No kidding?!! Me too! (NKM2)

Also visit:

nkm2.org

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How Can I Support Someone with Persecution Delusions

An August 24th post on the weblog, Overcoming Schizophrenia:

Recently, a reader asked how to support, or what to say to someone who has persecutory delusions and confides in them. I thought this question was profound. By investigating this question it could help so many people maintain or develop a trusting relationship with their relative, friend, or client, etc. I asked the opinion of my therapist, and she gave some pointers and asked me to remember a time when I was psychotic and what could someone have said to me to make me feel more comfortable...

When I was at my peak of psychosis everything was a sign from God - that truck making a U-turn meant go back, that taxi cab driver telling me to stay out of trouble meant he was in on it too. While I was psychotic I heard conflicting voices. When I would ask someone a question on the phone the voices would give different information. I was extremely paranoid. And almost everyone was a threat. I couldn't confide in relatives because they would tell my secrets, I couldn't trust friends because they wouldn't believe me. I couldn't keep a journal because someone would find it and read it. I was mentally trapped. I remember trying to escape from family, for reasons that I cannot make sense out of, but the belief was that they were after me, and I was scared.

Wondering about the city I spotted a man with a bike, (I thought to myself I could take his bike and escape from everyone), I asked this man questions about his bike. It was early in the morning and I wore a short sleeve top, he asked me if I was cold and gave me his sweater. I took the sweater then eye-balled his newspaper, I was anxious to know what day it was. He asked me if I wanted it and I said no (I don't know why I didn't take the newspaper). By this time I re-evaluated taking his bike, (this man must be an angel- he gave me his sweater because he knew I was cold, and offered his newspaper when I really wanted it, to know the date). We talked about nothing, I asked him random questions like if he was married with children. He told me he was divorced. I asked why didn't he have children, and he replied because his wife was on birth control. I felt at peace with this man. Finally, I told him I had to go and went my separate way.

If he had known I was psychotic and offered support I would have wanted him to say what my therapist suggested: "What can I do to let you feel more safe?" My therapist also suggested that an individual ask the person experiencing psychosis if there was another explanation for their situation, such as why the FBI would be following them or why their family or anyone would try to harm them.

It is important to show empathy by telling the person with psychosis that "I understand you feel like everyone is after you (or whatever the scenario)..." DO NOT PROMISE to keep information confidential because if that individual who confides in you is a danger to them self or to others I would strongly recommend that you contact a professional ASAP.

My therapist also said to try to maintain neutral facial expressions and tone of voice to not come off as threatening. The man that spoke to me was very kind, warm, and concerned for my well being. Also, do not encourage the delusions. Instead, remind them that it must be scary for whatever they are experiencing, but just show your concern for them and how you are there to support them.

I hope this post gave you some insight into how someone feels when psychosis takes over and what you can do to support them. I appreciate you for reading my posts and would love to hear from you- whether it be a question, comment, or simple "hello".

If you would like to learn more information about schizophrenia visit the National Alliance on Mental Illness (NAMI), or Schizophrenia Society of Nova Scotia (Canada).

Thanks for this excellent posting Ashley!

Mental health court long overdue

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

By Marilla Stephenson [pictured]

THE TORIES MAY have promised it, the NDP may have delivered it and the Liberals may have backed it. But credit for this week’s announcement that Nova Scotia will finally establish a mental health court goes to the many justice system officials who have pushed for years, and then finally said enough is enough.

Remember the story of Jean Roberts, the 70-year-old Dartmouth woman who ended up in court for setting fire to her own apartment?

She was unable to properly care for herself, could not be cared for in a traditional nursing home and found herself in trouble with the law. She had been in and out of jail over an 18-month period after what her family described as a slow slide into dementia and mental health problems.

Sadly, during a court appearance, Roberts had asked to be returned to jail because she had nowhere else to go. But is jail really the right place for people like Jean Roberts?

In 2006, Judge Bill MacDonald said no, it was not. After releasing her from custody on a series of relatively minor charges, he ordered sheriff’s deputies to delivery her to the Health Department and to leave her in their care.

"Why should the criminal justice system have to come up with all the options?" the judge asked at the time.

"I don’t want to take the responsibility of putting her out in the parking lot. There needs to be a facility in our society to deal with people like Jean."

Since then, the previous Tory government did move to establish a transition shelter for people with mental health problems, though with just a handful of beds I doubt it is able to accommodate the needs that exist. Still, it was a start.

More recently, Nova Scotians have heard the disturbing testimony at the inquiry into the death of Howard Hyde, the Dartmouth man who died in custody in 2007 after police shocked him with a stun gun.

He suffered from paranoid schizophrenia, but was not sent for a mental health assessment as one doctor had requested after he had been taken into custody on a domestic assault charge.

But the long-promised mental health court has been slower to materialize.

The Tories had finally promised to have it in place April 1 of this year, but a delay was soon announced. Summer or fall was the new target. Of course, an election and a change in government soon followed.

Finally this week, Justice Minister Ross Landry, under the new NDP government, announced that it will open in Dartmouth in November.

Once a week — guess who? — Judge Bill MacDonald will hear cases that are recommended by a provincial mental health court team.

They will be diverted from the regular provincial court case stream, but will not include more serious crimes such as murder or sexual assault.

Landry says the new court will help to balance public protection requirements and the needs of those who suffer from mental illness and find themselves in trouble with the law.

"It ensures public safety, and at the same time ensures the accused’s health needs are met," said Landry.

The court will not hold regular trials. Those who appear in the mental health court will have given either an admission of guilt prior to a regular trial, or have received a guilty verdict in a regular court.

The intent will be to work out treatment options, and in some cases, charges could be withdrawn once treatment is complete, says Landry.

With the closures in past years of mental health residential facilities, more people have found themselves without the care options they need.

For some folks, this had led to life on the streets and an absence of needed medications. Landing in court on charges, followed by jail, should not be the only option our society can offer.

The new court is a long-awaited initiative that will require offenders to be responsible for their crimes, while offering a helping hand to those with mental illnesses so they can get on the road to better health.

Also see:

Mental health court: Delivering on Tory promise

New Mental Health Court to Open in Dartmouth

From the Nova Scotia Department of Justice website:

Justice Minister Ross Landry (left) tours the construction site of the new Mental Health Court which will open in Dartmouth, Nov. 2. He is joined by Stephen Ayer, Executive Director of the Schizophrenia Society of Nova Scotia. Minister Landry said the new court will help people who are in greater need of counselling and treatment instead of being held in custody or put in situations that may lead to confrontations.

Photograph courtesy of the Nova Scotia Department of Justice.

Nova Scotia sets up mental health court

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

Service intended to divert those who need help into treatment

By Michael Tutton, The Canadian Press

Nova Scotia is setting up a special court to divert some of the province’s mentally ill away from the criminal justice system and into treatment programs.

Justice Minister Ross Landry, standing in the gleaming new courtroom Thursday, said the new mental health court would balance the needs of the public and the mentally ill.

"It ensures public safety, and at the same time ensures the accused’s health needs are met," said Landry.

The once-a-week sitting at the court will not hold trials, but rather will serve as a setting where the court can work out alternatives to jail sentences and set up treatment programs, Landry explained.

Under the system, which begins Nov. 2, provincial court Judge Bill MacDonald will take cases recommended by a mental health court team.

The cases would include crimes normally brought to provincial court, like thefts and assaults, but not more serious acts such as murder and sexual assault.

The person being tried must either admit to the crime prior to appearing in the mental health court, or have been found guilty in a regular court and then referred.

In some instances, the mentally ill would have criminal charges against them withdrawn if they successfully complete their treatment program and fulfil the court’s conditions, Landry said.

The province’s handling of the mentally ill has come under scrutiny during the public inquiry into the death of Howard Hyde, who had a long history of schizophrenia and involvement with the courts.

Hyde died in jail on Nov. 21, 2007, about 30 hours after he was arrested for an alleged assault and Tasered during a struggle inside a Halifax police station.

Landry said he couldn’t say whether a mental health court system would have helped Hyde avoid his conflict with the law. But he said he believes that overall, it will improve the chances of treatment of mentally ill people who come before the courts.

He said a mental health court in Saint John, N.B., that has operated for over eight years has had positive results.

Statistics kept by that court for last year indicate that almost nine in 10 people using the court complete their treatment programs, and 86 per cent avoid further conflicts with the law.

However, during Thursday’s news conference the mother of a mentally ill man posed questions to Landry about whether the new court would be likely to accept people who have trouble recognizing their own illness.

Mary Elizabeth Greene, a Halifax-area social worker, told the minister her son has psychotic episodes and can’t recognize when he has done something wrong.

"He doesn’t believe he has a mental illness and he wouldn’t choose to go to a mental health court and there are many like my son who don’t have insight," she said.

The minister invited the woman to come to his office and talk, and said they would consult with medical experts. He said he hoped that once a mentally ill person receives treatment following a psychiatric assessment, he or she would agree to use the new court.

Greene said in addition to the courts, the province badly needs better group homes where her 24-year-old son could be monitored more often and treated.



Mary Elizabeth Greene watches as Justice Minister Ross Landry announces the province’s first court to help those with mental health issues during a news conference in Dartmouth on Thursday. Ms. Green’s son John Can­dow is in the mental health system as a patient.

Photograph by Eric Wynne, The Chronicle Herald.

Also see:

Hyde’s sister doubts mental health court would have helped

Justice Minister Announces Opening of Mental Health Court

A news release circulated today by the Nova Scotia Department of Justice:

The province's first court to help people with mental health illnesses will open in Dartmouth on Nov. 2.

The court was set up to help people who are in greater need of counselling and treatment instead of being held in custody or put in situations that may lead to confrontations.

"The government is seeking new ways to help those offenders who have mental health issues," said Attorney General and Justice Minister Ross Landry, today, Aug. 27.

"This court will look at the person and their illness, not just their crime when it comes to administering justice."

Two years of planning of the made-in-Nova Scotia court included input from representatives from police agencies, RCMP, Public Prosecution Service, legal aid, judiciary and several government departments.

The specialized court will sit one day a week at the provincial court building. Judge Bill MacDonald will hear the cases which have been recommended by the mental health court team as being eligible for the program. A team of mental health clinicians and lawyers will be at the courthouse to assess potential clients and assist with their needs through counselling and other support.

The mental health court program is based on the best practices of other jurisdictions, and is tailored to meet the needs of Nova Scotians.

FOR BROADCAST USE:

The province's first court to help people with mental health illnesses will open in Dartmouth on November 2nd.

The court was set up to help people who are in greater need of counselling and treatment instead of being held in custody or put in situations that may lead to confrontations.

Attorney General and Justice Minister Ross Landry says the government is seeking new ways to help those offenders who have mental health issues.

He says this court will look at the person and their illness, not just their crime when it comes to administering justice.

The court will sit one day a week at the provincial court building.

-30-

Media Contact:

Sherri Aikenhead
Department of Justice
902-424-3313
E-mail: aikenhsl@gov.ns.ca

Federal study to give homeless places to live

An article published in the August 25th edition of the Ottawa Citizen:

By Tiffany Crawford

A new federal project will look at helping homeless people with mental illness in five cities across Canada reintegrate into society by giving hundreds of them places to live.

The study, by the Mental Health Commission of Canada, will monitor a total of 2,225 homeless people living with a mental illness in Moncton, N.B., Montreal, Toronto, Vancouver and Winnipeg over four years.

Of that number, 1,325 homeless Canadians will be given a place to live, including apartments and group homes, and will be offered psychological and social support to assist them over the four years.

The remaining participants will receive normal services, such as counselling and emergency shelters that are currently available in the five cities.

The participants will be selected next month, said research lead Dr. Paula Goering, who is also head of the Health Systems Research and Consulting Unit at the Centre for Addiction and Mental Health in Toronto.

"It is a very exciting chance to learn. We have never done anything like this in Canada before," she said.

Goering said the budget from Health Canada is $110 million.

Candidates will get to choose from several options where to live, and be visited at least once a week by program staff. The researchers aim to prove that by giving homeless people a stable place to live, they will be able to reintegrate into society.

"If it's an apartment we offer rent supplements. But they might prefer to live in a group home," said Goering. "It's important to note that we aren't placing people, we are helping people with their problems."

The study will compare how much money the federal government spends on services for the people who have been given accommodation, compared to those using the regular services, for example policing costs, emergency room visits and shelter beds.

Goering said there will be no requirement for participants to give up drugs.

"Many of the individuals will have mental illness and addictions. We won't put restrictions on people to be dry or stop using and we will still house them and then offer them help with their problems."

Data from this kind of extensive research does not currently exist in Canada, according to the commission.

The research projects will end in 2013, and will produce a body of evidence to help Canada develop services to homeless people living with a mental illness, said Goering.

Photograph by Arlen Redekop, The Province (please click on the photograph to enlarge it).

Lunenburg County Chapter's Annual Barbeque

On Saturday, August 22nd, the Lunenburg County Chapter of the Schizophrenia Society of Nova Scotia held their annual summer barbeque at Big Mushamush Lake. Many thanks to Aubrey Zinck and Kaye Joudrey for hosting this year's barbecue!



Barbeque Masters - Dachia Joudrey (left) and Aubrey Zinck.


Please click on the photographs to enlarge them.

Photographs by Jan House

A step in the right direction

An article published in the August 21st edition of The News:

By Jennifer Vardy Little

STELLARTON – For Dale Robinson, a new directory to mental health services in the county is a dream come true.

Robinson is the president of the local branch of the Canadian Mental Health Association. More and more frequently, Robinson picks up the phone and finds someone on the other end who needs to know where to turn.

Now, the answers will be at his fingertips.

“The questions I get most often from people looking for services is where do I go and how can I access what’s available,” Robinson said.

“Now I have a tool to make finding those answers easier. I know my copy will be permanently on my desk.”

Robinson is talking about The Compass, a new mental health resource and directory developed by the Pictou County Health Authority in conjunction with the two community health boards.

The book features information about mental health, like how to recognize depression in teens, understanding seniors’ mental health, addictions and differentiating between sadness and depression.

It also features a complete directory of the services available in the county.

The book is the last of seven initiatives suggested by the community health boards in the community health plan released in 2006.

The book has undergone several revisions and was presented to local groups to get feedback on what the book should include. Thanks to those sessions, the book was further expanded to include topics like post-partum depression.

Carolyn Hemmings, a member of the Pictou West Community Health Board, says she feels blessed to have been involved with the project.

“This book is going to mean a lot to a lot of different people,” she said during the launch of the book at the Nova Scotia Community College on Thursday.

“People can go to the directory and know exactly where to turn to to get help.”

The book is free and will be available at doctors’ offices, pharmacies and departments at the health authority. People can call 752-7600, ext. 3316, to get their own copy of the directory.

Implementing Evidence-Based Practices for People With Schizophrenia

An abstract published in the July 2009 edition of Schizophrenia Bulletin:

By Robert E. Drake (1,2), Gary R. Bond (3), and Susan M. Essock (4)

1. To whom correspondence should be addressed; Psychiatric Research Center, 2 Whipple Place, Lebanon, NH 03766, tel: 603-448-0263, fax: 603-448-3976, e-mail: Robert.E.Drake@dartmouth.edu
2. Dartmouth Psychiatric Research Center, Dartmouth Medical School, Lebanon, NH
3. Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN
4. Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, NY
   

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions.

Keywords: evidence-based practices / schizophrenia / implementation research

To read the entire article, please click here (free Medscape registration is required).

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

Cannibis smokers have a seven-fold schizophrenia risk

Harper government devotes funds to studying the link between marijuana use and mental illness

An article published in yesterday's edition of The Toronto Star:

WINNIPEG – The Harper government is putting up $550,000 to gather research on marijuana use and mental illness.

The Schizophrenia Society of Canada will use the money to further research the links between cannabis and early psychosis as well as develop promotional materials warning youth about the dangers of smoking pot.

The money is part of Ottawa's $30 million national anti-drug strategy announced in 2007.

Chris Summerville, CEO of the Schizophrenia Society, said the public doesn't realize that cannabis users have a seven-fold increase in risk of developing schizophrenia.

He pointed to recent research out of Victoria, B.C., linking pot smoking and mental illness.

As part of the society's research, some 30 youths who have experienced psychosis will be trained to gather information about the reasons their peers use cannabis.

The results will be used to develop educational materials aimed at decreasing the use of illicit drugs among young people.

Winnipeg Conservative MP Joy Smith said Tuesday that while the public regards marijuana as a soft drug, there may be very serious consequences for young pot smokers who have a predisposition to mental illness.

"Science has shown that cannabis may actually trigger the onset of psychosis and may also intensify the symptoms for those who already have a psychotic illness," Smith said in announcing the grant.

"It has been suggested that up to 80 per cent of youth who have had a psychotic episode were using cannabis. And that's pretty shocking," said Smith, who was filling in for Health Minister Leona Aglukkaq at news conference.

Photograph by Rotbuche.

Climbers to scale African peak to benefit Laing House

An article published in the August 9th edition of The Chronicle Herald:

A group of six Nova Scotians is on its way to Africa to climb Mount Kilimanjaro as part of a fundraising effort for Laing House.

The group — Henry and Rena Demone, Hans and Dani Himmelman, and David Kirkpatrick and Paula Taylor — is paying all its own expenses so that all of the more than $60,000 that’s been raised will help support youth living with mental illness.

The idea for the climb was born at the Laing House masquerade ball fundraising event in 2007. Each member of the group has had a friend, family member or colleague experience mental illness and wanted to come up with a unique way to support Laing House.

The house is a peer support organization for youth with mental illness. It opened in Halifax in 2001 and has helped hundreds of young people. It’s the only organization of its kind in Canada.

Kilimanjaro, the highest peak in Africa, is the world’s highest free standing, snow-covered equatorial mountain. The climb will begin on Sept. 11. To learn more, visit www.lainghouse.org.

Photograph by Paul Shaffner. Photograph used under Creative Commons Attribution 2.0 License

System failing mentally ill in jails: experts

An article published in today's edition of The National Post:

Phase one of inquiry into Taser death ends

By Megan O'Toole

Phase one of an inquiry into the death of a Nova Scotia man who was Tasered while in police custody ended yesterday, and experts say the process has underscored a dire need for changes in the treatment of mentally-ill prisoners.

After five weeks of testimony and a number of controversial witnesses, including officers involved in the struggle to subdue Howard Hyde of Dartmouth, N. S., the inquiry has been adjourned for two months.

Testimony to date has shown a number of systemic flaws, observers say, including a severe lack of co-ordination between police and health-care services.

"There were a lot of balls dropped," said Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, noting the case underscores the need for police to be better trained in how to handle mentally-ill prisoners. "Right from the get-go, police didn't give Howard a fair shake."

The paranoid schizophrenic, who reportedly harboured a deep fear of police, was initially arrested for assault after an argument with his girlfriend, who told authorities Mr. Hyde had not been taking his medication.

At that point, Mr. Hyde should have been taken to hospital for assessment and treatment, Mr. Ayer said, but instead he was taken to the Halifax police detachment. Rambling and in a psychotic state, Mr. Hyde apparently attempted to flee after a booking officer took out a knife to cut the drawstring off his shorts.

That prompted a violent struggle, captured on surveillance video and shown during the inquiry, in which a shirtless and frantic Mr. Hyde screams and struggles to escape. Police say they were concerned he would reach for a knife from a nearby drawer of weapons, and shocked him with the Taser to regain control. He collapsed and was taken to hospital.

The use of a Taser on a paranoid schizophrenic person, as an aggressive act, "could have a tendency to make things worse, to have the issue escalate out of control," noted University of Alberta psychiatrist Patrick White.

While hearing testimony from a couple of the officers involved in the scuffle, the inquiry learned -- contrary to earlier official reports -- that Mr. Hyde had not been asked to co-operate as officers struggled to handcuff him, nor was he warned the Taser would be deployed.

Chris Summerville of the Schizophrenia Society of Canada said a better technique would have been attempting to talk Mr. Hyde down from his psychotic state, then handcuffing him once he had calmed down. Police should be trained for such situations, Mr. Summerville said, but in many cases they are not.

Mr. Hyde's girlfriend, Karen Ellet, has said he "was treated as a prisoner, not as a mental-health patient."

After doctors cleared Mr. Hyde to leave the hospital, they requested he have a follow-up psychiatric examination after his morning court hearing, or that he be returned to the emergency room -- something the officers were not authorized to do.

Neither happened, and Mr. Hyde ended up back in his jail cell, where he died about 30 hours after receiving the initial Taser jolt. Nova Scotia's medical examiner pegged the cause of death as "excited delirium" linked to his mental illness.

Carol Tooton, executive director of the Canadian Mental Health Association's Nova Scotia division, says the case could have ended differently had Mr. Hyde received proper treatment for his schizophrenic condition. The inquiry, she noted, has underscored a staggering lack of co-ordination between police, mental-health workers, courts and hospital staff -- resulting in a failure to properly deal with a man travelling between those systems.

"We often talk about working in silos," Ms. Tooton said. "It seems that [those] systems really do operate independent of one another."

The inquiry resumes in October, with recommendations from Judge Anne Derrick expected next year.

Zyprexa (Olanzapine) Class Action - Notice of Class Certification

The Schizophrenia Society of Nova Scotia suggests to its members that they should seek legal advice immediately so that they may be properly apprised of their rights, particularly because of the limited time within which a potential claimant may "opt out".



To view a high resolution PDF of the above document, please click here.

From the above document:

...

This notice does not constitute medical advice. Patients who have been prescribed Zyprexa should consult with their physicians if they have any questions with respect to their medical condition and should not stop taking Zyprexa without consulting with their health care professional.

...

IF YOU WISH TO EXCLUDE YOURSELF FROM THE CLASS PROCEEDING (“opt out”) you must deliver a written notice to one of the solicitors for the parties ... specifying your desire to opt out of the class proceedings. Notice of your decision to opt out must be received by either one of the solicitors by October 16, 2009.

ANY JUDGMENT OBTAINED ON THE COMMON ISSUES IN THE ACTION, WHETHER FAVOURABLE OR NOT, WILL BIND ALL CLASS MEMBERS WHO DO NOT OPT OUT OF THIS ACTION.

...

For further information, please click here.

Films attack mental health stigma

Posted online yesterday by BBC News:

To view one of the videos, please click here (the video appears after an advertisement).

To read the entire article, please click here.

Mental health experts target ‘huge mismatch’ in funding

An article published in yesterday's edition of The Ottawa Citizen:

Stigma is diverting money for research, doctors say

By Tony Spears

The stigma of mental illness is diverting research money from a multibillion-dollar economic problem, Ottawa’s leading mental health experts say.

Mental illness affects one in five Canadians and is the leading cause of workplace disability. According to a Senate report, the Canadian economy takes an $8.1-billion hit from productivity lost to mental illness, and the cost balloons to $33 billion if substance abuse is included.

The World Health Organization did an assessment showing the global burden of mental illness was second only cardiovascular illnesses, said Dr. Zul Merali, head of the Institute of Mental Health Research at the University of Ottawa. Mental illness is the No. 1 reason for workplace disability.

Lacking the “sex appeal” of heart-disease and cancer, mental illness research funding is languishing and accounts for less than five per cent of health research in Canada, Royal Ottawa Mental Health Centre data show.

To read the entire article, please click here.

Extended-Release Injectable Paliperidone Approved in the US for Schizophrenia

A news release posted today by docguide.com:

The US Food and Drug Administration (FDA) today approved paliperidone palmitate (Invega Sustenna) extended-release injectable suspension for the acute and maintenance treatment of schizophrenia in adults. It is the first once-monthly, long-acting, injectable atypical antipsychotic approved in the United States for this use.

Bold emphasis in the text is mine.

To read the entire news release, please click here.

Also see:

FDA Approves INVEGA® SUSTENNA™ for the Acute and Maintenance Treatment of Schizophrenia

FDA Approves First Monthly Atypical Antipsychotic for Schizophrenia

Monthly Shot Treats Schizophrenia

International Symposium on Mood Disorders - Halifax

Friday, October 2nd!

Please click on the image to enlarge it.

Schering-Plough Wins Panel’s Backing on Antipsychotic (Update 2)

An article posted on July 30th by Bloomburg.com:

By Catherine Larkin

Schering-Plough Corp. won a U.S. panel’s backing to introduce a new antipsychotic drug that would compete with Eli Lilly & Co.’s Zyprexa and AstraZeneca Plc’s Seroquel.

Outside advisers to the Food and Drug Administration voted 9-1, with two abstentions, that the drug’s benefits outweighed its risks for adults with schizophrenia, and 12-0 in favor of its use in treating manic or mixed episodes of bipolar disorder. The FDA usually follows the recommendations of its advisers, though it isn’t required to do so.

Asenapine [molecular structure shown], a fast-acting tablet that dissolves under the tongue, would help patients who can’t swallow pills or have side effects such as weight gain on other treatments, the advisers said. Merck & Co. offered to buy Schering-Plough on March 9 to get asenapine, to be marketed as Saphris, and six other drugs targeted for sale by 2012.

“We believe that the opportunity for Saphris is underappreciated, as we think an antipsychotic with little to no weight gain and no cardiovascular safety issues is a lay-up blockbuster,” Jon LeCroy, an analyst at Natixis Bleichroeder in New York, said today in a note to clients. “We are modeling 2013 sales of $650 million.”

Positive Expectations

Investors anticipated a positive recommendation from the advisory panel meeting in Silver Spring, Maryland, after FDA staff voiced their support for Schering-Plough’s data in briefing documents released this week. The agency delayed asenapine last year and is now scheduled to make a decision on approval by Aug. 20.

To read the complete article, please click here.

Also see:

FDA Approves Saphris to Treat Schizophrenia and Bipolar Disorder (August 14th, 2009)

Scientists try to stop schizophrenia in its tracks

An article posted on July 26th by ABC News:

Seeking to block voices, 'odd thoughts,' scientists try to stop schizophrenia in young people

By Malcolm Ritter, Associated Press

PORTLAND, Maine — She was sociable and happy in high school. But in college that changed abruptly: Depressed and withdrawn, some days she couldn't get out of bed.

And that wasn't all.

"I had really odd thoughts," recalled the woman, now 21, who asked that her name not be used. While walking across campus at the University of Southern Maine, "sometimes I'd feel like people were just right behind me (who might) jump me or something."

She knew it wasn't true, but she couldn't shake the feeling.

Sometimes, while driving, she saw imaginary, shadowy people on the sidewalk. And now and then, out of nowhere, there would be a woman's voice in her ear during class, or random soft noises like knocking or the fizzy hiss of a newly opened soda can.

When she visited the university health service and talked about feeling depressed, a nurse practitioner saw another problem: a possible case of schizophrenia in the making.

This schizophrenia "prodrome" — the early signs — involves a troubled mental state usually found in teens and young adults. It can lead to psychosis, the loss of touch with reality that marks not only schizophrenia, but also some forms of depression or manic-depression. The prodrome can linger for weeks, or years, before it gives way to psychosis — or mysteriously disappears without a trace.

Researchers have known about this warning phase for decades, but they're still working on how to treat it. Now they're calling in tools like brain scans, DNA studies and hormone research to dig into its biology. They hope that will reveal new ways to detect who's on the road to psychosis and to stop that progression.

In the prodrome, people can see and hear imaginary things or have odd thoughts. But significantly, they understand these experiences are just illusions, or they have a reasonable explanation.

In contrast, people with psychosis firmly cling to unreasonable explanations instead. When someone interprets an odd halo of light over a bedroom doorway as an urgent message from a dead relative, "that's when they have gone over to the psychotic side," said Dr. Thomas McGlashan, a Yale University psychiatry professor.

Some early signs of the prodrome are subtle. "Sometimes kids will (say) light seems different," and windows are too bright, said Ann Lovegren Conley, the family nurse practitioner at USM who spotted apparent prodromal symptoms in the student on her campus.

That can signal "this is not just typical depression or situational stress," Conley said. "There's something more here."

After hearing the student's story, Conley put her in touch with the Portland Identification and Early Referral program, called PIER, one of about 20 clinics in the United States that focus on treating prodrome cases. PIER has trained her and thousands of other school nurses and counselors, pediatricians and others in greater Portland in how to spot them.

PIER emphasizes non-drug therapies for its patients, ages 12 to 25, although about three-quarters of them take anti-psychotic medication.

The treatment regimen includes group meetings in which patients and families brainstorm about handling the condition's day-to-day stresses. It also focuses on keeping patients in school and in touch with their families and social networks.

With a grant from the Robert Wood Johnson Foundation, the PIER approach is also being tried in California, Oregon, Michigan and New York.

Even before treatment begins, a patient's encounter with someone who understands can be dramatic. McGlashan recalled that one young woman at the Yale clinic burst into tears when being asked about symptoms, explaining, "I thought I was the only person in the world who was having these experiences."

Or, when asked if they've felt like the television was speaking to them personally, young clients may reply, "How did you know?" McGlashan said.

Studying the schizophrenia prodrome has been tough for the small but growing group of researchers in the area, because the condition is relatively uncommon. A typical community may get only one new case per 10,000 people each year,* and only a fraction of those people would end up in a research study.

A federally funded project kicked into gear this year to uncover biological signals that will help identify people headed toward psychosis. There's already early evidence, for example, that combining brain scans with a standardized interview can greatly help, said Tyrone Cannon of the University of California, Los Angeles.

Such research should also point the way to better treatments, by exposing the biological roots of psychosis, Cannon said. He's the principal investigator of the project, which is being carried out at several medical centers.

When it comes to treating the prodrome, scientists say they have some promising approaches but no firmly proven treatments to prevent psychosis from appearing.

Low doses of anti-psychotic drugs dampen symptoms. But it's not clear whether those drugs can actually prevent psychosis. Side effects like serious weight gain are a problem, especially since many treated patients would never have developed psychosis anyway. What's more, the weight gain can turn young people away from anti-psychotic drugs, even if they move on to become psychotic and clearly need them.

Researchers are finding promise in psychosocial treatments, like those aimed at helping patients learn to manage stresses in their lives or understand and interpret their symptoms. Efforts to help young people complete their education, hold a job and stay connected to peers will help them avoid unemployment and social isolation later on, whether they progress to psychosis or not, experts say.

In fact, keeping up social contacts may help manage the prodrome. "We're convinced that if they start closeting themselves, coming home after school and just spending time in their bedroom, that will accelerate any process toward psychosis," McGlashan said. "If you dim your social life, it makes it easier for your brain to hallucinate and develop strange ideas."

The PIER program, which began eight years ago, hasn't yet published detailed results on its effectiveness. Its goal is to cut the rate of hospitalizations for first episodes of psychosis in Portland. Dr. William McFarlane, who directs it, says early analyses of the results look promising but that it's too early to draw conclusions.

And results from other locations trying the PIER approach won't be available for a couple of years, says Jane Lowe of the sponsoring Johnson foundation.

Still, in Portland, McFarlane said, "we see kids getting better every day."

One of them was the college student Conley referred. With the help of individual counseling, antidepressants and an anti-schizophrenia drug, "gradually I opened up to people," the young woman said.

She started playing tennis, joined a sorority and began exercising in the school gym. She wasn't sad all the time any more. And she stopped hearing and seeing things that weren't there.

On the Net:

• PIER and similar programs: www.preventmentalillness.org

* This statistic represents 94 people per year in Nova Scotia; not an insignificant number, particularly as it relates to the individuals, families, friends, and coworkers who are affected.

Taser guidelines: Adopt B.C. blueprint

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

IT ISN’T the first report on Taser use and abuse, and it won’t be the last. But retired B.C. judge Thomas Braidwood’s 546-page tome on the sub­ject deserves to be adopted as the gold standard for law enforcement and policy makers nationwide.

Mr. Braidwood has become a fixture in the na­tional news firmament as he presides over the in­quiry into Canada’s most infamous Tasering fiasco — the videotaped confrontation that led to the death of Polish immigrant Robert Dziekanski at Vancouver airport in 2007. Part 1 of his analysis, Restoring Public Confidence: Restricting the Use of Conducted Energy Weapons, was released last week. The second phase of the inquiry, focusing on the circumstances of Mr. Dziekanski’s demise, has been adjourned until late September.

In his report, Mr. Braidwood finds no shortage of actors to upbraid. In a stinging rebuke to Taser International Inc., he asserts that Tasers can in­deed kill — a reasonable conclusion, given the stun gun’s track record, that is still firmly rejected by the weapon’s manufacturer.

Mr. Braidwood also finds fault with the B.C. gov­ernment for adopting Tasers without independ­ently testing them first and for the lack of uniform standards governing their use. But, significantly, he does not advocate shelving them. We agree with this view: Overall, Tasers can do more good than harm if they are deployed with restraint.

On that score, Mr. Braidwood sets an eminently sensible threshold that the stun gun use should be confined to violations of criminal law, not provin­cial or municipal statutes. Furthermore, offering “active resistance" to a police officer — running away or mouthing off — should not be considered a Taserable offence. But if a subject is inflicting or threatening bodily harm, then Tasering is justified. Uniform standards and clear rules of engagement should help eliminate the use of the Taser as an easy compliance tool and prevent outrageous acts such as the Amherst police subduing an obstrep­erous diabetic last year over the objections of para­medics who had called for assistance.

Also of particular relevance to Nova Scotians following the inquiry into the death of schizophren­ic Howard Hyde in Halifax police custody, was the warning that Tasering “an emotionally disturbed person is, in most cases, the worst possible re­sponse."

For police officers who have been issued a Taser, it does makes sense to have a defibrillator handy too, although this could be an expensive proposi­tion. In all, there are 19 recommendations in the report, which B.C. has pledged to immediately adopt. The findings should also be embraced by every other jurisdiction and the RCMP, which, in fairness has tightened its Taser-use protocols.

Certainly, Nova Scotia need look no further than the Braidwood report for inspiration to establish its own provincewide guidelines.

Bold emphasis in the text of the editorial is mine.

Also see:

Safe use is key

B.C. stun gun report applies here, too

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

By Marilla Stephenson [pictured]

WHILE THE DEATH of Howard Hyde in a Dartmouth jail remains an incident of confusion and contradiction, the report from a British Columbia public inquiry this week was crystal clear: stun guns can kill.

The fatality inquiry called into Hyde’s death by the Nova Scotia government and the B.C. inquiry are different in many ways but they also have much in common: both deal with the death of a disturbed man who had earlier been Tasered by police officers.

The two men died about a month apart in 2007.

Robert Dziekanski died on the floor of the arrivals area of the Vancouver International Airport in October 2007 after officers used a stun gun to subdue him. The Polish man, who spoke no English, had been wandering the terminal for hours before becoming disruptive and exhibiting erratic behaviour. The RCMP were called in to deal with him, eventually delivering five Taser shocks before he collapsed and died.

Hyde died 30 hours after he had been Tasered by Halifax Regional police officers in November of the same year. The medical examiner ruled that his death, after a scuffle with guards at the jail a day after being arrested, was a result of "excited delirium" caused by paranoid schizophrenia.

The fatality inquiry into the Hyde case has different parameters from the B.C. inquiry. Judge Anne Derrick has not been tasked to assign blame in her findings.

In B.C., former judge Thomas Braidwood found that stun guns can kill or cause serious injury. As a result, the B.C. government has ordered the use of stun guns to be "severely restricted," but stopped short of an outright ban on the weapons, which have often been used to bring unruly suspects under control.

"Conducted energy weapons are unique — they are the only weapon designed to cause intense pain and to incapacitate through an electrical current," Braidwood said at a Vancouver news conference.

In releasing his report on Thursday, Braidwood noted that Tasers were introduced without prior independent government testing, relying instead on information from the manufacturers, the Canadian Press reported.

Braidwood issued 19 recommendations, including that police only use the weapons when someone is causing or is about to cause bodily harm. He said 25 people have died in Canada after being subjected to electrical shock from a stun gun.

He undertook a detailed review of existing research into Tasers. He concluded they are a better option for police than guns, noting the threat of a Taser has enabled some police forces to resolve up to 80 per cent of incidents.

But he also found that they can cause heart irregularities and are an especially high-risk weapon for those who are medically or emotionally compromised, particularly if they receive repeated shocks.

"Deploying a conducted energy weapon against an emotionally disturbed person is, in most cases, the worst possible response," said Braidwood.

Among his recommendations is a call for additional training to help police officers deal with emotionally disturbed people.

These findings will be of particular interest to the family and friends of Hyde, who have heard testimony at the Halifax inquiry from police officers and medical officials that seems, at times, at odds with common sense.

The inquiry has been told of procedural errors relating to Taser use by the officers involved in the incident, acknowledgement that written reports about Hyde’s time in custody are in conflict with what appears on security tapes, and a written doctor’s order that called for Hyde to receive a psychiatric assessment.

That never happened. Communication about Hyde’s condition appears to have been minimal among the police, medical staff who cared for Hyde after he was initially Tasered, and corrections staff. While the confusion that existed is apparent from testimony at the inquiry, there seems to have been little effort made to seek clarification.

One day later, Hyde was dead. Suggestions that jurisdictional limitations and ignorance of proper procedures may have prevented Hyde from getting the help he needed are far from good enough.

Bold emphasis in the text of the article is mine.

Also see:

Hyde lawyer: Adopt Taser guidelines

CACP launches new Canadian Police/ Mental Health Liaison Information website

A posting on the Canadian Mental Health Association, Ontario's website:

July 23, 2009

The Canadian Association of Chiefs of Police recently launched a new Canadian Police/Mental Health Liaison Information website in recognition of the key role that police services play in ensuring that individuals living with mental illnesses are not inappropriately criminalized. This website provides a broad range of resources targeted at police service personnel, mental health service providers as well as program developers, policy makers and researchers from within both disciplines.

Front-line workers can access basic information about mental illness and tips for responding. For communities involved in implementing or managing a collaborative police/mental health response initiative, this site offers program and policy development guidelines and sample agreements and memorandums of understanding. Researchers will find a comprehensive bibliography as well as relevant research reports. Finally, there are educational resources available for police who are assuming a leadership role in this area of mental health.

For more information about the Canadian Police/Mental Health Liaison activities, contact Dr. Dorothy Cotton or Terry Coleman by email at info@pmhl.ca.

See Canadian Police/Mental Health Liaison Information website, at www.pmhl.ca.

Note: The Police and Mental Health Research Reading List posted on the Canadian Police/Mental Health Liaison Information website has not been updated since May 31st, 2007.

Mental Health Commission of Canada 2008-2009 Annual Report: "Out of the Shadows - Forever"

An email to the SSNS received today from the Mental Health Commission of Canada:

It is our pleasure to provide you with a copy of our inaugural Annual Report, documenting the nineteen months since September 2007 when the Commission became operational. This Annual Report shows the extensive progress that has been made towards achieving the mandate that has been set out for the Commission, which is to promote mental health in Canada, to change the attitudes of Canadians toward mental health problems and mental illness, and to work with stakeholders to improve mental health services and supports.

We appreciate the support and contributions from many committed organizations and passionate people from across this country participating on boards and committees, in public and online consultations, in working groups and research teams, and in so many other important ways.

Please spread the word; let everyone know that this groundbreaking work is underway. There will be increasing opportunities for Canadians to get involved as the Partners for Mental Health program is launched.

Michael Kirby
Chair
Mental Health Commission of Canada


About the Mental Health Commission of Canada

The goal of the Mental Health Commission of Canada is to help bring into being an integrated mental health system that places people living with mental illness at its centre.

To this end, the Commission encourages cooperation and collaboration among governments, mental health service providers, employers, the scientific and research communities, as well as Canadians living with mental illness, their families and caregivers.

Genes for Psychosis and Creativity

The abstract of a research report posted online on July 6th by the journal Psychological Science:

Genes for Psychosis and Creativity: A Promoter Polymorphism of the Neuregulin 1 Gene Is Related to Creativity in People With High Intellectual Achievement

By Szabolcs Kéri

Semmelweis University, Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest H1083, Balassa u. 6, Hungary

Abstract

Why are genetic polymorphisms related to severe mental disorders retained in the gene pool of a population? A possible answer is that these genetic variations may have a positive impact on psychological functions. Here, I show that a biologically relevant polymorphism of the promoter region of the neuregulin 1 gene (SNP8NRG243177/rs6994992) is associated with creativity in people with high intellectual and academic performance. Intriguingly, the highest creative achievements and creative-thinking scores were found in people who carried the T/T genotype, which was previously shown to be related to psychosis risk and altered prefrontal activation.

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

Also see:

Genetic link between mental illness, creativity: Study

New Taser rules for B.C.

An article posted online yesterday by CBC.ca.

The B.C. government will restrict the use of stun guns by police, following the release of a report by the Braidwood Commission in Vancouver on Thursday.

Effective immediately, all police, sheriffs and corrections officers in B.C. have been directed to severely restrict the use of conducted energy weapons, in accordance with recommendations from the inquiry, Solicitor General Kash Heed said.

The B.C. government also will immediately raise the threshold for use of the electric stun guns to match former judge Thomas Braidwood's recommendations.

That means Tasers should only be deployed when all of the following criteria are met:

• The officer is enforcing a federal criminal law.

• The subject is causing bodily harm or will imminently cause bodily harm.

• No lesser-force option has been or will be effective in eliminating the risk of bodily harm.

• De-escalation and/or crisis intervention techniques have not been or will not be effective in eliminating the risk of bodily harm.

• In addition, the government will move to ensure all police using stun guns have access to defibrillators, said Heed.

Conducted energy weapons will now undergo regular testing and police will be required to report all use of the weapons to the province, said the statement.

In addition, B.C. will work with the federal government during contract negotiations to incorporate Braidwood's recommendations into future contracts with the RCMP for policing in the province.

Report based on speculation, says Taser manufacturer

Meanwhile, both the provincial RCMP and the Taser manufacturer issued written statements in response.

Taser International Inc. of Scottsdale Ariz., said it appears that "politics has trumped science."

It said the recommendations in the report are based largely on speculation and ignored key facts.

It is the opinion of Taser International, the statement said, that the inquiry's recommendations do not "meet the realities of modern day law enforcement."

The RCMP, however, said it welcomed the report from the first phase of the Braidwood Inquiry.

The force said it would "review and assess the findings, conclusions and recommendations" in the report.

The statement said the RCMP believes that Tasers, when used appropriately by officers who are well trained, can be a useful tool that contributes to officer and public safety.

Braidwood made a total of 19 recommendations to the B.C. government.

The commission inquiry was called after the death of Robert Dziekanski, a Polish immigrant who was stunned by RCMP officers at Vancouver International Airport on Oct. 13, 2007. The commission finished its first phase of testimony in May.

Also see:

Tasers need stricter control, B.C. inquiry finds

VIDEO: Thomas Braidwood releases preliminary findings from Taser inquiry (Runs 15:43)

Judge: Tasers can kill

Hyde transfer order confused cop

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

Note instructed police to ensure mentally ill man got psychiatric help, inquiry hears

By Michael MacDonald, The Canadian Press

An inquiry into the death of a mentally ill Nova Scotia man who died in jail is zeroing in on a police officer’s flawed interpretation of a form that instructed police to ensure Howard Hyde received psychiatric help.

Hyde, a 45-year-old musician who suffered from schizophrenia, was arrested on Nov. 21, 2007, amid a domestic dispute and was later taken to the Halifax police station, where he was Tasered twice while trying to escape.

The inquiry has heard that Hyde stopped breathing after he was shocked a second time, but he was revived by an officer who performed CPR and then taken to hospital. Const. John Haislip, a rookie officer at the time, testified that his supervisor, Staff Sgt. Don Fox, told him to make sure Hyde was taken to court once he was cleared as medically stable.

Haislip testified that Fox told him Hyde was in hospital for treatment of possible physical injuries, not mental health issues.

"He advised me that he had not been brought there for that; that if he was medically stable and medically cleared, then we had a duty to get him to court," he told the inquiry.

The doctor who examined Hyde, Dr. Janet MacIntyre, determined he was well enough to be discharged, but she included a note on a Health Information Transfer form that made it clear police should return Hyde to hospital if he did not receive a psychiatric assessment.

Haislip testified he was aware that once Hyde was turned over to sheriff’s officers at the court or correctional officers at the jail, he would no longer be in his custody. He admitted that it was unclear to him who would be responsible for getting Hyde to a psychiatrist. He said the doctor’s instructions, which referred specifically to police doing the job, probably should have been changed.

When asked if Fox’s directions had left him confused, he responded: "I guess it’s fair to say, yes."

The transfer form is a key piece of evidence in the inquiry.

Earlier testimony from other Halifax police officers indicates there was a general lack of understanding of how the form was supposed to be used, who was supposed to fill it out and what authority it provided.

Const. Steve Hillier testified that he didn’t even know the form existed until Tuesday, even though he was Haislip’s partner on the day Hyde was released from the Queen Elizabeth II Health Sciences Centre.

Hyde was eventually taken back to the police station for booking.

Haislip said he relayed MacIntyre’s instructions to a senior officer at the station, but he was given no assurances they would be acted on.

The officer said he assumed officials would see the form and get Hyde assessed.

However, Hyde was later transferred to the Central Nova Scotia Correctional Facility in Dartmouth, where he died the following morning after struggling with correctional officers.

Nova Scotia’s chief medical officer listed the cause of death as excited delirium due to paranoid schizophrenia. He concluded the use of the stun gun was not a factor.

In earlier testimony, another officer said he placed his right foot on Hyde’s back for more than 30 seconds as officers struggled to restrain him after the multiple Taserings at the police station.

Const. Christopher MacMahon said he didn’t lift his foot off Hyde until another officer said it appeared he had stopped breathing and was turning blue.

MacMahon insisted he did not place any pressure on Hyde’s back as three other officers struggled to control him in a hallway off the station’s booking room.

He said he wanted to stop Hyde from attacking the officers.

"I placed my right foot on his back should he flip over," he explained. "I put it there as a precautionary measure should he roll over and try to resist."

After watching a surveillance video of the incident, MacMahon estimated he kept his foot on Hyde’s back for 37 seconds.

Outside the hearing room, Kevin MacDonald, a lawyer for the Hyde family, said it would be reasonable to assume Hyde was out of breath after struggling with the officers and any amount of weight placed on his torso could have affected his breathing.

"I believe that is significant," he said.

"Mr. Hyde had just been through quite a struggle and it wouldn’t be unreasonable to say he was out of breath and any amount of weight on Mr. Hyde’s torso when he’s in the prone position, with hands cuffed behind his back and feet up towards his rear end — I think that is a significant issue."

Hyde’s struggle with police began after a special constable told him he had to use a serrated cutting tool to remove the string that was holding up his shorts.

Photograph of the Queen Elizabeth II Health Sciences Centre courtesy of the Capital District Health Authority.

Limited scope

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

The current investigation into the death of Howard Hyde is being conducted under the Fatality Investigations Act of Nova Scotia and is not a public inquiry under the Public [Inquiries] Act of Nova Scotia.

The difference is not merely a play on words because the outcomes can be completely different. Under the Fatalities Act, the findings of Judge Anne Derrick shall not contain any findings of legal responsibility. The judge may make recommendations to the Attorney General to help prevent whatever caused the death of Mr. Hyde from happening to someone else, but the scope of the inquiry is not as in-depth as a public inquiry would be.

In a public inquiry such as the Nunn Commission and the Westray Mine disaster, the scope of the inquiry was much more in-depth and a public inquiry is usually requested by the government.

The public should be better informed as to the difference between a fatality inquiry and a public inquiry. The main issues in this fatality inquiry are centered around the use of a Taser and how Mr. Hyde was treated while suffering from a mental illness.

A public inquiry should have been called by government because of the current controversy surrounding Taser use and mental illness awareness. This incident may have been the opportunity to equal the Nunn Commission in its recommendations, which went to government for implementation. This fatality inquiry is not a public inquiry and therefore will be limited in its findings, which is unfortunate.

Jim Hoskins, Halifax

Understanding Complex Interactions Key to Preventing Alcohol Abuse

An article published in the July 17th edition of Psychiatric News:

A genetically associated characteristic — the level of response to alcohol — connects genetic vulnerabilities with the environment to reveal the complicated process through which alcohol use disorders develop.

By Jun Yan

Like other mental illnesses, alcohol use disorders (AUDs) develop through interactions of multiple genetic vulnerabilities and environmental factors over a long period. By understanding these interactions, psychiatrists can devise and apply targeted, effective, and efficient prevention methods.

These were the messages of Marc Schuckit, M.D. [pictured], in his Adolf Meyer Award lecture at APA's 2009 annual meeting in May in San Francisco. Schuckit is a professor of psychiatry at the University of California, San Diego, and director of the Alcohol and Drug Treatment Program and Alcohol Research Center at the Veterans Affairs San Diego Healthcare System.

His lecture, "How Alcoholism Develops: Identification of Genetic and Environmental Influences in a 25-Year Longitudinal Study," examined groundbreaking research by him and his colleagues on the intricate dynamics between genes and environment that reveal much about AUDs as well as other mental illnesses.

To read the entire article, please click here.

Photograph by David Hathcox

Province Releases Report on Suicide, Attempted Suicide

A July 15th media release from the Nova Scotia Department of Health Promotion and Protection:

A new report will better position government and its partners to help Nova Scotians at risk of attempting suicide.

The report, Suicide and Attempted Suicide in Nova Scotia, was released today, July 15. Its purpose is to help those who work in the areas of suicide prevention, intervention and support.

"Suicide is a very complex and sensitive public health issue," said Dr. Robert Strang, Nova Scotia's chief public health officer. "We need to talk about it more and better understand it to ensure the right programs and supports are in place to help Nova Scotians."

The report describes the conditions surrounding suicide and attempted suicide in Nova Scotia. The data is based on hospital and vital statistics records of suicides and suicide attempts from 1995 to 2004. It examines demographic factors, how people attempt suicide and complete suicide, and the types of health-care services used by Nova Scotians at risk.

"This report is a baseline we can use to evaluate future efforts on this important issue, and we've made good progress since 2004," said Dr. Strang. "We've developed a suicide prevention framework to reduce suicides and attempted suicides, we're doing additional research with the medical examiner's office, and we fund our community partners who work with Nova Scotians."

Dr. Stan Kutcher, Sun Life Financial chair in adolescent mental health, a partnership with the IWK Health Centre and Dalhousie University, said that even though suicide and suicide attempt rates are decreasing, and Nova Scotia is experiencing lower suicide rates than most Canadian provinces, there is more to be done.

"Improving care for people with mental disorders, enhancing the capability of health care and education professionals to identify people at risk, promoting overall good health and resiliency, and improving access to good mental health care, can all help further reduce Nova Scotia's suicide rates."

Highlights of the report include:

• the rate of hospitalizations for suicide attempts declined by 30 per cent over the 10-year period

• 55 per cent of those hospitalized were female

• Lower income was associated with higher rates of both hospitalizations for suicide attempts and suicide deaths

• The rate of suicide death declined from 11 to nine individuals per 100,000

• Nova Scotia's suicide rate was lower than the national average, nine out of 100,000 individuals compared to 11 out of 100,000

• 84 per cent of suicide deaths were male

• 55 per cent of suicide deaths were previously diagnosed with a mental disorder

The report is available online at www.gov.ns.ca/ohp/publications/Suicide_Report.pdf.

Media Contact:

Rachel Boomer
Health Promotion and Protection
902-424-5323
E-mail: rachel.boomer@gov.ns.ca

Also see:

Panel: Report says programs to prevent suicide working