Putting a Price on Mental Illness

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

Mental illness costs the Canadian economy a staggering $51-billion annually. That number includes:

• $5-billion in direct medical costs

• $9.3-billion in lost productivity due to short-term sick leave

• $8.5-billion in lost productivity due to long-term disability

• $28-billion is attributed to "reductions in health-related quality of life" - a method used to put a dollar figure on pain and suffering.

The World Health Organization estimates that by 2020, depression will be the leading cause of disability on the planet. Employers see the impact of mental illness every day:

• 500,000 Canadians daily are absent from work because of psychiatric and psychological problems.

• 40 per cent of all disability claims, short-term and long-term, involve mental-health conditions.

• 18 per cent of workers in Canada have had a diagnosis of clinical depression.

• 8 per cent of workers currently on the job are taking drugs for a mental-health condition.

• 6 per cent of all workers are under the care of a physician for treatment of a psychiatric or psychological condition.

Sources: Centre for Addiction and Mental Health; Great-West Life Centre for Mental Health in the Workplace; World Health Organization

Also see:

When the office gives back

Breaking Through

Lunenburg County Chapter - Halloween Party 2009

The Lunenburg County Chapter of the Schizophrenia Society of Nova Scotia held their Halloween Party 2009 on Tuesday, October 20th.

The Scary Witch won 1st prize for the most creative and scary costume.

Our gal Audrey a.k.a. Aubrey Zinck won 2nd prize for the funniest costume and the nicest legs.

Juanita won a prize for the best foreign costume.

Click on any photography to enlarge it.

All photographs by Jan House.

Nurse: MD’s note didn’t look official

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

No psychiatric exam had been set up for Hyde; man didn’t show acute symptoms, woman says

By Michael MacDonald, The Canadian Press

The nurse who admitted a man to a Nova Scotia jail where he later died knew about a doctor’s note requiring the inmate to receive a psychiatric exam, but the nurse told an inquiry Wednesday she didn’t consider it an official physician’s order.

Sandra McLeod was the nurse in charge at the Central Nova Scotia Correctional Facility [pictured] when Howard Hyde — under arrest for an alleged assault — was dropped off there by deputy sheriffs on Nov. 21, 2007.

Hyde, a 45-year-old musician with a long history of mental illness and run-ins with the law, died the next morning as he struggled with guards, yelling there were "demons" in the jail.

McLeod told the inquiry she knew Hyde had not refilled his prescription for an anti-psychotic drug for about four months, and that he had been Tasered by police after his arrest and later sent to a hospital for treatment.

As well, McLeod confirmed she had read a handwritten note on Hyde’s health information transfer form, written by Dr. Janet MacIntyre, that said he had to be returned to hospital if he did not receive a court-ordered psychiatric assessment.

McLeod testified that when she read the note from the emergency room doctor, she called the Mentally Ill Offender Unit to determine if they were expecting Hyde for a court-ordered psychiatric assessment. But she was told nothing had been scheduled.

The form also said Hyde required ongoing treatment for schizophrenia and psychosis. As well, it said he had demonstrated aggression towards others and the potential to hurt himself.

The nurse said she saw no reason to send Hyde back to the hospital because he wasn’t displaying any acute symptoms.

"He wasn’t disoriented, he wasn’t agitated, he wasn’t hallucinating and he was following direction," she testified during her second day in the witness box.

McLeod said MacIntyre’s note did not constitute a physician’s order because it was written on a form she was unfamiliar with and lacked instructions on a specific time and place for an appointment.

"This isn’t the same kind of form that we follow through on," she said.

Still, McLeod said she asked one of the jail’s support clerks, Maureen Walford, to contact the hospital to make sure Hyde had been medically cleared.

Walford, who also testified Wednesday, confirmed Hyde had been cleared and said she also asked the hospital about MacIntyre’s note.

Recalling the conversation, Walford told the inquiry: "(A hospital administrator) just said, "No, he doesn’t have to come back. I have nothing here.’ "

McLeod said she would have contacted an on-call doctor had Hyde started displaying psychotic behaviour.

She also testified that she was not made aware that Hyde had been given an anti-psychotic drug when he was at the hospital.

However, Hyde did not have any prescriptions with him when he arrived at the jail, which McLeod did not find unusual.

Hyde was placed in a health-care cell, which meant guards would check on him every 15 minutes, but McLeod confirmed the guards were not told to watch for anything unusual.

Most of the guards who have testified at the inquiry have said they had little or no training on how to deal with the mentally ill.

The inquiry, which began in July under the direction of provincial court Judge Anne Derrick, is trying to determine why Hyde didn’t get the psychiatric help he needed, and what can be done to prevent similar tragedies in the future.

Earlier in the inquiry, MacIntyre testified that she would not have discharged Hyde if she had known he would be sent to a jail cell rather than a psychiatric hospital. She said police had assured her Hyde would receive a court-ordered assessment.

The inquiry has also heard that the Halifax police officers working on Hyde’s case knew they did not have the authority to follow the doctor’s instructions once he entered the court system.

The deputy sheriffs escorting Hyde to court did not hand the health form to lawyers handling the case because legislation at the time forbade them from sharing such information with anyone but health-care providers, such as McLeod.

Bold plus italic emphasis is mine.

Writing Together

Please click on the image to magnify it.

Holly House - Accepting applications for affordable, supportive housing

Adapted from the October 15th edition of the Community Action on Homelessness Newsletter:

The Elizabeth Fry Society of Mainland Nova Scotia owns a residence [pictured] at 1 Tulip Street in Dartmouth, Nova Scotia. The residence will house our Society’s offices and will offer single occupancy rooms with shared kitchen, common room and bathrooms for rent to seven women. The house will provide safe, affordable housing for women for up to two years. This is not a half-way house. All women in the community are eligible to submit an application. Tenants will have access to:

• Elizabeth Fry’s professional staff
• Communal living space
• Support to develop a Personal Transition Plan
• Individual counselling
• Education and employment exploration
• Housing search support and advocacy
• Community resources referrals
• Personal development programming
  

Rent will be geared to income and tenancy is subject to a lease and the policies and procedures of the residence, which include a zero tolerance policy for drug or alcohol use, and a commitment by tenants to support the spirit of communal living.

If you are interested in applying to rent a living space, please obtain an application form by calling 454-5041 or 1-877-619-1354 (toll-free), and forward it to:

Elizabeth Fry Society of Mainland Nova Scotia
Attention: Tenant Application
2352 Gottingen Street
Halifax, Nova Scotia
B3K 3B9

Fax: 902-455-5913
email: mjmilley@efrynovascotia.com
Website: www.efrynovascotia.com

oneinfive.ca - Speaking up about Nova Scotia Mental Health Issues

From www.oneinfive.ca:



To view more of the videos, please click here.

Recovery Quilt winner!

Dorothy Gregor, right, is presented with the Schizophrenia Society of Nova Scotia's Recovery Quilt. Ms. Gregor's winning ticket was drawn by Judge Alfred Brien during the Schizophrenia Society of Nova Scotia's 21st Annual Conference on October 1st, 2009. Presenting the Recovery Quilt to Ms. Gregor is Cecilia McRae, president of the Schizophrenia Society of Nova Scotia.


About the Recovery Quilt

The Recovery Quilt depicts life after a diagnosis of mental illness. Picking up the pieces to create something beautiful and functional, yet often different from what we had initially intended.

The Iris represents the individual; and the blades of grass, the support system. Supports include: family, friends, caregivers, co-workers, medical staff, education, skills, jobs, housing, religion, community and various organizations. All help weather the storm; for alone the Iris is vulnerable and frail.

The checkerboard border is suggestive of the journey, and how each move we make has an impact on the outcome.

The gently scalloped edge illustrates that the road to recovery is not always straight, we have to expect some curves along the way.

In 1994, The Schizophrenia Society of Nova Scotia chose the Iris as an emblem for its crusade against mental illness. The Iris’ three petals represent courage, wisdom and hope. The Iris takes its name from the Greek word for “rainbow”.

The Recovery Quilt was hand-made by Cecilia McRae and Roberta Smith. It was hand-quilted by the Merigomish Presbyterian Church Guild in 2009.

Judge says mentally ill shouldn't fill jails

An article published in the October 8th edition of the Saint John Telegraph-Journal:

By Sandra Davis

SAINT JOHN - Professional development days to train teachers how to deal with students with mental health problems and mental health response teams in schools would be big steps toward transforming the health care system, says a prominent judge.

"Who spends more time with kids than teachers?" said Judge Michael McKee [pictured] as he addressed about 20 members of the mental-health profession and the public who attended a meeting of the Saint John Community Advisory Committee on Wednesday morning.

McKee recently wrote a report urging government to break down the bureaucratic barriers that too often send mentally ill citizens to jail.

"It's easy to be decent and kind. We'd be surprised to know how many people need that in life and how easy it is."

Who to contact and how to respond is most important, he said.

"The first contact somebody with mental illness makes should be concerned about recovery," he said. "We need to focus on recovery if we're going to transform the system." In government, where the bottom line is a major concern, "the longest planning is from one election to the next," McKee said.

"The money spent on jails would be better spent on the front end.

"It's easy to come back and say 'we don't have the resources'."

Saint John's mental-health court has cost nothing - thanks to Judge Alfred Brien - McKee said, adding that he believes there are other New Brunswick judges who are willing to go that extra mile."There are people willing to take on extra files and work extra hours," he said. Eighty per cent of people who are dealt with in mental-health court never go back to court, he said.

"We've got to find a better way than bringing in the paddy wagon and handcuffs. They're not criminals, they're sick. People need to be sensitized. At the end of the day, it's about having a little bit of heart."A mental-health crisis response team comprised of a psychiatrist, psychologist, counsellors and other experts who would respond to schools would go a long way to nipping problems in the bud, he said.

Collaboration and co-ordination of government departments and professionals is also necessary, said the former Liberal cabinet minister and MLA.

"Government departments wouldn't share a nickel with another department," he said.

Uncomplicated access to housing and income support are also necessary if the system is to improve, he said.

Government has responded to a number of his recommendations within the set time lines, McKee said, but it remains a "work in progress."

"I didn't see all I would have liked. I have become a little unrealistic, but I'm not going to apologize for that," McKee said.

"This is everybody's business."

Photograph courtesy of the Saint John Telegraph Journal.

Also see:

Together into the Future: A Transformed Mental Health System for New Brunswick (PDF)

Wait-and-see reaction to gov't mental health response

Advisory Council on Mental Health Act debated

Bill 26, An Act to Create the Nova Scotia Advisory Council on Mental Health, was debated in the Nova Scotia House of Assembly on October 7th, 2009. Reference to the Schizophrenia Society of Nova Scotia was made on two occasions during the debate. To read a transcript of the debate, please click here.

Photo credit

Province Introduces New Mental Health Resources in Schools

An October 5th news release from the Nova Scotia Department of Education:

Nova Scotia's students will gain a better understanding of mental health with the introduction of new resources to support health education in schools, Education Minister Marilyn More [pictured] announced today, Oct. 5.

The Healthy Mind/Healthy Body resources supplement the province's newly enhanced health education curriculum, which includes mental health as one of six priority areas.

"Healthy Mind/Healthy Body speaks to students in age-appropriate language, and teaches the difference between healthy and unhealthy feelings," said Ms. More. "It is intended to help both students and their families cope with the challenges that youth face as they grow and mature."

These resources, which include a pamphlet called Let's Talk About... Mental Health, encourage open and honest discussion around feelings and worries. The learning activities encourage students to talk to a trusted adult when they begin to feel overwhelmed by certain feelings.

Ms. More, accompanied by adolescent mental health experts Dr. Stanley Kutcher and Dr. Bianca Horner, who authored the materials, attended a class at Portland Estates Elementary School today where they shared their thoughts and feelings with Ms. Mamoona Brace's grade four and five class.

"The idea is that by learning to openly discuss emotions and concerns, students will begin to see mental health as an important and natural aspect of their overall health," said Ms. More.

In the earlier grades, Healthy Mind/Healthy Body has students track their feelings in a monthly calendar and identify what causes them to feel frightened, sad or worried. In grades seven to nine, students discuss common mental illnesses and learn to identify their warning signs.

These new resources are part of the recently developed Nova Scotia health education curriculum for grades primary to nine, and have been used in classrooms since spring. The resources further confirm Nova Scotia's position as the national leader in developing curriculum in child and adolescent mental health.


FOR BROADCAST USE:

Nova Scotia's students will gain a better understanding of mental health with the introduction of new resources to support health education in schools.

Education Minister Marilyn More announced today (October 5th) that the Healthy Mind/Healthy Body resources address child and adolescent mental health concerns and are intended to help youth and their families cope with the challenges of growing up.

The mental health materials are written in age-appropriate language and complement the health curriculum for grades four through nine already in place in Nova Scotia's public schools.

-30-

Media Contact:

Nicole Brooks
Department of Education
902-424-5432
E-mail: brooksnl@gov.ns.ca

Also see:

Province introduces mental health strategy for schoolchildren

Latest treatment for schizophrenia offers needed additional option to fight difficult-to-treat disease

An October 6th press release from Bristol-Myers Squibb Canada:

ABILIFY(TM) now available in Canada with several benefits: efficacy, good safety, tolerability and neutral impact on weight, cholesterol and blood sugar levels

MONTREAL, Oct. 6 /CNW Telbec/ - A new treatment option for Canadians with schizophrenia, ABILIFY(TM) (aripiprazole), is now available in Canada. For those living with this lifelong disease who may be struggling with a treatment that doesn't work for them or with side effects that are difficult to tolerate, ABILIFY offers efficacy and good safety and tolerability with limited impact on weight, blood sugar and lipids - significant clinical benefits that may help patients stay on treatment longer.

"Schizophrenia is a complex disease that is often challenging to treat. As a physician, the main challenge I face is that patients stop taking their medications and relapse," said Dr. Ruth Baruch, psychiatrist and director of the community program at Toronto East General Hospital. "Weight gain is particularly important. Two thirds of patients will stop taking their medication because of weight gain. Numerous studies have indicated that ABILIFY has the advantage of causing fewer long-term side effects such as lower weight gain and less increase in cholesterol. Where I think this will translate in the real world is improving adherence and patients will be more likely to stay on medication in the long-term."

Schizophrenia is a lifelong disease and treatment plays an important role in its management. ABILIFY is the latest medication in Canada to treat schizophrenia. It has not only been shown to improve day-to-day functioning and lessen social withdrawal, clinical studies show it does so with less impact on patient weight or other metabolic factors such as cholesterol, lipids and blood sugar levels. ABILIFY is effective in improving a range of so-called "positive" symptoms of schizophrenia, such as hallucinations and delusions, as well as the "negative" symptoms of the disease, such as lack of motivation and emotional withdrawal, that prevent many people with schizophrenia from leading full and fulfilling lives.

One person who knows the immense burden schizophrenia puts on those directly affected by it is Brian Good of Oakville, Ontario. His brother, Eric, was struck with the devastating disease when he was in his early 20s and at university, primed to advance in education and his adult life. Brian remembers what it was like growing up. "My brother's behaviour at home was very disruptive. He would cycle between not being on medication and do strange things like hitchhike across the country," said Brian. "I lost a brother and my children lost an uncle. If there had been better treatment options back then, our family might be very different." Now in his 50s, Eric lives in a group home in Gravenhurst, Ontario.

The Schizophrenia Society of Canada believes that patient access to new treatment advances is critical to making it possible for people with schizophrenia to control their illness and improve their quality of life. "Schizophrenia is treatable and recovery of a quality of life is possible. There can never be too many treatments options for schizophrenia," says Chris Summerville, CEO of the Schizophrenia Society of Canada. "Given the complexity of schizophrenia and psychosis, the challenges people face in recovering and finding the right medication that supports the recovery process, it's vital for patients to have as many options available as possible. For this reason we believe all therapies approved by Health Canada should be made available to patients by all drug plans in Canada, public and private."

About Schizophrenia

Schizophrenia is a form of psychosis, meaning it interferes with a person's ability to interpret what is real or not. It causes patients to have "positive" symptoms, including hearing voices and having hallucinations, and "negative" symptoms, such as emotional withdrawal and apathy. Symptoms vary widely among patients. An estimated 335,000 Canadians have schizophrenia, most diagnosed in their late teens or early adulthood. There is no cure and it is a lifelong disease. The primary goal of treatment is to provide relief of both positive and negative symptoms. With such control, people can live full and productive lives. Unfortunately, treatment discontinuation among patients with schizophrenia remains high at 40 to 50%. Because symptoms, individuals, and medications differ so greatly, there is always a need for new and effective treatment options.

About ABILIFY(TM)

ABILIFY(TM) (aripiprazole) is a new treatment in the class of atypical antipsychotic medications, available by prescription only. It has been approved by Health Canada for the treatment of schizophrenia and related psychotic disorders in adults. It is also indicated for the acute treatment of manic or mixed episodes in bipolar I disorder in adults, alone or in combination with lithium or divalproex sodium.

ABILIFY is the first and only dopamine and serotonin partial agonist. It acts in specific areas of the brain where levels of the neurotransmitters dopamine and serotonin are too high or too low and appears to balance the levels of these chemicals.

ABILIFY has undergone a rigorous clinical development program and has been evaluated for safety in 13,543 adult patients.

About The Schizophrenia Society of Canada

The Schizophrenia Society of Canada (SSC), founded in 1979, is dedicated to improving the quality of life for those affected by schizophrenia and psychosis through education, support programs, public policy and research. The Society works with 10 provincial societies in a federation model to: raise awareness and educate the public in order to reduce stigma and discrimination; support families and individuals; advocate for legislative change; and support research through the SSC Foundation and other independent efforts.

About Bristol-Myers Squibb Canada

Bristol-Myers Squibb Canada is an indirect wholly-owned subsidiary of Bristol-Myers Squibb Company, a global pharmaceutical and related health care products company whose mission is to extend and enhance human life. Bristol-Myers Squibb Canada is a leading provider of medicines to fight cancer, cardiovascular and metabolic disorders, infectious diseases (including HIV/AIDS), nervous system diseases and serious mental illness. Bristol-Myers Squibb Company is listed on the New York Stock Exchange under the BMY symbol (NYSE:BMY). Bristol-Myers Squibb Canada's operations are headquartered in Montréal, Québec.

-------------------------------------------------------------------------

(TM)ABILIFY is a trademark of Otsuka Pharmaceutical Co., Ltd. used under license by Bristol-Myers Squibb Canada.

For further information, or to arrange an interview, please contact:

Marc Osborne, Director, Government Relations and Public Affairs, Bristol-Myers Squibb Canada, (514) 333-2463, marc.osborne@bms.com, or

Ethan Pigott, Hill & Knowlton, (416) 413-4744, ethan.pigott@hillandknowlton.ca

Note: ABILIFY(TM) (aripiprazole) is not yet listed in the Nova Scotia Drug Formulary. If you would like to have ABILIFY(TM) (aripiprazole) added to the Nova Scotia Drug Formulary, please contact your MLA.

Painting raffle: Lunenburg County Chapter

The Lunenburg County Chapter of the SSNS (LCC-SSNS) is holding a raffle for a framed painting, entitled Down South (above), by Richard Balser, a Chapter member who lives with schizophrenia. Janet Mason, a well known Lunenburg marine artist, and also Richard's art instructor, has valued the painting at $400. Proceeds from the raffle go to a bursary fund set up to assist individuals living with schizophrenia in furthering their educational and skill-building goals.

Tickets are one for $2.00 or three for $5.00. Tickets can be purchased by contacting Jan House at (902) 527-1692 or janice.house@xplornet.com, or Carolyn Eisnor at (902) 543-5418.

The winning ticket will be drawn at the LCC-SSNS's Christmas Party to be held beginning at 6:00 pm on Tuesday, December 15th, 2009, at St. Paul's Lutheran Church on Phoenix Street in Bridgewater.

Richard Balser is selling the two paintings pictured below. If you are interested in purchasing a painting, please contact Jan House or Carolyn Eisnor.





Please click on any image to magnify it.

NEWS RELEASE: Opening Minds to take the stigma out of Mental Illness

An October 2nd news release from the Mental Health Commission of Canada:


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Also see:

From tower to 'beacon of hope'

SSNS's 21st Annual Conference: Mental Illness and the Criminal Justice System

The Schizophrenia Society of Nova Scotia’s 21st Annual Conference was held on Thursday, October 1st. The theme of this year's conference was Mental Illness and the Criminal Justice System, with a focus on mental health courts.

To download a PDF verson of the Conference Program, please click here.

The plenary speaker was Judge Alfred H. Brien of the Saint John Mental Health Court.

Dr. Ruth Carter (right), Director of Forensic Services, IWK Health Centre, and Kimberley Brennan, Acting Manager of Forensic Services, IWK Health Centre, making a presentation on youth and the justice system.

Dr. P. Scott Theriault, Clinical Director, East Coast Forensic Psychiatric Hospital, Clinical Director, Specialty Programs, Capital District Mental Health Program, and Associate Professor, Department of Psychiatry, Dalhousie University, presenting on lack of insight.

Judge Brien answering a question from the audience during the Questions from the Audience / Panel Discussion session. Seated beside Judge Brien is the keynote speaker, Judith McPhee, Executive Director, Policy and Information Management, Nova Scotia Department of Justice.

Members of the panel listening to a question from the audience during the Questions from the Audience / Panel Discussion session. Panel members, from left to right, are Judge Brien, Judith McPhee, Patrick Burke (moderator), Kimberley Brennan, Dr. Carter, and Dr. Theriault.

The conference was held in the Ashley Lounge at the Sea King Club in Shearwater, Nova Scotia.

Conference Master of Ceremonies, Laura Burke (left), with Patrick Burke, a member of the Board of Directors of the Schizophrenia Society of Nova Scotia.

The Recovery Quilt on display at the conference. Congratulations to Dorothy Gregor, the winner of the Recovery Quilt raffle!

Nancy Vidito, the producer of Podium TV, taped both Judge Brien's and Judith McPhee's presentations for broadcast on EastLink Television in late October 2009.

Please click on any photograph to enlarge it.

All photographs by Stephen Ayer.

Conference Supporters

www.mylan.com

www.mentalhealthns.ca

www.gov.ns.ca/just

System is in chaos, mental health advocates say

An article published in the October 1st edition of Metro Halifax:

By Paul McLeod

Mental health advocates from various fields met in Province House yesterday to warn the system is in a state of chaos.

They say mentally ill people are slipping through the cracks because outreach staff are too overburdened to keep up. However, they said the first and most urgent step is cheap and easy to fix.

Nova Scotia currently does not have a comprehensive mental health strategy. They said that needs to change

“They are our family, our friends and our coworkers,” said Stephen Ayer [pictured, left], executive director of the Schizophrenia Society of Nova Scotia.

“As many people as I am able to help, I know there are just as many who continue to suffer alone wondering what exactly is wrong with them, wondering if anybody can help. Sadly, some don’t survive. They die by suicide.”

Ayer estimated 180,000 Nova Scotians will battle mental illness at some point. But he said people still suffer in silence and shame because of social stigma, while issues like swine flu get swift government action.

In the meantime, they’ve taken new action to get the word out. Yesterday they announced the website oneinfive.ca, dedicated to raising awareness about mental health issues in Nova Scotia. The name comes from global studies showing one in five people will deal with serious mental health issues at one point in their life.

Along with information and personal testimonials, the site allows visitors to sign a petition and send letters to politicians urging the creation of an overarching strategy.

Liberal MLA Diana Whalen, who helped organize the event, has put forward a bill to create an advisory council on mental health made up of educators, psychiatrists, mental health consumers and their family members.

The council would advise government on how to best meet the mental health needs of the province.

Photograph by Ryan Taplin, Metro Halifax

Mental health court lauded

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

Conference today on system’s benefits

By John McPhee, Health Reporter

Much more needs to be done to support the mentally ill in Nova Scotia, but the creation of a mental health court is a good start, advocates say.

The Schizophrenia Society of Nova Scotia will hold a conference today in Halifax to highlight the benefits of the court, which the province announced this summer.

"I think it’s only a logical step," said Stephen Ayer, executive director of the society, in an interview. "The idea is to get the person to the point where they can reintegrate themselves into society with a treatment plan. But the person has to accept responsibility for their crime."

Other provinces, including New Brunswick, have had mental health courts for years. The society has pushed for one in Nova Scotia for a long time, Mr. Ayer said. He’s not sure why it took so long for the province to move on the issue.

"Some would argue it’s not necessary, that it’s (the responsibility) of mental health services," he said. "But who’s going to start the process — Health or Justice? Health is dragging its feet and has been for years on the treatment of the mentally ill. Somebody has to start somewhere."

Judge Alfred Brien will speak about the success of the N.B. mental health court system at the conference, which will start at 8 a.m. at 12 Wing Shearwater. Other speakers will include Judith McPhee, of Nova Scotia’s Justice Department, who will explain the province’s plans.

The once-a-week sitting at the Halifax 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.

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

Mr. Ayer said the court’s success hinges on the province improving other supports for the mentally ill in society, such as housing and employment programs.

"That’s where we’re challenged," he said. "I’m going to be interested in hearing the answers on that."

More information on the conference can be found at www.ssns.ca.

Conference: Youth Mental Health and the Justice System

Please click on the image to magnify it.

For further information, please click here.

Recovery After Psychosis (RAP): A Compassion Focused Programme for Individuals Residing in High Security Settings

The abstract of an article published online on September 21st by the journal Behavioural and Cognitive Psychotherapy:

By Heather Laithwaite (1,3), Martin O’Hanlona (1), Padraig Collinsa (1), Patrick Doylea (1), Lucy Abrahama (1), Shauneen Portera (1), and Andrew Gumleya (2)

(1) The State Hospital, Carstairs, Scotland

(2) University of Glasgow, Scotland

(3) Reprint requests to Heather Laithwaite, Rowanbank Clinic, Balornock, Glasgow G21 3UL, Scotland. E-mail: heather.laithwaite@ggc.scot.nhs.uk


Background:

The aim of the study was to evaluate the effectiveness of a recovery group intervention based on compassionate mind training, for individuals with psychosis. In particular, the objective was to improve depression, to develop compassion towards self, and to promote help seeking.

Method:

A within-subjects design was used. Participants were assessed at the start of group, mid-group (5 weeks), the end of the programme and at 6 week follow-up. Three group programmes were run over the course of a year. Nineteen participants commenced the intervention and 18 completed the programme.

Results:

Significant improvements were found on the Social Comparison Scale; the Beck Depression Inventory; Other As Shamer Scale; the Rosenberg Self-Esteem Inventory and the General Psychopathology Scale from the Positive and Negative Syndrome Scale.

Conclusions:

The results provide initial indications of the effectiveness of a group intervention based on the principles of compassionate focused therapy for this population. The findings of this study, alongside implications of further research are discussed.

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

Teens to learn about mental health

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

Pilot project could be coming to Digby County high schools in new year

By Brian Medel, Yarmouth Bureau

High school curriculum designed to teach students about mental illness may be coming to Digby County classrooms in January as a pilot project.

"This is new," said John Roswell, one of the program co-ordinators with the Digby-Clare Mental Health Volunteers Association.

"We hope to do it during the 2009-2010 school year, hopefully beginning in January," Mr. Roswell said about the project that will be conducted in four local high schools.

He hopes the curriculum will someday be included in all Nova Scotia high schools.

The curriculum was prepared by Dr. Stan Kutcher [pictured] in co-operation with the Canadian Mental Health Association.

"This is really a wonderful opportunity," said Dr. Kutcher, an adolescent mental health expert at Dalhousie University’s school of medicine.

The course will give students information on how the brain works and tell them how to maintain good mental health. Suicide prevention and depression will also be discussed, Dr. Kutcher said Tuesday.

He’ll help teachers better understand mental illness and the new curriculum in special workshops that will be held before the start of the course.

"They’ve been very enthusiastic about this," said Dr. Kutcher.

Next week, staff from the Education and Health departments, along with representatives from local school boards and health authority, will gather in Digby to talk about the new high school course and how it will be implemented.

"We’re not quite sure where it will fit . . . that’s part of what this discussion is going to be about," said Mr. Roswell. "We hope to make (it) a larger project . . . an overall approach to addressing adolescent mental health.

"We’re trying to create a dialogue around this issue in the community and make it OK for people to talk about mental health and mental illness."

Mr. Roswell said 80 per cent of all psychiatric disorders emerge in adolescence. He had mental illness as a young person but was undiagnosed until the age of 40.

"My life would have been so much different had I been diagnosed as a teenager," he said.

Elyn Saks Wins MacArthur Foundation Award

An article posted on September 22nd by USC News:

USC Gould School of Law professor and Associate Dean Elyn Saks [pictured] has been selected as a 2009 fellow of the MacArthur Foundation. Saks is the first fellow selected from the faculty of USC and one of only 24 selected for this year’s awards.

The prestigious fellowship, known informally as the "genius grant," provides each recipient with a $500,000 "no strings attached" award over five years. The awards were announced by the Chicago-based John D. and Catherine T. MacArthur Foundation.

Saks is a nationally recognized scholar in mental health law, criminal law and the ethical dimensions of medical research. She also has battled schizophrenia and acute psychosis. In 2007, after decades of hiding her illness, Saks published a memoir about her struggles and successes in The Center Cannot Hold: My Journey Through Madness. The book won far-reaching acclaim from literary critics and advocacy groups.

To read the entire article, please click here.

Photograph by Mark Berndt.

Schizophrenia Patients Show High Rates of Comorbid Illness

An article published in the September 18th edition of Psychiatric News:

By Mark Moran

Metabolic conditions were common but so were such medical conditions as epilepsy and viral hepatitis.

Hospital discharge records of people with a primary diagnosis of schizophrenia showed higher proportions of all comorbid psychiatric conditions and of several general medical conditions than did those of people who did not have schizophrenia.

The general medical conditions included acquired hypothyroidism, obesity, epilepsy, viral hepatitis, type 2 diabetes, essential hypertension, various chronic obstructive pulmonary diseases, and contact dermatitis and other forms of eczema, according to data from the National Hospital Discharge Survey reported in the August Psychiatric Services by researchers in the Department of Epidemiology at Walter Reed Army Institute of Research.

The survey data confirm what has been reported before: that patients with schizophrenia have higher rates of morbidity associated with some general medical conditions.

However, the study authors pointed out that virtually all existing studies of comorbid disorders in schizophrenia test hypotheses and have focused on a single comorbid condition in relatively small and nonrepresentative samples. The current study appears to be the first systematic analysis of comorbidity in general with schizophrenia in the U.S. hospitalized population.

"Our study is hypothesis-generating rather than hypothesis-testing, with the main purpose of presenting a systematic review of comorbid conditions," said coauthor Natalya Weber, M.D., M.P.H. "Psychiatrists can see in this very large and representative sample what conditions are more frequently comorbid with a primary diagnosis of schizophrenia compared to any other primary diagnosis among the U.S. hospital discharges."

Weber is health science administrator in the Division of Preventive Medicine at Walter Reed Army Institute of Research.

To read the entire article, please click here.

Nova Scotia Speech From The Throne

From page 10 of yesterday's Nova Scotia Speech From The Throne:

My government will improve support for individuals with mental illness, and for their families.

We will collaborate with mental health service providers to identify, monitor, and refer youth requiring mental health supports.

Community-focused living bungalows will be developed to provide appropriate, respectful care for individuals coping with mental illness.

Next month, the first mental health court will open and will help people who need counselling and treatment instead of being held in custody or put in situations where conflict may arise.

Vancouver judge: Community court works

An article published in todays edition of The Chronicle Herald:

By The Canadian Press

VANCOUVER — It's the personal anecdotes that tell the story of Vancouver's community court for judge Thomas Gove [pictured].

One year after opening Canada's first court to fully integrate the legal process with health, housing and social services, Gove measured the project's success Thursday by recounting the impact on a drug addict who was nudged into a residential detox program while doing street cleaning as community service for theft.

Gove also spoke about a chronic offender, approaching 60 years old, who was in court on a theft charge.

With the assistance of court workers, he has held down a full-time job for the past six months and not committed any further crimes. Keeping that man away from crime is probably saving $100,000 a year in the cost to merchants, police, the court system and prisons, the judge said.

He recounted details, as well, about a case earlier this week that reflects how different the community court is from a traditional courtroom. The offender broke down in tears after the judge made a strong personal appeal to her.

``Don't you understand, all the people here are trying to help you?'' Gove recalled saying to her. ``What is it we are not doing right? What more can we do? What is missing?''

Vancouver's community court, located in the heart of the city's drug-infested, poverty-ridden Downtown Eastside, was opened one year ago with considerable fanfare.

The jury is still out on the new system. Statistics for the first year of operations have not yet been compiled.

James Threlfall, the acting chief justice of the provincial court, said Thursday an analysis of the impact of the community court on the court system will be completed later this fall.

But Gove, the presiding judge who has been involved with the project since it began, was positive about the court's track record so far.

The court has achieved ``real successes,'' he said in an interview. More cases are resolved sooner, offenders are required to make fewer court appearances, more appearances happen on the day they are scheduled, crime is reduced in downtown Vancouver and, he believes, the rate of reoffending has been reduced.

He was ``frustrated'' that more housing, detox centres and mental-health services were not immediately available for offenders, but he was reluctant to be critical.

The organizations are going in the right direction, he said, adding that more housing has become available in recent months.

Gove could not really think of anything the court should have done differently over the past year.

``The first year has been the experiment - how do we do this? The next year is going to be whether we really (pass) the test - how much impact are we going to have?'' he said.

Cases involving theft from autos, stores and homes, mischief, assaults, drug possession and shoplifting are heard in the community court, while more serious crimes remain in the traditional court system.

Gove said the court saw about 2,000 people in its first year. Around 25 per cent, according to a rough estimate, were repeat offenders.

Multidisciplinary teams devise a plan that is intended to respond to the offender's underlying problems, whether it is mental illness, drug addiction, homelessness or poverty. The court enforces the plan as an alternative measure to traditional court-imposed penalties.

In the first 10 months, 568 people were involved with social, health and mental-health programming, 209 received housing. Offenders did 6,055 hours of community service.

Photograph by Sam Leung, The Province.

Also see:

More than meds & beds

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

Re: "Suicide prevention: Time to get on with what works" by Stan Kutcher (Sept. 12).

Lack of treatment was acceptable in children’s mental health when we didn’t know the difference. However, it is totally unacceptable when the knowledge and proof of improved capability of sustaining a productive life is within a proper treatment plan, but lacks the dollars and commitment to provide it. All children deserve proper treatment without prejudice and stigma over their mental health issues!

It is time for the torture, neglect and abuse to stop. It is time for psychiatrists to stop delivering inadequate treatment proposals to parents and caregivers for their mentally ill children, because the province does not support the mental health needs of its young people, or perhaps, the hospital itself covers its inadequacy.

It is time for our government to invest more dollars into treatment facilities, with not just meds and beds, but with the educated, experienced staff and specialized treatment programs when prescribed. It is time for our children’s hospital to invest in a psychiatric unit and all existing mental health treatment programs, an art therapy program, music therapy program, "in house" psychologists and "on-call psychologists" when in-patient youth are in trauma episodes.

Actually, it is past time!

Sherry Beck Ramey, New Germany

Your Recovery Journey: Train-the-Trainer Workshop

On September 15th, the Schizophrenia Society of Nova Scotia held a full-day train-the-trainer workshop for the Schizophrenia Society of Canada’s new and innovative program, Your Recovery Journey. The training introduced participants to a five-session peer-support program focusing on recovery from mental illness. The Your Recovery Journey program builds on the premise that there is hope, that people with mental illness can get well, stay well for long periods of time, and do the things they want to do with their lives.

The program is designed to be co-facilitated by people who themselves have experience with mental illness and have also experienced recovery in their own lives. Collaboration with a recovery-oriented service provider or a family member is also an option to consider for delivery of the Your Recovery Journey program.

The train-the-trainer workshop was led by Chris Summerville, CEO of the Schizophrenia Society of Canada, and covered the content of the program, as well as providing helpful information and tips about bringing the program to life into the participant's communities.


Chris Summerville leading the Your Recovery Journey Train-the-Trainer Workshop in Halifax on October 15th.


A total of 39 participants attended the Your Recovery Journey Train-the-Trainer Workshop (a full house). In addition to those from HRM, participants from Kentville, Truro, Windsor, and Yarmouth were also in attendance.


Participants watch one of the videos provided as content in the Your Recovery Journey program.

Please click on any photograph to magnify it.

The Schizophrenia Society of Nova Scotia will be delivering Your Recovery Journey in Halifax beginning in mid-October 2009. Please contact Laura Burke at 465-2601, 1-800-465-2601 (toll-free in Nova Scotia) or ssns@ns.sympatico.ca for further information.

Photographs by Stephen Ayer.

The media must stop ignoring suicide

An article published in today's edition of The Windsor Star:

By Mark Henick, Special to The Windsor Star

On the evening of Tuesday, Aug. 25, a well-known former Fredericton city councilor walked into the Emergency Room with a lot on his mind. It is not known if he told them he was going to take his own life. Whatever happened in the ER, one thing was certain: He did not get rushed past the queue for immediate psychiatric care.

Instead, he ended up leaving, just walking right out the door. He called the police from in front of the hospital and, with phone in one hand and 16-gauge shotgun in the other, told them that he intended to kill himself.

To read the entire article, please click here.

Also see:

He was always looking for the good in people

What clients want from treatment: Quality of life issues top list of desired outcomes

An article published in the Summer 2009 issue of CrossCurrents:

By Hema Zbogar

The Schizophrenia Society of Canada has recently released the results of North America’s largest-ever poll of people living with schizophrenia. The Quality of Life Survey asked 1,086 mental health consumers and family members what quality of life means to them and what they perceive as barriers to its attainment. The survey found that people with schizophrenia have similar hopes and frustrations as the general population.

The survey findings challenge other quality of life research on people with mental illness that has focused heavily on clinical issues and managing negative life events rather than on the concept of recovery. The respondents’ views indicate that service providers, policy planners and funders need to move beyond a narrow focus on treating symptoms of mental illness to also supporting clients’ hopes and goals in the areas of employment, housing, economic security and freedom from discrimination and violence. Respondents also wanted more community-based services, family education and social and recreational opportunities.

CrossCurrents conducted its own informal survey of people with schizophrenia and their families to find out what they want from treatment and treatment providers, and what they want from life. We posed three questions:

1. Is there an aspect of your life related to having schizophrenia that treatment doesn’t address but that you wish it would?


2. What does a good outcome for schizophrenia treatment look like to you? In other words, what is the most important outcome for you?


3. Do you feel that the mental health professionals you have dealt with have different expectations and goals than you?
   

This is what some of our respondents, from across North America, had to say.

Byron, Toronto, Ontario

For me a good outcome means a return to relationships. The symptoms of schizophrenia often make it difficult or impossible to maintain and enjoy these necessary relationships. We, like everyone else, need the laughter, sharing, trust, companionship, and the perspective and objectivity that come from friendships and family. Sometimes as a sufferer of this disease it can be difficult to assess the veracity of our own perspective, to figure out whether or not what we feel and perceive is grounded in reality or is in part or wholly changed, shifted, modified by our disease. Surrounding ourselves with positive people gives us a sounding board. Without them it can be incredibly lonely. Thirty years ago it might have made sense to have lower expectations of people with schizophrenia because medication had such strong side-effects and many people were left undiagnosed and untreated. I’ve had several doctors who had clearly given up on me achieving the things I am now doing. One of them actually told my mother that she should “lower her expectations” of me. This was early in my recovery. If my mother or I had listened to the doctor I may not have believed in myself enough to make the efforts I have.

Mental health practitioners also need to realize that these outcomes occur in their own time and that progress may be slow and difficult to perceive, but that it is nevertheless happening. I’ve recently finished a redirection through education program with straight A’s. I socialize on a regular basis and organize social events; I’m learning how to live on my own; I have a girlfriend; I have creative and career ambitions; I make and keep all of my appointments. I’m getting closer to full recovery.

We shouldn’t be punished by unnecessarily low expectations because of assumptions that are based on old truths and old knowledge. Realistically and practically, hope for your patients to reach the stars, because they may need your belief and conviction to get there.


Tamara, Winnipeg, Manitoba

I am 26 years old and have been living with schizo-affective disorder for 11 years. The ideal outcome for treatment allows for good quality of life and achievement of goals and dreams. Being diagnosed with schizophrenia doesn’t mean we can’t achieve our goals and dreams. It just means that they require necessary adaptations and available opportunities.

Often people living with schizophrenia receive treatment in just one area of their lives and not others. The ideal treatment for schizophrenia includes necessary outlets such as having a psychiatrist for discussing medications and a counsellor to address issues inside and outside the realm of mental illness because mental illness affects all areas of life.

There should be more opportunities for obtaining education and career goals through adaptations and mentoring. I am a university student and have endured many obstacles over the past five years, but my family and workers believe in me and encourage me to pursue my goals, so that I may one day achieve my goal of becoming an occupational or recreational therapist.


Angela, Orlando, Florida

I was diagnosed with schizophrenia about four years ago when I was 25. A good treatment outcome is to be motivated to pursue life to the best of your ability. I wish more treatment would address how to cope with the real world. More education about the illness is helpful. We need awareness and ways to cope and challenge ourselves while living with this illness. Without constant motivation and sometimes even guidance there is little to look forward to. My advice to clinicians: Never expect too little or too much from your clients.


Natasha, Belleville, New York

I’ve had paranoid schizophrenia since 1991. A good outcome involves reduced hallucinations, delusions and paranoia to the point where we can function on the job or at home on a day-to-day basis. My ideal treatment for schizophrenia is a psychiatrist who will listen to us, educate us and our families and recommend supports and community resources. It is important that psychiatrists remind us that we can lead a happy, productive life. There is always hope of recovery, even if our symptoms don’t go away.


Jake, Boston, Massachusetts

No hallucinations and the ability to function without having paranoid thoughts is the ideal outcome. I would like better medication that can treat anxiety along with psychotic symptoms. I want fewer side-effects, especially weight gain and muscle stiffness. I’d also like to see more non-drug related treatments.


Anna, Seattle, Washington

I wish that more doctors would listen to the “patient” rather than telling them.


Raymond, Toronto, Ontario

Most psychiatrists focus on symptom reduction, without an image of wellness to drive a recovery-based model of care.


George, Annapolis, Maryland

Most of us with mental illness wish for a better life than just collecting disability. I want to work for a living and not be a disability recipient, even though I could live on the payments I get. Some of us gave up on work because of drug side-effects. I want more from life. I want more power. I want the power to be alive!


John, Regina, Saskatchewan

We need more coaching towards developing coping skills for school and work. On several occasions I attempted returning to school, only to drop out after I became depressed. I did try evening courses and when taking only one subject I often earned an A. Most of my learning since the psychiatrist advised that I should have “no more school” has involved self-teaching. Now, with supports in my life, I am successfully self-employed.


David, Winnipeg, Manitoba

I am 33 years old and have had schizophrenia for nine years. The best outcome is full participation in society, whatever the role. My goal was to find employment with an income that reflected my academic credentials and skills. I underwent psychological-social rehabilitation and now have a high-income job that matches my education and skills. My counsellor had the same view of empowering me to learn life skills (independent living, leisure, etc.) and to obtain and keep a job.


Dan, Midland, Ontario

One ideal treatment that doesn’t exist is medication that controls negative symptoms. I’ve had paranoid schizophrenia for 22 years (I’m 38), and my positive symptoms are under control with medication, but I’ve yet to find a drug that treats negative symptoms like blunted affect. I still struggle in my relationships and often would rather spend time alone. I also can’t concentrate the way I used to and was unable to progress in my education as well as I might have hoped. Negative symptoms should be as much of a priority as the positive ones.


Maureen, Toronto, Ontario

This morning I worked on an extensive survey for family members of residents of the supported home where my daughter, who has schizophrenia, lives. This itself speaks volumes. Staff welcome me and communicate with me about my daughter and the goals of the house for her. On the other side of the street, figuratively and literally, where my daughter receives treatment, I know nothing about her treatment and goals. I have never spoken with her doctor, though I have asked time and again, but I finally gave up.


Mike, White Rock, British Columbia

My daughter is 22 and has had schizophrenia for six years. The ideal treatment would provide constant support to both the person with the illness and the people who support them. Currently, support is sporadic at best for both. This illness is devastating, and without good support and education a successful outcome is difficult.


To download the Schizophrenia Society of Canada report, “Quality of Life: As Defined by People Living with Schizophrenia and Their Families,” visit
www.schizophrenia.ca/QualityLife.htm