Sunday, August 8, 2010

Kaleidoscope of the heart: Coming forward and talking about illness


An article published today by The Mainichi Daily News [Japan]:
By Rika Kayama, psychiatrist [pictured]

I invited two members of the BALBAL Club -- an organization that is engaged in activities in which those who have suffered from mental illnesses talk about their experiences -- to deliver speeches during my lecture at a university in the Kansai district. Male member Naohito Inamura and female Daria Sugano, talked about their experiences of schizophrenia.

Inamura experienced auditory hallucinations and delusion when he was a high school student. He said he was initially confused and did not understand what had happened to him.

After being hospitalized several times, Inamura took part in a workshop for those who have suffered from mental problems. He then made friends with many former patients and now his condition remains stable. Inamura has now recovered to the extent that he visits hospitals for those with mental illnesses and tells other patients about his experiences to encourage them.

"Hospitals that provide detailed care to patients are good, but you can relax at institutions that leave you alone," he jokingly says.

Sugano, who appears to be serious and intellectual, suffered from schizophrenia when she was in her teens. She and her family were initially unable to accept the fact that she suffered from schizophrenia, and were reluctant to receive social welfare services. In a desperate bid to be independent and self-reliant, Sugano attended a post-graduate school while working part-time, and was involved in stressful work in the social welfare sector. She suffered a relapse of her illness several times after being overworked. Now she has fully accepted the fact that she is a patient with schizophrenia, and can live at her own pace.

Sugano told students in my class that when she was 17, she was told by her doctor that she would need to regularly take medicine for schizophrenia for the rest of her life. On her way home from the clinic, she was concerned for her life, thinking that she was different from the people around her.

The students appeared impressed with her heartbreaking speech. I think students occasionally feel sad when they think all people except themselves are happy, but the degree of their despair is completely different from that Inamura and Sugano experienced.

Nevertheless, Inamura and Sugano found ways to deal with their disease by adopting lifestyles that suited their conditions, by going to places where they can truly be themselves and making friends after struggling for 10 to 15 years.

Their messages that, "You can certainly recover from your illnesses" and "If you find mentally ill people around you, please understand them," have a ring of truth because they experienced despair.

I wonder how the guest speakers' words sounded to the students of today, who tend to be sensitive and easily abandon their own goals. The two guest speakers wanted to advise the students not to give up hope even if they are in despair and to be patient, believing that anything takes time to solve. Their experiences give a lesson to everybody.

It is not easy for anybody to talk about their illnesses. But some people willing to do that help a growing number of people understand the illnesses and give courage to more and more people. Activities like those of BALBAL Club are now widespread throughout the country. If you have an opportunity, I would like you to listen to what its members have to say.

Photo credit

An Update from Nova Scotia



Please click on the image to magnify it.

To view the PowerPoint slides (PDF) of the presentation that Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, made during the Schizophrenia Society of Canada's 2010 National Conference, please click here.

Saturday, August 7, 2010

Shift to Community Care Slowing in Many States


An article published in the August 6th edition of Psychiatric News:
By Rich Daly

Eleven years after the Supreme Court required that community-based treatments be offered to people institutionalized with major health conditions, including serious mental illness, that promise remains unfulfilled and may need legal action to get back on track.

Numerous initiatives by Congress, federal agencies, and mental health advocates have greatly expanded access to community-based treatment for people with serious mental illness in the 11 years since the Supreme Court required such alternatives for qualified people in institutional care. But some observers warn that those efforts are stagnating or even receding.

The Supreme Court's 1999 Olmstead v. L.C. decision declared that “unjustified institutional isolation of persons with disabilities is a form of discrimination” under the Americans With Disabilities Act (ADA) and obligated states to serve those individuals in the most “integrated” setting possible. Since then, mental health advocates have sought to move most people with serious mental illness out of institutional settings and into community treatment where they would have opportunities to work, socialize, and move freely in society.

Those efforts have resulted in community-based treatment and assisted-living programs throughout the country that usually cost states much less than the institutional programs they succeeded, according to Robert Bernstein, president and director of the Bazelon Center for Mental Health Law.

To read the entire article, please click here.

Thursday, August 5, 2010

Photographs from the SSC National Conference in St. John's, NL


The Schizophrenia Society of Canada's (SSC) National Conference took place from July 26th to 28th, 2010, in St. John's, Newfoundland and Labrador.

To download PowerPoint slides from some of the presentations made during the conference, please click here.




Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia (left), Greg Zed, past president of the Schizophrenia Society of New Brunswick (centre), and Cecilia McRae, president of the Schizophrenia Society of Nova Scotia (right).




Anita Hopfauf, executive director of the Schizophrenia Society of Saskatchewan. At the far right is Phil Rogers, treasurer of the Schizophrenia Society of Nova Scotia.




Laura Burke, peer support facilitator with the Schizophrenia Society of Nova Scotia, performs spoken word poetry during the conference banquet. Laura also received the SSC's 2010 Flag of Hope Award during the banquet.




Laura Burke at The Rooms, an art gallery and museum in St. John's.




View of the entrance to St. John's harbour from The Rooms.




At a conference with a theme of Social Inclusion: Well Beyond Recovery, we didn't have too look very far for signs of social prejudice.




The Supreme Court of Newfoundland and Labrador.


Please click on any photograph to magnify it.

EEG predicts response to medication for schizophrenia



Pictured left to right are Dr. Gary Hasey, Department of Psychiatry and Behavioural Neurosciences; Professor James Reilly and Ph.D. student Ahmad Khodayari‑Rostamabad, Department of Electrical and Computer Engineering; Prof. Hubert de Bruin, McMaster School of Biomedical Engineering. Missing: Dr. Duncan MacCrimmon, Department of Psychiatry and Behavioural Neurosciences.


An August 4th media release from McMaster University:
A commonplace electroencephalography (EEG) test may hold the key to predicting whether a person will respond to certain prescribed drugs, particularly those related to psychiatric conditions.

In a study to be published by Clinical Neurophysiology, and now posted online, engineering and health sciences researchers at McMaster University applied machine learning to EEG patterns and successfully predicted how patients with schizophrenia would respond to clozapine therapy.

Clozapine is recognized as an effective treatment for chronic medication-resistant schizophrenia but can produce serious side effects such as seizures, cardiac arrhythmias or bone marrow suppression. Some patients can develop blood problems that are life-threatening. Weekly to monthly blood sampling is required.

"Some people can suffer terrible side effects from clozapine," said Dr. Gary Hasey, associate professor at McMaster and director of the Transcranial Magnetic Stimulation laboratory at St. Joseph's Healthcare Mood Disorders Clinic in Hamilton. "The logistic difficulties for the patient and treatment team are also substantial. A method to reliably determine, before the onset of therapy, whether a patient will or will not respond to clozapine would greatly assist the clinician in determining whether the risks and logistic complexity of clozapine are outweighed by the potential benefits."

To conduct the study, EEGs were taken from 23 patients diagnosed with medication-resistant schizophrenia before they began taking clozapine. Twelve were men and 11 were women, all of middle age. The brainwave patterns and response to the clozapine therapy of these patients were used to "train" a computer algorithm to predict whether or not a specific patient will respond to the drug. The prediction accuracy was approximately 89 per cent. This algorithm showed similar predictive accuracy when it was further tested in a new group of 14 additional patients treated with clozapine.

This innovative work grows out of the close collaborative relationship between members of the Department of Electrical and Computer Engineering (Prof. James Reilly, Ph.D. student Ahmad Khodayari-Rostamabad), the School of Biomedical Engineering (Prof. Hubert de Bruin), and the Department of Psychiatry and Behavioural Neurosciences (Drs. Gary Hasey and Duncan MacCrimmon).

"The computational power available today supports new machine learning methodologies that can help doctors better diagnose and treat illness and disease," said Prof. Reilly. "Large amounts of data can be processed very quickly to identify patterns or predict outcomes. We're looking forward to applying the findings to other areas."

EEG records the brain's electrical activity close to the scalp. Traditionally, it has been used to monitor for epilepsy, and to diagnose coma, encephalopathies, and brain death. EEG is still often used as a first-line method to diagnose tumors, stroke and other focal brain disorders.

"EEG is an inexpensive, non-invasive technique widely available in smaller hospitals and in community laboratories," explains Dr. MacCrimmon. "Also, EEG readings take only 20 to 30 minutes of a patient's time, with no preparation required, so pose minimal inconvenience."

Funding for the research was provided in part by The Magstim Company Ltd., a developer and manufacturer of medical and research devices for the neurological and surgical fields. The company is based in Wales, U.K.

The researchers now plan to test their findings on a larger sample group. They have successfully demonstrated the application of machine learning methods for analyzing EEG signals to predict the response to various treatments available for patients with other psychiatric conditions, specifically major depression. They have also demonstrated the effectiveness of machine learning methods as a diagnostic tool for distinguishing various forms of psychiatric illness. It may also be possible to incorporate a range of other clinical and laboratory data such as personality inventory scores, personal and demographic information and treatment history to improve performance.

Image credit

Sunday, August 1, 2010

A New Kind of First Aid


Monday, September 27th & Tuesday, September 28th!



From the Nova Scotia Department of Health website:
Research shows that at some point in their lives, mental health problems affect one in three Canadians. So the chances are good that each of us knows someone with a mental health problem such as a substance-related disorder, depression, anxiety, or a psychotic disorder.

While thousands of people across the country know how to provide first aid to someone with a physical injury, a lot fewer people are able to recognize the signs of and support someone needing mental health first aid. But that’s changing thanks to a new mental health first aid training program for the general public, being offered coast-to-coast by Mental Health First Aid (MHFA) Canada.

“Mental health first aid is help for a person experiencing a mental health problem or a mental health crisis. Just like physical first aid, the goal is to offer a person immediate assistance until they can receive appropriate professional treatment or until the crisis is over,” says Tony Prime, Instructor MHFA .

MHFA Canada is an interactive course for anyone and no previous mental health experience is necessary. It can benefit teachers, health care professionals, emergency service workers, human resource professionals, employers, managers and supervisors, community groups, and the public.

The 12-hour course provides general information about what is meant by mental health problems and illnesses, how to identify signs of mental health problems in yourself and others, effective interventions and treatments, and how to support an individual and help them find out about and access the professional help they may need.

It also dispels common myths surrounding mental health problems and reduces the stigma around mental illness, since estimates suggest that more than half of people with a mental health problem will never seek treatment.

“The course doesn’t train people to diagnose mental illness or be a therapist or counselor,” says Prime. “It provides the first aider with actions to guide a person in need to appropriate professional help when a problem first arises. We know the sooner a person with a mental health problem gets help, the better their chances of recovery.”

More information about mental health first aid can be found at www.mentalhealthfirstaid.ca.

For more information, contact:

Tony Prime, Instructor
Phone: (902) 424-7235
Email: primets@gov.ns.ca


Schedule

MHFA Canada (12 hours)
Monday & Tuesday, September 27 & 28, 2010
Boardroom 11
Joseph Howe Building
1690 Hollis St., Halifax, Nova Scotia

Adults Interacting With Youth (14 hours)
Monday & Tuesday, October 4 & 5, 2010
Same location as above.

MHFA Canada (12 hours)
Monday & Tuesday, October 25 & 26, 2010
Same location as above.

MHFA Canada (12 hours)
Monday & Tuesday, November 1 & 2, 2010
Same location as above.

MHFA Canada (12 hours)
Tuesday & Wednesday, November 23 & 24, 2010
Same location as above.

Adults Interacting With Youth (14 hours)
Monday & Tuesday, December 6 & 7, 2010
Same location as above.


Registration

Registration Fee:

Mental Health First Aid Canada
Registration fee: $120.00; Nova Scotia Government Employees: $50

Adults Interacting With Youth
Registration Fee: $50

For workshops in your community or workplace:

If room rental and catering for breaks is required and/or travel for instructor the registration will be determined and negotiated with the party requesting the workshop.


Register by phone or email:


Instructor: Tony Prime
Phone: (902) 424-7235
Email: primets@gov.ns.ca


MHFA Canada Instructor Training Course

Mental Health First Aid (MHFA) Canada is an evidence-based training program designed to enable people to recognize the symptoms of a person in mental health crisis and to provide support as a first aider until professional help available.

The next MHFA Canada Instructor Training - Basic (5 Days) in Nova Scotia will be held Monday, April 26, to Friday, April 30, 2010, location TBD.

Youth Instructor Training Course

The next MHFA Canada Instructor Training - Adults Who Interact with Youth in Nova Scotia - will be held Sunday, September 12, to Friday, September 17, 2010, location TBD.

Friday, July 30, 2010

Survey focuses on public perceptions of mental illness in the criminal justice system


An article posted on July 22nd by the CMHA - Ontario Division:

The Federal Government has released a preliminary report of its 2009 Annual National Justice Survey, which focuses on mental health issues. Introduced by the Department of Justice in 2007, the survey collects in-depth, timely and policy-relevant public opinion on current issues. The 2009 survey is a first of its kind, as public opinion research has never been carried out on the topic of mental health and the criminal justice system.

The survey results, which consist of 4,008 respondents from a telephone sample and 1,000 respondents from an online sample, provide an understanding of the Canadian public's perspective of justice and mental health issues. According to the survey, more than three-quarters of respondents agreed that it is important for the court to take the mental health needs of victims who testify into account, and that is it essential that people charged with a crime are able to understand what is going on and are able to communicate with their lawyers. As well, about three-quarters of respondents agreed that it is important for the court to consider the mental competency of people charged with a crime at the time the crime was committed.

More than one-third of respondents agreed that people should not be convicted of a crime if their mental competency prevented them from knowing what they were doing or that it was wrong, whereas more than one-third of respondents disagreed. While almost three-quarters of respondents agreed that there should be alternatives to the regular criminal court process for people charged with non-violent crimes who have mental health or developmental disorders, for violent crimes, only about half of respondents agreed that there should be alternatives to the regular court process.

More than three-quarters of respondents agreed that people who are found Unfit to Stand Trial (UST) or Not Criminally Responsible on Account of Mental Disorder (NCRMD) for both violent and non-violent crimes should remain under the supervision of the justice or mental health systems indefinitely, if necessary, for public safety reasons. However, approximately two-thirds of respondents agreed that people who are found UST or NCRMD for a non-violent crime and are detained in a hospital should be reintegrated back into society when detention in a hospital is no longer necessary for public safety reasons. This figure was significantly lower (approximately one-third) for those charged with violent crimes.

A full report of the survey will be released later this year.

See National Justice Survey 2009: Mental Health Disorders in the Criminal Justice System, Department of Justice Canada, 2010, available by clicking here.

Saturday, July 17, 2010

Largest effort to find gene-environment interactions underlying schizophrenia risk



An article posted on July 16th by news-medical.net:
At the 23rd ECNP Congress 2010 in Amsterdam, Professor Dr. Jim van Os, Chairman of the Department of Psychiatry and Neuropsychology at Maastricht University Medical Centre, The Netherlands, will present the EU-GEI project, involving more than 7,500 patients and their families, which brings together a multidisciplinary research team from 15 countries in the largest effort to date to find gene-environment interactions underlying schizophrenia risk. In particular, he will explain the development of tools that will make it possible to monitor, and possibly modify, vulnerability at the behavioural level, thus preventing transition to overt illness.

Schizophrenia and related psychotic disorders are the most mysterious and costliest of mental disorders in terms of human suffering and societal expenditure, representing a major challenge to scientists. Until recently, researchers had relatively few starting points in trying to unravel the causes of psychosis and to identify better treatments. While epidemiological research has characterised powerful environmental effects on schizophrenia risk, twin and family studies have established that more than half of the vulnerability for schizophrenia is of genetic origin. However, despite enormous investments, it has proven extremely difficult to identify molecular genetic variants underlying schizophrenia liability. According to the model of gene-environment interaction, genes influencing schizophrenia risk may do so indirectly by making individuals more sensitive to the effects of causal environmental risk factors (e.g. urbanisation, migration, cannabis use, childhood trauma). Now, for the first time, a focused scientific collaboration has been organised in Europe in order to elucidate the causes of schizophrenia, focussing on both genes and environments in the same research project.

Image credit

Thursday, July 15, 2010

Directory of Self-Help Groups in Nova Scotia 2010



An email received today from the Self-Help Connection:
We are happy to announce that the 2010 edition of the Self-Help Connection’s Directory of Self-Help Groups in Nova Scotia is now available for purchase. The directory contains a listing of self-help groups, support groups and supporting organizations throughout Nova Scotia. Topics range from Abuse & Violence, Cancer, Family & Parenting, Heart & Stroke, Mental Health to Youth Organizations.

This year we have given you the option of either purchasing a hard copy of the directory or a PDF file download (1.69 MB in size) with a "click and find" feature.

Whether you are someone looking for a particular group to meet your specific needs, a professional seeking an appropriate referral point for a client, or a researcher looking for self-help group contacts or information about a certain topic, we hope you will find this document to be an informative and user-friendly resource.

The directory can be purchased for $30 by any of the following methods:
  • Calling us at 466-2011 if you would like a directory mailed to you. Please note that there is a $5.00 postage and handling fee applied to mail out orders.
We would like to thank you for your continued support and look forward to hearing from you. Please do not hesitate to call me if you have any questions.

Self-Help Connection
Email: selfhelp@eastlink.ca
Tel: (902) 404-7800 Ext.#14
Fax: (902) 404-3205

Image credit

Thursday, July 8, 2010

Address the real barriers


A letter to the editor published in today's edition of The Globe and Mail:
Untreated mental illness is a major risk for suicide: The rate of suicide for people with schizophrenia is 50 times higher than the general population, and 15 to 30 times higher for people with bipolar disorder (Suicide Barriers Fail To Address Root Of Problem – July 7). Suicide is the leading cause of death for 15- to 24-year-olds.

In Canada, only three in 10 adults access mental health care; the situation is worse for children and youth. While stigma may be a factor, the biggest problem is the lack of accessible mental health services and a lack of focus on early intervention. It is ironic that the share of health spending on mental health continues to decline, even though we know recessions lead to increased demands for mental-health services.

Provincial governments have an opportunity to use the increase in federal health transfers between now and 2014 to reverse this trend and focus on early intervention.

Steve Lurie [pictured], executive director, CMHA Toronto Branch

Also see:

Effect of a barrier at Bloor Street Viaduct on suicide rates in Toronto: natural experiment

Suicide barrier on Bloor Viaduct worked, but jumpers went elsewhere: study


Photo credit

Wednesday, July 7, 2010

Some With Psychosis Decide Social Life Not Worth It


An article published in the July 2nd edition of Psychiatric News:
By Joan Arehart-Treichel

If people with schizophrenia function poorly in social settings, it may be because they have developed negative beliefs about social functioning, perhaps to protect themselves from rejection.

“Get a life!” people sometimes quip.

“Well, that's not easy to do if you've got schizophrenia,” an individual with this illness might respond.

But it might still be possible. The reason? Negative beliefs about a social life seem to be the major reason why individuals with schizophrenia don't have a social life, a new study has found. And if that is the case, then changing those beliefs might help them “get a life.”

The study was conducted by Paul Grant, Ph.D., a research assistant professor of psychology in psychiatry at the University of Pennsylvania, and Aaron Beck, M.D., [pictured] University Professor Emeritus of Psychiatry at the University of Pennsylvania. Beck is also considered “the father of cognitive therapy.” Results were published in the May 15 Psychiatry Research.

People with schizophrenia tend to isolate themselves from others, yet at the same time they say that they would like to have friends, get a job, and perhaps have a family. What is the explanation for this discrepancy? Could it be negative beliefs and expectations rather than the illness itself? Grant and Beck conducted a study to find out.

The study sample included 123 adults with an average age of 39 who had been diagnosed with schizophrenia or schizoaffective disorder. Various scales were used to evaluate subjects on social functioning, neurocognition, emotion perception, positive symptoms, negative symptoms, depression, anxiety, and negative beliefs about social functioning.

Negative beliefs about a social life were determined with 15 statements from the Revised Social Anhedonia Scale. Several of the statements, for example, were “People are usually better off if they stay aloof from emotional involvement with others,” “Making new friends isn't worth the effort it takes,” and “Having close friends is not as important as most people say.” For each statement, subjects answered yes or no. Subjects' responses were summed into a total score of 0-15, with higher scores indicating more negative beliefs about a social life.

The researchers then used correlational analysis to see whether there were any orderly, predictable relationships between subjects' social functioning scores and their scores on the other measures. None could be found between their social functioning scores and their neurocognition, emotion perception, positive symptoms, and anxiety scores. But such a link could be found between their social functioning scores and their negative symptoms, depression, and scores indicating negative beliefs about the value of a social life.

And most striking, high scores on negative beliefs about a social life were associated with poor social functioning scores.

The researchers then determined the relative contribution to social functioning of neurocognition, emotion perception, negative symptoms, depression, and negative beliefs about social function. They found that neurocognition and emotion perception contributed a negligible amount—a finding that surprised them—but they also found that negative symptoms and depression accounted for somewhat more, and that negative beliefs about a social life accounted for the largest contribution to social functioning.

Finally, they conducted a longitudinal analysis of 13 of the subjects to see whether negative beliefs about social functioning at baseline significantly predicted social withdrawal a year later, or whether social withdrawal at baseline predicted negative beliefs about social function a year later. The former was the case.

Putting all these results together, it looks as if negative beliefs about a social life may be a major reason why people with schizophrenia don't relish social interactions, the researchers concluded. “We propose that the patients' asocial beliefs trump their need for social acceptance,” they wrote.

And, if that is the case, would certain interventions help individuals with schizophrenia change such beliefs and thus improve their social lives? The researchers think that they might.

For example, “encouraging the patient to engage in social contact can expose the dysfunctional beliefs, which can then be the target for cognitive restructuring. Various behavioral techniques such as social-skills training and assertiveness training can facilitate social engagement and demonstrate to the patient the positive consequences of social engagement.... Modifying beliefs that maintain depression, which is also linked to poor social functioning, can further motivate the patient to socialize productively.”

The study was funded by the Foundation for Cognitive Therapy and Research, NARSAD, and the Heinz Foundation.

Also see:

Asocial beliefs as predictors of asocial behavior in schizophrenia


Photo credit

Friday, July 2, 2010

New blood-test to aid in schizophrenia diagnosis



A July 1st news release from the University of Cambridge:
A new blood-test resulting from research at Cambridge University could aid in the early diagnosis of recent-onset schizophrenia – complementing the traditional patient interview-based diagnosis.

VeriPsych, developed by Professor Sabine Bahn, Director of the Cambridge Centre for Neuropsychiatric Research, and collaborators at Psynova Neurotech and Rules-Based Medicine, is based upon a blood-based biomarker test - where characteristics are objectively measured and evaluated as an indicator of the presence of disease.

Professor Sabine Bahn, said: "Schizophrenia is a complicated and challenging disease, yet current diagnostic approaches continue to be based on patient interviews and a subjective assessment of clinical symptoms. We expect VeriPsych to be used as an aid to this current process, and we hope it will provide the psychiatrist with additional confidence in their evaluation, as well as speed up the process."

Schizophrenia is a disease that typically begins in early adulthood; between the ages of 15 and 25, affecting 51 million people worldwide with more than 250,000 cases in Britain. Current diagnosis of Schizophrenia is conducted through interviews by a psychiatrist, who follows structured guidelines such as The Diagnostic and Statistical Manual of Mental Disorders, a process that can take several months.

During VeriPsych's developmental stage, researchers analysed 200 biomarker candidates individually and in combination to assess their connection to schizophrenia. They discovered a set of 51 biomarkers with linkages to schizophrenia and to various biochemical pathways, including inflammation, metabolism and cell-to-cell signaling. In a subsequent study, the 51 biomarkers were validated in combination with a mathematical process to separate schizophrenia patients from normal controls. The study included analysis of more than 800 well-characterised blood samples collected by leading psychiatric hospitals.

The research was published in the online journal Biomarker Insights. Commercial rights resulting from this research are held by Psynova Neurotech Ltd., which was launched by Cambridge Enterprise in 2005 and is now majority-owned by Rules-Based Medicine, Inc. Professor Bahn is the Co-Founder, Director, and Chief Scientific Officer of Psynova.

Also see:

Validation of a Blood-Based Laboratory Test to Aid in the Confirmation of a Diagnosis of Schizophrenia (PDF)


Image credit

Thursday, July 1, 2010

National project aims to highlight human rights issues for persons with mental illness


A June 28th media release from the Canadian Mental Health Association - Winnipeg Region, Public Interest Law Centre of Legal Aid Manitoba, and the Mental Health Commission of Canada:
Mental Health Commission of Canada (MHCC) funds national project to examine issues of equality, dignity and inclusion for people with mental illness

The Canadian Mental Health Association – Winnipeg office (CMHA) in partnership with the Public Interest Law Centre of Legal Aid Manitoba have been engaged by the Mental Health Commission of Canada’s (MHCC) Mental Health and the Law Advisory Committee to conduct research related to mental health, human rights, and relevant law, policies, and service standards. One of the Committee’s mandates is to examine Canada’s legal framework as it relates to persons with mental illness, including legislation, regulations, and policies.

“This is a very exciting year to engage in this work, with Canada’s recent ratification of the UN Convention on the Rights of Persons with Disabilities we can see there is a real spotlight now on how we protect these rights throughout Canada.” Nicole Chammartin, Executive Director, CMHA Winnipeg adds, “CMHA has been a long standing advocate for human rights for people experiencing mental health issues, and we know Canadians value human rights as being a core part of the Canadian experience, but unfortunately that is not always the case for everyone.”

A key component to this project will be the work of a consultative group of persons who have experienced mental health issues that will guide the research and development of an evaluative framework for national and provincial mental health related laws and policies, as well as the development of a draft set of core service standards.

Six individuals representing the pre-determined pilot jurisdictions of Manitoba, Nova Scotia, British Columbia have been selected as members of the consultative group as well as one individual each from Quebec and the Northwest Territories. Lindsay Evangelista, a consultative group member from BC shares, "I knew something needed to be done when I first entered the assessment unit at one of the hospitals. The staff seemed totally disinterested in my care and I had one nurse tell me that I was faking all my symptoms and called me the equivalent of a female dog. Needless to say, it was the worst experience of my life.”

This 18-month project is now underway with an anticipated completion date of September 2011. For more information on this project please visit www.cmhawpg.mb.ca for a project description, information on the consultative group and updates on progress throughout this project. In addition, the project research team is aiming to consult with other stakeholders in each of the pilot jurisdictions and there is an opportunity to indicate your interest in being involved when you visit
the site.

-30-

Media inquiries may be directed to Nicole Chammartin, CMHA Winnipeg Region, at (204) 982-6103.

Class action settlement in drug for schizophrenia


An article published in the June 30th edition of The Toronto Star:
Some users of antipsychotic drug say they were not warned of risk of diabetes

By Theresa Boyle, Health Reporter

Canadian courts have approved a $17.6 million settlement in a class-action lawsuit launched by individuals who became diabetic after taking an antipsychotic drug.

The settlement with Eli Lilly, manufacturer of Zyprexa, was announced Wednesday. It stems from allegations that the drug giant failed to warn about risks of severe weight gain, diabetes, hyperglycemia and pancreatitis.

Zyprexa is used for treatment of schizophrenia and bipolar disorder.

Eli Lilly denies any wrongdoing and the allegations have not been proved in court.

“While we believe the allegations are without merit, Lilly is taking this difficult step because we believe it is in the best interest of the company as well as the Canadian health care professionals who depend on this important medication,” John Rudolph, legal counsel for Eli Lilly, said in a written statement.

The drug continues to be used, but changes have since been made to its label to include warnings of diabetes.

The class action was filed on behalf of 11 people from Ontario, British Columbia and Quebec and approved by the superior courts of those provinces.

“We acknowledge that Eli Lilly has done the right thing,” said Harvin Pitch, counsel for Stevensons LLP, which represented some of the plaintiffs. “We encourage all users of Zyprexa who qualify to apply for their benefits.”

To receive a settlement payment, an individual must have started taking the drug prior to June 6, 2007 and then been diagnosed with diabetes, hyperglycemia, ketoacidosis or pancreatitis. The size of each payment will depend upon severity of illness and the total number of approved claims.

The settlement was based on an estimate that there would be 1,450 claims, though it is possible that the actual number may be higher, Pitch said.

The total number of prescriptions filled in 2009 in Canadian retail pharmacies for Zyprexa and its generic equivalents was 2,493,081. It is the third most prescribed antipsychotic on the Canadian market.

Further information is available at classaction.ca, from lawyer Daniel McConville at Stevensons LLP: (866) 940-8329, or from lawyer Matthew Baer at Siskinds LLP: (800) 461-6166 x 7782.

Note:

The claims deadline is October 28th, 2010.

Also see:

Notice of Settlement Approval (long version) [PDF Document]

Claim form [PDF Document]

Press Release – June 30, 2010 [PDF Document]

Sunday, June 27, 2010

Standing Committee on Public Accounts - Mental Health Services - June 23rd



Standing Committee on Public Accounts

Wednesday, June 23, 2010

Witness/Agenda:

9:00 - 11:00 am

Department of Health

Mr. Kevin McNamara, Deputy Minister

Re: Mental Health Services


To view the video recording of this session, please click here.

Thursday, June 24, 2010

Sunday, June 20, 2010

Recidivism Drops in Those Supervised by Mental Health Courts


An article published in the June 18th edition of Psychiatric News:
By Aaron Levin

Research on the outcomes of mental health courts is steadily accumulating, and the results show promise, but some critical questions remain unanswered.

Criminal defendants who complete programs supervised by mental health courts are less likely to be rearrested in the following two years, according to a new study by North Carolina researchers appearing in the May Psychiatric Services.

About 72 percent of those who completed the program were not rearrested in that time, compared with just 19 percent of those who were expelled from the program and 37 percent of those who chose to leave, said Virginia Hiday, Ph.D., a distinguished professor of sociology and anthropology, and doctoral student Bradley Ray, M.A., both at North Carolina State University.




To read the entire article, please click here.

Also see:

Nova Scotia's Mental Health Court Program

Officer in the Order of Canada


A posting made on June 19th by daylife.com:



Chair of the Mental Health Commission of Canada Michael Kirby is awarded the rank of Officer in the Order of Canada by Canada's Governor General Michaelle Jean at Rideau Hall in Ottawa, June 18, 2010.


Photo credit

Friday, June 18, 2010

John Devlin's Dreams of Cambridge




An article posted today by the BBC:
In the middle of an island in Nova Scotia, Canada, John Devlin has created an idyllic version of Cambridge and Oxford Universities.

But, Canadian-born John [pictured] has not actually built this dream structure. It began as the idea of a damaged mind coping with psychotic episodes.

Therapy came in the form of sketches of the colleges, as a reminder of John's days as a student in Cambridge.

These Dreams of Cambridge are on show until 25 June, 2010 at King's College.

To read the entire article, please click here.

Also see:

John Devlin: Alchemy and Architecture

Tuesday, June 15, 2010

News from the Lunenburg County Chapter of the SSNS (LCC-SSNS)



Nelson Miguel (left, CMHA Lunenburg/Queens Branch) and Richard Balser (LCC-SSNS) volunteered to host a community booth at the Bridgewater Mall to increase awareness and provide information about mental illness and the possibilities for recovery.

As part of fulfilling its mission, the Lunenburg County Chapter of the SSNS will be hosting a booth at the Bridgewater Mall on a bimonthly basis until December 2010.


A big THANK YOU to all of the businesses who sponsored the LCC-SSNS' Walk The World 2010:


Please click on the image to magnify it.

Thursday, June 10, 2010

Hospitals told to meet mental health standards


An article posted today by CBC.ca:

Health minister sends letters after AG's report

Nova Scotia's Minister of Health has sent hospitals across the province a reminder about their obligations when it comes to mental health services.

Maureen MacDonald [pictured] has ordered top hospital administrators to comply with seven orders, in a one-page letter sent to all nine of the province's district health authorities.

MacDonald said the directive is a response to criticism levelled against her department in a recent report by the province's auditor general.

"I was surprised when I saw the auditor's report," she said Thursday. "There is no point in having standards if you don't implement and monitor the standards."

Last week, Auditor General Jacques Lapointe released a report that looked at whether Nova Scotians were able to access timely mental health care, no matter where they live in the province.

He said Nova Scotia was failing to meet its standards when treating mental illness, and said there is no plan to fix the situation.

Lapointe also said there was inadequate oversight of the system and no effective monitoring of the standards.

The auditor general's office found that of 538 Nova Scotians who received mental health care in Colchester-Hants counties, the Annapolis Valley and the Capital District Health Authority in Halifax, only 14 per cent of the patients got care that met mental health standards.

MacDonald said the letter — sent by Deputy Minister Kevin McNamara on her behalf — was sent to the CEOs of the health authorities on the same day Lapointe's report was released.


DHAs


"District health authorities are not spending their own money and they're not spending my money, they're spending the public money and they need to be accountable for that," she said.

"I'm accountable for the health care system on the floor of the house of assembly but the district health authorities are accountable to me for how they deliver health care services."

MacDonald said as part of her seven directives, she reminded hospitals they cannot refuse to admit patients simply because they do not live in the district.

"There are no geographic barriers to getting health-care services within the province of Nova Scotia," she said.

The Health Minister said she has not yet heard from any of the health authorities in the week since she issued the directives.

Health authority responds

Peter Croxall, the director of the mental health program in the Capital District Health Authority, said one of the problems is that the standards are vague and hard to measure.

"Full of, really, of too much mental health jargon and not really written in a clear, explicit fashion," he said.

Croxall said statistics show one in five Nova Scotians will develop a mental illness.

That large number makes the issue difficult to address, he said.

"The fact that we only have … four per cent of the health budget, I think you can draw your own conclusions from that," said Croxall.

"I'm not saying that we're doing terribly badly but we certainly could use more resources or a redistribution of resources within health into the mental health area."

Croxall said in his experience, there was nothing to indicate Nova Scotians were getting substandard care, despite the auditor general's findings.

Fatality Inquiry Into the Death of Howard Hyde -- Live Web-Cast and Video Archive


Concluded on June 10th, 2010


Judge Derrick expects to complete her report later this year (2010).

The Schizophrenia Society of Nova Scotia (SSNS) had standing at this inquiry and was represented by a total of five lawyers, all of whom were working on a pro bono basis. The SSNS thanks Blair Mitchell (lead counsel), Angela Byrne, Michele Cleary, Marion Ferguson, and Sharmi Jaggi.


Howard Hyde

Adapted from the Nova Scotia Department of Justice's Howard Hyde website:

Pursuant to the Fatality Investigations Act, S.N.S. 2001 C. 31

Presiding Judge:
The Honourable Judge Anne Derrick of the Nova Scotia Provincial Court

Inquiry Counsel:
Dan MacRury Q.C., Chief Crown Attorney for the Cape Breton Region


To view archived recordings the closing submissions, please click below:

HYDE INQUIRY ARCHIVE


Also see:

Hyde remembered fondly at close of inquiry

The Howard Hyde inquiry wraps up today (audio, mp3)

Restraint technique led to Hyde's death: lawyer

N.S. inquiry counsel recommends foregoing Tasers to restrain mentally ill

No Tasers on mentally ill: lawyer

Inquiry to wrap up in Nova Scotia jail death

Howard Hyde Inquiry

Monday, June 7, 2010

MENTAL HEALTH AUDIT



An editorial published in today's edition of The Chronicle Herald:
Slippery standards

NOVA Scotia has long pointed out that it’s the only province in Canada with mental health standards.

And yes, adopting those standards in 2003 was certainly a laudable step towards improving mental health services in this province.

Having standards on paper, however, is one thing. Ensuring they’re being complied with, or, more basically, seeking sufficient funding to do so, is another.

The problem, as Auditor General Jacques Lapointe’s 2010 review of mental health services makes painfully clear, is that the Department of Health seems to have done neither.

Mr. Lapointe was unable to assess whether the department had even asked for the money to meet the standards — an estimated $23.5 million — as the department, following instructions from cabinet officials, denied him access to budgetary requests and possible departmental plans to improve accountability.

This is the same problem that led Mr. Lapointe to criticize the government’s "pervasive policy of secrecy" that prevented him from even auditing Nova Scotia Business Inc. and the Industrial Expansion Fund (IEF).

What the auditor general did uncover, looking at mental health standards and services, showed there’s lots of room for improvement.

The four health authorities audited in depth — Capital Health, Colchester East Hants, Annapolis Valley and IWK Health Centre — met all the standards selected for review in just 14 per cent of 388 files.

Meanwhile, some standards were so poorly written that staff at the DHAs were asking the auditor general’s staff for help in interpreting compliance.

Mr. Lapointe also found no way to compare waiting times for mental health outpatients, the only category tracked, across the province. That meant the department was also unable to do so, he added. Not surprisingly, Mr. Lapointe concluded that mental health patient care could be suffering as a result of these problems.

The Department of Health says a new mental health strategy, along with a plan to address meeting the standards, is to begin this fall.

The auditor general has certainly laid out, in convincing detail, just how this needs to be done.

Chronic underfunding


A letter to the editor published in today's edition of The Chronicle Herald:
John McPhee’s worrying page-one article on June 2 refers to the fact that in Nova Scotia only 3.5 per cent of the health budget goes to mental health services. This contrasts sadly with 10 per cent allocated to mental health services in the U.K.

Is it any wonder, therefore, that our mental health services — for adults and the elderly as well as for children and adolescents — are in serious difficulties?

William O. McCormick, psychiatrist, Mental Health Services Bedford/Sackville

Friday, June 4, 2010

Official defends mental health service


An article published in today's edition of The Chronicle Herald:
Provincial official says officials know system needs more resources

By John McPhee, Health Reporter

Mental health providers are doing the best they can with limited resources for Nova Scotians, the acting head of mental health services for the province said Thursday.

Faizal Nanji was responding to the auditor general’s report released Wednesday. It highlighted failures to meet standards of mental health care.

Jacques Lapointe [pictured] also criticized the standards for being vague and the fact that a clear monitoring system doesn’t exist.

"We knew these standards were something we’d need to aspire to, and really, that a significant amount of resources — financial, human capital — would be required to help bridge the gap," Nanji said in an interview.

But those resources don’t yet exist, he said.

"That’s our constant battle, to continue to advocate from here for increased funding, to make the case," Nanji said. "We’re at a key juncture."

Nova Scotia is the only province to have mental health standards, which were established in 2003.

Lapointe’s office studied 358 cases in three different health authorities and the IWK Health Centre in Halifax in an attempt to gauge how well those standards are being met. Only 14 per cent of those cases met all of the standards the auditor general selected for testing.

For example, when a doctor refers a patient to mental health care, that referral should be reviewed within one working day. The auditor general’s office looked at 125 cases in the Capital, Annapolis Valley and Colchester East Hants health districts, and at the IWK. Of those referrals, 41 were reviewed in one day.

As well, a patient accepted into the system should be assessed within 10 working days. Out of 54 cases examined in the three districts and at the IWK, only six people were assessed within that time, the auditor general said.

The Capital district health authority, the IWK and the other health districts targeted in the report have accepted the auditor general’s recommendations.

Lapointe was working with information from a year ago, a Capital health district official said Thursday.

Progress has already been made in some areas that were singled out, said Barbara Hall, vice-president of person-centred services.

The district does keep tabs of wait times and how quickly cases are reviewed, Hall said.

"Some of those systems are not the best. There a lot of manual processes, and we have been working on improving that."

The province’s mental health services department will work with each of the province’s nine health authorities to improve care, Nanji said.

On top of the auditor general’s report, an IWK official told MLAs this week that up to 1,000 families are on a year-long waiting list for mental health services.

"We’re doing the best we can to provide a service that’s good, safe and accessible," Nanji said. "But again, we do need more resources in various forms."

Photo credit

Wednesday, June 2, 2010

Auditor General's Report - Mental Health Services in Nova Scotia



An excerpt for the Auditor General’s Statement to the Media today:

A second audit covered in this report was hampered to a lesser extent by the same restrictions on information. The Department of Health, under instruction from the Executive Council Office, refused to provide us information on budget requests related to mental health services.

Treatment of mental illness is a significant part of the health care system. Mental illness accounts for over 15 per cent of the disease burden in developed countries, and for 3.4 per cent of the Nova Scotia health budget.

In 2003, Nova Scotia became the first province to implement mental health service standards. The Department was aware at the time that funding levels were inadequate to achieve these standards.

When the standards were introduced, the Department acknowledged it would take five to ten years to fully achieve compliance with them. Seven years later, our audit found that the mental health service standards were met in only 14 per cent of the cases we tested; and there is no evidence of a plan or funding to close the gap.

The Department of Health has failed to meet its legislated requirement to monitor and evaluate the quality of mental health services. The lack of departmental oversight and monitoring significantly increases the risk that the mental health care system will fail the people who need it most.

The Department of Health has accepted our report and agrees with all 19 recommendations. However, the government has a poor record of implementing our recommendations. I would draw your attention to the next chapter of this report - a follow-up on the 82 recommendations we made in June 2007. To date, the government has implemented just 27 per cent of those recommendations. This is the worst performance since we began tracking government response to our recommendations in 2002.

The Department of Health was the subject of 48 of those recommendations, and accepted all but one. Two years later, 34 recommendations - 71 per cent - were still not implemented.

This is a concern given the nature of the 2007 recommendations, dealing with issues like financial and quality controls in nursing homes and equitable placement of seniors in need of care.

To access the entire Auditor General’s Report, please click here (PDF).


Also see:

Lax oversight of mental health standards, N.S. auditor says

Children waiting for mental health services


An article posted today on CBC.ca:
Children and families are waiting up to a year for a routine referral for mental health services at the IWK Health Centre, a group of Nova Scotia MLAs were told Tuesday.

Senior mental health officials told the community services committee that the health system is struggling to keep up with an ever-growing demand for services.

"We have between 700 and 1,000 children and families waiting. It's a moving target so it changes daily," said Susan Mercer, senior director of mental health and addiction services at the IWK, the children's hospital for the Maritimes.

Mercer said it should take no more than three months to get a regular appointment, but people are now waiting anywhere from six months to a year.

Linda Courey, director of mental health and addictions for the Cape Breton District Health Authority, said early diagnosis and treatment can be key.

"If you can identify these symptoms before the first psychotic episode the major decrease in functioning that these kids will experience over the course of their lives and the subsequent demand on the health-care system, you can prevent that. You can have a massive impact," she said.

But in Cape Breton, as in Halifax, only the sickest get help quickly, Courey added.

More money not the answer

New Democrat MLA Maurice Smith [pictured] found the news alarming.

"I just find it overwhelming," he said. "I'm amazed. It seems to me almost like a crisis kind of situation."

Mercer said there are too few resources to meet the demand. Even with more money, she said, there aren't enough mental-health workers to do the work.

"Everybody is struggling to provide adequate mental-health services across the country," Patricia Murray, director of children's services at the Department of Health, told the MLAs.

The government wants to revamp mental-health services across the province. It plans to name the members of a committee tasked to come up with a strategy in the next few weeks.

Also see:

Staff, money woes plague kids’ mental health care

About IWK mental health and addiction services