Beacon for troubled daughter

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

Woman sees hope in centre being built for those with mental illnesses

By John McPhee, Health Reporter

Kim Clark spends a lot of time waiting for her daughter [pictured] to break the law.

It’s the only way she can get Koral off the street and back on her medication for paranoid schizophrenia.

"We are moving forward with the mental health courts and everything else, but trying to get a community treatment order in place is somewhat difficult at times," the Halifax woman said in an interview.

"The law does recognize them as independent and as an adult, although she’s not cognitively capable of making those decisions."

Ms. Clark hopes that a mental health transition centre under construction in Dartmouth will help people like Koral, 25, who has been on and off the streets many times over the past two years.

Work is set to begin this fall on four 10-bedroom bungalows at the former site of Simpson Hall at the Nova Scotia Hospital.

The hall was recently demolished.

The homes will serve as transitional spaces where people who have been hospitalized for treatment of mental illnesses can continue to receive care while practising the life skills they’ll need to live in the community.

Ms. Clark said the project will fill a big gap in the mental health system.

That system, she says, now leaves people like Koral on their own after being treated in hospital for mental health problems such as going off their medication.

"There’s no community support in the sense of re-teaching the skills that she needs," such as managing money, cooking and cleaning, she said.

"This new initiative will allow that transition and give them a higher sense of self-esteem.... When they leave, they will be a part of the community."

The former Conservative government originally announced the community living project three years ago.

Construction was expected to be finished last year at a cost of $6.7 million.

The plan was put on hold because bylaws prohibited construction of the homes on the desired waterfront site.

The NDP government is carrying through with the project, now expected to cost about $11 million because of rising construction costs and the need to demolish Simpson Hall.

The province has set aside $8,250,000 for the project.

The rest will be raised by the Mental Health Foundation of Nova Scotia as part of its capital fundraising campaign.

That effort got a big boost Tuesday from IMP Group. The aerospace firm contributed $150,000 to the foundation’s Open Minds fund.

The housing will accommodate 40 people at a time, for periods of several months and possibly up to two years, said Dr. Nick Delva, chief of psychiatry at Capital Health, who also works with the Mental Health Foundation.

It’s meant for people who have serious mental health conditions, but they must be stable enough at the time to fit in a home-like environment, Dr. Delva said in an interview.

"The whole look and feel of the place will be quite different" from traditional psychiatric facilities, he said.

Each bungalow will have a kitchen and common area, and the bedrooms will have small ensuite bathrooms.

The project is part of a move toward community-based treatment for mental health.

Five outpatient clinics have been established throughout the district, Dr. Delva said.

Besides this restructuring, there will be a push for more funding from the provincial government.

Dr. Delva said the Health Department should devote at least five per cent of its budget to mental health.

The department now spends about 3.8 per cent.

Ms. Clark agrees more needs to be done, saying there are long waiting lists for mental health services.

As for Koral, her mother saw her Saturday in person for the first time in six months.

"She’s not in good shape at all," she said.

Over the years, Ms. Clarke has kept tabs on her through a network of family and friends.

With little money, Koral usually ends up living in rooming houses.

"It’s been a hard road, making sure she’s alive and safe," she said.

Also see:

Site Selection, Financial Contribution Boost Community-Focused Living Residences

Missing woman speaks with family

An article published in the June 20th edition of The Chronicle Herald:

Mother: With no services to help her daughter, she’ll continue to run away

By Heather Amos

Koral Lynn Clark [pictured] is 24 and [lives with schizophrenia]. She went missing for two weeks after she stopped taking her medication.

It’s happened before.

Her mother, Kim Clark, says that’s because there aren’t enough services for her daughter when she’s well.

Her comments on Friday came a day after the Halifax Regional Police asked for the public’s help in locating her daughter. Koral heard the media reports and called her family, but would not tell them where she was.

Ms. Clark was hoping to make physical contact with her soon.

Koral was diagnosed with schizophrenia when she was 20. Since then Koral has been caught in a vicious circle, her mother said.

When Koral feels well, she stops taking her medication, which makes her paranoid. She thinks her family is trying to control her life and begins to distance herself, Ms. Clark said.

Ultimately, Koral requires medical treatment that includes hospitalization and drugs to help her control her condition.

She’ll get better. And because she’s better, she’s sent out into the community to fend for herself.

Feeling better, she stops taking her pills. Legally it’s her right to stop taking them.

The circle repeats itself. "The system says I can’t help her until she gets to the point where she’s no longer capable of making proper decisions for herself," Ms. Clark said.

She’s had to step in to get her daughter help before. Last October, Ms. Clark went to court to get Koral confined under the Involuntary Psychiatric Treatment Act, a law enacted in July 2007.

Koral was released from the hospital at the end of April.

And the circle repeated itself.

"The reason why she goes off her meds, in my opinion, is because there’s a major gap between the services provided by the medical profession and getting back into the community," Ms. Clark said.

She believes the circle could be broken if her daughter was aided through the transition period. What she would like to see is a team approach at this stage of her daughter’s treatment.

She’d like there to be housing available where patients have access to psychiatrists, community health nurses and psychologists. Someone needs to help her daughter learn to shop, cook, clean and integrate back into society, she said.

There also needs to be someone available to make sure she complies with her medical regimen.

This type of service is available under the Involuntary Psychiatric Treatment Act, but is rarely enforced on an individual, said Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia.

"The stipulation in the act requires that the person lacks the capacity to make their own treatment decisions," he said. "Quite frankly, generally what happens is that a person is hospitalized involuntarily . . . and they get to the point . . . where they can make their own treatment options."

But one of the problems for people with schizophrenia is a lack of insight into the illness.

"Over 50 per cent of people, particularly those who have a first episode of psychosis, lack any insight that they’re ill," Mr. Ayer said. "In some cases, people, even when they’re treated, continue to lack insight. Those are the ultimate problem cases in terms of the revolving door, in and out of hospitals."

Mr. Ayer thinks Nova Scotia needs more community-based services, especially supportive housing services.

"Ideally there would be housing available specifically for people who live with schizophrenia and other psychotic disorders," he said.

Often if someone relapses, they can’t return to where they lived. It’s one of the reasons why Koral has lived on and off the streets for the last three years. If supportive housing were available, she could return to it even if she had a relapse.

Mr. Ayer said Ontario has a good supportive housing system and thinks the problem in Nova Scotia might be that the responsibility for mental health and housing support fall under different government departments.

He explained that about four per cent of the population is affected by schizophrenia or psychosis. His society provides services for these individuals and their families.

Koral could not be reached for this story because contact information for her was unavailable.

Services Provided

The Schizophrenia Society of Nova Scotia provides services to people living with schizophrenia or psychosis and the families of those living with the illnesses.

If you are indirectly affected by schizophrenia or psychosis the society provides support by:

• A monthly support group meeting in Halifax — guest speaker and discussion

• Individual support for people who call in

• Help with understanding and navigating the Involuntary Psychiatric Treatment Act

• Education services

The society is also involved in public policy, research and provides other forms of support. They have four chapters:

• Halifax Regional Municipality

• Bridgewater, Lunenburg County

• Kentville, Kings County

• Springhill, Cumberland County

The society can be contacted at: 1-800-465-2601 or by visiting their website at: www.ssns.ca

I have taken the liberty to edit this article to remove the word schizophrenic.