities: Dr. Frank Shelp

News from the Schizophrenia Society of Canada's national conference

The Schizophrenia Society of Canada held its national conference from September 13th to 15th, 2011, in Regina. The theme of the conference was Changing Minds.

Below are links to three news articles summarizing some of the presentations at the conference.

Taking away the stigma

Good housing linked to health

Pot poses psychosis puzzle

L.A. Times columnist, author of ‘The Soloist’ to speak September 29th in APSU Dunn Center

An article posted today by Clarksville Online:

Clarksville, TN – In 2005, Los Angeles Times columnist Steve Lopez [pictured] strikes an unlikely friendship with Nathaniel Ayers, a homeless musician with schizophrenia who slept each night on one of skid row’s most dangerous streets.

Lopez learned Ayers had been a promising violinist, and that he had left the prestigious music program at the Juilliard School because of his struggle with mental illness. The journalist chronicled Ayers’ struggle in several columns at the Los Angeles Times, inspiring readers to send instruments to Ayers through Lopez.

The friendship that Lopez formed with Ayers eventually helped the musician get off the street, settle into an apartment and find help for his schizophrenia.

This story since has inspired newspaper columns, a book titled The Soloist and a movie of the same name starring Robert Downey Jr. as Lopez and Jamie Foxx as Ayers.

Lopez will share his discovery of Ayers and how their relationship left a profound impact on the writer’s life at 7:00pm, Thursday, September 29th in the Dunn Center at Austin Peay State University. The talk is free and open to the public. A book signing will follow his talk.

Lopez joined the staff of the Los Angeles Times in May 2001 after four years at Time Inc., where he wrote for Time, Sports Illustrated, Life and Entertainment Weekly.

Prior to Time Inc., Lopez was a columnist at the Philadelphia Inquirer, the San Jose Mercury News and the Oakland Tribune. His work has won numerous national journalism awards for column writing and magazine reporting. In addition to The Soloist, Lopez is the author of three novels.

Lopez’s book and September 29th appearance are part of a reading initiative at APSU called The Peay Read, designed to provide a unifying experience and contribute to the academic experiences for freshmen students. However, the reading program also offers opportunities for sophomore, junior and senior students.

A committee reviewed several books and chose The Soloist as The Peay Read’s common reading book, with homelessness as the theme. Committee members also have worked with other academic departments to plan activities culminating in Lopez’s keynote address, all supporting the current theme of homelessness. For instance, student organizations have been encouraged to plan and implement campus-wide, theme-based programs related to homelessness. In addition, piggy banks have been distributed to all APSU 1000 First-Year Experience classes to raise money for organizations that support Clarksville’s homelessness population.

Other examples of The Peay Read student activities and memorabilia include the following:

• T-shirts with “The Soloist” printed on them and given to freshmen students enrolled in the APSU 1000 First-Year Experience program, which is including the book in its classroom discussions.

• Bookmarks with book quotations, which will be used in student discussion groups focused on those quotations.

• Faculty-student class discussions, including how to help the homeless population and the issues that affect them.

• Student book reviews, with authors of the “best 10” essays invited to a dinner with Lopez.

• A showing of the movie The Soloist.

A mobile app detailing all events and activities associated with The Peay Read has been developed and can be downloaded via Apple’s iTunes.

For more details about this year’s book reading selection or The Peay Read, visit www.apsu.edu/Read/ or visit Peay Read on Facebook.

For more information about Lopez’s upcoming talk, contact Dr. Dixie Dennis, chair of The Peay Read committee at APSU, by telephone at 931.221.7415 or by email at dennisdi@apsu.edu.

Photo by Giles Mingasson

Living with Schizophrenia

To view the entire video (25.5 minutes), please click here.

Also see:

Living with Schizophrenia: A Call for Hope and Recovery

Overcoming Schizophrenia

A New Blood-Based Diagnostic Aid for Schizophrenia

An letter to the editor published in the September 2011 edition of Psychiatric Services:

To the Editor: Many people with schizophrenia exhibit poor insight into and lack of acceptance of their illness (1,2). The absence of objective proof of this disease contributes to this problem. Investigators have been interested in developing a blood-based biomarker test to help identify a biological signature to aid in diagnosis of schizophrenia, particularly in the prodrome of the illness (3,4).

Such a test has recently been developed, validated, and marketed in the United States. This test, VeriPsych, uses a multiplex immunoassay technology that profiles a proprietary disease signature comprising 51 analytes. The test has been found to be 83% sensitive and specific in distinguishing persons with schizophrenia from those without the disorder; the study in which the test's validity was established included more than 500 patients in the development phase and more than 800 patients in the validation phase (5). However, little has been subsequently published about this test, and its clinical utility remains unclear.

Our treatment team administered the test to a 30-year-old woman with a five-year history of schizophrenia who did not accept the fact that she had schizophrenia and who had problems remaining adherent to antipsychotic medications. The test yielded a positive result for the diagnosis of schizophrenia (score of –9199), with a conditional probability score that indicated a 95% chance of having the illness. After being informed of these results, our patient began to accept that her symptoms could be attributed to schizophrenia. For the first time, she expressed interest in learning about schizophrenia, acknowledged a personal connection to her family history of the disorder, and accepted her need of antipsychotic medications. Her therapeutic alliance with her psychiatrist and treatment team has improved, she has enrolled in a college-level class, and her attitude toward antipsychotic treatment remains positive. Her psychiatrist notes that this remarkable change was the result of her confidence in the blood test results—for the first time she had objective data about her illness.

Improving insight and illness acceptance among patients with schizophrenia has proven to be no small task. Psychoeducation, meta-cognitive training, cognitive therapy, and family intervention aimed at developing an understanding and acceptance of schizophrenia have shown only some success (1). Our interest in the test was not to confirm a clinical diagnosis of schizophrenia but to help a patient with schizophrenia accept her illness. We feel that if this test or future serum tests are more widely utilized, then their use as an aid in helping people who have no illness insight or who lack acceptance of their illness may be an important application. We hope that our letter will bring attention to this new test and encourage further research to replicate and validate our results. We also need to develop a better understanding of the clinical and research uses of this blood-based diagnostic aid and of its potential role and place in the treatment of patients with schizophrenia.

Deanna L. Kelly, Pharm.D., B.C.P.P., Sheryl Thedford, Pharm.D. and Gopal Vyas, D.O.

Dr. Kelly is affiliated with the Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore.

When the test was administered, Dr. Thedford was with the Department of Pharmacy Practice, School of Pharmacy, University of Maryland. She is now with the Bernard J. Dunn School of Pharmacy, Shenandoah University, and the Pharmacy Department, Winchester Medical Center, Winchester, Virginia.

Dr. Vyas is with Spring Grove Hospital Center, Baltimore.

Acknowledgments and disclosures

Rules Based Medicine supplied the VeriPsych test but had no involvement in the use of the test, the results, or publication.

The authors report no competing interests.

References

1. Lysaker PH, Buck KD, Salvatore G, et al: Lack of awareness of illness in schizophrenia: conceptualizations, correlates and treatment approaches. Expert Review of Neurotherapeutics 9:1035–1043, 2009 [CrossRef][Medline]
2. Buckley PF, Wirshing DA, Bhushan P, et al: Lack of insight in schizophrenia: impact on treatment adherence. CNS Drugs 21:129–141, 2007 [Medline]
3. Schwarz E, Guest PC, Rahmoune H, et al: Identification of a biological signature for schizophrenia in serum. Molecular Psychiatry epub ahead of print PMID , 2011 [Medline]
4. Dudley E, Hassler F, Thome J: Profiling for novel protemonics biomarkers in neurodevelopmental disorders. Expert Review of Proteomics 8:127–136, 2011 [CrossRef][Medline]
5. Schwarz E, Izmailov R, Spain M, et al: Validation of a blood-based laboratory test to aid in the confirmation of a diagnosis of schizophrenia. Biomarker Insights 5:39–47, 2010 [Medline]

Mental health strategy draft doesn’t go far enough

An article published in today's edition of The Globe and Mail:

By André Picard (pictured)

Copies of the “confidential” draft of Canada’s highly anticipated mental health strategy are circulating widely among “targeted stakeholders.” So let’s take a look at what’s being offered up.

Canada is the only G8 country without a mental health strategy, so the document – and, more important, the underlying philosophy that we need to make life better for those with psychiatric and psychological illnesses – is long overdue.

After all, one in five Canadians will suffer a bout of mental illness; it is the principal cause of absenteeism and disability, and costs the economy a staggering $51-billion annually.

A strategy is essentially a way of setting priorities, of ensuring that no group is overlooked or neglected, that services are co-ordinated and that voices are heard in the corridors of power.

The Mental Health Commission of Canada, whose role it is to draft and implement the strategy, more or less has its priorities right, as evidenced by its six “strategic directions”:

1. Shift upstream and across sectors. This means emphasize the promotion of mental health (not merely the absence of mental illness), intervene early when people are sick – at school, at work or wherever – and tackle the stigma of mental illness.
2. Transform relationships and uphold rights. The draft document emphasizes recovery (most, but not all, people with psychiatric illnesses get better) and the need to get the sick out of the criminal justice system.
3. Strengthen capacity in the community. The strategy calls for a shift to community-based care and underscores the importance of housing and income support to aid the recovery of those with mental illnesses. 
4. Improve equity. Access to mental health services varies markedly across the country and among various age groups (with access to care for children being particularly abysmal), and the gaps need to be closed. 
5. Seek innovation with first nations, Inuit and Métis. Some communities, such as aboriginals, have specific challenges like sky-high rates of addiction and suicide that need particular attention. 
6. Mobilize leadership. The strategy calls for a “whole of government” approach, meaning mental health is not strictly a health issue – it affects the workplace, housing, justice and so on. The draft also calls for a strengthening of the mental health infrastructure.

The commission and the strategy have their genesis in a landmark 2006 Senate report entitled Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. The 567-page report was thoughtful, reasoned, forward-looking and, sometimes, even bold in describing the shortcomings of mental health treatment, dubbed the orphan of the health system, and in proposing solutions.

The committee, headed by then-senator Michael Kirby (who now heads the MHCC), made 118 recommendations, most of which find echo in the new document.

But there are some subtle, yet important differences between the tone and content of Out of the Shadows at Last and the draft strategy.

First, the language is more bureaucratic and wishy-washy. Mr. Kirby and his senatorial colleagues were refreshingly blunt on what needed to be done; the anonymous drafters of the strategy are far more circumspect.

Far more troublesome is what you can read between the lines of the proposed strategy. There is far too much emphasis on the “recovery model” – the notion that everyone will get better with support – and not enough emphasis on brain science. It’s a legitimate approach for those with mild and moderate mental health problems but not those with severe conditions such as schizophrenia.

In fact, reading the draft strategy, one is left with an unpleasant aftertaste: the distinct feeling that psychiatry and medications have no place in Canada’s approach to tackling mental illness.

There are distinct – and sometimes clashing – views in the mental health field. But the strategy gives too much credence to social science and not enough to neuroscience.

It also pays far too much attention to the views of “psychiatric survivors” who hide their vehemently anti-treatment views in the promotion of “peer support” and the language of “rights.”

But hope – and false hope – cannot be allowed to take the place of care. Where in the strategy, for example, is the call for investment in brain research, psychiatric beds and more addiction treatment facilities?

The draft also gives short shrift to the sickest of the sick, those with severe (and often intractable) cases of schizophrenia and bipolar disorder, who often suffer from anosognosia (where people don’t even recognize they have a mental illness).

This group, while small (less than 1 per cent of those with mental illness), are those who populate our streets and prisons. They don’t need the right to refuse treatment, they need the right to be well. And their families need to be empowered to help them, not cast aside.

Susan Inman, author of the memoir After her Brain Broke: Helping my Daughter Recover her Sanity, offers up a detailed critique of the strategy’s shortcomings in this regard in her article Suppressing Schizophrenia, published this week by The Tyee.

One of the MHCC’s key goals has been to help create a social movement, one that empowers people living (or having recovered from) mental illness. This is how women with breast cancer, men with prostate cancer and people living with HIV-AIDS have brought their issues to the forefront and made great strides.

But the mental health movement has to learn an important lesson from these other movements: You have to be inclusive, you have to embrace science, you have to be mainstream and you cannot allow those with ulterior motives to set the agenda.

There is a lot of good in Canada’s draft mental health strategy. But it’s not good enough yet.

Also see:

An open letter to Canadians from the Mental Health Commission of Canada

North Shore Schizophrenia Society Advocacy Bulletin (September 2011)

Suppressing Schizophrenia

An article posted yesterday by TheTyee.ca:

Schizophrenia is invisible in Canada's new mental health strategy.

By Susan Inman (pictured)

It is hard to imagine that life could get any harder for individuals living with schizophrenia (one per cent of the population) and the families who provide support to them. However, the controversial choices made by the Mental Health Commission of Canada (MHCC), in the latest draft of the new Mental Health Strategy, make it likely that their situations can actually get worse. These choices, which were not apparent in any earlier MHCC documents, are not receiving the public scrutiny that is needed because this draft is not available for the public. This draft, which was shared with a very small number of people, is currently being polished, and the Canadian public will not see it until it is unveiled in early 2012.

Through both what the strategy suggests and what it fails to support, this plan represents decisions that are dangerous to the well being of people with schizophrenia.

None of the MHCC documents have provided even the most basic information about this often misunderstood mental illness. For instance, the public has never learned that 40 to 50 per cent of psychotic people don't understand that they are ill and so have no reason to ask for or consent to treatment. Nor does any of the educational material promoted by the MHCC in its Mental Health First Aid program mention that 90 per cent of people with schizophrenia who stop taking their medications will have a relapse. A clearer understanding of this neurobiological disorder can help people understand the mental health policies that are most appropriate.

One major problem with the strategy is its approach to legal issues. The new draft strategy promises funds for court challenges to human rights abuses. The public deserves to have open access to this document to find out exactly what the MHCC intends with this action. Since the MHCC has allied itself with groups opposed to involuntary treatment of psychotic people, it is likely that federal funds could be made available to challenge involuntary treatment orders that have been made under various provincial mental health acts. Some human rights activists insist that no one should be treated for psychosis unless they choose this option; however, the notion of choice does not make sense in this context because people experiencing a profound psychosis do not have access to their rational thinking processes. They are not able to act in their own best interest, which is why mentally ill people frequently end up homeless or, increasingly, in prison.

To read the entire article, please click here.

Photo credit

Also see:

Mental Health Strategy for Canada - DRAFT (June 3, 2011)

Re: The lost, beautiful mind of Ivan Car, Aug. 21.

A letter to the editor published in yesterday's edition of the Ottawa Citizen:

After reading this article, I wish first to offer thanks to Anouk MontpetitCar for sharing her story about her husband Ivan Car's [pictured] struggles with depression - a battle he fought bravely but sadly lost.

Car's story is more common than one might think - and so often, these kinds of stories go untold and unnoticed. By sharing her husband's story with Citizen readers, MontpetitCar has not only provided a glimpse into what is a severe, chronic and disabling illness, but also the frustrations that someone with mental illness faces in seeking appropriate treatment as quickly as possible.

As with any other severe, chronic and disabling illness, quick response, expertise and ongoing care are all necessary if one is to recover. Unfortunately, it appears that by the time Car decided to seek the services offered at the Royal Ottawa Mental Health Centre, it was too late; he was too tired to face what lay ahead.

Perhaps he would have received the proper care and treatment if the waiting lists for psychiatric treatment at mental health facilities weren't so very long and if the Ministry of Health hadn't decided over 10 years ago that psychiatric emergency services should only be provided at local hospitals that have certain emergency-room capabilities. (An exception was made for the Centre for Addiction and Mental Health in Toronto, which still operates emergency services at the Clarke Institute on College Street.)

Because of this government decision, the Royal - which has obvious expertise in mental health - was forced to close its emergency services department in 2000. Former patients of the Royal speak fondly of the empathetic, caring environment and expert care received at the emergency room prior to this forced closure.

I and many other families I know have experienced the extreme difficulties of sitting for hours in a hospital emergency waiting room with a severely ill loved one who is in immediate need of psychiatric services. Often, very sick people never receive psychiatric services because, due to their illness, they are unable to wait and are unlikely to return, no matter how severe the symptoms.

There are real practical benefits to receiving emergency service at a mental health centre as opposed to an emergency room geared to treating fevers and broken bones. When someone is suffering from mental illness, it is imperative that appropriate mental health care begin at the first encounter between the health provider and the client. It can make the difference between success and failure.

Given the recent discussions about "client-centred" care, it is incumbent that two things happen - that the wait list for psychiatric services be addressed and that emergency services be returned to the Royal where specialized, therapeutic care goes beyond dispensing of medication.

Cynthia Clark, Ottawa Chair, Family Advisory Council, ROMHC

Image credit

Capital Health changes guards

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

Paladin to take over from RMAC, commissionaires

By Brian Medel

Most Capital Health hospitals will be protected by a new security company beginning Oct. 1.

Paladin Security, Canada’s largest supplier of health facility security, will begin a five-year contract that will cost Capital Health more than $18 million, paying out $3.63 million annually, said a recent notice to staff.

Capital Health now pays about $3 million annually for security, spokesman Peter Graham said Thursday.

The existing contract with two suppliers, RMAC Security and the Nova Scotia division of the Canadian Corps of Commissionaires, will expire Sept. 30.

"We did go out with a (request for proposals) earlier this year," said Graham.

The existing security providers did submitted bids.

"Neither of them were successful," said Graham.

The memo to staff said "RMAC Security and the Corps of Commissionaires have provided us with quality service, for which we are very grateful."

The current security providers will be on the job until midnight Sept. 30, when Paladin Security will take over.

About 100 security officers, 78 of whom are commissionaires, work in Capital Health buildings.

Security staff employed by either the Corps of Commissionaires or RMAC Security will be given opportunity to apply for positions with Paladin, with interviewing and hiring expected to begin almost immediately, said the memo.

The job search website now-hiring.ca said Paladin Security held a job fair in Halifax over two days last week at the Lord Nelson Hotel & Suites, where the company recruited health-care security officers.

Paladin recently opened an office on Spring Garden Road in Halifax.

Two hospital departments that have special security needs are the mental health and emergency units.

Paladin managers will meet with staff from the emergency and mental health departments to ensure the transition is smooth. All Paladin staff receive training that enable them to work in mental health and emergency settings, said the memo.

Health-care security is different from all other types, often involving aggressive patient behaviour, said Leo Knight, chief operations officer with Paladin Security.

"We’re about halfway through our (hiring) process, so we’re probably looking for another 50 to 60 people," Knight said Thursday from Vancouver.

"We got into the Nova Scotia market by doing an acquisition of a local company. . . . Reliant (Security Services)."

It was not a requirement to work here, he said.

"We were coming to the Nova Scotia market anyway. We’re the largest full-service security provider in Canada and we’re the fourth-largest guard company in the country.

"We’re the largest provider of health-care security in the country."

Paladin provides security for every hospital in Alberta and many in British Columbia and Ontario, he said.

Col. Mike Brownlow, chief executive officer of the Nova Scotia division of the corps, said the organization has provided security at Halifax hospitals for many years.

"We’re extremely disappointed, as you can imagine," Brownlow said about not being retained.

"Our relationship has always been a very positive one,"

He said the corps was always concerned with the safety of staff, patients and visitors.

The corps must now look for alternate employment for the 78 veterans hired to work at Capital Health, Brownlow said.

Most commissionaires are military veterans, with some coming from RCMP and municipal police force backgrounds.

Of the 1,700 commissionaires in Nova Scotia, 1,200 are in the Halifax area.

"We’re presently engaging in getting them all placed in different locations," said Brownlow. "There’s a number of them that are retiring.

"Our main mandate is to get employment for veterans."

(bmedel@herald.ca)

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Police learn to use words instead of force

An August 23rd posting by bryancountynews.net:

A recent Crisis Intervention Team graduate went to work one day earlier this month, expecting just another day on the job, but the situation he faced could have ended in violence had he not been part of Georgia’s CIT training program.

The CIT-trained police officer recently shared his story:

“We were called to a situation where a male was physically abusing his mother. He had been drinking and was armed with a gun. The individual was known to be schizophrenic and had been noncompliant with his treatment,” the officer said. “Using our CIT training skills, we de-escalated the situation and got him to give his gun to us. I couldn’t believe it. We had just graduated the week before from CIT training.

“Through the intervention skills we learned, we were able to bring a safe conclusion to this potentially deadly situation for the mother, the individual and our team.”

Law enforcement from the sheriffs’ offices of Tattnall, Toombs and Bulloch counties, along with the police departments of Pembroke, Glennville, Reidsville, Vidalia and Baxley, spent 40 hours in CIT training to help them effectively and humanely interact with persons affected by mental illness, developmental disabilities, Alzheimer’s disease and addictive diseases.

Since 2004, the Georgia CIT program has sought to equip Georgia law-enforcement officers with the skills to recognize and assist people with behavioral-health disorders in crisis, thereby advancing public and citizen safety and reducing stigma, according to a news release.

The recent training class was hosted Aug. 8-12 by the Tattnall County Sheriff’s Office and staffed by local Georgia Association of Community Service Boards member Pineland MH/DD/AD, with assistance from NAMI.

It included clinical classroom instructions, practical de-escalation role-play exercises, experiences of consumers and family members and site visits to Pineland facilities.

The training covered a variety of subjects, including understanding and preventing suicide, signs and symptoms of mental illness, de-escalation techniques, legal issues and mental health law, addictive diseases and child and adolescent interventions.

“CIT is vital for law enforcement to take part in, and our goal is to have our whole team trained,” Capt. Kevin Keyfauver of the Tattnall County Sheriff’s Office said. “On a day-to-day basis, we not only encounter individuals on calls that may be experiencing behavioral issues, but we also regularly transport individuals to our community mental-health care facilities. CIT helps our team learn how to use words instead of force when diffusing situations. It makes it safer for everyone involved.”

Through Georgia CIT partnerships, more than 4,000 law enforcement officers have received special training since the program’s inception.

“The specialized training of CIT enables officers to better understand and relate to individuals with mental disabilities or disorders when in the field,” said GBI Special Agent Debbie Shaw, CIT coordinator for state law enforcement. “This program brings law enforcement, mental-health providers and the community at large together to provide the best service possible to all its citizens.”

Image credit

Rochester group launches website devoted to schizophrenia

An article posted on August 22nd by the Rochester Democrat and Chronicle:

By Michael Zeigler

A Rochester-area organization that raises money for research and education about schizophrenia is marking its 25th anniversary by taking to the Internet.

CARES (Committee to Aid Research to End Schizophrenia) has launched cares-web.com, a website offering information about the complex mental disorder that can cause depression, delusions and paranoia.

The site includes more than 100 videos by medical professionals about symptoms, diagnosis and treatment; the emotional impact on families; dealing with stigma; and community resources for families and caregivers.

Beginning this fall, the site also will include "CARES Corner," a monthly feature in which viewers can interact with health professionals on specific subjects.

"We'll be able to reach hundreds and thousands more people than we have before," said the organization's president, John Delehanty of Penfield.

CARES was started in 1986 by Barbara Swigert of Penfield after her daughter was diagnosed with schizophrenia.

Since then, the organization has held fundraisers and donated $250,000 to assist more than 90 research projects.

CARES had planned this year to end large fundraising events, such as golf tournaments, because its members were aging.

The group still planned to accept donations, however.

But at a luncheon in June, Dr. J. Steven Lamberti, a professor of psychiatry at the University of Rochester Medical Center, and health educator Thomas Conant unveiled a proposal to develop a website that would be a resource for people with schizophrenia and their families, Delehanty said.

The organization agreed and the site was up and running by early August.

The website includes a donation function. The organization also will continue its plans to conduct mail-in fundraisers, Delehanty said.

MZEIGLER@DemocratandChronicle.com

A Moment of Silence for Kelly Thomas in Beverly Hills

Also see:

Kelly Thomas' father fights for justice

The Canadian Medical Association Awards Medal of Honour to Dr. Austin Mardon

An August 16th media release from the Canadian Medical Association:

OTTAWA, Aug. 16, 2011 /CNW/ - The Canadian Medical Association (CMA) will present the 2011 CMA Medal of Honour to Dr. Austin Mardon, PhD, who has demonstrated outstanding public commitment to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

"The CMA Medal of Honour recognizes personal contributions to the advance of medical research and education," said CMA President Dr. Jeff Turnbull. "Dr. Mardon has worked tirelessly to help Canadians better understand the issues around mental illness. In courageously talking openly about his own experiences, he is truly making a difference in coaxing mental illness out of the shadows in this country."

Diagnosed with schizophrenia at the age of thirty, Dr. Mardon uses his own experience and his road to recovery in advocating in the areas of stigma, service delivery, awareness and education. He tries to improve the lives of those with schizophrenia through public education. His efforts have led him meet with politicians, clergy, academics and others in positions to effect change. He has influenced public policy in Alberta through his service as vice-chair of the Alberta Disabilities Forum steering committee and as chair of its low-income working group; as a member of the Premier's Council on the Status of Persons with Disabilities; as an addiction and mental health committee member of Alberta Health's service integration working group; and as chair of the Edmonton Champions' Centre advisory committee. He also was instrumental in winning changes to Alberta's income assistance program for the severely handicapped.

"I have put my experiences out there for all to see, but it hasn't been easy and for some people it's impossible," said Dr. Mardon. "My goal continues to be to see the unfair and debilitating stigma our society holds against the mentally ill wiped out for all time."

Austin Mardon, PhD, has been a public educator and tireless advocate for the mentally ill, particularly those with schizophrenia, since he was diagnosed with that illness in 1992. At the time he was a promising graduate student and Antarctic explorer, and the diagnosis of schizophrenia could have ended his academic career and severely limited his prospects in life. Instead, he survived many setbacks through his sheer determination to continue his studies, to make a difference, to contribute to society, and to help others.

Dr. Mardon graduated with a major in geography from the University of Lethbridge in 1985. The following year, at age 24, he was investigating meteorite impacts 170 km from the South Pole as a junior field member on an Antarctic meteorite recovery expedition sponsored by NASA and the National Science Federation. He received the U.S. Antarctic Service Medal for his work. However, the extreme hardships of the expedition affected him mentally and physically. While he went on to earn masters degrees in science (South Dakota State University) and education (Texas A&M University) and published a number of articles and books, his health issues persisted. At the age of 30 he was diagnosed with schizophrenia.

Although some of his abilities are compromised by the disease, he earned a PhD in geography from Greenwich University, Australia; continued his remarkable publication record, including articles in both Science and Nature; was elected an International Fellow and Corresponding Fellow of the Explorers Club of New York; and was inducted into the International Academy of Astronautics.

Equally impressive has been his work on behalf of the mentally ill. In addition to giving countless interviews to the media on the topic of mental illness, he has published articles about faith and schizophrenia, homelessness, medication, and income support. He has provided leadership as a member of the board of directors of both the Edmonton and Alberta chapters of the Schizophrenia Society, and for a number of years he was coordinator of the Alberta Mental Health Self-Help Network.

"I hope to soon see the day when schizophrenia is treated like any other disease and is finally detached from the stigma that makes a difficult burden to bear even worse," added Dr. Mardon.

Dr. Mardon has received a number of awards, including the Order of Canada (2007). Others include: the Flag of Hope Award (2001) and the Bill Jefferies Family Award (2007) of the Schizophrenia Society of Canada; the Distinguished Alumni Award of the University of Lethbridge (2002); the Presidents Award of the Alberta chapter of the Canadian Mental Health Association (2002); the C.M. Hincks Award from the national division of the Canadian Mental Health Association (2007); and the Medal of Honour of the Alberta Medical Association (2010).

A popular member of the Speakers' Bureau of Alberta, Dr. Mardon has publicly assisted the medical profession by supporting development of policy positions that have helped medical providers treat those with mental illness.

Dr. Mardon is the 28th recipient of the CMA Medal of Honour, the highest award bestowed upon someone who is not a member of the medical profession. He will receive the award at a ceremony at the D.F. Cook Recital Hall, Memorial University, in St. John's, N.L., on Aug. 24 as part of the CMA's 144th annual meeting.

For further information:

Lucie Boileau, Manager, Media Relations
Tel: 613-731-8610 or 1-800-663-7336 ext. 1266
Mobile: 613-447-0866
lucie.boileau@cma.ca

Photo credit

Also see:

Austin Mardon to receive honorary Doctor of Laws degree from University of Alberta

Austin Mardon on Schizophrenia

Government cuts hurt people with disabilities

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

By Wayne MacNaughton [pictured]

Last week, the government announced that it was "clarifying" the rules around "special needs" for people living in poverty (re: "Social assistance won’t cover pot," Aug. 10). However, the news coverage thus far has failed to explain the scope and severity of the government cuts that have occurred, and the fact that they will hurt people living with disabilities, on fixed incomes, who cannot afford to pay for their own medical needs.

Far from simply "clarifying" the previous law, the amendments significantly reduce government assistance for essential health needs. In addition, people will be subject to a cookie-cutter approach: If their need does not fall within a pre-existing list, it will not be considered, no matter how essential for health or necessary to alleviate pain and suffering. The government cuts were made without notice, public consultation or input from health or disability rights groups.

The cutback on special needs will have a number of repercussions. On an individual basis, it will undermine people’s health, and increase pain and suffering. This is not good for society, but in addition it will increase the social burden on the health care system, as people struggle with poorly managed medical conditions and illnesses without access to the services they need.

People who had no other alternatives, who had a recommendation from their doctor and needed medication or other services to alleviate pain and suffering, or because it was essential to their health, could apply for "special needs" assistance. As a result of government amendments to the law, that access to those medications and services is now no longer available.

The Department of Community Services has suggested the cuts won’t have a big impact. But ask any person with disabilities who needs to pay higher rent to obtain allergen-free housing, or needs to meet the cost of the only medication that works but isn’t on the list of approved medications, or needs access to counselling for post-traumatic stress, and they will tell you these needs are essential, not frills.

Let’s look at the single biggest justification the government relies on in making these cuts: medical marijuana. Medical marijuana is prescribed by doctors for pain management. Patients who are permitted to use medical marijuana do so on a doctor’s recommendation, under a licence from Health Canada, where no other method or drug for pain management has worked. In denying access to medical marijuana, the government forces people back to reliance on Dilaudid and Oxycontin, drugs that have many more side effects and fewer positive individual outcomes, and have been the subject of inquiries and concerns regarding social costs and addictions. Big Pharma wins, and people with disabilities lose and the rest of us see Pharmacare costs escalate.

Don’t believe the government’s portrayal of "special needs" requests as frivolous wastes of taxpayers’ money. Under the previous regulations, needs that are "essential to health" and "necessary to alleviate pain and suffering" were recognized as "special" and people living in poverty were forced to meet a stringent test to qualify for assistance. These were needs that many of us take for granted because they are essential for health. (In an era when people are trying to decide whether to buy an iPhone 5 when they come out this fall, recipients of social assistance are not even given funding to have a basic telephone in order to look for a job.)

Why is the government cutting back on essential health services for people with disabilities? Figures cited by Community Services in a media release identify only 20 to 25 cases. The release fails to provide comparison figures for increases to other, already listed special needs and Pharmacare (formulary costs), or what we can expect in increased costs to the Pharmacare program and other health services as a result of these cutbacks. The auditor general’s report cited in the release criticizes government accounting procedures, but makes no recommendations concerning the merit of the requests and cannot be interpreted to justify these cutbacks.

Special needs assistance must be restored. When the law was introduced in 2001, special needs for people with disabilities was described as the "cornerstone" of the program. That cornerstone needs to be rebuilt, and fast, to avoid pain and suffering and protect the right to health of all Nova Scotians — including those living with disabilities.

Wayne MacNaughton is an anti-poverty activist living in Halifax.

Photo credit

Also see:

Critics slam changes to special-needs funding

Clear, Consistent Access to Special Needs Funding for People on Income Assistance

Welfare Rights Guide

Income Assistance and Nutrition: Are You Getting What You Need?

Mental Health Commission of Canada - 2010/2011 Annual Report

Please click on the image to magnify it.

An email from the Mental Health Commission of Canada which the SSNS received today:

Hello,

On behalf of the Mental Health Commission of Canada (MHCC) I am pleased to present the English and French versions of our 2010-2011 interactive annual report.

Together we can. It is our theme this year because our accomplishments are due in large part to collaboration with a wide variety of individuals, groups and organizations. Alongside our partners we worked to promote mental health, reduce stigma and improve services and supports. With our hundreds of partners, we are helping to make mental health a priority for all Canadians.

MHCC Annual Report

Our Annual Report outlines the significant progress we have made towards achieving our goals. Among other updates, readers will learn that we have now housed hundreds of people in five Canadian cities through At Home/Chez Soi – our national research project on mental health and homelessness. We have now trained over 20,000 people across the country in Mental Health First Aid. This represents an increase of over 100% since it became an official MHCC program in 2010. These are just two milestones made possible through support from the Government of Canada.

I hope you will find this document engaging and informative and will enjoy flipping through its pages. Please forward it along to your colleagues, friends and families. I look forward to your feedback.

Yours sincerely,

Louise Bradley
President and Chief Executive Officer

To download the PDF version of the MHCC Annual Report, please click here.

Clear, Consistent Access to Special Needs Funding for People on Income Assistance

An August 8th media release from the Nova Scotia Department of Community Services:

Clearer regulations now make it easier for income assistance clients to understand what special needs funding they can receive, and ensure funding decisions are consistent and fair province wide.

The amended Employment Support and Income Assistance Regulations Around Special Needs funding take effect today, Aug. 8.

"We know that some people on income assistance have special needs and often need help with medical issues, or even to get to work," said Community Services Minister Denise Peterson-Rafuse [pictured]. "We are committed to meeting those needs, and have been increasing our budget to do so.

"At the same time, the criteria for receiving special needs funding must be clear, fair and consistent so that people are treated the same no matter where they live."

Over the past two years, the department has increased the special needs budget by 15 per cent, or about $6 million, bringing the total investment in funding to more than $45 million. These funds are intended to help income assistance clients with medical and employment-related special needs.

Over the years, the department has received special needs requests for items and services like hot tubs, gym memberships, and humming touch therapy. These were never intended to be covered under special needs, but because the regulations were not clear, about 20-25 of these requests were approved either by a caseworker or through an appeal.

The department has also received a number of special needs requests for medications and substances, such as medical marijuana. The amendments now make it clear that Community Services can only cover medically related items and services that are covered by MSI or listed on the Nova Scotia Pharmacare Formulary. This is consistent with how other provinces handle requests for medical marijuana.

The amendments are also consistent with recommendations from the auditor general who said clear systems and controls must be in place to ensure special needs funding is being spent as intended, which is to fairly meet the needs of income assistance clients.

The change only affects new applications for special needs funding received after Aug. 8. Income assistance clients now receiving special needs funding will continue to do so as long as the special need exists.

In addition to the more than $45 million invested in the Employment Support and Income Assistance Special Needs program, the department is also investing an additional $18.25 million this year to help income assistance clients and low-income Nova Scotians make ends meet. These include a 22 per cent increase per child, per month to the Nova Scotia Child Benefit, a $15 per month increase in the Income Assistance Personal Allowance, indexing the Affordable Living Tax Credit and the Poverty Reduction Credit to keep up with inflation, and allowing working income assistance clients to keep more money each month.

FOR BROADCAST USE:

Clearer regulations now make it easier for income assistance clients to understand what special needs funding they can receive, and ensure funding decisions are consistent provincewide.

Community Services Minister Denise Peterson-Rafuse says the criteria for receiving Special Needs funding must be clear, fair and consistent so that people are treated the same no matter where they live.

Community Services invests more than $45 million in special needs funding annually. The funds are intended to fairly meet the special needs of all income assistance clients.

The amendments now make it clear that Community Services can only cover medically related items and services that are covered by MSI or listed on the Nova Scotia Pharmacare Formulary.

The change only affects new applications for funding received after August 8th. People now receiving special needs funding will continue to receive it as long as the need exists.

-30-

Media Contact:

Susan Tate
Community Services
902-424-4038
E-mail: tatese@gov.ns.ca

Image credit


Also see:

Employment Support and Income Assistance Policy Manual (PDF) (Chapter 6 - Special Needs, pages 106 to 150)

Employment Support and Income Assistance Act

Employment Support and Income Assistance Regulations

Assistance Appeal Regulations

New mental health treatment worth fighting for

An opinion piece published in yesterday's edition of the Daily Record:

By Valerie Fox

I had planned to write about involuntary outpatient commitment (IOC) once it was finally up and running in New Jersey, but the editorial in the July 28 Daily Record (“Treatment funding is a good investment”) has prompted me to write at this time.

When Governor Corzine signed IOC into law, I was invited to the bill signing. Cathy Katsnelson [pictured], a Burlington County woman who lobbied for the new law, introduced herself to me. I felt honored. We both expressed our joy that, after many years, IOC was finally law. Over the years at legislative hearings in Trenton, I would hear Ms. Katsnelson testify as a mother who lost her son because of untreated mental illness. I am very pleased the IOC law is called “Gregory’s Law.”

I am not a family member. I am a person who has lived with schizophrenia since first being diagnosed in 1963. I have been fortunate that I can function pretty well, as long as I take my medication and take care of myself both physically and mentally.

Over the years, I only had one very severe setback, which changed the course of my life forever. I stopped taking my psychiatric medication for what I thought was a good reason — against the advice of my psychiatrist. I tumbled into homelessness and untreated schizophrenia for a two-year period.

A healthy, normal person cannot imagine living homeless in a schizophrenic state. It is not pretty. It is very dangerous to oneself and possibly others. Voices were my guide during this period. As a result, some decisions I made were risky. I was very vulnerable and I suffered tremendously. When I regained my health, I had to reconcile my healthy self with the trauma of living exposed with untreated mental illness. It was difficult. Good mental health supports helped me tremendously.

Almost immediately after I stabilized, I heard about involuntary outpatient commitment and knew I would advocate very hard to bring this treatment option to New Jersey because I believed it could help others from living with untreated mental illness that put themselves and possibly others in danger.

My first testimony was at least 20 years ago. Many mental health advocates were and still are against this treatment. It is my belief that, if any of these advocates lived the horror of untreated schizophrenia or other severe mental illness and homelessness, their opinions would change quickly — if they were lucky enough to have treatment and regain mental health.

Finally, IOC became law in 2009. Proponents of IOC had given the Legislature a good picture of untreated mental illness and the law passed unanimously.

Since the passage of IOC, unfortunately, it has faced a number of pitfalls. Implementation was stalled because the Department of Human Services waited until the day of supposed implementation to state there was no money allocated for it. IOC has been discussed in private, invitation-only meetings. I believe some who were invited were agaist involuntary commitment. I was not invited, even though I advocated tirelessly in an appropriate manner for IOC.

I once sat at a mental health conference at which a high-ranking state mental health administrator told a roomful of impressionable people that, while he does not want to implement IOC, it is law and he has to do it. It would have been so much better to say that he hoped IOC could make a difference in someone’s life. I further think $2 million will be too little money to do an adequate job of effectively rolling IOC out.

It is my hope that, when all the negative rhetoric about this treatment is proven untrue and some mentally ill people avoid the inevitable collision course of homelessness and voices because of this treatment, that those who have been so adamantly against IOC will see they did not fully understand the dangers that IOC can prevent — including violence, death and physical illness.

Photo credit

Also see:

Schizophrenia, Medication, and Outpatient Commitment

Personal Accounts: Schizophrenia and Socialization

OneInFive.ca - A Focus on Psychosis

To read more, please visit OneInFive.ca.

Also see:

Nova Scotia Early Psychosis Program

Nova Scotia Housing & Homelessness Network - First Annual Provincial Housing Conference

Tuesday & Wednesday, November 22nd & 23rd!

Please click on the image to magnify it.

From an email received from the Nova Scotia Housing & Homelessness Network on August 4th:

Theme: Fast Forward

The Conference will be an opportunity to strengthen the non-profit, private and public housing sectors by bringing together leaders from across the Atlantic Provinces. This event will be a leading regional resource, attracting a full spectrum of people living in and working within the affordable housing industry - people who are committed to advancing what Nova Scotians have asked for in their communities – safe and affordable housing.

Beginning on Tuesday, November 22nd, National Housing Day, the programme will include:

• Launch of the Nova Scotia Housing & Homelessness Network

• Plenary Session

• Keynote Speakers

• “Meet the Dragons” - bring your development project ideas to our expert ‘Dragons’ panel for qualified expert advice

• Open Space workshops

• Award Luncheon and Dinner

• Book Launch

Further programme details will be posted as they become available.

Who should attend?

Everyone involved in the housing industry, particularly builders and developers, finance specialists, policy-makers, municipal, provincial and federal government representatives, both elected and appointed, as well as those involved in community grassroots efforts to promote affordable housing:

• Architects and HRM city planners

• Housing authorities

• Affordable energy associations

• Neighbourhoodgroups

• Affordable housing advocates

• Professional associations

• Public agencies

• Service and shelter providers

• Sustainable development experts

• Tenants/subsidized housing consumers

Sponsors/Partners:

Canadian Mortgage and Housing Cooperation (CMHC)

Conference Program Planning Committee

• Network Steering Committee

• email the Committee

Overview - Mental Health Commission of Canada

Overview of the Mental Health Commission of Canada as posted on LinkedIn:

People living with mental illness have the right to obtain the services and supports they need. They have the right to be treated with the same dignity and respect as we accord everyone struggling to recover from any form of illness.

The goal of the Mental Health Commission of Canada is to help bring into being an integrated mental health system that places people living with mental illness at its centre.

To this end, the Commission encourages cooperation and collaboration among governments, mental health service providers, employers, the scientific and research communities, as well as Canadians living with mental illness, their families and caregivers.

The organization of publicly funded mental health services and supports to the general population is the responsibility of each provincial and territorial government, not of the Commission.

The Mental Health Commission of Canada will:

• Be a catalyst for the reform of mental health policies and improvements in service delivery;

• Act as a facilitator, enabler and supporter of a national approach to mental health issues;

• Work to diminish the stigma and discrimination faced by Canadians living with mental illness;

• Disseminate evidence based information on all aspects of mental health and mental illness to governments, stakeholders and the public.

United front on mentally ill urged

An article published in the July 19th edition of the National Post:

By Joseph Brean

Canada needs a "dynamic, broadly based social movement" to improve its citizens' mental health, a "whole of government" approach that unites everyone from political leaders to "experts by experience," says a national strategy five years in the making.

The goal, says the Mental Health Commission of Canada (MHCC), should be a "cultural shift toward recovery," which favours real improvement over ideal cure, and is informed by "multiple sources of knowledge," including the traditions of restorative justice and the hard-won wisdom of people in recovery.

The 37-page draft strategy document, obtained by the National Post, also seeks to reduce the stigma of suicide; calls for an end to "seclusion and restraint" of psychiatric patients; and demands that, in criminal-record checks, police stop disclosing information about people they have driven to hospital in a mental health crisis.

"This practice inhibits people's ability to volunteer or get a job, and should be stopped," reads the report, Mental Health Strategy for Canada - Draft, Not For Circulation. A final version is expected to be presented to the MHCC's board in October, and released publicly next year.

The strategy acknowledges the federal government's arm's-length role in healthcare delivery, but argues that mental health is not purely a health issue, as it also involves criminal justice, housing, finance and child services. The MHCC's broad solution is to "shift upstream and across sectors" by taking a "whole of government" approach, in which actions are nationally co-ordinated, and "leadership [is] located at the highest level possible within government and the bureaucracy."

Clinically, the strategy calls for a "genuine partnership" between caregivers and people with mental illnesses, who should be offered "self-directed care-funding initiatives," so they can "directly manage part of their social service and health budgets."

"The expertise gained from lived experience should be complemented by professional expertise, not dominated by it," the report reads.

"Not only will this change in the distribution of power within the mental-health system benefit users of services, it will also create a more positive context in which mental health providers can deploy their skills, experience and knowledge."

Examples of self-directed care choices might include art or music therapy, or training in mindfulness techniques, said Howard Chodos [pictured], special advisor to the MHCC.

Finding the right balance, he said, "involves the skill and art of medicine as much as it does the science.

"Unfortunately, in mental health there are no blood tests and there are no medical tests which tell you what illness you have and what treatment to use," he said.

The strategy also calls for better training for so-called "gatekeepers" - teachers, doctors, clergy, police and prison staff - to help them recognize and react to warning signs of suicide, and to promote mental health.

This focus on prevention and health promotion is a target of early critics of the report, who say it offers little to people with serious mental illnesses, such as schizophrenia or bipolar disorder, which cannot be prevented by social policy, as they are organic diseases of the brain.

They cite New York State's Office of Mental Health as a cautionary tale of a system in which the "worried well" gained support at the expense of the truly sick.

Susan Inman, a Vancouver advocate for the families of people with serious mental illnesses, whose daughter recovered from schizophrenia, said the strategy's deference to lived experience will make things worse for people who are so mentally ill they are incapable of realizing it - a condition known as anosognosia. She fears the emphasis on personal empowerment will make involuntary treatment almost impossible.

"This plan is really about mental wellness," she said. "People with serious mental illnesses are ignored."

Mr. Chodos said research shows a range of factors can increase or decrease the risk of even the most serious mental illnesses.

"We do not yet know that there is anything more than a genetic predisposition," he said.

"Prevention [in the strategy] is not only prevention of onset, but also the debilitating consequences of it."

He gave the example of homelessness, often associated with schizophrenia and substance abuse, as an area where social policy can, in fact, prevent the worst of a mental illness.

He said another is cannabis use among youth, a known risk factor for schizophrenia.

The MHCC, which was established in 2007 by Prime Minister Stephen Harper on the recommendations of former Senator Michael Kirby, has a twin mission. Erasing stigma has always been the long-term goal, but this formalized national strategy is the immediate plan.

The strategy comes at a crucial moment for psychiatry, not just in Canada but globally, as the discipline's diagnostic manual undergoes a thorough revision.

There is also a strong climate of suspicion about the role of drug manufacturers in the proliferation of psychiatric drugs, and about the spike in diagnoses of childhood behavioural disorders.

jbrean@nationalpost.com

Image credit

Also see:

An open letter to the Mental Health Commission of Canada - A response to their draft Mental Health Strategy for Canada

Identification of a biological signature for schizophrenia in [blood] serum

A 12-Step Program For Canada