Changing How We Look at Mental Illness and Changing Lives

A March 13th posting by Psychology in Action:

By Rachel

One in five children in the US suffers from mental illness, but less than 25% of those children actually receive mental health services. That’s absolutely terrifying, especially if you consider all the kids who have other psychological struggles but don’t meet diagnostic criteria for a psychological disorder. How many children then aren’t getting the help they so desperately need? What kind of effect is that having on the future generations of workers, leaders, innovators, educators, and generally just society? As a future clinical psychologist, this is shocking. How has the field failed? Don’t get me wrong, there have been great innovations and huge strides in understanding mechanisms of psychological disorders and developing treatments that alleviate some of the suffering, so why aren’t these kids getting helped?

The Problems

• The stigma associated with mental health problems and treatment is huge. The public has a very limited understanding of what psychological distress is. The media is flooded with stories about people with all sorts of mental issues doing terribly harmful things, like Jared Loughner who shot Arizona House Representative Gabrielle Giffords and eighteen others, murdering six. This is the poor and incomplete representation of mental illness that we get every day. As a society, we equate mental illness with the crazy criminals we see in the news. To some extent, we fault individuals for their own issues, attributing it to a lack of will power or just weakness or bad character. The stigma and blame actually keep people from understanding how prevalent mental disorders actually are and seeing how individuals suffering from them may not be at fault. Mental illness is not just Jared Loughner or Seung-Hui Cho the Virginia Tech shooter. It is also people struggling with severe depression leading to isolation or those with overwhelming social anxiety who fear making friends, among other things.

• People don’t know how to identify signs of psychological distress. Disruptive behavior disorders, like ADHD or conduct disorder, are noticed because they interfere in the classroom. Other disorders, like anxiety, can even be functional to an extent, leading to high academic achievement, but can also become so overwhelming to the point of a complete loss the ability to concentrate and learn.

• People don’t know where to get help or what kind of help is best when they figure out that there’s a problem. If they figure out what kind of help they need, financial burdens may make it hard for them to actually get help, especially in the age of managed care and reimbursement problems from insurance companies.

• Researchers aren’t doing enough to get their awesome treatments out there. Tens of millions of dollars are spent each year on developing and testing treatments that have the potential to change lives. Lots of published research trials support their efficacy, but still, they’re not getting out into the clinics and hospitals and to the people that need them most.

• The economic crisis and lack of advocacy from the public are leading to huge funding cuts for community clinics and research. All of the other problems contribute to this issue too. If people don’t believe that mental health is important and don’t believe that psychological treatments might work, they won’t push for funding to support the community clinics or increase research efforts to figure out how treatments can work outside of research labs.

What can we do to fix it?

• As a member of the general public, get informed about mental health issues. Learn what’s going on through websites, newspapers, or other venues. The New York Times has been running a great series called “Lives Restored” about people struggling with severe mental illness who have managed to positively change the trajectories of their lives.

• Spread the word about mental health needs. Talk to your friends about it as you learn. Share informative links with members of your community.

• If you are gateway personnel, like a teacher or school counselor or pediatrician, who is regularly in touch with children and families, learn the signs and symptoms of mental illness.

• As a mental health professional, psychologist, social worker, or whatever, spread the word about mental health services. Talk to gateway personnel about available resources, either online, books, or clinics, to help them refer those struggling in the right directions.

• Mental health professionals should also keep up on the literature. What is the research showing to be effective? How can that work be applied to inform the work you do?

• As researchers and treatment developers, form partnerships with schools and community clinics to understand their systems and needs. Work with them to integrate your research findings into their framework. Offer training and supervision opportunities.

• As a community, talk to government officials about mental health needs. Push for funding for that work. Really make a case for how important it is to identify struggles early and give people the skills to deal with them.

• As an individual, just try to alter how you think about mental illness and how you talk about it. The homeless man on the corner is not a schizophrenic. He is a man struggling with schizophrenia. See people as people who are suffering, not as a disorder.

There are a million other problems and probably even more solutions. We are at a crossroads. The need is great and it’s finally our chance to impact the outcome, whatever our small role may be.

Also see:

Mental Health First Aid

Capital District Health - Community Mental Health: First Visit

From the OurHealthyMinds.com website:

Community Mental Health has changed the way individuals access their services.

First Visit

On May 2, 2011, Community Mental Health changed the way individuals access their services. In the past, Individuals have often had to wait weeks or months to be seen. These changes will drastically reduce the time they will have to wait. Each Community Mental Health location will have a designated day or days each week when they will be seeing new clients. This new initiative is called First Visit.

First Visit is a simple, easy way for people with significant mental health problems or mental illness to access help from Community Mental Health. We do not offer emergency services. Call Mental Health Mobile Crisis - 429.8167 or 1(888) 429.8167 – or go to your local emergency department.

During your First Visit, you will see a therapist to talk about the mental health problem that prompted you to seek help; what helps your manage; and ways to build on your strengths and resources. If you need further assessment or treatment, this will be offered.

How do you book a First Visit?

We encourage you to contact your family doctor for a referral. They will receive information about your visit in a timely manner.

You can [also] book a First Visit [on your own] with one of our Community Mental Teams by calling on Monday (Friday if Monday is a holiday). Each of our locations has a specific day, or days, each week when new clients are seen.

Here are our locations and telephone numbers:

Dartmouth Community Mental Health
Belmont House, 33 Alderney Drive, Dartmouth
Tel: 466-1830
First Visit is offered on Thursdays.

Bayers Road Community Mental Health
Suite 109, Bayers Road Centre
7071 Bayers Road, Halifax
Tel: 454-1400
First Visit is offered on Tuesdays and Thursdays.

Bedford/Sackville Community Mental Health
Cobequid Community Health Centre
40 Freer Lane, Lower Sackville
Tel: 865-3663
First Visit is offered on Tuesdays and Thursdays.

Cole Harbour Community Mental Health
Cole Harbour Place
51 Forest Hills Parkway, Dartmouth
Tel: 434-3263
First Visit is offered on Tuesdays.

West Hants Community Mental Health*
89 Payzant Drive, Windsor
Tel: (902)792-2042
First Visit is offered on Tuesdays.

This service is offered through Capital Health and there is no direct cost to the patient. We provide consultation and individual and/or group therapy to people living with a mental illness or struggling with a mental health problem. We work closely with family doctors and community agencies.

First Visit is for individuals 19 years of age and older.

*West Hants supports adults, youth and children.

Also see:

Stats, research lead to sooner First Visit

People Living with Mental Illness Propose Improvements to Interactions with Police in Canada

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

Also see:

People Living with Mental Illness Propose Improvements to Interactions with Police in Canada

Study finds mentally ill more likely to be arrested, harmed by police

Advancing Standards of Care for People with Schizophrenia

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

Also see:

Pilot program demonstrates measurable benefits for people with schizophrenia

Advancing Standards of Care for People with Schizophrenia: A National Council Quality Improvement Project

Outpatient Art Group - Abbie Lane Art Room

Every Tuesday, 6:00 pm!

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Healthy Minds Cooperative Newsletter - March 2012

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

Also see:

Healthy Minds Cooperative

Nova Scotia Bipolar Peer Support Alliance – Halifax Chapter

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Stereotypes of mental disorders differ in competence and warmth

A February 21st posting by Neuroskeptic:

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Fighting "the stigma of mental illness" is big business at the moment. But does "the stigma" really exist?

As I said back in 2010:

There is a stigma of schizophrenia, and there's a stigma of depression, etc. but they're not the same stigma. We're told it's a myth that "the mentally ill are violent" - [but] no-one thinks depressed or anorexic people are violent. They think (roughly) that people with psychosis are. They have other equally silly opinions about each diagnosis, but there's no monolithic "stigma of mental illness".

Now a paper has come out which explores this idea in some detail: Stereotypes of mental disorders differ in competence and warmth. The title says it all : people have stereotypical views of people suffering from different mental disorders, but these stereotypes vary substantially.

To read the entire post, please click here.

Image credit

Also see:

Stereotypes of mental disorders differ in competence and warmth

Assisted Outpatient Treatment: The Data and the Controversy

A November 17th, 2011, presentation by Marvin S. Schwartz, MD, Services Effectiveness Research Program, Duke University Medical Center, at New York University Langone Medical Center, New York, NY.

Also see:

Community Treatment Order (PDF, Nova Scotia)

Landlords pitch in to help people with mental illness find housing

From the February 22nd edition of Information Morning:

The CBC's Rob North tells us about a new initiative that might make things better. [Note, the segment begins after a short advertisement for a podcast.]

Also see:

250 Homes

Community Living Initiative: The Bungalows

Amanda Tetrault speaks at a Media Symposium

From the YouTube posting:

Amanda Tetrault, photographer, shares her personal experience with mental illness at the King's College media symposium.

Amanda Tetrault created a photographic book about her relationship with her father called Phil and Me. She shares her story from a lifetime with a father who lives with severe schizophrenia through captivating photographs.

Also see:

Phil and Me

Canadians Need Better Access to Psychological Services

A February 6th media release from the Canadian Psychological Association:

OTTAWA, Feb. 6, 2012 /CNW/ - Today in honour of Psychology Month, the Canadian Mental Health Association (CMHA), the Mood Disorders Society of Canada (MDSC) and the Canadian Psychological Association (CPA) joined forces to highlight the need to enhance access to mental health services in Canada.

Mental disorders are a leading cause of disability in Canada and represent a significant burden on the economy. It estimated to cost the Canadian economy $51-billion annually. Psychologists are the largest group of regulated and specialized mental health care providers in Canada. Yet Canadians, in particular those in lower and middle income levels, face significant barriers when it comes to accessing psychological services due to their cost.

"The services of psychologists are not funded by provincial health insurance plans which make them inaccessible to Canadians with modest incomes or no insurance" said Peter Coleridge, National Chief Executive Officer, of the CMHA. This is in spite of the fact that some of the most effective treatments for common mental disorders - depression and anxiety - are psychological ones like cognitive behaviour therapy".

The U.K. has invested 400 million pounds over four years to make psychological therapies more accessible, and Australia has also enhanced access to psychologists through its publicly funded health insurance plans" adds Coleridge. "Canada must do the same."

"It is vitally important that we look to the needs of the community when it comes to mental disorders and health promotion and that we respond to those in ways that are effective" said Dave Gallson, Associate National Executive Director of MDSC. "Our research has found that the lack of insured services prevents a majority of individuals with mental illnesses from seeking the support they need."

Next week the Government of Manitoba is hosting a mental health summit with a focus on children and youth. Seventy percent of adults living with a mental disorders experience the causes or onset of their disorders before age 18. Early intervention can make a dramatic difference in the course of a disorder and, ultimately in a person's life.

"Psychological services are proven effective in helping Canadians to manage and overcome psychological problems and disorders," added Dr Karen Cohen, Chief Executive Officer of the Canadian Psychological Association. "Canada's private health care insurance plans and publicly funded programs don't do enough to ensure Canadians have equal and adequate access to needed psychological service. Canada's governments and employers must do more to ensure all Canadians - regardless of income - can access the psychological care they need."
For further information:

Tyler Stacey-Holmes, Manager, Association Development, Membership and Public Relations
Canadian Psychological Association
613-237-2144, ext. 325 | publicrelations@cpa.ca

Bell Let’s Talk 2012: Join the conversation to support Canadian mental health!

On February 8th, 2012, for every text message sent and every long distance call made by Bell and Bell Aliant customers, Bell plans to donate 5 cents to Canadian mental health programs.


A video made in Halifax on January 28th, 2012:

Canadian Mental Health Association - Nova Scotia Division -- February 2012 Newsletter

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


Also see:

Canadian Mental Health Association - Nova Scotia Division

Wellbeing: The continuing struggle to raise awareness for mental illness

An article published in the January 30th edition of the National Post:

By Melody Lau

In its first year, the Bell Let’s Talk campaign managed to rally more phone traffic than the 2010 Olympics moment when Sidney Crosby scored his famous game-winning goal, a previous Bell volume record. Now entering its second year, the campaign is bigger than ever.

The extensive five-year initiative aims to get people across the country talking about mental health, in order to create awareness and raise money to fund programs. This year, Bell will donate 5¢ to mental health for every text and long distance call made by a Bell customer on Feb. 8. Last year alone generated more than $3-million. Not with Bell? Then just hop on Twitter; every retweet about the campaign also contributes 5¢ to the cause.

“We’ve had incredible support from so many places, from our advertising partners but also from our competitors,” says Mary Deacon, chair of the project. “Just in terms of getting involved and supporting this initiative, we don’t know how big it can get, but all we want to do is do better than last year, and we’ve added so many new dimensions.”

Such forms of expansion include a heavier focus on local stories and experts, a more comprehensive website to help inform people about mental health and the addition of two new spokespeople. Joining national spokeswoman and Olympian Clara Hughes [pictured] will be actor-comedian Michel Mpambara and author, composer and performer Stefie Shock.

“Clara came forward herself and said this is something she wanted to be part of, which is remarkable for somebody obviously as busy as she is,” says Deacon, about Hughes’ role in the campaign. “She’s a remarkable human being and we’re excited to have two more spokespeople this year.”

“We wanted to ensure that the messages that we’re sending were going to resonate with our various audiences,” Deacon adds. “What we want to do is help bring a voice to mental health that it maybe hasn’t had before.”

At least one in five Canadians will suffer from mental illness in their lifetimes and Bell hopes this initiative will shine a light on the underfunded and highly stigmatized subject.

“We really felt that it was an area where we could make a difference,” says Deacon about the impetus behind Bell’s decision to back this cause.

Deacon has spent the past 25 years in the business of not-for-profits and 10 years specifically focusing on mental health issues. She is proud of Bell’s efforts, adding that, “it was really refreshing, for me, to see a company apply the same kind of talents and strengths to something that was charitable.

“At the end of the day what this means is more money for mental health programs all across the country which we really want to help.”

For more information on the initiative, visit letstalk.bell.ca

Photo credit


Statistics provided by Bell Canada:

• At least 1 in 5 Canadians experiences a form of mental illness at some point in their lives – every one of us has a family member, friend or colleague who will experience mental illness

• Mental health funding is modest relative to other health care issues – mental illness represents 15% of Canada’s health care burden but receives only 5% of health care funding

• Just one-third of Canadians who need mental health services actually receive them

• Mental illness is the number one cause of workplace disability in Canada – accounting for 30% of disability claims and 70% of disability costs

• Mental illness costs the Canadian economy $51 billion each year in lost productivity – every day, 500,000 Canadians are absent from work due to a form of mental illness.

Also see:

Bell Media Fuels the Conversation About Mental Health in Support of Bell Let's Talk Day, Feb. 8

Stefie Shock and Michel Mpambara join Clara Hughes for second annual Bell Let's Talk Day on February 8, 2012.

Healthy Minds Cooperative Newsletter - February 2012

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

Also see:

Healthy Minds Cooperative

Colorado Voices: Harness the fear of schizophrenia

An opinion piece posted online on today by The Denver Post:

By Jean Trester

For four consecutive days, The Denver Post published pictures of Gabrielle Giffords and informed us that she is resigning from her office of U.S. Representative to focus on her recovery. If I were a U.S. visitor, I might wonder, "from what is she recovering?" Rereading the articles provides two hints: "massacre in Tuscon" and "shooting in January, 2011."

On day five, January 27, The Denver Post printed an "opinion" that had originated in The Washington Post. Gabby was wounded "allegedly by a deranged young man."

I know the culprits in the "massacre" are a gun, a young man, and a disease, schizophrenia.

In 1981, when President Reagan was wounded in an eerily similar act, the culprits were a gun, a young man, and a disease, schizophrenia.

The gun issue has been addressed (albeit ineffectively) through legislation and ongoing public discourse. (Please refer to The Washington Post "opinion.")

Young men, and women, too are to be nurtured.

What have we done with the disease schizophrenia?

We mimic brain addled cowards, hide in fear, and use euphemisms to describe the consequences of untreated schizophrenia. Please appreciate my arduous effort to restrain my cynicism.

I wish Gabby Giffords the epitome of medical treatment and Godspeed.

What I really wish is that the "shooting" had never occurred.

In the 1970s, we dismantled our state run mental hospitals, preferring community mental health care. We neglected to educate ourselves about major mental illnesses.

We need a comprehensive and concerted Public Health Policy to promote education for our entire population. Anyone who has contacts with adolescents or young adults should know the signs and symptoms of schizophrenia, should be comfortable with discussing these symptoms and assisting in find treatment. We teach sex education and heart health to middle school and high school students. Provide the same fact based information about major mental illnesses.

Schizophrenia signs and symptoms first exhibited are insidious and mild. Withdrawal from family and social contacts, confusion, inability to concentrate and insomnia, appear before florid hallucinations and dangerous delusions. If a college student, experiencing hallucinations, had been educated about major mental illnesses in middle school, he may be less likely to hide in shame and denial and more amenable to seeking treatment.

Anyone in our society should be able to say the word schizophrenia with the same ease and equanimity that we say poppycock, democracy, cancer, apology, Islam, Caucasian, AIDS, mulatto, thank you, etc. Accessing mental health care should be as socially acceptable and as readily available as seeing an orthopedist for a fracture.

I urge anyone who has experienced schizophrenia, has a family member or friend living with this disease, or earns a living caring for those afflicted to speak out, hold hands with our naive neighbors, harness our well-founded fears, and focus our energies on 21st century effective treatments and cures.

Demand science-based information, education, and research for better diagnosis, treatment, and prevention of schizophrenia. Like cancer, early diagnosis and treatment can thwart sickness and death.

Do it for our communities, our youth, and for Gabby.

Jean Trester (jrdtpost@gmail.com) of Centennial is a retired nurse.

EDITOR'S NOTE: This is an online-only column and has not been edited.

How antipsychotic medications cause metabolic side effects such as obesity and diabetes

An media release posted today by EurekAlert!:

Sanford-Burnham study suggests that many antipsychotics affect metabolism because they activate the TGFbeta pathway -- a finding that could lead to safer therapeutics for bipolar disorder and schizophrenia patients

LA JOLLA, Calif. -- In 2008, roughly 14.3 million Americans were taking antipsychotics — typically prescribed for bipolar disorder, schizophrenia, or a number of other behavioral disorders — making them among the most prescribed drugs in the U.S. Almost all of these medications are known to cause the metabolic side effects of obesity and diabetes, leaving patients with a difficult choice between improving their mental health and damaging their physical health. In a paper published January 31 in the journal Molecular Psychiatry, researchers at Sanford-Burnham Medical Research Institute (Sanford-Burnham) reveal how antipsychotic drugs interfere with normal metabolism by activating a protein called SMAD3, an important part of the transforming growth factor beta (TGFbeta) pathway.

The TGFbeta pathway is a cellular mechanism that regulates many biological processes, including cell growth, inflammation, and insulin signaling. In this study, all antipsychotics that cause metabolic side effects activated SMAD3, while antipsychotics free from these side effects did not. What's more, SMAD3 activation by antipsychotics was completely independent from their neurological effects, raising the possibility that antipsychotics could be designed that retain beneficial therapeutic effects in the brain, but lack the negative metabolic side effects.

"We now believe that many antipsychotics cause obesity and diabetes because they trigger the TGFbeta pathway. Of all the drugs we tested, the only two that didn't activate the pathway were the ones that are known not to cause metabolic side effects," said Fred Levine, M.D., Ph.D. [pictured], director of the Sanford Children's Health Research Center at Sanford-Burnham and senior author of the study.

In a previous study aimed at developing new insights into diabetes, Dr. Levine and his team used Sanford-Burnham's high-throughput screening capabilities to search a collection of known drugs for those that alter the body's ability to generate insulin, the pancreatic hormone that helps regulate glucose. That's when they first noticed that many antipsychotics alter the activity of the insulin gene. In this current study, the researchers set out to connect the dots between antipsychotics and insulin. In doing so, experiments in laboratory cell-lines showed that antipsychotics known to cause metabolic side effects also activated the TGFbeta pathway—a mechanism that controls many cellular functions, including the production of insulin—while the drugs without these side effects did not.

Wondering whether their initial laboratory observations were relevant to the human experience, the researchers reanalyzed previously published gene expression patterns in brain tissue from schizophrenic patients treated with antipsychotics. What they found supported their earlier findings—TGFbeta signaling was activated only in those patients receiving antipsychotic treatment. Looking further, they found that the extent to which each antipsychotic drug activated the TGFbeta pathway in human brains correlated very closely with the extent to which those same drugs activated SMAD3 and affected the insulin promoter in their cell culture experiments.

The TGFbeta pathway also plays an important role in metabolic disease in people who don't take antipsychotic medications. "It's known that people who have elevated TGFbeta levels are more prone to diabetes. So having a dysregulated TGFbeta pathway—whether caused by antipsychotics or through some other mechanism—is clearly a very bad thing," said Dr. Levine. "The fact that antipsychotics activate this pathway should be a big concern to pharmaceutical companies. We hope this new information will lead to the development of improved drugs."

###

This study was funded by a gift from Mr. T. Denny Sanford to the Sanford Children's Health Research Center at Sanford-Burnham. Co-authors include Thomas Cohen, Sanford-Burnham and University of California, San Diego; S. Sundaresh, NextBio; and Fred Levine, Sanford-Burnham.

About Sanford-Burnham Medical Research Institute

Sanford-Burnham Medical Research Institute is dedicated to discovering the fundamental molecular causes of disease and devising the innovative therapies of tomorrow. The Institute consistently ranks among the top five organizations worldwide for its scientific impact in the fields of biology and biochemistry (defined by citations per publication) and currently ranks third in the nation in NIH funding among all laboratory-based research institutes. Sanford-Burnham is a highly innovative organization, currently ranking second nationally among all organizations in capital efficiency of generating patents, defined by the number of patents issued per grant dollars awarded, according to government statistics.

Sanford-Burnham utilizes a unique, collaborative approach to medical research and has established major research programs in cancer, neurodegeneration, diabetes, and infectious, inflammatory, and childhood diseases. The Institute is especially known for its world-class capabilities in stem cell research and drug discovery technologies. Sanford-Burnham is a U.S.-based, non-profit public benefit corporation, with operations in San Diego (La Jolla), Santa Barbara, and Orlando (Lake Nona). For more information, please visit our website (http://www.sanfordburnham.org) or blog (http://beaker.sanfordburnham.org). You can also receive updates by following us on Facebook and Twitter.

Contact

Heather Buschman, Ph.D.
hbuschman@sanfordburnham.org
858-795-5343
Sanford-Burnham Medical Research Institute

Image credit

Also see:

Antipsychotics activate the TGFβ pathway effector SMAD3

Meet Halifax's Mental Health Mobile Crisis Team

An article posted on January 27th by CBC.ca:

Halifax's Mental Health Mobile Crisis Team is shrouded in secrecy.

They don't wear uniforms, they don't travel in marked vehicles and they keep the location of their headquarters a secret, to ensure the safety of the people working there.

Mary Pyche (pictured, centre), the program leader for crisis emergency services for the Capital District Health Authority, said the idea for a crisis team first started taking shape back in 2003.

"We started putting that proposal together to the department of health. Took a little while," she said.

"By 2006, we had the partnership up and running. We also included in the partnership the IWK as well, so that the service would offer crisis response in the community right across the age spectrum."

In a recent interview with CBC News, Pyche said the team handles about 1,000 cases a month. That's based on 300 to 350 people each making multiple calls for help to the team.

Pyche said 95 per cent of those calls are new — first-time callers or people who haven't called the crisis line for at least two months. That turnover is proof the team is successful, she said.

Mary-Beth Flory (pictured, right), a registered nurse and the clinical practice leader for the crisis team, spends her mornings preparing for when the team hits the road in the afternoon and evenings.

"Come 1 o'clock in the afternoon, the team sits down," Flory said.

"That's three clinicians and our two officers who are on for those hours. And we triage again where we're going to be going throughout the day — where we need to go first, what kind of supports do we believe the team is going to be needing to provide."

Halifax Regional Police support

Four members of Halifax Regional Police are assigned to the team. They work in plain clothes.

Const. Angela Balcolm (pictured, left), one of those officers, said a uniform wouldn't work in her job.

"We try to make people as comfortable as we can and of course, decriminalize mental illness," she said.

"We're there for the person's safety, not to look into any criminal matters."

Balcolm said officers operate under a memorandum of understanding, so they don't share what they hear on the crisis team with other police officers.

Pyche said the police officers give the team extra power.

"We knew if we could partner with police, that they had the authority to do wellness checks and we could go along with them," she said.

That police presence allows the team to respond when friends or family members warn about a person's deteriorating mental condition.

Not all 'lights and sirens'

Mary-Beth Flory said the team doesn't require family intervention to act.

"A person can refer themselves," Flory said.

"It's very easy access. It can simply be a phone call. A person does not need a referral from a physician or from a psychologist to access support, and that it is a wide range of intervention and services that can be provided."

For Angela Balcolm, working with the crisis team offers a different facet to police work.

"People watch TV and they see all the shows like Cops and all that," she said.

"Is that a reality in our work? Absolutely. Sometimes."

Balcolm said her work isn't all "lights and sirens."

"I think it's huge to see this program that is assisting people because the police role in this is huge — getting people, detaining people and taking individuals into hospital, if that's what needs to happen," she said.

Photograph by Blair Rhodes / CBC


Also see:

Mental Health Mobile Crisis Team

Mental Health Mobile Crisis Team (PDF)

Emergency Crisis Services - Mental Health Services - Cape Breton District Health Authority - Call (902) 567-7767

Key facts and trends in mental health: Updated figures and statistics

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To download the entire document, please click here.

Also see:

The NHS Confederation

Mental Health for All Coffee House

Every Saturday, 1:00 pm to 4:00 pm!

Bloomfield Centre, Rm 114, 2786 Agricola Street, Halifax

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Also see:

CMHA Halifax-Dartmouth Branch

NAMI Principles of Support

National Alliance on Mental Illness (United States)

Principles of Support

• We will see the individual first, not the illness.

• We recognize that mental illnesses are medical illnesses that may have environmental triggers.

• We understand that mental illnesses are traumatic events.

• We aim for better coping skills.

• We find strength in sharing experiences.

• We reject stigma and do not tolerate discrimination.

• We won’t judge anyone’s pain as less than our own.

• We forgive ourselves and reject guilt.

• We embrace humor as healthy.

• We accept we cannot solve all problems.

• We expect a better future in a realistic way.

• We will never give up hope.

Source

Yarmouth area attracts MDs

An article published in the January 3rd edition of The Chronicle Herald:

By Brian Medel, Yarmouth Bureau

YARMOUTH — Several physicians, including a number of psychiatrists, began practising in southwestern Nova Scotia during the summer and fall of 2011.

Three psychiatrists joined Southwest Health recently, bringing the number of psychiatrists to six in Nova Scotia’s westernmost health district.

All psychiatrist vacancies for the district are filled for the first time in more than 10 years, Southwest Health said in a news release.

Dr. Olufemi Banjo came in August, followed by Dr. Razi Hemani in September and Dr. Lourdes Soto-Moreno (pictured) in October.

"It certainly is good news, and hopefully we’ll hold on to them; there’s certainly the need," said John Roswell, a Digby Clare Mental Health Volunteers co-ordinator, on Sunday.

"It’s terrific if we have the full complement. Hopefully, it will mean that people get to see a psychiatrist and eliminate the lengthy wait process.

"It has been practically impossible to get to see a psychiatrist within six months, and it’s very heartening to hope that wait times may be decreased somewhat because of this."

The common wisdom is that 20 per cent of people will require psychiatric services or will experience a mental illness at some point during their lifetime, said Roswell.

The reporting of mental illness and the number of people seeking help has increased, he said.

Dr. Faten Germanus began working at a family medical practice in Barrington Passage in December. She is not yet accepting patients but an announcement will be made soon when she is ready to take on new patients, according to a news release.

Dr. Navdeep Mangat also began working in Digby General Hospital’s emergency department in December and will provide services at the Digby Well Womens Clinic starting this month.

And southwestern Nova Scotia residents with no family doctor but who have high blood pressure may take advantage of a new cardiovascular program at Yarmouth Regional Hospital, to be based in the facility’s wellness centre.

(bmedel@herald.ca)

Photo credit

Blessings from schizophrenia? Believe me, they exist

An article published in the today's edition of The Globe and Mail:

By Anne Aspler (pictured)

There was a ticking time bomb in my head that deactivated at the age of 26: the probability of schizophrenia. That’s when, for first-degree relatives, the statistical likelihood of developing the disease drops from 13 per cent to that of the general population: 1 per cent.

My mom is afflicted with schizophrenia. Despite never having had signs or symptoms, I used to live in constant fear that, one day, I might develop it. The path of my life was driven by this fear. I overworked myself to ensure a livelihood that would enable escape from the stigma of mental illness and unemployment. Becoming a doctor seemed the best I could do to champion my own mental sanity, and to further understand an illness that has never made sense to me.

For some, Christmas aggravates their heart failure – all those salty holiday indulgences. For others, the season precipitates their “brain failure” – the stress, anxiety and loneliness is amplified by the process of reflection on years past.

For part of last year’s holiday season, I found myself on the crisis-psychiatry team at one of the busiest inner-city centres in Canada: St. Michael’s Hospital in downtown Toronto. “Crazy” became the new norm, all day, every day, suicide and self-harm an acceptable and prevalent psychological exit.

My worst moment of flashback to my own experiences occurred when I had to make a phone call to the Children’s Aid Society. I’d just spent an hour developing a good rapport with a newly divorced, newly unemployed, suicidal single parent – courageous in seeking help. Calling CAS was a decision that would result in the removal of her children from her home – at Christmas.

To me, it was the ultimate betrayal of her trust. I felt as though I had betrayed my own mother. Instead of going home for the holidays last year, I externalized my distress by going to Haiti as a volunteer physician working on cholera-relief efforts.

As early as Grade 3, I had an understanding of the societal taboos around mental disease. That year, our art-project assignment was to “depict your parent’s career in a drawing.”

My mom? Unemployed. And so I developed a knack for creativity. I didn’t understand exactly what was wrong with my mother, so making up a career for her wasn’t a big stretch.

In high school, my sister and I were recruited for a University of Alberta study of children with a parent who had schizophrenia. Enrolling in this was like facing my biggest fear. I was sure the survey would uncover that, secretly, my mental stamina of steel had been blocking out symptoms that would eventually resurface with a vengeance.

Quite the opposite happened: It was a first step toward freedom. Not only did they declare my sister and I mentally “healthy”; they did something far more important to me – they normalized the disease.

I understand now that “mentally healthy versus ill” is an often unhelpful dichotomy. The psyche of the population exists on a spectrum. Scientifically, we have constructed an arbitrary standard. Past a certain point of dysfunctionality, some will be labelled, recommended for therapy and medically treated.

The rest of us can retain our status as “normal” and obtain socially acceptable therapy in the form of free counselling from family members and friends, self-therapy in the form of reflection, and perhaps moderate doses of self-medication.

Even for one individual, mental wellness fluctuates immensely over time. Practising medicine has reaffirmed for me that there is not one among us who is 100-per-cent mentally sound in all day-to-day exchanges and decision-making. Most of us could probably cite one or two mental hang-ups they could do away with. Thankfully, we escape any permanent labelling and write these off as a mood, an anxiety, impulse or worry.

I realized I'm tired of the silence around mental illness. I'm tired of contributing to the stigma by hiding the reality that these patients are our sisters and brothers, our parents, our closest friends – the ones in our lives whom we love but don’t know how to reach out to.

The reality? My mother is a great parent. With age, I’ve come to appreciate that her demeanour has given me a positive outlook on life; and it has imbued me with an inordinate capacity to tolerate chaos and disruption. They are traits that have served me well as an emergency resident physician in Toronto and working overseas in resource-poor settings in South America, Asia and Africa.

It's also taught me to value my clarity of mind and to put it to use. It gave me the opportunity to benefit firsthand from Canada’s social safety network. It has bred a doctor and a teacher (my sister) who will be strong lifelong advocates for redressing social inequity.

To my colleagues who work with those affected by mental illness: Thank you for showing them patience and understanding and treating them as equals, even when society, or sometimes their own family, doesn’t.

My mom has really done her best. She’s spent her entire life struggling to cope with the mind inside of her, as well as to cope with the reactions of the world around her.

She’s amazing, really. My sister and I will probably try to micromanage her symptoms until the end of her days. But we love her. And we owe her and her illness everything.

Anne Aspler lives in Toronto.

Photo credit

Mental Health First Aid Roleplay Video

From the YouTube posting:

The Jack Project at Kids Help Phone, in partnership with the Mental Health Commission of Canada / Mental Health First Aid has produced this role play video. It outlines the need for mental health awareness and the Mental Health First Aid helping actions that can be used to support someone who is struggling.

The Honourable Michael Kirby speaks to the importance of peer support

From the YouTube posting:

Chair of the Mental Health Commission of Canada, the Honourable Michael Kirby spoke to the importance of peer support in the Mental Health Strategy for Canada at the Peer Project event in Ottawa on October 5th, 2011.

Putting the focus back on the patient

An article published in the December 1st edition of The Chronicle Herald:

IWK hopes to whittle down wait for youth mental health services

By John McPhee, Health Reporter

Add value and keep it simple.

It sounds like a business marketing pitch but actually it sums up an increasingly popular system for treating young mental health patients.

Two child psychiatrists from Britain have been working with staff at the IWK Health Centre in Halifax this week to see if the Choice and Partnership Approach will work there.

About 1,100 people are on the waiting list for child and adolescent mental health services at the IWK Health Centre in Halifax. That wait can be as long as 18 months, compared with the standard acceptable wait of about a month.

"They’ve noticed some of their systems haven’t helped users as well as they would like," Steve Kingsbury [pictured], a child and adolescent psychiatrist based in London, said in an interview Tuesday during a break in the training session at a Halifax hotel.

"How you organize services (and) the paperwork you have to do? And I don’t think they could see any way of doing it better until they heard about this."

Kingsbury and Ann York, who also works in London, have taken the "reduce bureaucracy and focus on the patient" message to 11 countries in the past six years. They and other clinicians came up with the system as a way of tackling long wait times and unacceptable outcomes, York said.

"The central premise is how to design services to make things better for the young person and their family, a better experience and more effective for them. All the things we then do organizationally and clinically are around having them at the heart of it."

The usual treatment approach would see a doctor do a thorough assessment of the patient. But recommendations are often made based solely on such assessments, without finding out what makes sense to the family or the child or what they want, the doctors said.

The question of wants, not needs, is crucial to the Choice and Partnership Approach. If the patient is asked what they want, the list is usually short and can be addressed right away by giving the patient and family goals to work on at home.

"They wouldn’t be put on a waiting list for something," York said. "They would go away with an appointment in their hands to see somebody with the right skills to help them with the goals they wanted."

This method has reduced wait times at their London clinics from a year to several weeks. Similar successes have been reported in the countries where they have trained staff and managers. Those countries include the United Kingdom, Australia, New Zealand and Belgium.

York and Kingsbury came to Nova Scotia on the recommendation of a doctor now working in Halifax who underwent the training in New Zealand.

The IWK couldn’t provide an exact cost of the three-day session, but York and Kingsbury said they don’t charge full consultant’s rates. Rather they are paid the equivalent of what they would earn as clinicians in London. It is their first visit to Canada and they combined the working sessions with their vacation.

"It’s not our day job," joked York, who said they continue to work full-time as psychiatrists and devote an average of one day a month to their consultant work.

Sharon Clarke, clinical leader for mental health services at the IWK, said she was impressed by the Choice and Partnership Approach just from reading the material on the website.

"The exciting part for me is that they’re taking a business approach, in the sense of lean thinking, and using these ideas of demand and capacity to really be able to have an accurate assessment of what the needs are in the system — to put people in the right places, to do the right job at the right time."

The IWK will begin using the system in wait list interventions in January and it will be fully implemented by April.

(jmcphee@herald.ca)

Image credit


Also see:

The Choice and Partnership Approach Website

Evaluation Of The Choice And Partnership Approach In Child And Adolescent Mental Health Services In England

Taking stock of schizophrenia

An article definitely worth reading.

Also, you might want to listen to the audio interview with Prof. Sir Robin Murray (pictured) accompanying the article .


Image credit

Your Recovery Journey

An article published in the Fall 2011 edition of SZ Magazine:

Please click on an image to magnify it.

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

Also see:

Your Recovery Journey

Schizophrenia Society of Canada

Computerized Brain Training Can Produce Functional Changes in Schizophrenia

An article posted online on October 31st by Psychiatric News:

Successful training of the brains of people with schizophrenia in discrete attentional tasks is possible and appears to translate into improvements in quality of living, said Sophia Vinogradov, M.D., winner of APA’s Alexander Gralnick Award (pictured with past APA President and current APA American Psychiatric Foundation Treasurer Richard Harding, M.D.) At APA's Institute on Psychiatric Services in San Francisco, Vinogradov described research showing that computerized games aimed at training the brains of patients in very specific tasks can have effects on multiple interactive systems resulting in changes in global functioning. The finding marks a new direction in what has been called “cognitive remediation.” Further coverage of Vinogradov’s remarks will appear in a future issue of Psychiatric News. For further information about cognitive remediation, see "Neurocognitive ‘Training’ May Undo Schizophrenia's Brain Damage" and American Psychiatric Publishing's Essentials of Schizophrenia by Jeffrey Lieberman, M.D.

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Memoir About Schizophrenia Spurs Others to Come Forward

An article published in today's edition of the The New York Times:

Researchers have long wondered how some people with schizophrenia can manage their symptoms well enough to build full, successful lives. But such people do not exactly line up to enroll in studies.

For one thing, they are almost always secretive about their diagnosis. For another, volunteering for a study would add yet another burden to their stressful lives.

But that is beginning to change, partly because of the unlikely celebrity of a fellow sufferer. In 2007, after years of weighing the possible risks, Elyn R. Saks [pictured], a professor of law at the University of Southern California, published a memoir of her struggle with schizophrenia, “The Center Cannot Hold.” It became an overnight sensation in mental health circles and a best seller, and it won Dr. Saks a $500,000 MacArthur Foundation “genius” award.

For psychiatric science, the real payoff was her speaking tour. At mental health conferences here and abroad, Dr. Saks, 56, attracted not only doctors and therapists, but also high-functioning people with the same diagnosis as herself — a fellowship of fans, some of whom have volunteered to participate in studies.

“People in the audience would stand up and self-disclose, or sometimes I would be on a panel with someone” who had a similar experience, Dr. Saks said. She also received scores of e-mails from people who had read the book and wanted to meet for lunch. She told many of them about the possibility of participating in a research project.

She now has two studies going, one in Los Angeles and another in San Diego, tracking the routines and treatment decisions of these extraordinary people. The movie producer Jerry Weintraub has optioned the book.

It has been a remarkable response, considering that the book was almost abandoned. Dr. Saks surveyed friends and colleagues for years before publishing it and got very mixed advice. Her husband was against it; the risks were too high. Academic colleagues warned her that coming out with a disorder as serious as schizophrenia could only harm her. “You want to be known as the schizophrenic with a job?” one said.

Her friend Stephen Behnke, director of ethics at the American Psychological Association, was supportive of her decision. “I remember talking about it just on the cusp of when she was going to send off the manuscript,” Dr. Behnke said. “I said that we needed to sit down and make sure she was ready for this. It was like she was about to jump off of a cliff.”

Jump she did. With the MacArthur money, she founded the Saks Institute for Mental Health Law, Policy and Ethics to study mental health and society. She is now working on another book, “Mad Women: A Most Uncommon Friendship,” with the author Terri Cheney, who has written about her struggles with bipolar disorder.

“I was very lucky, being in academia, where people have been very accepting of this,” Dr. Saks said. “Most people struggling to manage a severe mental illness do not have the luxury to do what I did.”

Image credit

Also see:

A High-Profile Executive Job as Defense Against Mental Ills

Changing the face of Schizophrenia

FREE - Get your GED - Spryfield

Please click on the image to magnify it.

From an October 18th email received from Chebucto Connections:

The GED class is a go at the Captain William Spry Community Centre and we are recruiting students. Participants should be strong Level 2 students who are available and can commit to classes 4 days per week: Monday to Thursday / 9:30 am - 3:30 pm for 20 weeks. Those who call will be assessed for eligibility and classes will begin as soon as we have a small group.

Do you value the work of the Schizophrenia Society of Nova Scotia?

We hope you do.

Your donation will help us to continue our important and crucial work. To make a donation, please click here. Tax-deductible receipts are issued immediately.

Or send a cheque to:

Schizophrenia Society of Nova Scotia
Room B-23, Purdy Building
P.O. Box 1004, Station Main
Dartmouth, Nova Scotia
B2Y 3Z9

A photograph taken during the Schizophrenia Society of Nova Scotia’s Annual General Meeting held September 24th, 2011, in Springhill, Nova Scotia (please click on the photograph to enlarge it)


The Schizophrenia Society of Nova Scotia is working very hard to improve the quality of life for those affected by schizophrenia and psychosis through education, support programs, influencing public policy, and encouraging research.

www.ssns.ca

Psychiatrists Outline Plan to Tackle Stigma and Discrimination in Medicine: New Paper Released at Annual Conference of Canadian Psychiatric Association in Vancouver

An October 13th media release from the Canadian Psychiatric Association:

VANCOUVER, Oct. 13, 2011 /CNW/ - Today the Canadian Psychiatric Association (CPA) made public a paper that outlines how psychiatrists can tackle stigma and discrimination in medicine.

"Stigma and discrimination are one of the primary reasons that the one in five Canadians who will experience a mental illness in their lifetime either don't get help or delay getting help until their situation worsens," says Dr. Susan Abbey, author of the paper and member of the CPA Stigma and Discrimination Working Group. "People can recover from mental illness but until we address these issues, efforts to provide better mental health care will continue to be hampered," she adds.

Like their fellow Canadians, physicians, including psychiatrists, have been socialized with the same stigmatizing views towards people with mental illness. "Physicians are a reflection of their society when it comes to stigmatizing attitudes but it's devastating when patients who need help encounter such attitudes," explains Dr. Manon Charbonneau, Chair of the CPA Stigma and Discrimination Working Group. "That's why CPA chose to focus its efforts on tackling this issue in the house of medicine. As physicians and psychiatrists it is our responsibility."

Children and youth and health professionals are the two initial priority areas for the Mental Health Commission of Canada's anti-stigma, anti-discrimination initiative.

The three-prong approach on how physicians can reduce stigma presented by the paper can be summed up in three words, Protest, Educate and Contact. The CPA paper invites all psychiatrists to lead by example and protest stigma and discrimination when they encounter it, use education to counteract it and promote direct contact with people with lived experiences with mental illness.

"We need to protest discrimination at every level from the small injustices we witness in daily practice, in our clinics and hospitals, in our medical schools up to the federal and provincial level," says Dr. Abbey. The lack of funding for mental health is striking. While mental illnesses constitute more than 15 per cent of the disease burden in Canada, in the 2003-2004 fiscal year mental health care received only six per cent of total health funding—below the level in most European and developed countries.

Education is the second key to preventing stigma and making stigma it visible. "It's relatively easy to spot discrimination but it's harder to identify stigmatizing attitudes. Often people don't even realize they have these attitudes," notes Dr. Charbonneau.

The paper proposes education initiatives at many levels including making stigma and discrimination part of the formal medical school curricula, continuing physician education on the issue, talking about stigma with patients and engaging fellow physician organizations to effectively address discriminatory behaviour against psychiatric patients where they seek care—the emergency department, on inpatient medical and surgical wards, in walk-in clinics and when they see their family doctor.

Contact, the third pillar of the strategy, is crucial. "Research tells us that direct contact with people with mental illness who have recovered is a powerful tool that effects lasting change in attitudes," notes Dr. Charbonneau. The paper encourages medical schools to promote and teach direct personal contact with patients, both inside and outside the clinical context. It also advocates patients, as experts in their own care, be actively involved in their diagnosis and treatment and that patient advice be sought when new treatment and clinical structures are being planned.

"Tackling stigma and discrimination towards people with mental illness is the key to better mental healthcare. Canadian society and Canada's physician community efforts are in their infancy and much work remains to be done, but it can be done," says Dr. Charbonneau.

Read the position paper online: http://publications.cpa-apc.org/media.php?mid=1221

The Canadian Psychiatric Association is the national voice for Canada's 4,100 psychiatrists and more than 600 psychiatric residents. Founded in 1951, the CPA is dedicated to promoting an environment that fosters excellence in the provision of clinical care, education and research.

For further information:

Helene Cote
hcote@cpa-apc.org
1-613-297-5038

Bold emphasis is mine.

How to gain insight into schizophrenia and other mental illnesses

From the YouTube posting:

Bill MacPhee takes Don's question that asks how someone develops insight into their illness. Bill talks about how people think that they are alone, but once they are educated and see the big picture, they will gain insight into their illness.

Bill MacPhee lives with schizophrenia.

Also see:

SZ Magazine

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