Tinkerbell, Edwina, and Long-Term Outcomes, Part I

An article posted on May 27th by Psychology Today:

Is recovery really possible?

By Larry Davidson, Ph.D.

If so many people recover from serious mental illnesses, why is it that we don't see them? This is one of the most common questions raised by mental health professionals when confronted with the long-term outcome literature, at least in my experience. That literature suggests that between 45-65% of people diagnosed with schizophrenia - the most severe of the severe mental illnesses - will recover from the disorder over time. This literature has now been around, and consistently replicated, since the 1970's, but still has not made its way into the training of most mental health professionals. So, many mental health professionals, when exposed to this body of research, ask the question above. If so many people get better, then why don't I ever see them? A reasonable enough question, to be sure, and one for which we fortunately have several answers.

To read the entire article, please click here.

Also see:

Tinkerbell, Edwina, and Long-Term Outcomes, Part II


Photo credit

A national settlement has been proposed in the Zyprexa class action

Please click on the images to magnify them.

To view a high resolution version of the second document, please click here.


Also see:

ZYPREXA (OLANZAPINE) CLASS ACTION: NOTICE OF SETTLEMENT APPROVAL HEARING


From Poyner Baxter LLP:

Zyprexa

May 21, 2010

A national settlement has been proposed in the Zyprexa class action. This settlement cannot proceed until it has received court approval. The dates scheduled for the court settlement approval hearings are June 8, 2010 in Ontario, June 14, 2010 in Quebec and June 15, 2010 in British Columbia.

IF YOU OR SOMEONE CLOSE TO YOU TOOK ZYPREXA (OLANZAPINE) PRIOR TO JUNE 6, 2007, PLEASE CLICK HERE TO READ THIS NOTICE CAREFULLY AS IT MAY AFFECT YOUR LEGAL RIGHTS AND YOU MAY BE ELIGIBLE FOR COMPENSATION.

To view the full legal notice, click here.

To view the proposed settlement agreement, click here.

A further notice will be published once the settlement has been approved by the courts which will explain how individuals can make a claim.

For further information email classaction@poynerbaxter.com or phone 604 988-6321.

This Web site is offered for information only and is not legal advice. Use of the site and sending or receiving information through it does not establish an attorney-client relationship. No one should act, or refrain from acting, based solely upon this information without seeking appropriate legal or other professional advice. In particular, you should obtain advice about limitation periods as it may affect your right to bring a legal action on your own behalf. Links to and from from this Web site do not state or imply a relationship between Poyner Baxter LLP and the linked entity.

From Siskinds LLP:

UPDATE (May 21, 2010): We are pleased to announce that a settlement has been reached in this action:

• Settlement Agreement - May 5, 2010 [PDF Document]

The next step is to have the settlement approved by the courts. Settlement approval hearings have been scheduled for Ontario on June 8 , 2010, Quebec on June 14, 2010, and British Columbia on June 15, 2010.

• Notice of Settlement Approval Hearings [PDF Document]

Once the settlement has been approved by each of the courts, a further notice will be published which will explain the steps for making a claim.

Rethinking Mental Disorders

An article posted May 20th on Care2.com:

By Kristina Chew

Psychiatric or mental disorders such as schizophrenia, bipolar disorder, depression and psychosis are better understood and treated as 'disorders of the brain' according to an article by Tom Insel, M.D., Director of the National Institute of Mental Health, and Philip Wang, M.D., Deputy Director of NIMH. The article, Rethinking Mental Illness, is published in the May 19th issue of the Journal of the American Medical Association. The authors note that, while there have been many 'insights gained from genetics and neuroscience'---such as twin studies that show high heritability for autism, schizophrenia, and bipolar disorder---such research explains only a 'fraction of the heritability' of mental disorders. (For instance, some182 genes have been identified as linked to eating disorders, and some 100 to autism.) These should rather be seen as 'disorders of brain circuits':

"The genetics of mental illness may really be the genetics of brain development, with different out comes possible, depending on the biological and environmental context."

Other advances in the field of genetics contribute to a reconceptualization of mental disorders. Epigenetics looks at the inherited changes in gene expression caused that are caused by something other than than changes in the underlying DNA sequence; Insel and Wang note that:

"The same twin studies that point to high heritability also demonstrate the limits of genetics: environmental factors must be important for mental disorders......The advent of epigenomics [the study of the factors that control genes], which can detect the molecular effects of experience, may provide a powerful approach for understanding the critical effects of early-life events and environment on adult patterns of behavior."

Further, the authors write that the behavioral and cognitive symptoms that indicate 'mental illness' may actually be the 'late stages' of neurological processes that, if detected at early stages, might be better and more fully treated:

"As a result, interventions, rather than being ameliorative or rehabilitative, could become preemptive or even preventive. But this transformation in diagnosis and treatment, which can be informed by recent progress in cardiovascular disease and cancer, will depend on an intense focus on the genetics and circuitry underlying mental illness to ensure new approaches to detecting risk, validating diagnosis, and developing novel interventions that may be based on alter ing plasticity or retuning circuitry rather than neurotransmitter pharmacology."

As an example, in the past several years, autism has gone from being seen as a psychiatric, and even psychogenic, disorder, to a neurological/neurodevelopmental one, with significant consequences in how autism is conceived of, treated and, too, perceived by the public. Autism was once thought to be caused by bad parenting, by 'refrigerator mothers' who were emotionally withdrawn and 'cold,' and therefore did not 'bond' with their children, who 'withdrew into autism'; the damage wrought to families and individuals by these misconceptions is unmeasurable. Seeing autism as a neurodevelopmental disorder---due, perhaps, to 'abnormalities' in synapses in the brain does change how autistic individuals are see by others.

Similarly, understanding that an eating disorder such as anorexia nervosa is biologically based rather than simply putting the blame on parents, on our society's and culture's equating being thin with success, has significant changes on treatment and, again, understanding, and this can make a huge difference in people's (parents, for sure) lives. Societal factors do play a role, but seeing anorexia as biologically based---a recent study of brain imaging has found neurocircuit dysregulation in anorexics---can have real changes for people's lives and, hopefully, for the ultimate outcomes of those diagnosed with these conditions.

Also see:

NIMH Builds New Framework for Understanding Mental Illness

Image credit

Neurocognition and Social Cognition in Schizophrenia Patients: Basic Concepts and Treatment

Please click here to read the description of this book.

Behind the Scenes

Also see:

www.bringchange2mind.org

Duration of untreated psychosis is associated with more negative schizophrenia symptoms after acute treatment for first-episode psychosis

The abstract of an article published in the March 1st edition of
Clinical Psychologist:

Abstract

By Niklas Granö, Jenni Lindsberg, Marjaana Karjalainen, Peter Grönroos, and Ari-Pekka Blomberg

Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients. The sample included 41 first-episode patients who had an ICD-10 schizophrenia spectrum diagnosis (F20-F29) and were treated with antipsychotic medication. Longer duration in days from the first psychotic symptoms to the initiation of antipsychotic medication had a statistically significant positive correlation with mean level of negative symptoms (Spearman's ρ = .38; p < .05). Results suggests that DUP is associated with a higher level of negative symptoms after the onset of adequate antipsychotic treatment. This should be considered in the care of FEP.

Keywords: duration of untreated psychosis; first-episode psychosis; negative symptoms

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

2010 Road to Recovery Walkathon

Held on Saturday, May 8th, 2010

It's not to late to make a donation!

The Schizophrenia Society of Nova Scotia’s

2nd Annual Road to Recovery Walkathon

Your participation increased the public’s awareness of schizophrenia and helped raise over $27,500 to support the extensive and crucial work of the Schizophrenia Society of Nova Scotia. THANK YOU!

This year, in addition to the regular pledge sheets, we had online pledging! Walkers were able to set up their own pledge website, send e-mails to friends to request that they to make a pledge for them online, track their online pledges, and much more. To view the online pledging, please visit the 2nd Annual Road to Recovery Walkathon website by clicking here.

Stephen Ayer, executive director of the SSNS, welcoming the walkers.

Learning the chants from Cecilia McRae (left) and Donna Methot!

The 2010 Road to Recovery walkers posing for a group photograph.

The start of the five-kilometre Road to Recovery walk.

On the Road to Recovery!

Preparing for the auction!

Please click on any photograph to enlarge it. Photographs Kim Clark and Guy Methot.

The 3rd Annual Road to Recovery Walkathon will be held on Saturday, May 7th, 2011. For further information, please contact Donna Methot at 462-8658 or send an email to hrmchapterssns@accesswave.ca.

SSNS – Recovery is Possible!

2010 Major Sponsors

2010 Gift-In-Kind Sponsors

Randy Ross

Photography

Province to build housing for mentally ill

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

The Nova Scotia government is spending $8.6 million on new housing units for people recovering from mental illness.

The government says the units are for people who are moving from inpatient care into the community.

The four community living units will consist of 10 bedrooms and living space.

The province says they will be built on the Nova Scotia Hospital property in the Halifax suburb of Dartmouth.

The Capital District Health Authority and the Mental Health Foundation of Nova Scotia are contributing about $1.7 million, bringing the total cost of the project to $10.3 million.

Construction is scheduled to begin this summer.

How many times will the Government of Nova Scotia announce funding for the same project?

Media Advisory from the Schizophrenia Society of Nova Scotia

The Schizophrenia Society of Nova Scotia’s 2nd Annual Road to Recovery Walkathon

Halifax, May 6th, 2010
FOR IMMEDIATE RELEASE

The Schizophrenia Society of Nova Scotia is holding its 2nd Annual Road to Recovery Walkathon on Saturday, May 8th, 2010. The five-kilometre walk begins at 1:00 pm at the Halifax Curling Club, 948 South Bland Street, proceeds north on South Park Street and Bell Road, south on Robie Street, and finishes by returning to the Halifax Curling Club at 2:30 pm via Inglis Street. From 2:30 pm to 4:00 pm there will be refreshments, the presentation of prizes, and entertainment by Stand Up For Mental Health comedians Owen Redden and Shan MacDonald. The guest speaker is Cecilia McRae, president of the Schizophrenia Society of Nova Scotia.

Schizophrenia is not a split personality. It is a complex biochemical brain disorder characterized by one defining symptom – a loss of touch with reality (psychosis). Schizophrenia directly affects 1% of Nova Scotians at some point in their lifetime, and indirectly affects substantially more family members and friends. It is a highly treatable illness that influences the way a person thinks, acts, and perceives their world. With treatment, the majority of people with schizophrenia significantly recover. And the prognosis is getting better as research on the illness progresses, as treatments become more readily available, as people get help earlier, and as mental health laws recognize the urgent requirement for compassionate and effective involuntary treatment.

The Schizophrenia Society of Nova Scotia provides a community-based network of knowledgeable and dedicated volunteers so desperately needed by many individuals directly affected by schizophrenia, as well as their family members, friends, colleagues, and communities. Held during Mental Health Week, the Road to Recovery Walkathon is an opportunity for the greater community to get involved and to help reduce the stigma so often associated with a diagnosis of schizophrenia.

All proceeds from the Road to Recovery Walkathon go to the Schizophrenia Society of Nova Scotia to support the delivery of its crucial and extensive programs and services. For further information, to make a donation, or to make a pledge on behalf of one of the many walkers, visit www.ssnswalk.dojiggy.com.

-30-

Cecilia McRae, Owen Redden, Shan MacDonald, and Stephen Ayer will be available for interviews during the event.


For additional information or to schedule an interview contact:

Dr. Stephen Ayer
Executive Director
Schizophrenia Society of Nova Scotia
(902) 465-2601
ssns@ns.sympatico.ca

Do I Have Schizophrenia?

Please click here to view a larger version of this video.

First symptoms of psychosis evident in 12-year-olds

An article posted today by Lab Spaces:

Children normally experience flights of fancy, including imaginary friends and conversations with stuffed animals, but some of them are also having hallucinations and delusions which might be the early signs of psychosis.

A study of British 12-year-olds that asked whether they had ever seen things or heard voices that weren't really there, and then asked careful follow-up questions, has found that nearly 6 percent may be showing at least one definite symptom of psychosis.

To read the entire article, please click here.

I thank Terri Vernon for bringing this article to my attention.

Also see:


Etiological and Clinical Features of Childhood Psychotic Symptoms: Results From a Birth Cohort

Childhood Psychotic Symptoms: Etiologic and Clinical Features

Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001—05: an epidemiological survey

The abstract of an article published in the June 13th, 2009, edition of The Lancet:

By Prof. Michael R. Phillips, MD; Prof. Jingxuan Zhang, MMed; Qichang Shi, BMed; Zhiqiang Song, BMed; Zhijie Ding, BMed; Shutao Pang, MMed; Xianyun Li, MMed; Yali Zhang, MD; and Zhiqing Wang, BMed

Background

In China and other middle-income countries, neuropsychiatric conditions are the most important cause of ill health in men and women, but efforts to scale up mental health services have been hampered by the absence of high-quality, country-specific data for the prevalence, treatment, and associated disability of different types of mental disorders. We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China.

Methods

We used multistage stratified random sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China; the sampling frame of 113 million individuals aged 18 years or older included 12% of the adult population in China. 63 004 individuals, identified with simple random selection methods at the sampling sites, were screened with an expanded version of the General Health Questionnaire and 16 577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.

Findings

The adjusted 1-month prevalence of any mental disorder was 17·5% (95% CI 16·6—18·5). The prevalence of mood disorders was 6·1% (5·7—6·6), anxiety disorders was 5·6% (5·0—6·3), substance abuse disorders was 5·9% (5·3—6·5), and psychotic disorders was 1·0% (0·8—1·1). Mood disorders and anxiety disorders were more prevalent in women than in men, and in individuals 40 years and older than in those younger than 40 years. Alcohol use disorders were 48 times more prevalent in men than in women. Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents. Among individuals with a diagnosable mental illness, 24% were moderately or severely disabled by their illness, 8% had ever sought professional help, and 5% had ever seen a mental health professional.

Interpretation

Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.

Funding

China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health.

Bold emphasis in the text of the abstract is mine.

Posting of this abstract on the weblog is for the purposes of research into the prevalence and treatment of mental disorders in China.

Also see:

Mental disorders in China underestimated

Media Advisory - Story opportunities during Mental Health Week

A media advisory from the Mental Health Commission of Canada:

CALGARY, April 28 /CNW Telbec/ - Next week is Mental Health Week (May 3 -9, 2010). You can speak with the Mental Health Commission of Canada (MHCC) for a national perspective on mental health issues and to find out more about its initiatives. Here are some of the issues the MHCC is tackling:

More than one thousand off the streets

In February 2008 the Federal government allocated $110million to the MHCC to undertake a 4 year research demonstration project looking at mental health and homelessness, called At Home/Chez Soi. The initiative is working in 5 cities across Canada (Vancouver, Winnipeg, Toronto, Montreal, Moncton) to find ways to more effectively help people with mental illness who are homeless.

It is estimated that 25-50% of people who are homeless have a mental illness. Homelessness also costs the system up to $6 billion per year for health, criminal justice and social services.

Stigma: still the biggest barrier

Opening Minds is the MHCC's 10-year anti-stigma/anti-discrimination initiative designed to change the attitudes and behaviours of Canadians towards those living with mental illness. Launched in October 2009, the initiative is the largest systematic effort to reduce the stigma of mental illness in Canadian history. Opening Minds is focusing on three target groups: Youth (early intervention can make an enormous difference in reducing stigma), health care workers (stigma is mostly experienced on the medical front lines) and workforce (many employees choose to go untreated then risk being labeled by their employer).

The stigma of mental illness is one of the key reasons people with mental health issues report they would not seek help. Since more than seven million people will experience mental health problems this year alone in Canada, this is a significant issue.

Developing first Mental Health Strategy for Canadaever Mental Health Strategy for Canada

The MHCC is developing Canada's first ever mental health strategy. After an extensive national public consultation, the Commission released the document Toward Recovery and Well-Being in November 2009, which introduces the Commission's vision for change and the actions needed to address the mental health needs of Canadians. This document forms the framework for what will become Canada's first ever mental health strategy.


The MHCC is a non-profit organization created to focus national attention on mental health issues. It is funded by the federal government but operates at arm's length from all levels of government. The Commission's objective is to enhance the health and social outcomes for Canadians living with mental health problems and illnesses. www.mentalhealthcommission.ca

For further information: Karleena Suppiah, Communications Specialist, (403) 385-4050 (office), (403) 370-3835 (cell), ksuppiah@mentalhealthcommission.ca

Cartoonists should be careful how they portray mental health

An article published in today's edition of The Guardian:

It's not political correctness gone mad. Some things really should be unsayable

By Beatrice Bray [pictured]

Newspaper cartoons can be great. They can say the unsayable. They have licence to push the boundaries of taste. Their images can resonate for years. But Martin Rowson's cartoon "Dressing-up box" (Comment & Debate, 29 March) overstepped the mark.

Rowson had fun depicting different Conservative politicians in fancy dress. They are shown like kids in the playroom. But as one Tory lifts Mrs Thatcher's moth-eaten blue dress, he shouts: "Hey everybody! This is the 'psychotic yet tough union basher' cozzie!"

The use of the word "psychotic" was offensive. You may think this political correctness gone mad, but if you are ill, or have been, you need words to describe your experience to yourself and to others. If for you these words are negative, you will hate yourself. Language can make or break your happiness.

That is why mental health activists do not like psychiatric terms being used as abuse. We want to show the public how to use terms like "schizophrenia", "psychosis" and "bipolar" in the correct way.

For starters, do not use the word "schizophrenia" when you don't mean mental illness – as when, a few years ago, an MP on a Commons committee claimed there was "schizophrenia" within the BBC.

And please allow individuals an identity apart from their illness, so always say "a person with schizophrenia" rather than "a schizophrenic".

In general usage the word "paranoia" means an undue sense of suspicion. It does not mean illness. The psychiatric term "paranoia" involves an extreme sense of persecution.

"Psychosis" is another escapee into the fashionable world. In the street sense it implies wackiness, but some of us need it to report distressing symptoms to doctors in life-threatening crises. We are not always believed.

There are attempts to banish such ambiguity. "Bipolar" is a new term which was introduced to replace the stigmatised "manic depression". This creates a chance to reinvent the illness, but already the new label is becoming tarnished. You cannot separate words from their popular meanings. You have to change attitudes and behaviours as well as words.

Rowson's cartoon is testament to this, even though he does not sound like the kind of man who would want to disfranchise those of us with severe mental health problems.

We were not Rowson's target: Margaret Thatcher was. But just to complicate matters we are now championing the honour of Thatcher even though some of us are leftwingers. We do not think that Thatcher, a dementia sufferer, should face misused words of abuse.

In the mental health world we try not to offend. At conferences we agree to avoid insulting each other with derogatory terms. We are glad that the main party leaders have copied us. All three have signed a compact, drafted by the all-party parliamentary mental health group, on the use of language. This is the first time such an agreement has been reached. It would be appropriate if journalists and cartoonists were to respect this compact.

Photo credit

Help for the body and mind

An article published in the April 16th edition of The Record:

Centre NuHaB to add mental health programs to their services

By Corrinna Pole

For nearly fifteen years the Life Skills Development program at Centre NuHaB in Ascot Corner has offered non-traditional therapy focusing primarily on addictions.
This year, the centre anticipates an addition to its service, focusing on mental health, with the opening of a “Therapeutic Recover/Healing Ranch” called the Ranch de Cantons.

NuHaB founder André Rochon [pictured] and his wife Cindy have embarked on a mammoth venture to purchase a multifunctional property that will address multiple aspects of mental health issues in a non-institutional setting, helping “humans to find their human being.”

“We’ve been working in addictions for years… I’ve seen more and more addictions and mental health (issues) and I’m getting more and more calls from hospitals and institutions and support groups to work with their mental health clientele,” said André. “I’ve noticed there are fewer organizations dedicated to a complete approach to mental health issues, which is much more than giving them medication and putting them on a ward with papers and crayons. There is much more needed; it’s a big job.”

The Rochons envision an ecofriendly, self-sustained community dedicated to helping individuals suffering from a wide range of psychological and emotional disorders reconnect with themselves by focusing on six aspects - the mind, body, spirit, interdependence, independence and realization.

Although therapeutic ranches have been in existence since the early 1900’s, the Ranch de Cantons would be the first of its kind in the province. It would respond to the seven strategic goals that have been outlined by the Mental Health Commission of Canada that would enable everyone in the country to attain the best possible mental health and wellbeing.

The goals include support, prevention, responding to diverse needs, recognizing and supporting the family’s role in care, offering access to useful treatments and supports, advancing research and taking action using the best evidence from multiple sources of knowledge, and lastly valuing those living with mental health problems and illnesses.

To read the entire article, please click here.

Photo credit

NKM2.org PSA - "All-American Brain" - Stomping the Stigma & Discrimination

To view a larger version of this video, please click here.

Also see:

NKM2.org

Gene linked to schizophrenia: Canadian study

An article posted on April 13th by AFP:

MONTREAL — People with a specific mutated gene may be prone to schizophrenia, according to a Canadian study published Monday in a US scientific journal.

The study led by University of Montreal researchers found new mutations in the so-called "SHANK3 gene" in [schizophrenia] patients.

"That these new mutations occur in schizophrenia is rather unexpected and may explain why the identification of the genes linked to this disease has been so difficult," senior author Guy Rouleau [pictured] said in a statement.

"Our findings show that a significant number of schizophrenia cases are the result of new genetic mutations in the SHANK3 gene," he said in the study published in the US Proceedings of the National Academy of Science.

Schizophrenia is a mental disorder that affects about one percent of people worldwide. It is most commonly manifested as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking.

It often leads to significant social or occupational dysfunction.

SHANK3 proteins are involved in maintaining the physical structure of nerve cells, and mutations in the gene result in specific abnormalities in cell shapes.

These deformations have been observed in schizophrenia patients.

Lead study author Julie Gauthier said the SHANK3 gene had "previously been linked to autism," which suggests "a molecular genetic link between these two neurodevelopmental disorders."

It also means that SHANK3 "may have a role in other brain disorders," she said.

Posting of this article is for the purposes of research into schizophrenia.

Stick to facts on mental illness

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

By Aileen McGinty [pictured]

Although I have only lived in this country for nine weeks, I cannot let the March 28 letter by Elizabeth Azuya go without response. I hope the views expressed do not reflect those of the wider Canadian community.

While the incident referred to — the stabbing to death of eight children in China — is indeed a tragedy, some of the statements in the letter are inaccurate and are particularly disappointing, following on as they do from the recent focus on mental health in The Chronicle Herald.

Ms. Azuya states, "The fact that people suffering from mental illnesses are mostly the ones blamed for such offences should change the ways in which such people are treated anywhere they go." Fact: The majority of people who are violent do not suffer from a mental illness. People with mental illnesses have the same basic human rights as anyone else and they should not be treated any differently. I wonder how Ms. Azuya thinks they should be treated.

"Leaving them to wander around could turn into a huge social problem." If I presume that "them" are individuals with a mental illness, the idea that "they" all wander around causing social problems is farcical. Fact: People with mental illness are 2.5 times more likely to be victims of violence than to be perpetrators of violence.

Does Ms. Azuya realize the large numbers of "them" who are wandering around anyway? Fact: In Canada, one in five people will experience a mental illness at some time in their life. Does this mean that 20 per cent of the people in this land should somehow be seen as posing such a risk to society that the streets are unsafe to walk on, as the letter suggests?

Ms. Azuya might like to know that statistically, the incidence of mental illness is actually less in China, at 17.5 per cent, although she may be relieved she does not live in Scotland where it is 25 per cent!

The fact that the suspect in the incident in China was once a "medical worker" is irrelevant. Given the incidence of mental illness, health service providers will undoubtedly have people working for them who have experienced mental illness at some point, and quite rightly so. Is it any wonder that while some people still hold outdated ideas about mental illness, individuals may not feel comfortable sharing that information, especially within the workplace?

I did wonder if this letter was a joke, but sadly, I fear it is not. And yes, Ms. Azuya, I am one of "them," but I am also a qualified lawyer (Scottish), psychologist (U.K.), teacher (U.K.) and music therapist (Canadian). I have spent many years working in the health care sector, have a very successful career and three thriving children, so please do not be afraid that I am "coming to stab (you) to death."

Aileen McGinty lives in Hammonds Plains.

Photo credit

Workplace Mental Health Resources

Please click on the image to magnify it.

National Call to Action: Identifying the Need for Specialized Treatment and Care of Concurrent Mental Health and Substance Use Disorders

An April 9th news release from the Canadian Centre on Substance Abuse:

Ottawa, April 9, 2010 – The Canadian Centre on Substance Abuse (CCSA) — Canada’s non-governmental organization dedicated to reducing the harms associated with alcohol and drugs — today announced the release of Substance Abuse in Canada: Concurrent Disorders, the third in a series of biennial publications that highlight key contemporary substance abuse issues in Canada and identifies areas where action is needed.

Written by members of CCSA’s Scientific Advisory Council — a group of Canada’s leading biomedical, neuroscience and clinical experts — and other leading clinicians and academics in the field, Concurrent Disorders takes an in-depth look at the state of concurrent disorders and provides a call to action to address this significant health issue.

Concurrent disorders — cases in which individuals have both a mental health problem and a substance use problem — are currently poorly understood by the public and inadequately addressed by either Canada’s primary healthcare system or specialized mental health and addiction services.

"Concurrent disorders are generally seen as unlinked and separate as a result of mental health and addiction systems that are compartmentalized and largely independent of each other. The result is that clients are often being treated for one of their disorders but not the other," said Rita Notarandrea, CCSA’s Deputy Chief Executive Officer. "As this report indicates, treating each problem separately leads to poor client outcomes that are characterized by frequent relapses and crises, placing undue strain on the healthcare system and its professionals. Concurrent Disorders is a significant first step towards identifying the actions we must take to effectively address this public health issue."

The publication takes an in-depth look at six areas within the field of concurrent disorders, including the interplay between substance use and anxiety, stress and trauma, impulsivity, mood, and psychosis.

"The rationale for considering concurrent disorders a topic of special significance is in many ways self-evident: the two disorders frequently coexist; they often share common biological, psychological and social roots; and these co-occurring disorders represent a major health challenge," said Dr. Franco Vaccarino, Professor of Psychology and Psychiatry at the University of Toronto and Chair of CCSA’s Scientific Advisory Council. "The limited ability of our parallel substance use and mental health clinical and community programs to approach concurrent disorders in a coordinated, integrated manner represents a significant barrier to effectively treating those affected."

The cost of substance abuse and mental health to Canadians is considerable. In a 2002 study by CCSA, substance abuse disorders were estimated to cost Canada more than $40 billion annually. In addition, a 2001 Public Health Agency of Canada study estimated the price tag of mental health problems in Canada to be $14.4 billion annually. Collectively, substance abuse and mental health issues account for more than $54 billion in costs to Canadian society each year and exact an immeasurable toll on individuals, their family and friends.

The percentage of costs that can be attributed to those with concurrent disorders is currently unknown. However, findings within Concurrent Disorders suggest that these individuals likely account for a large portion of the total, as they have a limited ability to cope with everyday challenges, experience higher unemployment, and at the extreme, can become homeless, socially marginalized or criminally involved.

A Call to Action

Concurrent Disorders identifies the critical need for Canada to address the issue of concurrent disorders through:

• Policy makers, educators, researchers and health professionals acknowledging that specialized treatment for those with concurrent disorders is a major priority for Canada;

• Increased scientific programs that provide a better understanding of the processes and mechanisms underlying concurrent disorders, and that address current gaps in research and research funding;

• Increased community addiction programs that are better equipped to deal with clients with concurrent disorders;

• Integration of clinical practice guidelines in the substance use disorder and mental health fields that reflects a unified national approach to treatment and care;

• An educational platform that increases the number of trained professionals with a common understanding of concurrent disorders and treatment practices;

• A focus on youth and early detection, as concurrent disorders often have an onset during adolescence and are best treated early; and

• The development of prevention and treatment strategies that focus on life stressors and trauma as significant risk factors in the development and recurrence of concurrent disorders.

To read the full Concurrent Disorders publication or the Highlights report, please click here.

–30–

About CCSA:

With a legislated mandate to reduce alcohol- and other drug-related harms, the Canadian Centre on Substance Abuse (CCSA) provides leadership on national priorities, fosters knowledge translation within the field and creates sustainable partnerships that maximize collective efforts. CCSA receives funding support from Health Canada.


For further information, please contact:

Annie Boucher, Fuse Communications
Tel.: (613) 863-3702
Email: boucher@fusecommunications.ca

Also see:

National approach needed on care for mentally ill who abuse substances: report

Community Mental Health Groups - Capital Health District

Please click on the image to magnify it.

A video from the 2009 Canadian Federation of Mental Health Nurses Conference

A video made up of photographs taken during the Canadian Federation of Mental Health Nurses Conference held in Halifax on October 21-23, 2009.

Look closely, you might see some people you recognize!



To look at a larger version of this video, please click here.

Drug ads still stigmatise mental illness

An April 3rd news item from the University of Cambridge:

The way that drugs used to treat mental illness are advertised to doctors could be helping to perpetuate – rather than break down – the stigma still attached to mental health problems.

Over the space of a year, Dr Juliet Foster [pictured] analysed 96 different drug advertisements carried in the British Medical Journal and the British Journal of Psychiatry. She discovered stark differences in the way that psychiatric and non-psychiatric drugs are advertised to health professionals.

Whereas adverts for "physical" diseases such as pain and blood pressure medication usually picture people as happy and active, either in work settings or enjoying their leisure time, psychiatric drugs such as those used to treat depression and Alzheimer's disease are more likely to show troubled or inactive individuals.

According to Dr Foster: "The negative images of distressed, disturbed and often deviant individuals used in advertisements for psychiatric medication contrast sharply with advertisements for non-psychiatric medication which focus on happy smiling people engaged in healthy activity, and perpetuate links between mental health problems and abnormality, fear and otherness."

As well as looking at images, Dr Foster analysed the text used in the drug advertisements. She found that while adverts for non-psychiatric drugs majored on medically-related information on the drug itself, adverts for psychiatric drugs included less text and text that is focussed on narrative description or case studies.

The differences have important implications for the stigma still attached to mental illness, says Dr Foster.

"It is hard to argue that the general public should see mental health problems in the same light as any other health problem when it seems clear that this is not always happening in the health industry," she says.

"It would be wrong to deny that health problems don't cause suffering: people who experience mental health problems obviously do report very high levels of distress and unhappiness at their experiences. But to maintain a distinction between mental health and other health problems, and in particular to portray mental ill health more in terms of chaos, deviance, fear and otherness risks perpetuating stigma that professionals, and service users may strive so hard to dismantle in other areas."

The paper is published in the Journal of Mental Health

I thank John Devlin for bringing this article to my attention.

Also see:

Mental health research in The Lancet: A case study">Mental health research in The Lancet: A case study

Laing House Family Support Group

The Laing House Family Support Group is a self-help group for family/friends of an adolescent or young adult up to the age of 30 who has a mental illness (not restricted to any one illness in particular). Since January 2008, the Laing House Family Support Group has operated as a stand-alone group, at arm's length from Laing House, but with Laing House's support.

Because the Laing House Family Support Group it is now run BY family members FOR family/friends, it is meant to be inclusive rather than exclusive and there is no requirement for the youth themselves to be members of Laing House or for families to have the youth's permission to attend.

The goal of the Laing House Family Support Group is to provide support and education according to the needs determined by the Support Group members. Meetings always include a time for sharing and support amongst the Group and we invite speakers when a specific interest is identified by the Group.

The Laing House Family Support Group meets on the first Monday evening of each month at 6:30 pm.

There is no commitment to attend group meetings beyond what families find is helpful or convenient. Laing House is located at 1225 Barrington Street, Halifax, Nova Scotia.

Contacts:

Dani Himmelman, parent facilitator: phone (902) 826-224 or email dhimmelman@eastlink.ca.

Judy Bell, Team Leader, Laing House: phone (902) 473-7743.

Facts don’t concur

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

In his March 24 opinion piece, "Mental health clinics work," Dr. Ian Slayter states, "priority is given to people with more serious mental illness."

Dr. Slayter’s statement is inconsistent with the facts for the Dartmouth Community Mental Health Clinic. Of the 137 new referrals to the Dartmouth Community Mental Health Clinic in January 2010, the most recent month where data is publicly available, none were seen as "urgent/rapid follow-up."

In November 2009, the next most recent month, 94 people were referred to the same clinic and none were seen as "urgent/rapid follow-up." In October 2009, none of the 92 new referrals were seen as "urgent/rapid follow-up."

In total, of the 323 new referrals to the Dartmouth Community Mental Health Clinic over a four-month period, excluding December 2009 because the data are not publicly available, none were seen as "urgent/rapid follow-up."

Wait-time data for the five community mental health clinics in the Capital Health district can be accessed by visiting its website (www.cdha.nshealth.ca), clicking on "Accountability" and selecting "Mental Health Community Team Wait Times." A dash means there were zero people in a category.

Stephen W. Ayer, executive director, Schizophrenia Society of N.S.

Spring 2010 issue of CrossCurrents

A note from the editor published in the Spring 2010 issue of CrossCurrents:

This is an issue of CrossCurrents that you may not want to read. It forces us to confront our own contributions as health care providers in perpetuating stigma and discrimination against people with mental illness and addiction. We may think we are immune; after all, we work in this sector because we want to help people. Many health care providers I spoke with told me, “We don’t have that problem here.”

Yet consumers tell a different story. We solicited input from people with mental health and addiction issues. What became clear from the many submissions we received was the pervasiveness of stigma and discrimination in the health care system. People told us again and again that stigma is the single most important barrier to their quality of life, more so than the illness itself.

Stories like these describe the experience of stigma, but we know little about what interventions work in reducing it. This issue of CrossCurrents focuses on action. We hear first about Opening Minds, the 10-year anti-stigma campaign of the Mental Health Commission of Canada that in its first year is targeting stigma and discrimination among health care professionals, with the goal of developing promising practices. Next, Anne Ptasznik spends time with a group of psychiatry residents and consumers that meets informally in non-clinical settings, providing the valuable contact and context needed to combat stigma.

Social worker Cheryl Peever’s personal story shows that clinical knowledge does not always translate into effective workplace practices when mental illness or addiction is a workplace issue. Ned Morgan examines how the stigma that extends to those who work with people with mental health and addiction issues is perpetuated through film portrayals of mental health nurses. Other stories look at stigma in the emergency department and the black mark of borderline personality disorder. In her Last Word column, Jan Wallcraft asks whether public anti-stigma campaigns developed by psychiatrists do more harm than good. Visit the Last Word column to have your say.

Hema Zbogar
tel 416 595-6714
hema_zbogar@camh.net

Club Friday - Spring 2010 Schedule

Please click on the image to magnify it.

Also see:

Healthy Minds Cooperative

Call for Abstracts: 2010 Canadian Association for Suicide Prevention Conference

An email received by the SSNS on March 31st:

The Canadian Mental Health Association – NS Division & NS Department of Health Promotion & Protection, hosts of the 2010 Canadian Association for Suicide Prevention Conference: Communities Addressing Suicide Together, are pleased to announce that the Call for Abstracts is now open!

We invite communities, survivors, community-based practitioners, clinicians, researchers and policy-makers to submit an abstract that focuses on innovative and promising practice in addressing suicide. The guidelines and submission form for the Call for Abstracts are available on the conference website at www.suicideprevention.ca/2010.

The conference will take place at the Alderney Landing Cultural Convention Centre on the Dartmouth waterfront in Halifax, Nova Scotia from October 5-7, 2010. Registration will open on Tuesday, April 6, 2010. Please note that seats are limited – we encourage you to register early!

Looking forward to seeing you in Nova Scotia!

Angela Davis & Julian Young
Conference Co-Chairs

1-877-466-6606
Casp2010@eastlink.ca

Act to ensure rights of the incapacitated

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

By Davene Jeffrey

Nova Scotians will soon be able to retain more autonomy should they become incapacitated.

The province’s new Personal Directives Act becomes law on Thursday, replacing the Medical Consent Act, which gives people the right to name a proxy to make health-care decisions on their behalf.

Health Minister Maureen MacDonald said the new legislation goes beyond instructions for health care.

She said people will be able to assign someone to make sure their wishes for personal needs such as recreation and hygiene are followed.

"It means that people, and particularly, I imagine, people who are older or persons with disabilities, with perhaps some kind of a condition that has a degenerative element, would have the security of knowing that how they wish to be treated will be respected."

As of Thursday, forms will be available through the Justice Department website or through Service Nova Scotia offices, said Health Department spokesman Ryan Van Horne.

There will be two forms, one to appoint a delegate and the other to outline details of expected care and treatment. A booklet explaining the act also will be available.

"The Personal Directives Act covers a wide range of things, including personal-care decisions," Van Horne said.

"For example, if you are admitted to a nursing home and you are a vegetarian, you could ensure that you get a vegetarian diet or that you got fresh air for an hour a day."

The directives will have to be reasonable and legal, Van Horne said.

For instance, anyone living in a nursing home could not expect to receive treatment that the home could not offer to other residents, he said.

"If you want to ask for something that they do provide to everybody else, then you’ll get it," Van Horne said. "If you want something that they don’t provide to everybody else, then you need to make some other type of arrangement."

The act was passed in May 2008 after it was introduced by Cecil Clarke, who was then the justice minister in the Conservative government. MacDonald couldn’t say why it has taken almost two years for the act to take effect, but she said regulations had to be written and staff in health-care settings and elsewhere had to be trained in the new rules.

Van Horne said officials had hoped to bring the act into force last fall but it got sidelined by the H1N1 crisis.

With David Jackson, provincial reporter.

Also see:

Powers of Attorney and Health Care Directives (Nova Scotia)

Tough decisions must be made

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

Mental health strategy will include eating disorder help

By Michael Lightstone

Access to eating disorder pro­grams in Nova Scotia is likely to be addressed in the province’s new mental health strategy, Health Minister Maureen MacDonald [pictured]said Thursday.

Though the plan is in its in­fancy — it was announced in the Dexter government’s throne speech at Province House in Ha­lifax — she hinted it could in­clude some sort of expansion of the province’s existing program. “We have a small eating disor­der treatment program for young people here in the metro area," MacDonald said after the speech. “So, people from other parts of the province . . . have to come here, and the wait lists are long." MacDonald cited the size of the program and its waiting list as examples of “some weaknesses, perhaps, in the (mental health) system that need to be examin­ed."

She was short on details, how­ever, and couldn’t provide a cost estimate for the NDP’s mental health blueprint. The govern­ment is projecting a $525-million deficit for the 2009-10 budget year.

“We will have something in the near future, and we will be look­ing forward to having a compo­nent that will allow for public in­put in the development" of the strategy, MacDonald said in an interview.

Part of that consultation ele­ment, she said, will be a regional conference in Halifax this fall to be hosted by the provincial gov­ernment.

Although MacDonald didn’t provide specifics, she acknow­ledged the province-wide strate­gy won’t be note-perfect or all-en­compassing.

“I’m not prepared to wait as minister of health until we have some perfect strategy developed before we take action," she said. “We already know that there are some things that are needed."

Critics of Nova Scotia’s mental health system have long com­plained there are deficiencies.

And a recent Chronicle Herald investigation found resources for treating the mentally ill are thin in some areas of the prov­ince and non-existent in others.

Asked about the stigma many people still attach to mental ill­ness, MacDonald said public opinion of those with emotional problems or in a treatment pro­gram has changed.

“There’s a lot less stigma today than there has been in the past," she said. “So, I’m hopeful. I don’t think that changing attitudes is an impossible thing, but I don’t think that it’s something that will be solved quickly."

Photo credit