Monday, June 13, 2011

Do Not Cease from Exploration: A Report at the Nexus of Mental Health and the Criminal Justice System



Please click on the image to magnify it.


An article posted on June 13th by Jotwell.com:
Anne Derrick, In the Matter of a Fatality Inquiry Regarding the Death of Howard Hyde, Report pursuant to the Fatality Investigations Act (2010).

By Kim Brooks (pictured)

Long overdue, in 2010 Canada ratified the United Nations Convention on the Rights of Persons with Disabilities. (The United States has yet to ratify the Convention.) While countries can ratify conventions at the international level, it is often the case that only in translation to our domestic, sometimes even local, contexts do we see the real effects of our commitments.

Judge Anne Derrick’s piece, a report on the death of Howard Hyde ordered by Nova Scotia’s Minister of Justice, pushes at the boundaries of what most of us would consider scholarship; yet, it is the most interesting piece of scholarly work motivated by equality considerations that has crossed my desk in the last several months. It provides a marvellous illustration of the values reflected in the Convention played out against one very specific set of facts.

Howard Hyde, who was experiencing a recurrence of his chronic schizophrenia, was arrested by the Halifax Regional Police on November 21, 2007, after assaulting his common law partner. Mr. Hyde tried to escape from the police when he was being booked. A conducted energy weapon was twice used to shock Mr. Hyde. After additional struggles, Mr. Hyde collapsed and stopped breathing. He was revived and taken to the hospital. After recovering at the hospital, Mr. Hyde was discharged once again to the police. Later in the day, he appeared in court and was remanded to a correctional facility for the evening. Mr. Hyde did not sleep that night.

On November 22, while being transported to court, Mr. Hyde attempted to escape from correctional officers. He was restrained in a cell by correctional officers and stopped breathing. He was pronounced dead at 8:43 a.m.

This is the story that gave rise to the inquiry and the subsequent inquiry report. Even in its simple telling, drawn from the Preface of the report, the terror that a man living with a mental illness must have felt through the whole ordeal, and the inadequacy of the institutional response to his needs, is apparent.

The report deserves to be read in its entirety – all 7 parts, 57 chapters, 462 pages. Rooted in the experience of one man, in one small corner of the world, the inquiry report demands broad readership.

Following a moving introduction and preface, the report reviews the factual narrative (Part II), outlines the cause and manner of death (Part III), addresses a range of issues that arise from the inquiry (Part IV), delineates the major findings (Part V), reviews changes since the time that Mr. Hyde died (Part VI), and provides for recommendations (Part VII) and a conclusion (Part VIII).

Let me highlight two aspects of the report, simply as a teaser. First, the report’s 80 recommendations are essential ground for equality scholars with an interest in policy-relevant scholarship. It might be noted that the recommendations appropriately do not focus on the assault of Mr. Hyde’s common law partner (although the need for appropriate accommodation for accused persons living with mental illnesses is underscored); rather, they are focused on the interaction between mental health and the criminal justice system. The recommendations cover everything from the importance of developing a provincial mental health strategy that ensures coordination of care, integration of services and supports, and monitors quality and outcomes (Recommendation 1) to implementing a diversion program, including pre-charge diversion, for accused persons with mental illness (Recommendation 10) to training police with an eye to the overarching purpose of the development of a culture of respect and empathy for persons with mental illness in the justice system (Recommendation 49).

Second, the report is beautifully written. Let me draw from the conclusion, which demonstrates more than ably the skill of the author and her ability to cut to the core of the issues before her:

"At an immediate, fundamental level, what Mr. Hyde needed was human contact, reassurance and kindness. The evidence discloses how well he responded, even when somewhat agitated, to simple but effective interactions that incorporated these elements. Certain police officers, sheriffs and correctional officers were all successful in their interactions with Mr. Hyde utilizing approaches that were empathetic, respectful and caring. Even though he was acutely ill, Mr. Hyde was reassured and comforted “by talking to him.”3 Understanding this is to understand Mr. Hyde’s humanity and recognize in him, ourselves." (P. 388, footnotes removed)

I might conclude just by saying, briefly, something about the value of understanding this report as a form of scholarship. If the highest calling of scholarship is to reveal the truth of the world, and perhaps further to reason about what that truth should be, then this report fits within the core of that ambition. The report contributes to our knowledge about mental illness, the interaction between human beings experiencing a form of mental illness and the criminal justice system, and the potential to recognize and appreciate the fullness of the human experience. It is, in that regard, scholarship of discovery. In addition, Judge Derrick draws together diverse strands of evidence and weaves those together analytically, in a way that demonstrates the scholarship of integration. Finally, the report’s provision of thoughtful and detailed recommendations is exemplary of scholarship of application.

The report’s conclusion section opens with a quote from T.S. Eliot. It might be used to reveal the connection between the work of Judge Derrick in this report and the explorations we all take as scholars:

We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.
– T.S. Eliot

Mental Health Commission of Canada Peer Project

An email received on June 8th from the Mental Health Commission of Canada's Peer Project Team Leader (pictured):
Subject: Communiqué about the Peer Project – Mental Health Commission of Canada (MHCC)

Following the April 2011 Peer Project update, many of you expressed interest in participating in a Webinar session to discuss how to preserve the natural, organic way in which grass-roots peer support has functioned, as we develop a certification process for peer support.

We decided to consult members of the Peer community to help plan for this event. During our discussions, we talked about the format of the Webinar, possible panelists were identified and the most beneficial means for participants to have an open discussion was determined.

It was important for us to organize this Webinar in a way where the issue was treated in a responsible and respectful manner. It was clear from the two groups we engaged with that panelists should rapidly present varying views on the issue but that the majority of the time allocated for this Webinar be at the disposal of participants, allowing a healthy dialog to take place.

We invite you to participate in one of the following events:
The Webinar will be structured with two panelists each presenting views on the issue for 10 minutes followed by a 40 minute moderated discussion where all participants will be invited to the dialogue. Both sessions will be organised in the same fashion and host the same panelists and the presentations during each session will be the same. Following the sessions, participants will have access to the content of both Webinars and have the opportunity to provide further input.

Our panelists:

Joan Edwards-Karmazyn, Executive Director with the National Network for Mental Health;

Diana Capponi, Employment Works Coordinator for Center for Addictions and Mental Health; and

John Massam, Peer Support Program Coordinator, Coast Mental Health.

Our moderator:

Karen Liberman, Executive Director, Mood Disorders Association of Ontario

* Biographies of the panelists will follow shortly

At this time, we request that you sign-up for one of the webinar sessions by Friday, June 24th. In order to ensure maximum participation and entertain a good dialogue, we will host 20 people per Webinar and we are prepared to hold additional Webinars if required, to accommodate all participants. Please indicate clearly which session you would like to attend.

Joining instructions, panelist and moderator biographies will follow shortly.

Thank you very much for your interest in participating in this very important part of the process.
Image credit

Friday, June 10, 2011

New Nova Scotia guidelines for stun gun use

An article posted yesterday by CBC News:
Nova Scotia has issued new guidelines for the use of stun guns and they go into effect immediately.

The guidelines call on police officers, court security and jails guards to consider whether a person is mentally ill before they use a shock to try to subdue them.

When confronting someone who is known to suffer from a mental illness, the officer or guard should only use a conductive energy weapon — more commonly known as a stun gun or Taser — as a last resort.

If there's a danger that shock could seriously hurt that individual, paramedics should be called to the scene before deploying a stun gun.

"We're educating not only the officers that are involved, but the health care services when an incidence occurs what the response should be," said Justice Minister Ross Landry [pictured].

Landry said Nova Scotia is the first province in the country to spell out when a Taser should be used on someone who may be mentally ill.

Officials with the Schizophrenia Society of Nova Scotia are pleased.

"These guidelines direct the officer to make the best possible decision as to whether or not this individual... actually is affected by a mental illness and in crisis," said Stephen Ayer, the executive director of the society.

Ayer said the key to the new rules is proper training and awareness.
Image credit

Also see:

Stronger Guidelines for Conducted Energy Weapons

Nova Scotia Guidelines on Conducted Energy Weapons (CEWs)

Conducted Energy Weapons (CEW) Fact Sheet (PDF)

Thursday, June 9, 2011

Attitudes improving towards mental illness, survey shows

Quoting Marjorie Wallace (pictured), chief executive of the U.K. mental health charity Sane:


"If we aspire to end the stigma surrounding mental illness, we must not rely simply on educational campaigns, but must also provide the care and treatment people need at times of crisis, in order to prevent the tragedies that so often colour the public's view."
To read the entire article, please click here.

Tuesday, June 7, 2011

Mental illness leading cause of disability in youth




An article posted on June 6th by CNN.com:
Mental health problems such as depression account for nearly half of all disability among young people between the ages of 10 and 24, according to a new study from the World Health Organization (WHO).

Researchers looked at data from 191 countries and estimated the number of years of good health lost to disability resulting from disease and injury (known as disability-adjusted life years). Among adolescents and young adults, 45 percent of disability was related to depression, bipolar illness, schizophrenia, and other mental disorders, including alcohol abuse.

Health.com: 10 subtle signs of bipolar disorder

Dr. John S. Santelli, M.D., a professor of population and family health at Columbia University's Mailman School of Public Health, in New York City, says that, fortunately, mental health issues at the root of a young person’s disability generally respond to prevention, early detection, and treatment.

"There’s much better behavioral treatments, there’s much better pharmacological treatments as well," says Santelli, who wrote an editorial accompanying the study, which was published in the journal The Lancet. "We know what to do. We just need to do it."

Health.com: 9 ways you can help someone who's depressed

The study was the first ever to look at the international burden of disability in young people. Worldwide, the researchers estimated, disability claimed about 236 million healthy years from this group, which includes both estimated and actual years of life lost to illness and premature death.

After mental disorders, accidental injuries were the second largest cause of disability, accounting for 12 percent, followed by communicable diseases (including HIV, malaria, and tuberculosis) at 10 percent.

The top risk factors for disability were drug and alcohol use, unsafe sex, failure to use birth control, and iron deficiency, a common sign of malnutrition.

Health.com: Myths about safe sex and sexual health

"Youth is considered to be a time of good health," says one of the study's authors, Fiona M. Gore, a WHO researcher in Geneva, Switzerland. However, she says, "important health factors and risk factors for disease in later life emerge in these years "

The study revealed some regional and socioeconomic differences. Compared to the world as a whole, for instance, mental disorders account for a greater proportion of disability in the U.S., in Europe, and in nations with high per-capita income. On the other hand, disability due to injuries and communicable diseases was lower in those countries than worldwide.

"There is a need to focus on prevention strategies and on health promotion of noncommunicable and nonfatal causes of disease in young people," Gore says.

Also see:

Global burden of disease in young people aged 10—24 years: a systematic analysis

Mental Disorders Leading Cause of Disability in World's Youth

Monday, June 6, 2011

Empirical Support for the Family-to-Family Program

From the This Month's Highlights section of the June 2011 edition of Psychiatric Services:
Family- and consumer-driven care is at the center of a transformed system. Family members play important roles in the lives of most adults with serious mental illness. They need information and skills to help their loved one, as well as the support of others to fulfill their caregiver role without being overwhelmed by distress and burden. The Family-to-Family Education Program (FTF), introduced in the early 1990s by the National Alliance on Mental Illness, is the most widely disseminated mutual-support program for family members of people with mental illness.

Although an estimated 250,000 family members have participated in FTF, little research has focused on family selfhelp. In the lead article this month, Lisa B. Dixon, M.D., M.P.H. [pictured], and colleagues report the results of the first randomized controlled trial of the effectiveness of FTF, which involved assignment of 318 family members from five Maryland counties to FTF or a waiting list. At three months (course termination), FTF participants had significantly greater improvements in problem-focused coping, as measured by empowerment and illness knowledge. Their emotion-focused coping was also significantly enhanced, and they had less distress and better problem- solving skills. These empirical findings confirm the word-of-mouth popularity of FTF among participants, the authors note, and provide support for consideration of brief family-driven educational programs as an evidence-based practice (page 591).
Image credit

Also see:

Strengthening Families Together

Friday, June 3, 2011

Taser rules coming

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

New provincial guidelines on the use of Tasers by police in Nova Scotia have been approved and will be released soon, Justice Minister Ross Landry [pictured] said Thursday.

Three weeks ago, in response to an inquiry report into the death of a mentally ill Halifax man, Landry said the guidelines would be released within two weeks.

He now says he has reviewed and signed off on the guidelines and expects they will be made public within the next week or so.

Landry declined to say whether the rules would restrict Taser use against mentally ill people, but added that they would not be a major departure from national standards.

"We’re in line with the overall federal position," said Landry. "I think there are a couple of areas that we’ve probably tightened up ... and I believe it will meet our needs at this time."

The issue is a contentious one because the inquiry into the death of Howard Hyde recommended that Tasers not be used on emotionally disturbed people unless all attempts at de-escalation have failed.

Hyde died in November 2007 at a Halifax jail, 30 hours after police had Tasered him multiple times during a psychotic episode. But the inquiry concluded the Tasering did not cause his death.

Federal guidelines say the use of stun guns should be avoided where possible on women known to be pregnant, the elderly, young children and visibly frail people. The rules also say that the weapons should not be used on a restrained subject or on a person in control of a moving vehicle.

There are no references to mental illness in the national rules, but Landry said it would be addressed in Nova Scotia’s guidelines. He didn’t elaborate.
Image credit

Thursday, June 2, 2011

One Man’s Journey Through Crime, Drugs, Schizophrenia and Rehabilitation

An article and video posted yesterday by the Juvenile Justice Information Exchange:
By Leonard Witt

When Andrew Peterman of Idaho first came into the juvenile justice system at age 15, he did not know that schizophrenia was driving his anger, which in turn was resulting in arrests and illicit drug and alcohol usage. In time, thanks to juvenile detention and treatment for his schizophrenia he has been able to straighten out his life.

In fact, he has come so far on his journey that the Coalition for Juvenile Justice awarded him the 2011 National CJJ Spirit of Youth Award to “recognize and celebrate a young adult…who has made great strides through involvement with the juvenile justice system, overcome personal obstacles and is today making significant contributions to society.” In the video below by Leonard Witt, Peterman tells of his journey through crime, drugs, schizophrenia and rehabilitation.





Also see:

The Schizophrenia Society of Nova Scotia's YouTube Channel

Tuesday, May 31, 2011

The Crisis Intervention Team International (CITI) Conference

September 12th to September 14th, 2011
Virginia Beach, Virginia




An email received by the SSNS today from Maureen Wheller, Senior Strategy Advisor (Captial Health Mental Health Services):
Good morning,

Mary Pyche, acting program leader for Emergency Mental Health at Capital Health, has been chosen to speak at the International Crisis Intervention Training (CIT) Conference being held in Virginia Beach, Virginia, September 2011. Mary will be joined by one of the Halifax Regional Police Officers dedicated to the Mental Health Mobile Crisis Team. The constable presenting with Mary also co-delivers CIT education with Mary to police officers. Their topic is the Four Level Training matrix Mary developed to enhance mental health training for law enforcement and how it fits with a Crisis Team Co-Response Model.

Here is a brief summary written by Mary for the conference program:
The Mental Health Mobile Crisis Team, Capital Health Mental Health Program is a co-response model of policing and mental health. We believe that a combination of CIT and a co-response model provides the most comprehensive service for building capacity in a community response to mental illness. One aspect of the partnership the Mobile Crisis Team has with Halifax Regional Police in this co-response model is the delivery of mental health training and education to police members. They have developed a four level matrix model of training. Each level has distinct learning objectives and serves a purpose to deliver some level of education on mental health and crisis response to all police officers in the Halifax Regional Police Department. This presentation will meet the following learning objectives:
  1. Increase understanding of a co-response model of policing and mental health and the fit this has with a CIT Program.

  2. Gain knowledge of a model of police training in mental health that includes all police members attain one level of training.

  3. Increase knowledge in developing and implementing a training Matrix.
Mary also organized the provincial police/mental health liaison conference scheduled for June 13th, 2011.

Congratulations, Mary!

Thank you.

Maureen

Image credit

John Devlin, a member of the SSNS, is publishing a book entitled Nova Cantabrigiensis.



From the book's website:
ABOUT

Nova Cantabrigiensis is a utopian island in the middle of the Minas Basin, Nova Scotia.

It is the invention of visionary outsider artist John Devlin [pictured], and was designed to recreate the atmosphere and architecture of Cambridge, England, which John considers to be the perfect city.

John came to study in Cambridge in 1979, and fell in love with its unique ambience. When mental illness forced him to return home to Canada after just one year, he became obsessed with discovering the secret to 'the Cambridge essence'.

Over ten years, John created over 360 beautiful and unique illustrations, dream-like sketches of re-imagined and reconfigured Cambridge buildings, drawn again and again in the pursuit of perfection.

The book Nova Cantabrigiensis will present a selection of John's illustrations, his writings about the island and his mathematical theories about the architecture. It will be published in the summer of 2011.

*PRE-ORDER*

Nova Cantabrigiensis is now available for pre-order! Please click here to pre-order the book, to get a signed, limited edition copy, and to see a video about the book.

PRESS

John was interviewed on CBC Radio One on June 10th, 2010. To listen to the recording, please click here.

Read the BBC's piece on John's 2010 exhibition by clicking here.
Also see:

John Devlin's website

Monday, May 30, 2011

Electric Fire by Jon David Welland




Jon David Welland is an artist and writer living and working in Nova Scotia. He is a post-modern surrealist whose work draws upon popular culture, mysticism and psychology.

To visit Jon's blog, please click here.

Also see:

Veith Street Gallery

Tuesday, May 24, 2011

Million-dollar fellowship boost

An article published in yesterday's edition of The Chronicle:
PARLIAMENTARY Secretary for Community Services Julie Collins [pictured] today announced that the Schizophrenia Fellowship of Queensland in Toowoomba will receive more than $1.4 million.

It will allow the fellowship to continue providing much-needed support to local people with mental illness.

Schizophrenia Fellowship of Queensland is one of 79 community mental health services across the country which will have their funding extended for three years through the Government’s Personal Helpers and Mentors program.

"Schizophrenia Fellowship of Queensland provides invaluable support to local people with severe mental illness, their families and carers in our community," Ms Collins said.

"Personal helpers and mentors provide practical, intensive support to help people with severe mental illness set and achieve personal goals, such as finding suitable housing, looking for work or improving relationships with family and friends.

"They help make a real and lasting difference in local people’s lives."

The funding is in addition to the Federal Government’s $269.3 million boost for community mental health services announced in this year’s Budget, part of a total commitment of $2.2 billion over five years for mental health services across Australia.
Also see:

Understanding schizophrenia

Saturday, May 21, 2011

Thursday, May 19, 2011

Child and Yourth Mental Health


Please click on the image to magnify it.

To download this special issue of Healthcare Quartly (PDF), please click here.

Sunday, May 15, 2011

New film -- Living with Schizophrenia: A Call for Hope and Recovery

I highly recommend this film.

From this website:

This film is dedicated to the approximately two million Americans living with schizophrenia, and to the people supporting them in their journeys of recovery.

"Living with Schizophrenia: A Call for Hope and Recovery" explores the lives of three people living with schizophrenia, a chronic brain disorder that can be severe and disabling and often is misunderstood and stigmatized. The documentary reveals their daily struggles, personal insights about the illness, and paths the mental health recovery process.

These are the stories of hope that aren’t making headlines.

"Living with Schizophrenia" was funded and produced by Janssen Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. The people featured in the film present their own stories and ideas and were not compensated by Janssen to appear in the film. Janssen does not endorse any organization, source of information or project named in the film. Janssen products are not named or promoted in the film.
To view the film, please click here.

Also see:

"Living with Schizophrenia" Documentary Shines Spotlight on People with Schizophrenia: A Misunderstood and Stigmatized Illness

Overcoming Schizophrenia

Embracing My Mind, Inc. (EMM)

Rebecca Lyn Phillips (on Twitter)

Dr. Xavier Amador

Saturday, May 14, 2011

Mental health strategy still seems elusive

An opinion piece published in today's edition of The Chronicle Herald:
By Marilla Stephenson (pictured)

What’s the difference between "excited delirium" and "autonomic hyperarousal state?"

Not much. In fact, in the provincial government’s response to the Hyde Inquiry report, the second term is used as a replacement for the first.

The inquiry, headed last year by provincial court Judge Anne Derrick, studied the death of Howard Hyde, a Dartmouth man who died in custody in 2007 at the Central Nova Scotia Correctional Facility in Dartmouth. Hyde suffered from mental illness and the cause of his death was initially identified by a coroner as "excited delirium."

Derrick rejected that as a "red herring." She found that Hyde died as a result of a restraint technique used on him by guards during a struggle.

Hyde had been repeatedly shocked with a stun gun during his 30 hours in custody. Derrick found that while the use of the stun gun did not cause Hyde’s death, the repeated shocks contributed to his deteriorating mental state.

Derrick’s report also strongly called for improved training for law enforcement officers who come in contact with people suffering from mental illness. The judge painted a clear path towards the use of de-escalation techniques in advance of the use of stun guns.

But the province seems to be struggling to find the right balance between public safety issues and the use of stun guns by officers. It has yet to finalize its guidelines for stun gun use, though Justice Minister Ross Landry said Thursday they will be released within a few weeks.

The minister did not explain why there has been a delay in issuing the guidelines or why, if only a few more weeks were needed, the province’s response to the inquiry report was not delayed so the documents could be released together.

But it speaks volumes that the use of the stun guns has already dropped by over 70 per cent since Hyde’s death in 2007, as The Canadian Press reported on Thursday.

In addressing what is now being described as an "autonomic hyperarousal state," the report released Thursday did not rule out using a stun gun on a person who may be mentally ill. But plenty of work remains to be done on the training side of the equation.

"Law enforcement officers must have appropriate tools to assist them in maintaining public safety," says the report. "At the same time, people living with mental illness may already be experiencing a high level of anxiety and the use of restraint could escalate the situation.

"The province and policing partners agree that the use of conducted energy weapons should only occur when a person’s behaviour is aggressive or violent and could harm the person or the public or the police officer. Additional direction is required regarding the restraint of individuals with mental illness."

The delay in providing that direction is not explained but Landry is clearly not comfortable with the current level of knowledge and training.

"It’s very difficult in situations where . . . there’s a high level of disturbance for the police officer to determine whether the person is suffering from mental illness," the minister told reporters on Thursday after the response was released.

In fairness to police, officers are often called on to make very quick decisions about the use of force in highly charged situations. But the death of Howard Hyde, among other cases, provides a reminder of the responsibilities that accompany the use of force, including the use of stun guns and other various forms of restraint.

There are federal guidelines available to help officers make those judgment calls and the province has said its stun gun rules will consider the federal document as well as expert advice provided by a panel of psychiatrists.

Derrick was clearly on the right track in emphasizing the need for much better levels of training. And in fairness to the province, some progress has already been made in addressing areas of concern raised in the inquiry report.

But the wheels continue to grind slowly towards the judge’s most important recommendation, adopting a provincial mental health strategy. The government is still waiting for a report from stakeholders.

It has been nearly two years since the NDP formed government and promises to improve mental health policies and services are growing stale.

(mstephenson@herald.ca)
Image credit

Disclosure guidelines protect privacy, improve care

An opinion piece published in today's edition of The Chronicle Herald.
By Ian Slayter (pictured)

Capital Health’s Mental Health Program recognizes the need to listen better to our patients. Only the people living with mental illness can help us understand their goals and needs as they see them. For this reason, we must provide them with the information, treatment and support they need to follow their own path to recovery.

Often, care is shouldered by families — people, whether relatives or friends, who provide the emotional and practical support that is so critical to someone living with mental illness. They are one of our greatest resources because they provide timely, insightful information about a person who is becoming more ill or not responding well to treatments.

Providing families with general information about treatment and care improves their understanding of what their loved one may be experiencing. If we encourage patients to consent to share basic clinical information about their illness, treatment and needs, families are better able to help them. We know from research that working with families improves patient outcomes.

We have a duty of care not only to the patient but also secondarily to the family, as defined above, both to help them support the patient, and to help them cope with the challenges of living with, and caring for, someone with mental illness.

We have drafted disclosure guidelines, with insight from individuals living with mental illness, families and care providers to guide how and what information can be shared when the patient consents, and what is withheld when the patient is not prepared to do so.

This is all in accordance with the Personal Health Information Act and other applicable laws of Nova Scotia. We are now finalizing the guidelines in response to the extensive feedback received from stakeholders.

In an April 28 opinion piece titled "Mental health care: Are our rights to privacy being eroded?" Aileen McGinty stated that our policies, meaning the draft disclosure guidelines, "may not be in compliance with legislation." However, we have taken steps to ensure that the guidelines do follow legislation and the UN Convention on the Rights of Persons with Disabilities.

She suggested the guidelines prioritize the rights of family members over the rights of patients. We respect the rights of the individuals living with mental illness and work with them to arrive at the level of consent they are comfortable with, first and foremost. There are certain situations, allowed by law, where limited disclosure may be necessary to prevent danger.

Patients’ personal health information is private and confidential. The central message of our guidelines is that care providers should explain to patients that sharing of some of their clinical information about their illness, treatment and related needs can improve the level of their support. The care providers are advised to ask if the patient wishes to consent to share particular information with designated persons.

Ms. McGinty’s feedback is helpful; we need to make certain elements clearer. We have received a lot of helpful feedback from many people. The disclosure guidelines will be available on our website, OurHealthyMinds.com, along with other supporting material.

Collaboration is a major step in improving our services. The insight we gain from individuals and families based on their experiences in our system is invaluable. The disclosure guidelines provide a process to open communication among individuals, families and care providers, while protecting and respecting the rights of individuals living with mental illness.

Dr. Ian Slayter is clinical director, Adult General Psychiatry Services, Capital Health Mental Health Program; and assistant professor, Dalhousie University, department of psychiarty.

Also see:

CDHA Mental Health Program Disclosure Guidelines - DRAFT - 30 March 2011

Friday, May 13, 2011

Taser guidelines still in works

An article published in today's edition of The Chronicle Herald:
Justice minister promises rules resulting from Hyde inquiry will be released soon

By Michael MacDonald, The Canadian Press

More than three years after the jail cell death of a mentally ill man, the province’s Justice Department has yet to introduce new guidelines describing when peace officers can use Tasers.

Howard Hyde died on Nov. 22, 2007, after a struggle with guards at a Halifax-area jail. His tragic story attracted national attention because Halifax police Tasered him multiple times during a psychotic episode about 30 hours before he died.

In December of last year, provincial court Judge Anne Derrick released a fatality inquiry report that concluded the Tasering did not cause the death of the 45-year-old musician, who had long suffered from schizophrenia.

However, Derrick did find that the Tasering worsened Hyde’s rapidly deteriorating mental state, and she recommended that stun guns should not be used to immobilize emotionally disturbed people unless crisis intervention techniques have failed.

In its formal response to Derrick’s report, the provincial government said Thursday its revamped guidelines are still being finalized.

Justice Minister Ross Landry [pictured] said he is still concerned about the ability of police officers to recognize mentally ill people in distress.

"It’s very difficult in situations where . . . there’s a high level of disturbance for the police officer to determine whether the person is suffering from mental illness," Landry, a former RCMP officer, told a news conference.

Landry said he had hoped to have the guidelines ready before the government issued its response to Derrick’s inquiry. He didn’t say why there was a delay, but he confirmed the new rules will be released within two weeks.

During Derrick’s fatality inquiry, which lasted 11 months, Halifax Regional Police argued that its officers are trained not to stun anyone until de-escalation techniques have been tried. But Derrick rejected that position, saying police policy and the province’s standards made no mention of this requirement.

Despite the absence of new guidelines, the government’s response indicates police have already changed the way they use so-called conducted energy weapons.

Since 2007, the year Hyde died, police use of the type of stun gun used on the man has dropped by 74 per cent in Nova Scotia.

Landry said the dramatic decline was the result of a growing body of knowledge about the weapon. He said police were still learning about the impact of the weapon in 2007 when a medical examiner declared Hyde’s death was caused by a condition known as excited delirium.

The condition, also known as autonomic hyperarousal, is characterized by increased strength, paranoia and suddenly violent behaviour marked by profuse sweating and an elevated heart rate. Hyde demonstrated most of the traits in the hours before he died.

However, Derrick’s report rejected excited delirium as the cause of death, finding instead the death was caused by Hyde’s struggle with jail guards. The judge concluded the guards applied restraint techniques that may have interfered with Hyde’s breathing.

Kevin MacDonald, the lawyer representing Hyde’s sister, Joanna Blair, said his client was troubled by the fact that the government’s response says that police and corrections officials require a clear understanding of how conducted energy weapons may affect people in an autonomic hyperarousal state.

"There appears to be a suggestion that the police be trained to recognize the symptoms of (excited delirium) when . . . judge Derrick’s report states that the province should not emphasize in its policies or training the phenomenon of excited delirium," MacDonald said in an interview.

"It’s significant because excited delirium . . . can be used as a justification for the use of force, which is what happened in Mr. Hyde’s case. I think it’s wrong that they’re taking this position. It’s contrary to what judge Derrick found, and it indicates there’s not an acceptance of the cause of the death."

In her inquiry report, Derrick said she agreed with one expert who testified that citing excited delirium as a cause of death resulted in Hyde being "identified as the culprit."

"(Derrick) specifically cautioned police officers . . . from looking for signs of excited delirium," MacDonald said. "And here is the province suggesting they’re going to train them in recognizing it."

Most of Derrick’s 80 recommendations called for improved training, more funding for mental health services and better co-ordination and communication between justice and health officials.

On Thursday, Health Minister Maureen MacDonald said the province has already implemented some of the judge’s recommendations, but some will have to wait because the government has yet to receive a final report from a committee appointed last year to draft a provincial mental health and addictions strategy.

"There are a number of actions and activities that are very significant that will make a real difference for people who are suffering from a mental illness," MacDonald said, adding that 911 dispatchers have been given a standardized checklist that will help them recognize mental health issues.

Among other things, the province has increased crisis intervention training for police and health-care professionals, and it has established a new, psychiatric intensive care unit at the East Coast Forensic Hospital near Halifax.

As well, a new mental health and justice committee has been appointed, and the province is spending $4 million this year on residential units for people recovering from mental illness.

Aside from the money for the residential units, the province provided no other cost estimates.

Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, said the government’s moves represent an important first step.

"There’s a lot of work to be done yet," he said after the government report was released. "Things have changed immensely because of (Howard Hyde’s) death . . . I think that things are going to change substantially."

Also see:

Province Releases Plan to Improve Care in Custody

Building Bridges: Improving Care in Custody for People Living with Mental Illness

Hyde Fatality Inquiry


Image credit

Sunday, May 8, 2011

Tony Power - Healing Expressions


Accompanying text from YouTube:
Tony Power an amazing Newfoundland artist who lived his life with mental illness, had painted for twenty years as an outlet for his self expression and personal healing.

Tony is no longer with us but he is remembered for his talent, grace and quiet spirit. Tony was an active painter with Healing Expressions. The organization formed for those with mental illness and addiction in St. John's, Newfoundland, Canada. All are welcome at Healing Expressions.

Also see:

The man with the beautiful soul

The Schizophrenia Society of Nova Scotia’s 3rd Annual Road to Recovery Walkathon

Held on Saturday, May 7th, 2011


Your presence
had a strong impact on reducing stigma

Your presence
motivated our community to learn more about mental illness

Your presence
has inspired others to take action

Your presence was IMPORTANT!



The funds raised during the first three Road to Recovery walkathons have been crucial in allowing the Schizophrenia Society of Nova Scotia to carry out its mission of improving the quality of life for those affected by schizophrenia. Your support is vital to continuation of the extensive and important work of the Schizophrenia Society of Nova Scotia. Your support is essential to the delivery of the educational and support programs such as Strengthening Families Together, Your Recovery Journey, and the From Recovery to Discovery Peer Support Group. Your support is IMPORTANT!

There is still time to make a donation in support of the 3rd Annual Road to Recovery Walkathon! To do this, please click here and then click "Make a Pledge" for a specific person, or click here to make a general donation.


Please click on any photograph to magnify it.














SSNS – Recovery is Possible!


Major Sponsors





Gift-In-Kind Sponsors





Please click on the sponsor logos to be directed to their websites.

Thursday, May 5, 2011

Media Advisory - 3rd Annual Road to Recovery Walkathon


A media advisory issued today by the Schizophrenia Society of Nova Scotia:


Please click on the image to magnify it.

Also see:

www.ssnswalk.dojiggy.com

Mental Health Commission of Canada praises investments in mental Health by New Brunswick and Newfoundland and Labrador



A media release issued today by the Mental Health Commission of Canada:
CALGARY, May 5 /CNW/ - The Mental Health Commission of Canada (MHCC) is applauding the provinces of New Brunswick and Newfoundland and Labrador for their recent commitments to mental health. "I am so pleased to learn of these announcements," said Louise Bradley, MHCC President and CEO. "These commitments reflect the important steps taken by several provinces to transform their approach to mental health," she said.

New Brunswick has released a new action plan for mental health, with a vision for all New Brunswickers to have the opportunity to achieve the best possible mental health and well-being. The plan includes a range of initiatives such as the introduction of recovery-oriented treatment teams in communities across the province, cultural safety training and the promotion of mental fitness and resiliency early in life. The MHCC had the opportunity to participate in the province's Mental Health Strategy Advisory Committee alongside New Brunswick stakeholders. (Read the New Brunswick action plan at http://www.gnb.ca/0055/pdf/2011/7379%20english.pdf)

In its latest budget, Newfoundland and Labrador has committed 8.7 million dollars to mental health initiatives, including an awareness campaign to fight stigma, an e-mental health program and peer support. MHCC President and CEO Louise Bradley welcomed the chance to participate in discussions with Newfoundland and Labrador's Provincial Mental Health and Addictions Advisory Council related to the province's mental health planning. "I look forward to working with the Council on an ongoing basis," Bradley said. (Read the Newfoundland and Labrador budget details at: http://www.budget.gov.nl.ca/budget2011/default.htm)

The MHCC is currently developing a mental health strategy for Canada and continues to work directly with provinces and territories on the details. (For more on the MHCC strategy, please visit http://www.mentalhealthcommission.ca/English/Pages/Strategy.aspx)

The Mental Health Commission of Canada is a catalyst for transformative change. Our mission is to work with stakeholders to change the attitudes of Canadians toward mental health problems and to improve services and support. Our goal is to promote mental health and help people who live with mental health problems lead meaningful and productive lives. The Mental Health Commission of Canada is funded by Health Canada. For more, visit www.mentalhealthcommission.ca


The views represented herein solely represent the views of the Mental Health Commission of Canada.


Production of this document is made possible through a financial contribution from Health Canada.


For further information:

Nujma Bond, MHCC Communications, 403-385-4033

IWK 4 South Inpatient Mental Health Partners in Care Committee Newsletter - May 2011



Please click on the image to magnify it.

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

Wednesday, May 4, 2011

Mental health session draws ideas, skeptics

An article published in today's edition of The Chronicle Herald:
Committee seeks input from people affected by addiction, other issues

By Pat Lee, Staff Reporter

A public session on how to improve services for those with mental health or addiction issues elicited lots of input Tuesday on where the system needs improvement and a healthy dose of skepticism about the exercise.


While those attending the afternoon-long session in Halifax agreed there is an urgent need for a better way to treat and support those with mental illness or addictions, especially among the young, some said the problems have been studied for decades.

"These are the same issues that have being going on for 25, 30 or 40 years now," one person said. "What’s going to be different?"

Terry Taylor of the Nova Scotia Health Research Foundation, which was handed the task of running the consultations, said he’s not surprised by the skepticism.

"A question we’re asked, not infrequently, (is), ‘What’s different now?’ " Taylor said.

He said people should be optimistic that change will occur because Health and Wellness Minister Maureen MacDonald, who struck the committee a year ago, is "100 per cent committed and passionate about this issue. She has said publicly that she would like this to be her legacy."

Tuesday’s gathering was one of six public consultations organized by the committee that is charged with creating the province’s long-awaited mental health and addictions strategy. The committee is composed of a dozen health experts, researchers, mental health clinicians and people living with or affected by mental illness.

During Tuesday’s session, interest peaked when the discussion turned to the need for improved addiction services around the province, particularly for young people.

Of the 134 beds set aside for the treatment of alcohol or drug addiction, none are specifically for young people, Taylor said.

Many in attendance said it’s next to impossible to get help for mental illness or addiction unless someone has reached a crisis point.

It’s well known that a child in a mental health crisis will not be seen at the IWK Health Centre unless they are thought to be suicidal, Dr. Bob Frederickson said.

"That has to be publicly stated because that’s crazy," he said.

Dr. David Pilon, program leader of specialty mental health services for Capital Health's mental health program, said his staff is overwhelmed. He said 80 or so clinicians assess and treat more than 600 new referrals a month, on top of many other specialty treatment and programs offered at the hospital

"We have reached a critical point where we’re up against a wall," he said. "Less than four per cent of the total health care budget goes to mental health and it no longer computes."

"Psychiatric and addiction care is one of the worst services we have in Nova Scotia," said another physician, who did not want to be named.

"We need more timely access. My perception is that the system is mired in paperwork and passing the buck and working nine to five."

Along with public input, the committee is seeking input from health-care providers, government agencies, non-profit groups and any others involved with or impacted by those with addictions or mental health concerns.

Taylor said the information gathered, which will result in recommendations sent to government sometime in the fall, comes on the heels of work done by Senator Michael Kirby in the area of mental health advocacy. Closer to home, there has also been the Hyde Report by Judge Anne Derrick.

While the report on Howard Hyde, a [man with schizophrenia] who died after struggling with jail guards, focussed on dealing with the mentally ill within the justice system, Taylor said the report also highlighted the need for an infusion of funding within the mental health care system as well as other related recommendations.

Along with the public meetings, including one this Thursday from 9 a.m. to 12:30 p.m. at the South Shore Regional Hospital in Bridgewater, Taylor and his group have met with 67 other groups and plan to talk to about 40 more before the end of the month. The group expects to hear from about 1,000 people before it’s done.

People can also provide input online or through the mail. For more information, go to bit.ly/kCWwE2 or call 424-4043.

(plee@herald.ca)

Photograph by Eric Wynne / The Chronicle Herald

Sunday, May 1, 2011

Patient referrals and the law



From an article published in the January 2010 edition Psychiatric Services:
It is increasingly plausible that not referring [mental health] patients to recovery- and rehabilitation-oriented groups — to self-help groups, supported employment, supported education, and other similar community participation and consumer-run programs — may now raise liability issues, whereas such referrals may have been viewed as risky decades earlier.
To read the entire article (PDF) please click here.