Unveiling of the architectural drawings for the new Community Living Initiative

Photographs taken during today's barbeque to unveil the architectural drawings for the new Community Living Initiative.

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Danny Chedrawe (left), Vice-Chair, Board of Trustees, Mental Health Foundation of Nova Scotia, with Mary-Lou Crawley, Executive Director, Mental Health Foundation of Nova Scotia, and Dr. Nick Delva, Head, Department of Psychiatry, Dalhousie University, and Chief of Psychiatry, Capital District Health Authority.


Vince Daigle (far left), a peer support worker with the Healthy Minds Cooperative, stands with staff from William Nycum & Associates Limited and Shauna Blundon-Price (centre), an employee of the Capital District Mental Health Program.


Dr. Ian Slayter, Clinical Director, General Psychiatric Services, Capital Health District Health Authority.


Barbara Hall, Vice-President, Person-Centred Health, Capital District Health Authority, talks with a reporter.




Susan Hare, an employee of the Capital District Mental Health Program, enjoying the beautiful weather.


Peter Croxall (left), director of the Capital District Mental Health Program, cooking hamburgers.


Denyse Sibley, on-air host of the FX101.9 Country Breakfast cooks alongside Robert G. Zed, Chair, Zed Group.


Laura Ankcorn (left) and Amanda Crabtree, two employees of the Captial District Mental Health Program, enjoying the barbeque.

An SSNS office window is located in the upper right of the above photograph (i.e., the window partially hidden by Denyse Sibley).

Also see:

Initiative aims to ease patients’ transition time

Capital Health staff invest in Community Living Initiative


All photographs by Stephen Ayer.

Canada Post Foundation for Mental Health, 2010 Grant Recipients, National Launch

Held on September 21st at the Canada Post Halifax Mail Processing Plant:


Dominique Forest, General Manager, Regional Atlantic Operations, Canada Post.


Dominique Forest (left) and Wayne Stremel, Canada Post employee, unveil the 2010 Mental Health Stamp.


Wayne Stremel speaks about the 2010 Out of the Shadows Tour.




Tana Woodward, Member, Grants Advisory Committee, Canada Post Foundation for Mental Health.




Tana Woodward is also a social worker with the Mood Disorders Program in Halifax. Directly over Ms. Woodward's right shoulder is Donna Methot, President, HRM Chapter of the Schizophrenia Society of Nova Scotia.


Myra Donnelly-Gay, Executive Director, Healthy Minds Cooperative.


Stephen Ayer, Executive Director, Schizophrenia Society of Nova Scotia.


Funding provided to the Schizophrenia Society of Nova Scotia will be used for a project entitled Expansion of Community-Based Volunteer Support Network and Strengthening of Mental Health System Advice/Connection Services. This project will include eight rural communities in Nova Scotia, incuding Cape Breton.


Please click on any photograph to enlarge it.


Also see:

Canada Post delivers $1.5 million to mental health organizations across Canada

Mental health care receives boost from Canada Post, Bell Canada

Schizophrenia: Personal confrontations and a philosophical investigation

Audio from the September 18th broadcast of AllInTheMind (ABC National Radio, Australia):

Listen Now | Download Audio

Philosopher, poet and writer Dr. Paul Fearne [pictured] had his first psychotic episode as a young university student, and continues to take medication. 'To live is to take a leap into a sea of daggers, each one stabbing the fabric of your being,' he wrote in his diary at the time, now published. From Freud to Wittgenstein, his experience inspired a unique PhD investigation into the philosophical questions posed by schizophrenia.

Show Transcript

Also see:

The sea of daggers - A philosophical & personal interrogation of psychosis

The Continuum of Psychotic Symptoms in the General Population: A Cross-National Study

The abstract of an article published online on September 13th by Schizophrenia Bulletin:

By Roberto Nuevo (1,2), Somnath Chatterji* (3), Emese Verdes (3), Nirmala Naidoo (3), Celso Arango1 (4), and José Luis Ayuso-Mateos (1,2)

Author Affiliations

1. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
2. Department of Psychiatry, Universidad Autonoma de Madrid, Hospital Universitario de la Princesa, Madrid, Spain
3. Department of Health Statistics and Informatics, World Health Organization, Avebue Appia 20, Geneva 27, CH 1211, Switzerland
4. Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
   

* To whom correspondence should be addressed; tel: +41-227913609/3202, fax: +41-227914328, e-mail: chatterjis@who.int.

Abstract

Objective:

To identify the cross-national prevalence of psychotic symptoms in the general population and to analyze their impact on health status.

Method:

The sample was composed of 256,445 subjects (55.9% women), from nationally representative samples of 52 countries worldwide participating in the World Health Organization's World Health Survey. Standardized and weighted prevalence of psychotic symptoms were calculated in addition to the impact on health status as assessed by functioning in multiple domains.

Results:

Overall prevalences for specific symptoms ranged from 4.80% (SE = 0.14) for delusions of control to 8.37% (SE = 0.20) for delusions of reference and persecution. Prevalence figures varied greatly across countries. All symptoms of psychosis produced a significant decline in health status after controlling for potential confounders. There was a clear change in health impact between subjects not reporting any symptom and those reporting at least one symptom (effect size of 0.55).

Conclusions:

The prevalence of the presence of at least one psychotic symptom has a wide range worldwide varying as much as from 0.8% to 31.4%. Psychotic symptoms signal a problem of potential public health concern, independent of the presence of a full diagnosis of psychosis, as they are common and are related to a significant decrement in health status. The presence of at least one psychotic symptom is related to a significant poorer health status, with a regular linear decrement in health depending on the number of symptoms.

Keywords: World Health Survey, extended phenotype, schizophrenia

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

"A Disease Like Any Other"? A Decade of Change in Public Reactions to Schizophrenia, Depression, and Alcohol Dependence

The abstract of an article published in the September 15th edition of The American Journal of Psychiatry:

By Bernice A. Pescosolido [pictured], Ph.D., Jack K. Martin, Ph.D., J. Scott Long, Ph.D., Tait R. Medina, M.A., Jo C. Phelan, Ph.D., and Bruce G. Link, Ph.D.

From the Schuessler Institute for Social Research and the Department of Sociology, Indiana University; and the Mailman School of Public Health, Columbia University, New York.

Objective:

Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice.

Method:

The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma.

Results:

In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection.

Conclusions:

More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion.

Posting of this abstract is for the purposes of research into social predudice and stigma.

Also see:

Study: Mental illness stigma entrenched in American culture; new strategies needed

Americans still not tolerant of the mentally ill

Mental Illness Stigma Entrenched in American Culture; New Strategies Needed, Study Finds


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The Voices of Schizophrenia

An article posted yesterday by The New York Times:

By Tara Parker-Pope

Few mental illnesses are as complex and confusing as schizophrenia, a mental disorder in which people may experience hallucinations or delusions, hear voices or have confused thinking and behavior.

Although the word “schizophrenia” means “split mind,” the disorder does not cause a split personality, as is commonly believed.

The latest Patient Voices segment by Karen Barrow, a Web producer, offers rare insights into schizophrenia and schizoaffective disorder, a related condition that combines thinking and mood problems, as seven men and women share their experiences.

“It disrupted my education, my relationships, it disrupted friendships,” explains Alita Van Hee, 32, of Santa Cruz, Calif. “I was so bombarded by voices. They would tell me things like ‘Don’t trust these people,’ ‘Don’t talk to your friends,’ ‘They’re not real friends,’ things like that. It’s kind of like having a TV or radio on blasting inside your head just all the time that you can’t turn off no matter what you do.”

You’ll also meet Michael Runningwolf, 40, of Tempe, Ariz., who wants to change people’s perceptions and fears about schizophrenia.

“I wish I could get a T-shirt that says, ‘We’re more afraid of you than you are of us,’ ” he says. “There are people with schizophrenia every day that are doing things to break down the stigma. They hold down jobs, and they’re out there every day giving it everything they’ve got. Even though schizophrenia is a disabling illness, it’s not the end. There is recovery.”

Susan Weinreich, 54, of Mount Kisco, N.Y., says that although her illness has made life difficult, it also has become part of her art. “I believe my art was a vehicle for me to be able to express some things that were very deep, deep down inside and that were trapped and difficult to get out and communicate,” she says.

Another artist, John Cadigan, 40, who is Ms. Van Hee’s partner, says the challenges of his illness have also played a role in his art. “The difficulty is I’m not always cognizant of what reality is,” he says. “I can’t trust my own brain…. When you have a brain disorder it unlocks parts of the brain I think normal people don’t have any knowledge of. I think I translate that into my woodcuts.”

To hear these and other stories of schizophrenia, click on the Patient Voices audio link. And then please join the discussion below.

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Third Mental Health Stamp Raises Funds for Community Mental Health Organizations

A September 13th media release from Canada Post:

Nearly $600,000 in funding provided to non-profit, community based programming

OTTAWA, ONTARIO - Canada Post has issued its third annual fundraising stamp {pictured] in support of mental health. Canada Post's two previous Mental Health fundraising stamps have generated nearly $600,000 in funding for non-profit, community based programming that supports individuals and families coping with mental illness. The 2010 stamp features a mental health patient on the path towards recovery. A tree—the universal symbol of growth, healing and renewal—stands at the summit of a mountain.

As with the previous mental health stamps, a dollar from every booklet sold supports the Canada Post Foundation for Mental Health. Over the last two years the Foundation has distributed $2.5 million in grants to community groups in every region of Canada that provide front-line help to people living with mental illness.

"Mental illness can be far-reaching, but there is hope of recovery," says Jim Phillips, Canada Post's director of stamp services. "We're incredibly proud of what this stamp is accomplishing. The goal of this year's campaign is to raise $2 million and we're sure this new stamp will contribute a good portion to the cause."

Canada Post made mental health its cause of choice in 2007. Since then, customers, employees, suppliers and the public have raised more than $2.5 million for the Foundation. Nearly $600,000 of that was from sales of the 2008 and 2009 mental health stamps.

Lowe-Martin is printing 4 million of the 2010 stamps, which will be sold in booklets of 10 stamps. Measuring 24.75 mm x 35.25 mm (vertical), the stamps will be printed using seven-colour lithography on Tullis Russell paper and tagged on all sides. The Official First Day Cover will bear an Ottawa, Ontario cancel to note the location of the Foundation's headquarters.


For more information, please contact:

Canada Post
Media Relations
613-734-8888
medias@canadapost.ca

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Also visit:

Mental Health - Booklet of 10

The SSNS's 2010 Annual General Meeting

Photographs taken during the SSNS's 2010 Annual General Meeting held on September 11th at Acadia University in Wolfville, Nova Scotia.
























Please click on any photograph to magnify it.

All photographs by Stephen Ayer.

Early warning signs of schizophrenia

An article published today by the Boston Globe:

By Emily Anthes

These symptoms, alone or in combination, do not necessarily mean that a child has psychosis or psychosis risk syndrome. But they may indicate a need for evaluation.

• Mild hallucinations or delusions, often accompanied by the awareness that the experience is not real. Teens may feel as though they are being followed, for instance, even though they know that’s probably not true.

• Strange bodily sensations, such as the feeling that one’s brain is bouncing back and forth inside the skull.

• Difficulty focusing mentally, especially if this is a new problem. A sudden diagnosis of attention deficit disorder in an older teen or young adult can be a red flag.

• Other cognitive difficulties, such as trouble remembering. People with psychosis risk syndrome often complain that their minds aren’t “working right.’’

• Social withdrawal and isolation.

• Trouble sleeping.

• Blunted facial expressions or a blank gaze.

• Any other sudden changes in interest, activity, or functioning.

Screening children for mental illness

In 2008, Massachusetts began requiring doctors to offer mental health screening to all children on MassHealth, the state’s Medicaid program, during checkups. The number of children screened has been steadily increasing, reaching more than 60 percent of those who had checkups in the first quarter of this year. Of those screened, 8 percent to 10 percent might need further attention, says Emily Sherwood, director of the state Children’s Behavioral Health Initiative.



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Also see:

Getting ahead of trouble


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A special issue of Current Directions in Psychological Science devoted entirely to schizophrenia

Due to the widespread attention it is getting, the August 2010 issue of Current Directions in Psychological Science, devoted entirely to schizophrenia, has been made freely accessible online. The articles (all available by clicking here) are:

• Editors’ Introduction: Special Issue on Schizophrenia

• Neurodevelopment and Schizophrenia: Broadening the Focus by Elaine Walker, Dan Shapiro, Michelle Esterberg, and Hanan Trotman

• Prenatal Factors in Schizophrenia by Suzanne King, Annie St-Hilaire, and David Heidkamp

• Current Research on the Genetic Contributors to Schizophrenia by Michael F. Pogue-Geile, and Jessica L.Yokley

• Schizophrenia Course, Long-Term Outcome, Recovery, and Prognosis by Thomas H. Jobe and Martin Harrow

• Structural and Functional Brain Abnormalities in Schizophrenia by Katherine H. Karlsgodt, Daqiang Sun, and Tyrone D. Cannon

• Ventral Hippocampus, Interneurons, and Schizophrenia: A New Understanding of the Pathophysiology of Schizophrenia and Its Implications for Treatment and Prevention by Anthony A. Grace

• Social Factors in Schizophrenia by Jill M. Hooley

• Social Cognition in Schizophrenia by Michael F. Green and William P. Horan

• Cognitive Functioning and Disability in Schizophrenia by Philip D. Harvey

• Emotion in Schizophrenia: Where Feeling Meets Thinking by Ann M. Kring and Janelle M. Caponigro

• Psychosocial Treatments for Schizophrenia by Jean Addington, Danijela Piskulic, and Catherine Marshall

• New Opportunities in the Treatment of Cognitive Impairments Associated with Schizophrenia by Mark A. Geyer

Also view:

The Cost of Mental Health and Substance Abuse Services in Canada

From the Institute of Health Economics, Edmonton, Alberta:



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

Committee Recommends the Creation of Mental Health and Addictions Ontario

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An August 26th media release from the Select Committee on Mental Health and Addictions of the Legislative Assembly of Ontario:

The Select Committee on Mental Health and Addictions of the Legislative Assembly of Ontario today released its final report, "Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians". This follows the release of an interim report (March 2010) that provided an overview of the hearings and activities of the Committee to that date.

Key Recommendations

The final report includes 23 recommendations. The main recommendation is the creation of an umbrella agency, Mental Health and Addictions Ontario, to design, manage, and coordinate the mental health and addictions system, and to ensure the consistent delivery of programs and services across Ontario.

The Committee's other recommendations include:

• The consolidation of all mental health and addictions programs and services in the Ministry of Health and Long-Term Care
  

• The availability of a core basket of services in all regions of Ontario
  

• Access to system "navigators" who can connect people with the appropriate treatment and community support services
  

• The provision of additional affordable and safe housing units

• Increased respite care to provide more support for families and caregivers
  

• The creation of a task force to examine Ontario's mental health legislation
  

Each member of the Committee, regardless of their political convictions, recognized that all Ontarians must get the mental health and addictions care they deserve.

Members' Statements

"We have been privileged to work collaboratively with our fellow Members of Provincial Parliament, mental health and addictions experts and, most importantly, individuals and their families, to develop this comprehensive plan for mental health and addictions services in Ontario," said Christine Elliott (PC) and Sylvia Jones (PC). "It is our sincere hope that these recommendations will result in wellness, dignity, and opportunity for all Ontarians."

"As a Committee we were challenged by the people whose lives have been so completely altered by mental illness and addiction to be creative and innovative," said Maria Van Bommel (LIB) on behalf of the Liberal Members of the Committee. "Their stories forged the determination of Committee members from all political parties to develop a plan that will better the lives of so many deserving Ontarians. We are hopeful and proud to recommend the creation of a provincial agency that will change our approach to mental wellness and addictions recovery."

"I agreed to join the Select Committee because I knew we needed to do better," said France Gélinas (NDP). "Listening to all the testimony was very difficult. Our existing system has failed so many people, often with catastrophic consequences. Our recommendations will make Ontario an example of excellence for people facing mental health and addictions issues. I look forward to the implementation of the report."

The release of the final report marks the conclusion of the Committee's work. The report now moves forward to await debate by Members in the Legislative Assembly, and implementation of the recommendations by the Government of Ontario.

Background on the Select Committee

The Select Committee was struck on February 24, 2009 with a mandate to consider and report "its observations and recommendations concerning a comprehensive provincial mental health and addictions strategy". Over the intervening 18 months, the Committee heard over 230 presenters from all regions of Ontario and received more than 300 written submissions. The Committee also conducted site visits to mental health and addictions facilities as well as First Nations communities.

Each of the province's three political parties was represented on the Committee. The members of the Committee were: Kevin Flynn, Chair (LIB), Christine Elliott, Vice-Chair (PC), Bas Balkissoon (LIB), France Gélinas (NDP), Helena Jaczek (LIB), Sylvia Jones (PC), Jeff Leal (LIB), Liz Sandals (LIB), and Maria Van Bommel (LIB).

Copies of the report are posted on the web site of the Legislative Assembly of Ontario at www.ontla.on.ca under "Committees" - "Committee Reports".

For further information:

Office of Kevin Daniel Flynn, MPP, Chair of the Committee, Tel. (416) 325-1856, kflynn.mpp@liberal.ola.org; Susan Sourial, Clerk of the Committee, Tel. (416) 325-7352, susan_sourial@ontla.ola.org

Also see:

The right to refuse wellness

Three Provincial Umbrella Organizations Applaud Newly Released Select Committee Report on Mental Health and Addictions

Coyle: Mental health ‘crisis has arrived’ say MPPs

Next step is funding for mental health

Overhaul mental health relief and services, says Sandals

Report urges changes to mental health care in Ont.

Province, psychiatrists sign two-year contract

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

Specialists to get $147.99 an hour

By DAVID JACKSON, Provincial Reporter

Halifax-area psychiatrists have reached a new funding deal with the Health Department, one the government hopes will help keep the specialists in Nova Scotia.

The province just signed off on the two-year deal, called an academic funding plan, this month. It will help ensure that doctors are actually getting paid for the hours they work, said Victoria Goldring, director of physician services for the Health Department.

Psychiatrists had complained that they were working a combined 20,000 hours more a year than what the previous contract would pay them for, she said.

Goldring said the new contract focuses on hours of service, for both clinical work and teaching. It says the department will cover 156,000 hours a year, with 80 per cent for clinical work and 20 per cent for teaching, research and administration.

That number of hours is the equivalent of 75 doctors working 40 hours a week for the 52 weeks in a year.

The hourly rate increases to $147.99, a 2.9 per cent increase from $143.78. The ballpark salary for a psychiatrist, depending on whether they’re a full professor and other factors, is about $300,000 [per year], Goldring said.

The deal adds about $3 million to the $20-million budget under the previous interim agreement.

Goldring said the new agreement would cover up to 75 psychiatrists, but they are currently several doctors short of a full complement. They work at the Queen Elizabeth II Health Sciences Centre and the IWK Health Centre and teach at Dalhousie University.

She said recruiting and retaining psychiatrists, who are in demand across the country, was top of mind during contract negotiations. She said the province aimed for the new deal to put psychiatrists’ pay here in the middle of the pack nationally.

"They are now at a more competitive rate compared to their counterparts across the country," Goldring said.

"There are shortages of psychiatrists all across the country, but this will help in providing a bit of stability to their numbers here."

A spokesperson for the psychiatrists could not be reached Friday.

Last November, they had threatened to withhold services from the new mental health court after they said the province missed an Oct. 31 deadline for a new deal.

It wasn’t clear Friday whether they had followed through.

The psychiatrists’ last contract expired in 2007, but there was an interim agreement to 2009. This new deal is effective from April 1, 2009 to March 31, 2011.

(djackson@herald.ca)

Vancouver Coastal Review Sidesteps the Main Issue

An August 24th media release from the North Shore Schizophrenia Society:

Vancouver Coastal, in a review of the death by suicide of Marek Kwapiszewski, has ducked the leading question they needed to answer: Why is “dangerousness” still considered a requirement for involuntary admission rather than “to prevent the person’s... substantial mental or physical deterioration,” as spelled out in the Mental Health Act?

What was promised by CEO David Ostrow [pictured] to have been an “independent” review, moreover, turned out to be not so independent after all, with senior managers under question in the review taking part in drawing up its recommendations.

Kwapiszewski, 54, of Vancouver, who suffered from schizophrenia, jumped off the Granville Street Bridge to his death June 29, 2008. His sister, Halina Haboosheh, together with her lawyer, had made 16 different attempts to get him the treatment he needed – treatment which required involuntary admission since Kwapiszewski, like many suffering from schizophrenia, did not have insight into his own condition.

Instead of dealing with the factors leading to Kwapiszewski’s death, the review came up with three brief items in a so-called action plan, which involved no changes or improvements in practice, nor was any fault determined although it was an obvious case of clinical failure.

“The ‘action plan’ should have been called an ‘inaction plan,’” NSSS president Herschel Hardin commented. “It was as if a review had not taken place.”

The so-called action plan was presented to Haboosheh and the North Shore Schizophrenia Society, which made the original submission in the case, at a meeting July 26, in Vancouver Coastal’s boardroom.

The first item, to facilitate a discussion to consider development of an operating definition of “deterioration,” makes no commitment to ultimately do anything, and is highly questionable to begin with in any case. Nor does it apply to the Kwapiszewski case, where the deterioration was quite clear and substantial.

The second and third of the three items were bureaucratic filler, not representing anything new and showing no grasp of what the problem was.

The review also completely missed two other crucial factors in the case: the failure of Vancouver Coastal staff to involve the sister, Halina Haboosheh, as an integral member of the treatment team, following best practices, and the concomitant failure to share clinical information with her. If that had been done, Marek Kwapiszewski might well be alive today.

It was also learned that the items were not the independent work of the external lawyer and psychiatric consultant hired to undertake the review, but were a consensus arrived at with senior community mental health managers and, possibly, Vancouver Coastal’s risk management officer. In effect, they had a veto over what would be presented.

As well as forfeiting the review’s independence, this meant that a major shake-up of senior mental health management, called for in NSSS’s 2009 submission, could not even be addressed. Instead, the primary subjects of the review, as NSSS considered them, were parties to the review’s outcome.

In response to Vancouver Coastal’s items, NSSS has presented four recommendations of its own to Vancouver Coastal and has asked Ostrow and his Board for leave to speak directly to the recommendations at a Board meeting.

Attached [please click here and here] are the NSSS recommendations and the Vancouver Coastal items. The NSSS submission on the case, June 26, 2009, is available on our website at www.northshoreschizophrenia.org/marek.pdf. A brief background analysis of the Vancouver Coastal items, such as they are, is also available on the NSSS website.

Media Contact

Herschel Hardin
North Shore Schizophrenia Society President
604-922-7153
herschel@northshoreschizophrenia.org

Photo credit

Serum S100B: A Potential Biomarker for Suicidality in Adolescents?

Structure of the S100B protein. Based on PyMOL rendering of PDB 1b4c.

The abstract of a paper published online by PLoS One:

By Tatiana Falcone, Vincent Fazio, Catherine Lee, Barry Simon, Kathleen Franco, Nicola Marchi, and Damir Janigro*

Cleveland Clinic-Lerner College of Medicine, Cleveland, Ohio, United States of America

Abstract

Studies have shown that patients suffering from depression or schizophrenia often have immunological alterations that can be detected in the blood. Others reported a possible link between inflammation, a microgliosis and the blood-brain barrier (BBB) in suicidal patients. Serum S100B is a marker of BBB function commonly used to study cerebrovascular wall function.

Methods

We measured levels of S100B in serum of 40 adolescents with acute psychosis, 24 adolescents with mood disorders and 20 healthy controls. Patients were diagnosed according to DSM-IV TR criteria. We evaluated suicidal ideation using the suicidality subscale of the Brief Psychiatric Rating Scale for Children (BPRS-C).

Results

Serum S100B levels were significantly higher (p<0.05) and correlated to severity of suicidal ideation in patients with psychosis or mood disorders, independent of psychiatric diagnosis. Patients with a BPRS-C suicidality subscores of 1–4 (low suicidality) had mean serum S100B values +/− SEM of 0.152+/−0.020 ng/mL (n = 34) compared to those with BPRS-C suicidality subscores of 5–7 (high suicidality) with a mean of 0.354+/−0.044 ng/mL (n = 30). This difference was statistically significant (p<0.05).

Conclusion

Our data support the use of S100B as an adjunctive biomarker to assess suicidal risk in patients with mood disorders or schizophrenia.


Citation: Falcone T, Fazio V, Lee C, Simon B, Franco K, et al. (2010) Serum S100B: A Potential Biomarker for Suicidality in Adolescents? PLoS ONE 5(6): e11089. doi:10.1371/journal.pone.0011089

Copyright: © 2010 Falcone et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

*E-mail: janigrd@ccf.org

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

Also see:

Serum Biomarker May Help Predict Suicidality in Adolescents

Identifying Suicide Risks in Adolescents


Image courtesy of Emw. This image is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.

Busy first year for chief C.B. Crown

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

MacRury headed inquiry into jail cell death of mentally ill man

By LAURA FRASER Cape Breton Bureau | FIVE QUESTIONS

Dan MacRury [pictured] spent most of his first year as chief Crown attorney for the Cape Breton region juggling his new job with his responsibilities as counsel for the Howard Hyde inquiry.

The inquiry into the death of the mentally ill man while in custody was one of the province’s longest fatality probes.

But MacRury said he is used to tackling more than one job at a time. He will be the incoming vice-chairman for the criminal justice section of the Canadian Bar Association, and treasurer of the Nova Scotia branch.

He has also sat as president of the Legal Information Society of Nova Scotia and the Canadian Criminal Justice Association. And in his spare time, he goes fly-fishing and makes pasta.

He recently sat down with The Chronicle Herald to talk about his 24-year career shortly after he won the Canadian Bar Association’s 2010 John Tait Award of Excellence.

Q: What sparked your interest in public prosecution?

A: I’ve been involved in public service pretty well my entire career. First, I was at (Nova Scotia) Legal Aid and then moved over to the Crown.

I think it was sort of natural for me because public service and volunteerism are sort of virtues of my family. My entire family works as public servants.

My father worked as a hospital administrator and a city councillor here in Sydney. My mother was a nurse in detox. Both sisters work in health care, and in fact, I married a public servant. My wife’s a public servant.

It’s certainly something that was instilled in my family as being very important, to give back to your community and try to make a difference, and that’s really what I’ve been trying to do throughout my career.

Q: So what was it initially that interested you about law?

A: I had a very good professor who was sort of a mentor and went on to be a senator. John. B. Stewart was my professor at St. F.X., and he was somebody that always encouraged people to go into law, and I guess that was where my interest was tweaked at that point in time.

And certainly as a lawyer, I’ve had some great opportunities. I’ve been involved as a defence counsel in two murders and as a Crown in seven murder cases. I’ve appeared before the Supreme Court of Canada three times, one being the (John Robin) Sharpe case that dealt with the constitutionality of the (child) pornography provisions of the Criminal Code.

And I was a legal adviser in 2002 to the G7 finance ministers conference in terms of the law and its relation on lawful assembly and protests.

Q: Recently, you were the counsel for the Howard Hyde inquiry regarding the death of a man with schizophrenia who died 30 hours after he was Tasered while in police custody in Halifax. Can you tell us about that?

A: The Hyde inquiry, of course, was the longest fatality inquiry in Nova Scotia history, and that dealt with issues of how the mentally ill are dealt with by the criminal justice system and the mental health system. We’re now awaiting Judge (Anne) Derrick’s report and certainly hoping that there will be recommendations in relation to those areas as well.

One thing that I’ve found both as a legal aid lawyer and as Crown over the last 20 years is that, really, there are too many people that suffer from mental illness that are being dealt with by the criminal justice system instead of the mental health system. That’s something that I always felt was important to try to improve if we can.

Q: What do you remember about your first case?

A: When I first started out in New Glasgow (as a lawyer with Nova Scotia Legal Aid), you dealt with a lot of people, and you realize that people don’t choose, and don’t have control over some of the circumstances (that affect criminal behaviour), whether it’s poverty or substance abuse. So a lot of times what you found as a legal aid lawyer is that people are just looking for help.

I guess one case that sort of stuck out in my mind is I represented a young man who had been institutionalized for most of his life, and disabled. It certainly brought home to me that sentencing sometimes has to be flexible because it was a serious offence that he was charged with and the jails couldn’t cope with him. We were able to speak with (the) correctional services (division of) Nova Scotia at the time and we were able to have him transferred to a hospital setting, which was more appropriate for him. He was able then to get at rehabilitative programs, and it was the only time he’d been involved in the criminal justice system that he was able to get programs to assist him. Certainly, that was very rewarding from my point of view. What we find is that when things aren’t as simple, you have to be a little innovative in terms of coming up with solutions to problems.

Q: You said that you’ve prosecuted seven murder cases.

A: One I got parachuted into. I think what you learn in this business is things happen on short notice. I had a vacation booked for New York City, and a colleague became very ill. With two weeks to go, I ended up being involved in the case in Halifax (R. vs. Assoun). And that was a long case where the accused fired three lawyers and was then self-represented, which was certainly a challenge.

I was involved in another case (R. vs. Tran) that was simultaneous translation in Vietnamese. In fact, while I was dealing with the Tran case . . . at the same time we were prosecuting another case called Simpson, which was somebody on a Cuban vessel that murdered somebody in Halifax Harbour. So, literally, we were going to jury on one case, and then up at the provincial court starting the other case, which was translated in Spanish.

The challenge in the case in the gentleman from Cuba is that all the witnesses were in Cuba and so we had to deal with Foreign Affairs to try to get them back in the country to testify . . . so it wasn’t your standard subpoenas. Certainly, that was a challenge, but an exciting case as well."

(lfraser@herald.ca)

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Old Vancouver motor hotel gets new life as part of homelessness experiment

An article published in yesterday's edition of The Vancouver Sun:

By Todd Coyne

Downtown Vancouver’s old Bosman’s Motor Hotel is once again filling up fast. Not with the road-weary travellers of earlier days, however, but with people whose paths in life have led them, wearily, to the streets.

Now renamed the Bosman Hotel Community, the four-storey former inn at 1060 Howe St. officially opened its doors Monday as the Vancouver site of a five-city federal research project studying the relationship between homelessness, mental illness and addiction.

With similar facilities in Winnipeg, Toronto, Montreal and Moncton, the Mental Health Commission of Canada is studying the effects of a “Housing First” approach to treating the mental health problems of chronically homeless people in Vancouver. This model means providing suitable candidates with housing and food as a first priority before trying to address their mental-health problems and their goals for recovery.

Inside the Bosman, the rooms are small and bear all the furnishings immediately familiar to anyone who’s ever stayed in low-cost, continental breakfast-included lodgings anywhere in North America. There’s a heavy-blanketed bed, a lamp, a bathroom on the left and even a Bible in the nightstand.

For a hundred of Vancouver’s hardest to house, it will be home.




“If it was not for this place, I do believe I would not be here today,” said new Bosman resident Nicola Keate [pictured].

In front of a crowd of city politicians, university researchers and homeless-outreach workers in the Bosman’s cramped main room, Keate told of how at age 14 she started using drugs and immediately became hooked.

Later, she found out she had a bipolar disorder — which, she said, led to more drugs and a life of crime.

It’s a cyclical refrain among the Bosman’s 67 residents — drugs leading to illness leading to drugs — and one which the federal mental health commission, in association with the Portland Hotel Society in Vancouver, is trying to end in the homeless population nationwide.

Jeff West, the Bosman’s project manager, said that 500 of Vancouver’s homeless with addictions and mental health problems were selected as potential candidates for residency at the Bosman Hotel. One hundred of them were then offered residency at the Bosman — something one resident compared to winning the lottery — for a maximum stay of three years.

That’s when the national study ends and when West said the Bosman Hotel’s owners, Prima Properties Ltd., plan to build condominiums.

Of the other 400 study participants in the city who will not be moving into the Bosman, 200 will not receive housing as the study’s “treatment as usual” control group, and 200 will be put into “scatter housing” around the city and connected to case managers and mental health support workers, West said. Nationwide, 2,285 people are participating in the three-year “At Home” study; of these, 1,325 will receive housing.

tcoyne@vancouversun.com

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Surviving Schizophrenia Video

Posted August 3rd by HealthyPlace.com:

Schizophrenia video interview with Dr. Fred Frese. Diagnosed with paranoid schizophrenia, renowned psychologist shares insights on living with schizophrenia.

Although schizophrenia is one of the most debilitating mental illnesses, it is treatable. With the right treatment, people suffering from schizophrenia can reach a productive and stable life.

Dr. Fredrick J. Frese was our guest on the HealthyPlace Mental Health TV Show. Dr. Frese has been living with schizophrenia for 40+ years. In this schizophenia video, he shares anecdotes about his diagnosis and how he's managed to be successful despite it.








Share Your Thoughts or Experiences on Schizophrenia

We invite you to call us at 1-888-883-8045 and share your experience in dealing with schizophrenia. How has it affected your life? What treatment has worked for you? (Info on Sharing Your Mental Health Experiences here.)


About Dr. Fredrick J. Frese, Our Guest on "Sane and Living with Schizophrenia" Video

Fredrick FreseFredrick J. Frese, Ph.D., Secretary at the Treatment Advocacy Center, was diagnosed with paranoid schizophrenia in 1966 while he was serving in the U.S. Marine Corps. Dr. Frese was involuntarily hospitalized in several hospitals and judicially determined to be an insane person in 1968.

Despite his disability, Dr. Frese has been able to function as a psychologist and an administrator, serving mentally ill persons in Ohio. A prolific writer and outstanding speaker, revered both for his sense of humor and his remarkable ability to translate research and public policy into usable information, Dr. Frese has lectured widely in the United States, Canada, and Japan. Dr. Frese has been featured in The Washington Post, The Chicago Tribune, The Wall Street Journal and on CNN, NPR, ABC World News Tonight, Nightline’s Up Close, and in the documentary film, I’m Still Here: The Truth About Schizophrenia.

Visit Dr. Frese's website here: www.fredfrese.com

Treatment Advocacy Center: www.treatmentadvocacycenter.org

More students than ever feeling the strain

An article published in the August 20th edition of Kelowna Capital News:

Sitting in a capacious lecture theatre at university for a first-year student can be daunting.

In the stiff chairs around you are a hundred faces you don’t know. You have to be attentive to the professor because you need a good grade in this class to take the next course, but you just can’t follow what he’s saying.

You keep thinking about how you’re going to pay for your books this semester. Your laundry hasn’t been done for weeks. Your work schedule has you stressed with not enough time to study and your caffeine intake has tripled. Your girlfriend is upset you don’t see her enough.

Add into the mix, you’re being treated for depression and anxiety disorders.

•••

According to a 2009 study by the American Health College Association, 84 per cent of the college students polled said over the past year they had felt at some time “overwhelmed by all they had to do” and 81 per cent “felt exhausted.”

As many as 49 per cent felt “overwhelming anxiety” and six per cent said they had “seriously considered suicide.”

It’s understandable. Some students are away from home for the first time, without their supports and high school friends and have to manage a heavier school and life load independently. It’s a sharp shift from the cocoon of home and high school.

But, the report also noted that college councillors are noticing more students showing up at their door and coming with more severe mental health issues.

Anecdotally, Okanagan College counselling services chairman Glendon Wiebe says the results of the American study are reflected at the college.

“I do feel the severity of the presenting issues has increased,” he says.

That’s not necessarily something to be alarmed about; in fact, it may be that students are more likely to seek help and college staff and faculty are more aware and supportive of helping the students in their mental health.

Wiebe says, “I don’t see a lot of evidence of mental health issues in the general public increasing. I don’t think the report suggests there are more mental health disorders. But, there is more awareness.”

“There is less stigma to self-identify,” explains Wiebe. “There are fantastic initiatives to educate people early.”

To read the entire article, please click here.

Also see:

College students exhibiting more severe mental illness, study finds

Mental Health Services and Choosing a College: Striking a Balance (NAMI)

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CMA awards Medal of Honour to the Honourable Michael Kirby

An August 11th media release from the Canadian Medical Association:

Ottawa, August 11, 2010 - The Canadian Medical Association (CMA) will present the 2010 CMA Medal of Honour to the Honourable Michael Kirby, who has demonstrated outstanding public commitment to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

“The CMA Medal of Honour recognizes personal contributions to advancing medical research and education,” said CMA President Dr. Anne Doig. “Mr. Kirby [pictured] has worked diligently to bring awareness to the mental health issue.”

Mr. Kirby is well known to physicians for his landmark Senate reports on health care reform. Now retired from the Senate of Canada after 22 years of service, Mr. Kirby chairs the Mental Health Commission of Canada where he has demonstrated the same outstanding public commitment – this time, to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

“I have been privileged to have worked on major Canadian public policy issues for more than forty years. In that time, nothing has been more gratifying than my work on health care in general and mental health care in particular,” said Mr. Kirby. “I believe that, with the help of all Canadians, it will be possible to substantially reduce the stigma and discrimination faced by people living with a mental illness, and to put in place a system of services and support that will enable them to lead a much more satisfying and productive life.”

Mr. Kirby’s personal interest in health care delivery was evident during his seven-year term (1999–2006) as chair of the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s focus was to develop a federal health policy that would support a financially sustainable health care system over the long term.

The committee published six reports on health care, culminating with Recommendations for Reform, in 2002. The report included numerous and varied recommendations: the need for better accountability through an annual report on the health care system and the health status of Canadians; the need for improved efficiency measures, including primary care reform; the need for timely access to health care in the form of health care guarantees; and the need to close gaps in the safety net by expanding coverage for catastrophic drug costs, and acute and palliative home care.

Following publication of the report, the Social Affairs Committee, chaired by then-Senator Kirby, turned its attention to the issue of mental health, mental illness and addiction. The committee published three background reports in 2004 and its final report, Out of the Shadows At Last, was released in 2006. One of the principal recommendations of this report was that the federal, provincial and territorial governments should establish the Mental Health Commission of Canada.

Mr. Kirby retired from the Senate in 2006 and was appointed chair of the newly created Mental Health Commission of Canada in 2007. The commission’s mandate is to develop Canada’s first national mental health strategy and to launch a decade-long, anti-stigma program to change public attitudes and behaviour toward people living with mental illness.

While the goals of the Mental Health Commission are certainly no small challenge, Mr. Kirby has a proven track record of successfully developing and implementing public policy for governments and the private sector. He served as principal assistant to Premier Gerald Regan of Nova Scotia (1970–73), assistant principal secretary to Prime Minister Pierre Trudeau (1974–76) and president of the Institute for Research on Public Policy (1977–80). While he was Secretary to the Cabinet for Federal-Provincial Relations and Deputy Clerk of the Privy Council (1980–83), he was the senior public servant involved in the negotiations that led to the patriation of the Canadian Constitution and inclusion of the Charter of Rights in the constitution.

He has been a professor at Dalhousie University, has taught at the University of Chicago and University of Kent, has served on the boards of numerous public companies, is a regular media commentator on public policy issues, and is a featured speaker at many national conferences.

In recognition of a lifetime of outstanding achievement on major public policy issues and his current commitment to confronting the challenges related to mental illness, Mr. Kirby was appointed an Officer of the Order of Canada in 2008.

The Honourable Michael Kirby is the 27th recipient of the CMA Medal of Honour, the highest award bestowed upon a person who is not a member of the medical profession. He will receive this award at a special ceremony at the Crowne Plaza Hotel, in Niagara Falls, Ont., on Aug. 25 as part of the CMA’s 143rd annual meeting.


For more information:

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

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Mental Health Commission of Canada: Annual Report 2009-2010

Please click on the image to magnify it.

To view the very interactive online report (which includes videos), please click here; or click here to download the entire PDF version (38 pages).

Also see:

Mental Health Commission of Canada

Peer Project - Mental Health Commission of Canada

A posting on the Mental Health Commission of Canada's website:

The Mental Health Commission of Canada has launched the Peer Project to enhance the utilization of peer support through the creation and application of national standards of practice. It is also designed to encourage a change in societal attitudes towards mental illnesses through peer based education strategies specifically targeting youth in schools and adults in workplaces. The project supports and shares in common a number of the objectives related to key initiatives and other projects of the Commission and its advisory committees.

The use of peer based approaches is founded on the belief that people who have faced, endured, and overcome the adversity of mental health conditions can offer beneficial support, encouragement and hope to others facing similar situations. Peer based services, i.e., peer support delivered in conjunction with mental health education delivered by peers can greatly enable Canadians to better understand and accept the realities of mental health challenges, leading to a more supportive society.

It is recognized that there are valuable and effective variations regarding the way peer support is provided in Canada and a “one size fits all” approach is not what the peer project intends to develop. A chief concern is to not lose sight of the grass roots, community based practices that have characterized the success of this type of mental health intervention.

The Mental Health Commission believes, however, that before organizations of different types and sizes are willing to further invest in peer based initiatives, evidence-based frameworks will need to be developed. The literature on peer based services in Canada and other countries suggests that the lack of adequate empirical evidence supporting the effectiveness of peer delivered interventions has impeded their growth and wider-scale use. Consequently, the design of both project components will be underpinned from the very outset with performance measurement and evaluation strategies.

Developing standards of practice will provide frameworks to enhance the credibility of peer based services. Standards of practice are established by identifying the competencies, experience, training/education, and values, which together constitute the hallmark for providing effective services.

Obtaining the views and input of stakeholders is a prominent feature of this project, particularly in relation to the peer support component at this stage. The Project Team is currently planning a comprehensive consultation process with the initial goal to develop standards of practice for peer support that will be implemented and tested beginning with workplaces.

As the Peer Project evolves, updates will be posted to the web site to allow interested parties to follow the development of this endeavour.

Also see:

Definition of ‘Peer’

Peer Project Outline

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