Grit health plans welcomed

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

Agencies agree with party’s proposals on mental health issues, tobacco taxes

By John McPhee, Health Reporter

Health organizations applauded some of the proposals in the Liberal party’s election platform released Thursday.

The Liberals say they’ll create a commission that will report directly to the health minister on mental health issues. The commission would include academics, professionals, clients and family members.

That would be a good thing, said Carol Tooton [pictured], executive director of the Nova Scotia division of the Canadian Mental Health Association.

While there is a provincial mental health steering committee, it hasn’t met for a year, she said Thursday.

Ms. Tooton also agrees with the Liberals that the province falls short on mental health services.

"Absolutely," she said.

"The funding of mental health is less than four per cent of the total budget. And we have 20 per cent of our population who may be requiring those services."

To read the entire article, please click here.

Posting of this article does not imply endorsement of the Nova Scotia Liberal Party by the Schizophrenia Society of Nova Scotia.

Giving Manitoba's poor a better place to live

An article published in today's edition of the Winnipeg Free Press:

The first concrete initiatives from the province's new anti-poverty strategy revolve around housing.

Up to 2,000 people are to benefit from 285 more "mental-health housing units." They will include options ranging from independent living with supports to 24-hour supportive-housing units. Included are 40 units in downtown Winnipeg, with supports, for people who are chronically homeless.

Six hundred low-income Manitobans with mental challenges and an unstable housing situation will receive a rent subsidy of up to $200 a month to access a broader range of private housing. Support workers will be available to help them.

Manitoba Housing's Community Wellness Initiative will be expanded to 14 sites from the current five. Some 760 tenants will receive enhanced services with the addition of 11 housing and mental-health support workers.

The province is adding 100 emergency homeless shelter beds and introducing new emergency homeless shelter standards. The guidelines are to ensure quality, consistent and safe services are provided at Manitoba's five emergency shelters.

A new cold-weather shelter protocol to serve an additional 80 people.

The province will hold a homeless prevention summit this fall.

Do Consumers Use the Word "Recovery"?

A letter to the editor published in the April 2008 edition of Psychiatric Services:

By Myra Piat, Ph.D., Judith Sabetti, M.S.W., and Audrey Couture, M.Sc.

Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada

To the Editor: Recovery has been celebrated as the guiding vision for mental health service delivery since Anthony declared the 1990s the "decade of recovery" (1). Both the President's New Freedom Commission (2) and the Kirby Commission in Canada (3) have made recovery the basis for transforming mental health services throughout North America, which is the result of decades of outcome research, consumer activism, and advances in psychiatric rehabilitation (4,5). Yet a recent Canadian study found that most recovering consumers were not using the word "recovery" to describe their experience and were not hearing about recovery from service providers.

In the context of a multisite, qualitative study of stakeholder perspectives on recovery conducted in 2006–2007, we asked 59 consumers with a diagnosis of bipolar disorder, schizophrenia, or major depression about their use of the word "recovery" and their sources of information on recovery. All had been receiving formal mental health services for at least six months before the study, most as long-term service recipients.

References:

1. Anthony WA: Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 16:11–23, 1993
2. Hogan MF: The President's New Freedom Commission: Recommendations to Transform Mental Health Care in America. Psychiatric Services 54:1467–1474, 2003 [Free Full Text]
3. Kirby MJL, Keon WJ: Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. Ottawa, Sénat du Canada, 2006
4. Roberts G, Wolfson P: The rediscovery of recovery: open to all. Advances in Psychiatric Treatment 10:37–49, 2004 [Abstract/Free Full Text]
5. Sowers W: Transforming systems of care: the American Association of Community Psychiatrists Guidelines for Recovery Oriented Services. Community Mental Health Journal 41:757–774, 2005 [CrossRef][Medline]
   

To read the entire letter to the editor, please click here.

Stamping out stigma

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

Last weekend, people of all ages gathered in Halifax for the Road to Recovery Walk-a-thon held by the Schizophrenia Society of Nova Scotia. We walked through Halifax together to support families, friends and all individuals who have been touched by mental illness. Our aim was to raise funds, but more importantly to reduce the stigma surrounding mental illness. I was disappointed that we received no coverage from The Chronicle Herald.

Many people and families touched by mental illness suffer stigma created by society and the public. It’s up to us to work together to learn more about schizophrenia and what we can do as a community to aid in eliminating the stigma surrounding it. Recovery is possible, but we need everyone’s help to make it a reality.

Laura Dunnington, Halifax

Early and network-oriented care may help adolescents at risk of developing psychosis

A press release posted May 14th by EurekAlert:

Family and network oriented, stress-reducing care improves level of overall functioning and mental health in adolescents at risk of developing psychosis, suggests a recent Finnish study.

Jorvi Early psychosis Recognition and Intervention (JERI) project at Helsinki University Central Hospital (HUCH), Jorvi Hospital, Finland, is a project with an early intervention team for adolescents at risk of developing first-episode psychosis. As developing psychosis has been suggested to be a result of a combination of acute life stressors and trait-like vulnerability to psychosis, the intervention is based on the idea of multiprofessional, need-adapted, community-, family- and network-oriented, stress-reducing, overall functioning supporting and low-threshold care.

The JERI team meets with adolescents at ages 12-20 in their natural surroundings, e.g. at school or at home, together with their parents and community co-worker, who has originally contacted the JERI team because of unclear mental health problems. The aim of the team is to recognize potential risk cases and reduce the stress level by family and network intervention.

A follow-up study was performed to test how presented intervention will help adolescents at risk. Data was collected between January 2007 and May 2008. During the intervention, mean scores rose statistically significantly on overall functioning and scores on quality of life, depression, anxiety and pre-psychotic symptoms decreased statistically significantly, showing an improvement in overall functioning and mental health in adolescents at risk of developing first-episode psychosis. Adolescents did not receive other therapy or any antipsychotic medication.

"JERI- intervention seems to improve level of overall functioning and support mental health in adolescents at risk of developing first-episode psychosis, even though further study with larger number of subjects, with a proper control group and with a longer follow-up time is needed", says Dr. Niklas Granö, the leader of the research.

###

Results are published in the journal Early Intervention in Psychiatry.

For further information, please contact:

Niklas Granö, PhD.
E-mail: niklas.grano@hus.fi
Tel. + 358 9 471 83007

Reference:

Niklas Granö, Marjaana Karjalainen, Jukka Anto, Arja Itkonen,Virve Edlund and Mikko Roine: An intervention to improve level of overall functioning and mental condition of adolescents at high risk of developing first-episode psychosis in Finland. Early Intervention in Psychiatry (2009; 3: 94-98)

Inspiring week

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

National Mental Health Week just ended and my spirits have not only been boosted, they have catapulted. What a week! There was so much going on that I could not attend everything.

There were three highlights for me: the Inspiring Lives Awards and Dinner (www.mentalhealthns.ca) in honour of those heroes living with mental illness who have shared their stories of struggle and humbly received accolades for living well; the official launch of www.OurHealthyMinds.com, a new website offering good information on mental health; and the Nova Scotia Schizophrenia Society’s incredibly successful walkathon (www.ssns.ca).

While Nova Scotia’s mental health care system is still an ailing soul, there is no doubt in my mind that the grassroots organizations and some very special people both within and without the mental health care system know what is needed. There is hope in the air, finally.

On a very personal note, some of the movement forward has touched my own family profoundly. I am so grateful and, yes, recovery is definitely possible. There is so much worth doing.

Sheila Morrison, Halifax

When Will We Get Over Stereotypes

Posted today on Overcoming Schizophrenia:

In the National Alliance on Mental Illness (NAMI) "Schizophrenia: Public Attitudes, Personal Needs" report stated the following statistics:

• 79% of people would want a friend to tell them if they were diagnosed with schizophrenia, but only 46% say they would tell friends if they themselves were diagnosed.
  

• 27% would be embarrassed to tell others if one of their own family members was diagnosed.
  

• 80% expressed discomfort with the prospect of dating someone with schizophrenia who has not received treatment, compared to only 49% if the person has (received treatment).
  

Why are people ashamed to admit that schizophrenia affects their lives? Many people have various misconceptions about schizophrenia - people with schizophrenia are violent, lazy, or homeless. While I do not fit into the stereotype of a person with schizophrenia as well as many of my readers with schizophrenia, people continue to believe these myths.

Again, 79 percent of people would want a friend to tell them they have the illness while almost half of study participants would not admit to that diagnoses if they had schizophrenia. Why is that - that is a double standard. Why do people expect so much from others, but want leniency when it comes to their status?

Going on the second prong, why is it that a relative would be embarrassed by their family member's diagnosis of schizophrenia? Nobody is perfect, many people have medical ailments such as diabetes and cancer or undesirable personality traits such as being conceited, a pathological liar, or a gossiper - those traits should be embarrassing, but not schizophrenia. Nobody can decide who gets mental illness.

About half of survey participates would not date someone with schizophrenia even if they had treatment. This statistic really saddens me. Again, nobody is perfect and they certainly cannot determine whether they have a mental illness or not.

What do you think of these statistics? Do the statistics surprise - why or why not?

To learn more about schizophrenia visit the following organization's websites: 1) the National Alliance on Mental Illness (NAMI), or 2) Schizophrenia Society of Nova Scotia (Canada).

The Road to Recovery Walkathon - May 9th, 2009

Please click on any photograph to enlarge it.





All of the above photographs taken by AnitaLouise Martinez.





All of the above photographs taken by Kim Clark.








All of the above pre-event photographs taken by Stephen Ayer.


A big thank you to ...

Sponsors:

Mental Health Services



Janssen-Ortho Inc.

Genpharm ULC

Prize and Gift Donors:

Please click on the above image to magnify it.

Every citizen must be treated fairly

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

By Carol Tooton and Stephen W. Ayer

The Canadian Mental Health Association-Nova Scotia Division (CMHA-NS) and the Schizophrenia Society of Nova Scotia (SSNS) need to be assured that the systems administered by our government will guarantee that every citizen of Nova Scotia, regardless of socioeconomic or health status, is treated in a fair and just manner. This principle is even more critical when applied to individuals who may not have the knowledge of how systems work, or who do not have the financial resources to engage the appropriate supports (e.g., lawyers). For people in these situations, well-functioning systems are particularly important.

The Nova Scotia Department of Justice is currently experiencing a breakdown in efficiency in relation to the Central Nova Scotia Correctional Facility in Burnside. Last week, the CBC reported on the case of an individual who remained incarcerated for two months beyond his release date, a case which was confirmed by the Nova Scotia Department of Justice. This can be viewed as just one more example of a justice system that appears to be operating in a very dysfunctional manner, particularly when the solution offered was: "… should this gentleman come into our custody again, then we would ask the courts to take into consideration that he had served extra time."

As reported by the CBC, the individual detained beyond his court-imposed sentence had previously been diagnosed with a mental illness; this causes both of our organizations significant concern. In fact, with one in five Nova Scotians at risk of experiencing a mental illness at some point in their lifetime, this is an issue that every citizen of Nova Scotia should be concerned about. Without knowing all of the details in this situation, one cannot help but question why we are continuing to hear of more and more cases of people who have a mental illness being inappropriately treated by the justice system, while, in the meantime, the opening of the new Mental Health Court in Dartmouth has been delayed from April 1 to Nov. 1, 2009.

We are of the opinion that finding appropriate solutions for rehabilitating mentally ill individuals who come into conflict with the law doesn’t rest solely with frontline workers who are administering programs, but also with policy decision-makers and ultimately with the ministers of Justice and Health. The issues of stigma and discrimination in relationship to mental illness remain prevalent and appear to be impacting decision-making at all levels.

All Nova Scotians deserve to be treated equally according to existing legislation. It’s time that government, particularly those responsible for the development of policy and operational procedures, ensure that every citizen of Nova Scotia receives the same fair and just consideration under the law.

An inquiry into the November 2007 death of Howard Hyde is currently underway. This inquiry will examine the facts, in detail, of the death of an individual at the Central Nova Scotia Correctional Facility who had a mental illness, in this case paranoid schizophrenia. As organizations with standing at the inquiry, the CMHA-NS and the SSNS will be doing our utmost to make sure that all of the facts are disclosed, and that appropriate and meaningful recommendations for changes to the justice and mental health systems in this province are made.

Carol Tooton is executive director, Canadian Mental Health Association-Nova Scotia Division. Stephen W. Ayer is executive director, Schizophrenia Society of Nova Scotia.

Canada-Wide Survey Addresses Ways to Improve Quality of Life for Canadians Living with Mental Illness…

A press release from the Schizophrenia Society of Canada:

(Winnipeg, May 4, 2009) – Mental illness can be a devastating illness for anyone; however, it is especially difficult for young adults as it often disrupts their education, career plans and the raising of a young family. The symptoms of psychosis can confuse the mind, disorient perceptions, and unsettle important relationships with family and friends. But there is hope, schizophrenia and psychosis are treatable and recovery of quality of life is possible when people are able to find the right path to open up options for treatment, support and hope.

The Schizophrenia Society of Canada (SCC) recently commissioned a Canada-wide survey to learn how it can support people living with schizophrenia and their families to recover the best quality of life possible. Through a qualitative and quantitative survey and cross Canada focus groups, 1,086 people who have experienced mental illness shared what quality of life means to them. The results revealed that people living with schizophrenia and their families share similar hopes and frustrations regarding their quality of life.

This extensive survey, the largest of its kind in North America, highlighted certain key areas in which quality of life can be improved for people living with a mental illness:

Hope, optimism and a belief in recovery are critical to improving the quality of life for people affected by schizophrenia and related mental health disorders. While 96% of people living with mental illness believe recovery is possible, families sometimes lose optimism in the face of illness and don’t always believe that professionals think recovery is possible.

Friendships and family support are foundational. Symptoms of psychosis can unsettle important relationships with family and friends and contribute to isolation and loneliness. The support of friends and family is essential to recovery, employment and greatly improves quality of life.

Stigma and discrimination are real barriers to quality of life. Approximately 90% of adults with serious mental illness are unemployed. Studies show that many of them want to work and many can work. However, the lack of rehabilitation programs and the prevalence of discrimination prevent them from finding meaningful employment. Poverty is the unfortunate outcome. Canadians living with mental illness also felt that treatment and support services are severely under funded.

Medications and services can foster recovery. While medications are important, most people feel their family and professionals place far too much focus on medication adherence and not enough on what supports recovery and builds their quality of life.

Family/caregivers need to find balance too. Families often carry a heavy burden, as a result the mental, emotions and physical health of the entire family can suffer. Having professional support, learning more about schizophrenia and understanding what supports recovery would help families cope.

Overall, the Schizophrenia Society of Canada’s national survey recommends encouraging professionals to move beyond a narrow focus on managing symptoms to supporting and nurturing recovery from a body, mind and spirit perspective. Stigma and discrimination also need to be addressed through education, public policies and promotion of rights. As well, funding of safe, affordable, secure housing needs to become a priority as does meaningful employment.

Full study report and summary data are available on the SSC website at www.schizophrenia.ca.

Please contact:

Chris Summerville - Chief Executive Officer, Schizophrenia Society of Canada
Office: (204) 786-1616, Mobile: (204) 223-9158

Mental Health Foundation of Nova Scotia Awareness Campaign

I am very impressed with the two new videos produced by the Mental Health Foundation of Nova Scotia (MHFNS). They can by viewed by clicking here.

For those who don't know, the video featuring Mr. Robert Hunt (pictured), Chair, Board of Directors, MHFNS, was filmed in the tunnels connecting buildings at the Nova Scotia Hospital, through which patients, staff, and volunteers travel on a regular basis, particularly during the winter months.

Please click on the image to magnify it.

The Soloist: A Call to Action

A press release from the National Alliance on Mental Illness:

April 23, 2009

Arlington, VA— The National Alliance on Mental Illness (NAMI) has launched a new Web site, www.nami.org/soloist, as part of a social action campaign with Participant Media surrounding Friday’s release (April 24) of The Soloist, starring Jamie Foxx and Robert Downey, Jr.

"The movie will help humanize people who live with schizophrenia and are homeless," said NAMI executive director Mike Fitzpatrick. "It will help people look beyond stereotypes and create better understanding of the challenge for treatment and recovery."

"The mental health care system is in crisis. After people exit theaters and leave popcorn behind, we want to translate new awareness into action."

Schizophrenia is a mental illness that affects about 2 million Americans—twice the number living with HIV/AIDS.

The Soloist is based on the true story of the unlikely friendship between Nathaniel Ayers, a street musician living in Skid Row, and Steve Lopez, a columnist with the Los Angeles Times. In a series of columns, Lopez reports on Ayers’ journey as a gifted student from the Julliard School of Music to the streets of Los Angeles, living with schizophrenia.

On NAMI’s special Web site, visitors can:

• Watch The Soloist trailer

• Test their schizophrenia knowledge

• Listen to Dr. Ken Duckworth, NAMI’s medical director, answer questions about schizophrenia, diagnosis and recovery
  

• Learn more about NAMI’s education programs

• Alert state and national representatives to NAMI advocacy goals

• Register for a local NAMIWalk to support people living with mental illness

OTHER RESOURCES

Participant Media: Take Part

NAMIWalks

NAMI Schizophrenia Report

NAMI 2009 Grading the States Report

Photograph of Nathaniel Ayers and cellist Yo-Yo Ma (2007) courtesy of G.P. Putnam's Sons.

Teen tries to quiet the voices caused by schizophrenia

Posted April 24th on CNNhealth.com:

By Madison Park

(CNN) -- The intrusive voices popped into William "Bill" Garrett's head. "They're coming for you," the voices told the 18-year-old. "Find somewhere to hide; they're going to get you."

They told the Johns Hopkins University freshman that his father had poisoned the family dog, his sister had injected crystal methamphetamine into his pet lizard and his grandmother had put human body parts into his food.

As schizophrenia took hold, the Maryland teenager became lost within his own mind and had to leave college after winning a full, four-year scholarship.

Garrett's experience echoes the teenage years of Nathaniel Ayers, a promising string bass player whose musical training at the Juilliard School was cut short by schizophrenia, a brain disorder that blurs a person's ability to distinguish between reality and delusions.

Ayers became homeless and played Beethoven pieces on a broken violin in the streets of Los Angeles, California. His struggles with schizophrenia and his friendship with a Los Angeles Times columnist inspired the movie "The Soloist," which releases Friday.

His sister, Jennifer Ayers-Moore, hopes the movie will raise awareness about schizophrenia and has established the Nathaniel Anthony Ayers Foundation for the artistically gifted mentally ill.

To read the entire article, please click here.

Jennifer Ayers-Moore plays an air violin next to her older brother, Nathaniel Ayers, in San Diego, California.

The Soloist ...

... opens today, Friday, April 24!



Also see:

The Soloist actually gets it right - to a point (The Globe and Mail, May 7th)

Robert Downey Jr. and Jamie Foxx Deliver a Wake-Up Call in The Soloist about the Complexities of Living With Schizophrenia (A press release from the Schizophrenia Society of Ontario, April 24th)

Struggle and Rescue, a Duet in Sharps and Minors (Film review, The New York Times, April 24th)

Review: 'The Soloist' (Film review, The Christian Science Monitor, April 24th)

The Soloist (Film review, Roger Ebert, The Chicago Sun-Times)

Good intentions, dubious decisions (Film review, The Globe and Mail, April 24th)

Hyde fatality inquiry to be webcast

An article posted today on CBCnews.ca:

The inquiry into the death of Howard Hyde [pictured], the Dartmouth man who died in a Nova Scotia jail 30 hours after he was shocked with a Taser, will be broadcast live on the internet.

It will be the first time a fatality inquiry in Nova Scotia will be visible to people outside the hearing room.

Lawyers agreed to the webcast on Tuesday.

Kevin MacDonald, who represents Hyde's sister, said it would give Hyde's father a chance to follow the proceedings from his home in the U.S., and also provide Nova Scotians with a front-row seat.

"The public are interested," said MacDonald. "The inquiry's going to be held in Halifax. But for the webcast it really would be closed off to many members of the public, even in rural Nova Scotia."

Halifax Regional Police used a Taser to subdue Hyde, 45, after responding to a domestic abuse complaint on Nov. 21, 2007. He was taken to the Central Nova Scotia Correctional Facility in Dartmouth, where he died 30 hours later after struggling twice with corrections officers.

Last fall, Nova Scotia's chief medical examiner ruled that Hyde died of excited delirium due to paranoid schizophrenia, and declared his death accidental.

MacDonald said Hyde's relatives have many questions.

"The family wants to know what those people did and why they did it, or why they didn't do what they didn't do?" said MacDonald.

There are also issues about mental-health crisis intervention, said Blair Mitchell, the lawyer acting for the Schizophrenia Society of Nova Scotia.

"Everyone's concerned about the Taser. Everyone is concerned about the use of force and the use of restraint, particularly in the case of a person in a situation of distress," said Mitchell.

Lawyers and court officials will meet again in June to discuss procedural issues, though Judge Anne Derrick won't hear from witnesses until early July.

Derrick can make recommendations relating to any matter that arises during the inquiry.

Also see:

From CBC News: Nova Scotia at Six:

In the fall of 2007, Howard Hyde died 30 hours after he was tasered by Halifax police. Now an inquiry into his death is about to begin. Jim Nunn speaks with Dan MacRury, the lawyer for the inquiry. (To view, please click here; runs 3:14, requires RealPlayer.)

Hyde inquiry online

Inquiry into death of man Tasered in police custody to be streamed on web

Schizophrenia: Take a walk on the Road to Recovery

A letter to the editor published in the April 16th edition of The Chronicle Herald:

By Sharon Murphy

Imagine that you are living with terrifying delusional thoughts that some unspeakable tragedy is about to devastate you or those you love. Or you are living with unsettling auditory or visual hallucinations that give you no peace. These are facts of life that many people who live with untreated schizophrenia, or some other untreated psychosis disorder, must deal with daily.

Schizophrenia and psychosis are highly treatable brain disorders. Psychosis, a common manifestation of schizophrenia, affects a person’s ability to distinguish what is real from what is not. Symptoms of psychosis include delusions (false beliefs that are not part of reality), hallucinations (sensing things that aren’t actually there), disturbances in thinking and communication, and withdrawal from normal social activities. These symptoms are thought to be caused by disturbances in the flow of information in the brain. Schizophrenia and other psychotic disorders often first develop among people between the ages of 15 and 25 – a critical period in a young person’s life.

While the exact causes of schizophrenia and other psychotic disorders are not yet known, many advances have been made in the past few years. Researchers are looking at a number of factors that may affect brain development, such as genetic factors and gene expression, maternal illness, and viruses. Environmental factors, such as stress or the use of marijuana, have also been implicated.

There remains much stigma and discrimination associated with schizophrenia, even when a person living with the illness is very well along in their recovery journey. Stigma can be defined as a negative attitude – characterized by a lack of compassion – towards someone living with schizophrenia. Schizophrenia and psychotic disorders continue to be stigmatized because having a mental illness somehow implies a distinction from being physically unwell, although, as neuroimaging studies have recently shown, the two are intimately entwined. To some, the term "mental" also suggests something besides a legitimate medical condition, something that results from the person’s own doing. That somehow the person should just get over it.

For someone with schizophrenia or some other psychotic disorder, the consequences of stigma can be devastating in many cases – almost as devastating as the illness itself. This results in people not seeking treatment because they fear being labelled and rejected by family, friends, co-workers and employers. And some people become socially isolated because of the shame engendered by the stigma.

Stigma also leads to discrimination in the workplace and inadequate health insurance coverage compared with coverage for other illnesses. The evidence indicates that the time has come to shift the focus of research and action from stigma to discrimination. So instead of asking an employer if they would hire a person with a mental illness, we should ask if they actually do so!

Language is also important – that is, the messages conveyed by everyday words that are tossed about without a care, and how this language contributes to negative stereotyping. We are all familiar with this language; it includes such words as "loony," "crazy" and "schizophrenic." Schizophrenia is not a religion (i.e., I am a Catholic), and it is not multiple personality disorder. It is interesting that such negative stereotyping language is rarely used now in reference to physical illness. It is difficult to fathom why it is still used in relation to the mentally ill.

Michael Kirby, in his report on mental illness called Out of the Shadows at Last, quotes from another report entitled More for the Mind: "In no other field, except perhaps leprosy, has there been as much confusion, misdirection and discrimination against the patient as in mental illness … Down through the ages, they have been estranged by society and cast out to wander in the wilderness. Mental illness, even today, is all too often considered a crime to be punished, a sin to be expiated, a possessing demon to be exorcised, a disgrace to be hushed up, a personality weakness to be deplored or a welfare problem to be handled as cheaply as possible."

Dr. Kirby notes these words were written in 1963, nearly half a century ago. He also notes, incredibly, that the 2,000 submissions to the standing Senate committee on social affairs, science and technology from 2004 to 2006 made it clear that these opinions still ring true today. Society still has a long way to go in combating stigmatization and discrimination of the mentally ill.

To help stamp out old prejudices and to raise awareness about schizophrenia and other psychotic disorders, the Schizophrenia Society of Nova Scotia invites you to lace up your sneakers and join us on our five-kilometre Road to Recovery Walkathon. The walkathon takes place on Saturday, May 9, from 12 noon to 6 p.m., and starts at St. Matthew’s Church Hall, 1479 Barrington St., Halifax. Registration is free. To register to participate, and to obtain an official pledge sheet, please contact Donna Methot at 902-462-8658 or email hrmchapterssns@accesswave.ca. For more information, visit www.ssns.ca.

The Schizophrenia Society of Nova Scotia is a community-based not-for-profit organization incorporated in April 1982. Its mission is to improve the quality of life for those affected by schizophrenia and psychosis – including families and friends. The society has over 25 years of solid history providing education and support services to individuals living with schizophrenia and other psychotic disorders, as well as their families and friends. The vast majority of its current work is focused on providing education and support, as well as influencing public policy relating to the timely provision of mental health services.

Sharon Murphy is director, Schizophrenia Society of Nova Scotia.

Also see:

Another Misconception of Schizophrenia

Laura Burke - This Much I Know

Laura Burke, an artist who read her original poetry at the 2008 SSNS Annual Conference, has released This Much I Know, a CD of spoken word poetry (including the poem she read at the Conference). The CD is available for purchase for $15.00 by contacting the Schizophrenia Society of Nova Scotia at (902) 465-2601 or by sending an email to ssns@ns.sympatico.ca. To view a YouTube videos of Laura performing, please click here and here.

Ms. Burke has been kind enough to donate a portion of the proceeds from the sale of each CD to the Schizophrenia Society of Nova Scotia.



Click on the image to magnify it.

Gaining Insight Art Prints for Sale!

Amber Christian Osterhout now has her art prints and posters available to purchase. Seventy five percent of ALL print sales will be donated to various mental health charities.

From Ms Osterhout's website:

The following poster series examines the relationship between mental illness and stigma. These posters encourage others to help put an end to stigma.



Click on the image to enlarge it.


Please Don’t Judge Me

The left-hand poster emphasizes the various misperceptions and stereotypes that exist today. For those dealing with a mental disorder, stigma can decrease the possibility of recovery.

This is Reality

The middle poster reveals the truth about mental illness. Many will be surprised by the facts and may begin to view mental illness in a positive light.

Proud of Who I Am

The right-hand poster puts a face on recovery and shows that a person should not be defined by his or her illness.

I thank Roger Cann for bringing this information to my attention.

Rethinking Mental Disorders

A series edited by Thomas R. Insel published in The Journal of Clinical Investigation:

Mental disorders such as schizophrenia, bipolar illness, depression, and autism are the number one source of medical disability for people 15–44 years of age in the U.S. and Canada. In the past, these disorders have been considered psychological conflicts or chemical imbalances, but, as highlighted in this Review series, recent research indicates they are brain disorders, developmental disorders, and complex genetic disorders.

All papers in the series are free to download by clicking here.

Also see:

Translating scientific opportunity into public health impact: a strategic plan for research on mental illness.

Dalhousie University Department of Psychiatry Headlines

Click on the image to expand it.


Page 6 of the March 2009 issue features a profile of Dr. Zenovia Ursuliak (pictured, right), a regular guest educator on motivational interviewing at meetings of the HRM Chapter of the SSNS.


To view back issues of Psychiatry Headlines, please click here.

Is Recovery from Schizophrenia Possible? An Overview of Concepts, Evidence, and Clinical Implications

An abstract from the June 2008 edition of Primary Psychiatry:

By Paul H. Lysaker [pictured] and Kelly D. Buck

Contrary to long-standing pessimistic views regarding the prognosis for people with schizophrenia, emerging literature suggests that many with this condition can meaningfully recover over time.

Using increasingly complex models of recovery with clearly defined operationalized criteria, numerous longitudinal studies have provided data pointing out that progressive deterioration is more of an exception than a rule for people with this condition.

To address the issues of the definition and likelihood of recovery from schizophrenia, this article reviews evolving definitions which stress that recovery must involve the development of a sense of hope, self-reliance, and a personalized awareness of current strengths and challenges.

Empirical research indicates that while many with schizophrenia experience significant bouts of disability, more people experience long periods of relatively good functioning, including symptom remission, healthy levels of self-esteem, and meaningful community participation.

Implications for how clinical practice can reinforce and promote recovery are discussed.

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

Posting of this abstract is for the purposes of research into schizophrenia.

Self-Stigma in People With Mental Illness

An article published in the November 2007 issue of Schizophrenia Bulletin:

By Amy C. Watson (1), Patrick Corrigan (2), Jonathon E. Larson (2), and Molly Sells (3)

1. Jane Addams College of Social Work, University of Illinois at Chicago
2. Joint Research Programs in Psychiatric Rehabilitation, Illinois Institute of Technology
3. University of Chicago
   

Persons with mental illnesses such as schizophrenia may internalize mental illness stigma and experience diminished self-esteem and self-efficacy. In this article, we describe a model of self-stigma and examine a hierarchy of mediational processes within the model.

Seventy-one individuals with serious mental illness were recruited from a community support program at an outpatient psychiatry department of a community hospital. All participants completed the Self-Stigma of Mental Illness Scale along with measures of group identification (GI), perceived legitimacy (PL), self-esteem, and self-efficacy. Models examining the steps involved in self-stigma process were tested. Specifically, after conducting preliminary bivariate analyses, we examine stereotype agreement as a mediator of GI and PL on stigma self-concurrence (SSC); SSC as a mediator of GI and PL on self-efficacy; and SSC as a mediator of GI and PL on self-esteem.

Findings provide partial support for the proposed mediational processes and point to GI, PL, and stereotype agreement as areas to be considered for intervention.

To download the full text of this article, please click here (PDF).

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

Also see:

An Anti-Stigma Approach to Working with Persons with Severe Mental Disability: Seeking Real Change Through Narrative Change (Journal of Social Work Practice, March 1st, 2009)

A Google Scholar search for "self-stigma" & "mental illness"

Altered Gene Can Increase Risk Of Schizophrenia

An article posted on April 7th by ScienceDaily:

Rutgers geneticist Linda Brzustowicz [pictured] and her colleagues have identified a specific DNA change that is likely to increase risk for developing schizophrenia in some people. It provides a potential mechanism that may be a point of entry for drug therapy, consistent with the growing trend of personalized medicine.

The research findings are reported in the April issue of the American Journal of Psychiatry (AJP). An accompanying editorial highlights the significance of this work.

Brzustowicz, a professor of genetics at Rutgers, The State University of New Jersey, and board-certified psychiatrist, said that the research has demonstrated a functional DNA change that increases gene expression. This conclusion is based on its presence in the genes of a Canadian study population of 24 families where multiple individuals had been diagnosed with schizophrenia. The gene in question, NOS1AP, previously known as CAPON, is one which Brzustowicz has been studying for six years.

The paper also presents an innovative statistical method, Posterior Probability of Linkage Disequilibrium (PPLD). This is the work of co-author Veronica Vieland of The Research Institute at Nationwide Children's Hospital, Columbus, Ohio. The new analytical technique quantifies the statistical evidence for association, in this case between the altered gene and schizophrenia. The researchers evaluated 60 variants of the gene or single nucleotide polymorphisms (SNPs).

"Our use of the PPLD was really helpful in sorting the evidence. It showed that of the 60 SNPs we were evaluating, three had a much higher probability of association with the illness," Brzustowicz said. "This paved the way for our next step – doing a functional analysis using cells grown in culture – which is much more labor intensive. We had reduced our 60 candidates down to a short list of three, which greatly simplified this next step."

Each of the three candidate SNPs was introduced into separate cultures of identical cloned cells derived from human brain tissue. The cultures differed only in which of the SNP variants was introduced. The challenge was to measure the quantity of overexpression, that is, how much excess protein was being produced by each of the three variants.

To each culture the researchers also added DNA that contained the gene that produces the enzyme which makes a firefly glow, along with human regulatory DNA which would control the production of that enzyme. The three kinds of DNA (the SNP, the firefly and the human regulatory) were all joined together prior to insertion into the brain-derived cells. Thus, the amount of expression of each SNP would be reflected (via the regulatory DNA) in the intensity of the light produced. An instrument known as a luminometer measured the glow produced and showed a dramatic increase in gene expression in one variant over the others. These results echo the increased expression of NOS1AP that has been observed in postmortem brain samples from individuals with schizophrenia.

Bonnie Firestein, a professor in Rutgers' Department of Cell Biology and Neuroscience, though not an author on the AJP paper, is conducting complementary research. She is investigating the consequences of increased expression of the NOS1AP gene. Firestein is looking at this gene in cells in culture and examining how the overexpression of this protein alters the way neurons branch.

Identifying this specific functional genetic variant is an important step, but there are qualifiers. Schizophrenia is not a single-gene disorder, and there are environmental factors that are also important. "It is not as though, if you have this altered gene, you will get the disease," said Brzustowicz.

The frequency of this variant in the general population is more than 40 percent. Approximately 1 percent of the general population has schizophrenia but not all of those with the illness will have this altered gene. Brzustowicz estimates that the frequency of the altered gene in people with schizophrenia is going to be higher than the average in the general population. For example, the frequency of this variant in people with schizophrenia in the Canadian families is 55 percent.

To refine this estimate, Brzustowicz and her team will be looking at the altered gene's frequency in DNA samples from the National Institute of Mental Health collection of cell lines housed in the Rutgers University Cell and DNA Repository. The collection includes samples drawn from large populations of Asian, Caucasian, African American and Hispanic individuals with schizophrenia.

Adapted from materials provided by Rutgers University.

Request for Proposals: When People Living with Severe Mental Health Illnesses Interact with the Police

Submission Deadline: Thursday, April 30th

From the Mental Health Commission of Canada:

The Mental Health Commission of Canada Announces a Request for Proposals for a study of Types of Interactions, Attitudes, Experiences and Feedback: When People Living with Severe Mental Health Illnesses Interact with the Police


The Mental Health Commission of Canada (MHCC) is requesting proposals from qualified candidates to conduct a study of types of interactions and experiences with, attitudes towards, and feedback for the police from the perspective of persons living with severe mental health problems and illnesses.

Background

The MHCC is an arms-length, federally-funded, non-profit organization. It was created to focus national attention on mental health issues and to work to improve the health and social outcomes of people living with mental health problems and illnesses. The Government of Canada established the Commission in 2007 in response to the findings of a Senate-generated report Out of the Shadows at Last – Transforming Mental Health, Mental Illness and Addiction Services in Canada (Standing Committee on Social Affairs, 2006).

Purpose of the Study

Therefore, the purpose of the study will be (1) to examine the perceptions of persons living with severe mental illness1 of their interactions with the police, (2) to determine the attitudes of persons with a severe mental illness* toward police in general and (3) to solicit feedback that persons with a severe mental illness would like to convey to police. It is hoped that these data will contribute to the development of evidence-based best practice guidelines for police services.


* “Severe mental illness” in this study will refer to disorders such as schizophrenia, bipolar disorder (manic-depression), and Alzheimer's disease which significantly disrupt a person's ability to think, feel, and relate to others and to their environment [Cotton, D. & Zanibbi, K. (2003). Police officers’ knowledge about mental illness. Canadian Journal of Police and Security Services, 1: 136-143.].

For the complete document, please click here (PDF)

Watchdog questions RCMP’s Taser use

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

Caution urged when using stun guns on young people, mentally ill

By Jim Bronskill, The Canadian Press

OTTAWA — The RCMP complaints commissioner says the Mounties should be more careful about using stun guns on young people and the mentally ill.

In a final report on RCMP Taser use last year, Paul Kennedy also says the force’s tracking and analysis of incidents still needs improvement.

The findings come 10 months after Kennedy, chairman of the Commission for Public Complaints Against the RCMP, called on the police force to rein in Taser use and better monitor how officers use the potent device.

In his report Monday, the RCMP watchdog said there has been commendable progress on his 22 recommendations to the force, "however, more needs to be done in order to alleviate many of the concerns repeatedly expressed by the commission."

To that end, the commission is working with the RCMP on member training, reporting and policy development "with the view to providing a more in-depth analysis of the RCMP’s progress on all of the recommendations."

Some of the commission’s figures, released in a preliminary report last week, show the Mounties were far less likely to fire their Tasers last year. Use dropped 30 per cent from a peak of 1,583 incidents in 2007.

The statistics suggest police officers were more cautious about firing the stun guns following a public furor.

A B.C. inquiry is probing the case of Polish immigrant Robert Dziekanski, who died in October 2007 after he was stunned five times with an RCMP Taser at the Vancouver airport.

The RCMP says it has limited Taser use to situations involving a threat to officer or public safety.

The new Mountie policy warns officers that Taser use carries a risk of death, particularly for agitated people.

But Kennedy says it’s too early to tell whether the changes will address the issues he’s outlined. "While the revised policy is a positive step forward, the commission remains concerned."

The report flags two specific groups — young people and the mentally ill.

"It is not that (Tasers) should never be used with these groups, but rather, that there should be a higher threshold for usage where these subjects are concerned. This higher threshold is not always observed."

It says the RCMP still appears to define "at-risk populations" as acutely agitated and delirious people and, before using the Taser, the force needs to consider those experiencing mental health crises or people who’ve taken large quantities of drugs or alcohol.

"This is problematic as there is a higher statistical likelihood that these persons will die in police custody and therefore any effort made to mitigate this outcome should be adopted by the RCMP."

The report also notes that while members reported that use of the Taser avoided the use of lethal force — that is, a conventional gun — in over half of the reports, "there is reason to be suspicious of this figure."

In many cases, the summaries of these Taser incidents "did not support the members’ statement" that lethal force would have been used if not for the Taser.

Finally, Kennedy said the RCMP has not fully addressed how it will tackle the issue of under-reporting by members who use stun guns — a problem identified in his previous report. And while the force has begun to share Taser usage reports with more people inside the force, it is not clear how the information is being incorporated into training.

The RCMP had no immediate comment on the report.

Hilary Homes, a human rights campaigner with Amnesty International Canada, says there is a lack of clarity about RCMP policy on Taser use.

"Until there is clear policy, and a demonstration that that clear policy is followed, there simply won’t be the confidence that the police would like to see in their own work."

‘While the revised policy is a positive step forward, the commission remains concerned.’

Also see:

News Release – CPC Chair Releases In-Depth Analysis of 2008 Conducted Energy Weapon (Taser) use by the RCMP

RCMP Use of the Conducted Energy Weapon (CEW): January 1, 2008 to December 31, 2008 (March 31, 2009)

RCMP shocked 16 people five times or more last year

Landmark Institute of Medicine Report Paves Road to Prevention

An article published in the April 3rd edition of Psychiatric News:

By Mark Moran

American Psychiatric Association (APA) leaders involved with the report say it points to a "paradigm shift" in the way medicine and psychiatry approach mental health and illness in the future.

Prevention of mental illness and promotion of mental health are scientifically feasible, and the time is ripe to transfer the science into practice.

That is the conclusion of a landmark report by the Institute of Medicine (IOM) titled "Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities."

Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations—such as children and youth in the child-welfare system—school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations, according to the report.

The report updates a 1994 IOM book, Reducing Risks for Mental Disorders, and focuses attention on the research base and program experience with younger populations that have emerged since that time.

The book-length report includes chapters on (among other subjects) using a developmental framework to guide prevention and promotion; perspectives from developmental neuroscience; preventive intervention research—including family, school, and community interventions; prevention of specific disorders; screening; benefits and costs of prevention; and implementation and dissemination of prevention and promotion practices.

APA leaders are hailing the report saying it points to a paradigm shift in the way psychiatry approaches mental illness in the future.

"Both prevention and psychiatry have always been the stepchildren of medicine," said APA President Nada Stotland, M.D. "It is not as glamorous as open-heart surgery or restoring a brilliant individual with bipolar disorder to her career and family. It is much easier to get credit for fixing something that is broken than for keeping it from breaking in the first place. However, most of the improvements in life span are the result of preventive, rather than treatment, measures—immunizations, pap smears, clean air and water, smoking cessation.

"Most health professionals are unaware of the crucial data in the IOM report," Stotland said. "Now that it has been published, and we know that there are effective ways to prevent psychiatric disorders in children, there is no excuse for our country's continued failure to implement the policies that would protect our children from lifetimes of suffering and disability."

Child psychiatrist William Beardslee, M.D., a member of the IOM committee and chair of APA's Corresponding Committee on Prevention of Mental Disorders and Promotion of Mental Health, echoed Stotland.

"This is a landmark report and deserves to be read with care by every psychiatrist," Beardslee told Psychiatric News. "Psychiatry has an opportunity to provide extraordinary leadership in the prevention of mental illness, and we strongly urge APA and individual psychiatrists to support the report's recommendations."

Those recommendations include a call for a coordinated national strategy originating in the White House for implementing prevention and promotion practices.

The IOM report stated, "The White House should create an ongoing mechanism involving federal agencies, stakeholders (including professional associations), and key researchers to develop and implement a strategic approach to the promotion of mental, emotional, and behavioral health and the prevention of mental, emotional, and behavior disorders and related problem behaviors in young people."

Psychiatrist Carl Bell, M.D., also a member of the IOM committee, said that recommendation was modeled on the success of a similar White House cabinet-level strategy during the Clinton administration concerning violence against women.

"What the IOM is saying is that it is possible to prevent psychiatric disorders, substance abuse, and problem behaviors," Bell told Psychiatric News. "The challenge for psychiatry is to shift its paradigm and stop thinking of itself as a field that only treats the sick, but begins to think in terms of a public-health model."

Beardslee and Bell both stressed that the IOM report underscores the importance—and scientific basis—not only of preventing or preempting the occurrence of major mental disorders among individuals who exhibit preclinical symptoms, but also broad population-based strategies aimed at promoting mental health.

Beardslee stressed as well that in the background of all behavioral disorders are the issues of poverty and health disparities.

"Prevention should be a part of regular psychiatric practice," Beardslee said. "I see three levels at which psychiatrists can be putting prevention into practice. As social scientists, we should be embracing the public-health perspective and broad reforms to address health disparities and poverty. A second level where psychiatrists can have a very large impact is in working with adults with mental illness who have children, doing preventive work using psychoeducational models.

"And the third level is the use of preventive strategies that have been designed for people at very high risk."