Friday, July 25, 2008

Charity to mark 'first real national push' on mental health


From today's edition of The Globe and Mail:
By Erin Anderssen

OTTAWA — Canada's leading champion of mental health will create a new national charity to raise research money for illnesses such as depression and schizophrenia – an effort to make funding and public awareness of the issue equal to cancer and heart disease.

The charity, tentatively called Mind and Brain Canada, will initially raise funds to develop programs to help hard-to-reach groups such as youth, who have some of the highest rates of mental health problems.

“This is the first real national push,” said former Liberal senator Michael Kirby, chair of the Mental Health Commission of Canada. “How do we keep mental health out of the shadows forever?”

Mr. Kirby said a prominent fundraising body similar to the Canadian Cancer Society or the Heart and Stroke Foundation is necessary to fight the persistent stigma surrounding mental illness and the lack of funds available to help the one in five Canadians who will struggle at some point in their lives with a mental-health problem.
To read the entire article, click here.

Thanks go to John Devlin for bringing this article to my attention.


Thursday, July 24, 2008

A Future With Hope



The Schizophrenia Society of Canada (SSC) publishes its A Future With Hope newsletter three times per year. It provides information on SSC and other Schizophrenia Society activities, current and emerging issues, and other relevant topics. To view the Summer 2008 issue, click here (PDF).

Wednesday, July 23, 2008

Man dies after being Tasered


Winnipeg police used stun gun after reportedly confronted by knife wielder

From today's edition of The Chronicle Herald:
WINNIPEG — Winnipeg has joined a growing list of Canadian communities where a confrontation involving a police Taser has ended in death.

On Tuesday, a young adult male died in hospital after police used a Taser to subdue him. They had gotten a call for help from a residence at about 3:50 p.m.

"Upon attending, officers encountered a male at the rear of a residence," said Const. Jacqueline Chaput. "This resulted in an officer deploying his electronic control device. The male who was struck . . . was conveyed to hospital in critical condition and he succumbed to his injuries in hospital."
To read the entire article, click here.

Also see:
Ex-cop may be charged in case of man Tasered to death

Photograph by J. Star. This photograph is licensed under Creative Commons Attribution 2.0 License.

Monday, July 21, 2008

American Medical Association (AMA) Calls for Remedies for Psychiatric-Bed Shortage


From the July 18th edition of Psychiatric News:
By Mark Moran

Physicians from all specialties emphasized the scope of the problem and that it is embedded in other, larger problems in American health care, such as the rising number of the uninsured and the closing of psychiatric units.

Diminishing access to psychiatric beds and the resulting overcrowding of emergency departments is an urgent crisis and a national disgrace, said psychiatrists, emergency department specialists, and other physicians at the AMA's House of Delegates meeting last month in Chicago (see Psychiatry-Related Issues Prominent on AMA Agenda).

With virtually unanimous support, the AMA house called for efforts to facilitate access to both inpatient and outpatient psychiatric services and the continuum of care for mental illness and substance abuse as a means of relieving pressure on emergency departments (EDs) across the country that have been forced to board patients in crowded hallways—sometimes for days—before available beds can be found.

The recommendations were part of a report titled "Access to Psychiatric Beds and Impact on Emergency Medicine," prepared by the AMA's Council on Medical Service.

Experimental Schizophrenia Drug Shows Encouraging Results


From the July 18th edition of Psychiatric News:
By Joan Arehart-Treichel

A small study of patients with schizophrenia taking an alpha-7 receptor agonist (DMXB-A) found a lessening of negative symptoms in those taking the experimental compound. Subjects also reported better organized thinking and behavior.

For a few years now, Robert Freedman, M.D., chair of psychiatry at the University of Colorado Health Sciences Center, and colleagues have been undertaking a valiant quest to find a drug that improves cognition and eradicates negative symptoms in individuals with schizophrenia—something that available medications for schizophrenia generally fail to do.

Specifically Freedman and his team have been trying to determine whether drugs that soup up the action of the alpha 7 nicotinic acetylcholine receptors in the brain—the so-called alpha 7 receptor agonists—might be the answer.

Two years ago, they reported very preliminary, but heartening results for an alpha 7 receptor agonist called DMXB-A. Eleven subjects with schizophrenia were found to experience significantly better cognition a day after receiving DMXB-A than a day after getting a placebo. Improvement in attention was especially notable. Results were published in the June 2006 Archives of General Psychiatry [AJP] (Psychiatric News, July 21, 2006).

Now Freedman and his group report more encouraging results regarding DMXB-A. The results, which first appeared online in AJP in Advance on April 1, will be published in the August print edition of the American Journal of Psychiatry. Freedman is editor in chief of the journal.
To read the entire article, click here:

Also see:
Initial Phase 2 Trial of a Nicotinic Agonist in Schizophrenia

Molecular model of the alpha-7 nicotinic receptor courtesy of Dr. Jerrel L. Yakel.

Wednesday, July 16, 2008

Public engagement in setting priorities in health care

From the July 1st edition of the Canadian Medical Association Journal:
By Rebecca A. Bruni, BA, BScN, Andreas Laupacis, MD, MSc, and Douglas K. Martin, PhD, for the University of Toronto Priority Setting in Health Care Research Group.

Setting priorities in health care means allocating limited resources so that some programs are supported and others are not (Box 1, below). For more than a decade, patients, scholars and government reports have asserted that the public should have greater involvement in setting health care priorities (1), but progress on this front in Canada has been slow. We believe the merits of public involvement are compelling and in keeping with a democratic society's desire for an informed, fully engaged citizenry. In this commentary, we review the value of public engagement, address the perceived barriers and suggest ways forward.


Reference:
1. New B, editor. Rationing: talk and action in healthcare. London (UK): Blackwell BMJ Books; 1997.

To read the entire article, click here (PDF).

Monday, July 14, 2008

On the road to reduce poverty


From the July 7th edition of The Toronto Star:
By Carol Goar

The experts and activists have spoken. Now the Senate committee examining urban poverty wants to hear from the people.

This summer, Senator Art Eggleton and his five colleagues (three Liberals, two Conservatives) head out to ask Canadians what they want to see in a national poverty reduction plan, how it should be designed and who should pay for it.

They'll visit eastern Canada in August, Toronto and Montreal in September and the four western provinces in October.

The committee will provide witnesses with a 90-page report that distills the testimony it has heard over the past 18 months and sets out a list of options – 103 in fact – ranging from the complete replacement of the current income support with a guaranteed annual income to a few low-cost adjustments.

Even those who don't plan to attend the hearings will find Poverty, Housing and Homelessness: Issues and Options (available at by clicking here) an excellent primer.
To read the entire article, click here.

Photograph of Senator Art Eggleton courtesy of the Senate of Canada.


Friday, July 11, 2008

North Carolina Teen Shocked By Taser Died From Change In Heart Rhythm


Posted July 3rd on WSOCTV.com:
CHARLOTTE, N.C. -- Autopsy results released this week reveal why a 17-year-old who police shot with a Taser died in March.

Darryl Turner was in an altercation with his boss at the Food Lion on Prosperity Church Road in north Charlotte when someone called police. Police said he was highly agitated when an officer shot him with a Taser. Turner was pronounced dead at the hospital a short time later.

Turner's autopsy says the stress of the situation and the shock from the Taser was too much for his body to handle. It says he died of acute ventricular dysrhythmia and ventricular fibrillation. In other words, his heart was pumping so fast and irregularly that he died.

The report states Turner did not have heart problems and he didn't have drugs in his system except for the medicines emergency workers used trying to save his life.

Turner's grandfather, Donald Fontenot, saw the report and said he's angry.

"Very much so. Why wouldn't I be? You know, you take a 17-year-old child away," he said.

Turner's family has not said whether they plan to sue police. They hired an attorney in March after a witness said Turner was obeying the officer’s commands when he was shocked. Police said Turner had been threatening the officer.

Police are doing their own internal investigation to see if the officer who used the Taser followed the rules. That officer is back on active duty after being put on administrative leave following the incident.

Critics say N.S. restrictions on stun guns do nothing to clarify use of weapon


From The Canadian Press - July 10th:
HALIFAX — The Nova Scotia government issued new restrictions on the use of Tasers on Thursday, claiming the measure will help clarify when the powerful devices are deployed.

Justice Minister Cecil Clarke said he would immediately limit the use of stun guns to instances where police officers face "violent or aggressive resistance or active threat to the law enforcement officer, the subject or the public."

Clarke said the interim guideline is aimed at ensuring the controversial weapons are used appropriately by police forces in the province. An earlier study done for the province found police officers have become increasingly reliant on the so-called Conducted Energy Devices.

But Clarke refused to impose a ban on them despite lingering questions over the death of Howard Hyde, a Dartmouth, N.S., man who died after being Tasered by police last year.

"There is no moratorium," he told reporters at the legislature after the release of a 36-page report, which was prompted by Hyde's death.

"In the vast number of occasions the Taser has been effective and safe when deployed."

But critics panned the announcement, saying it will do nothing to create clear standards for Taser use and doesn't differ greatly from existing guidelines on when the devices should be used.

According to the old language, the device should only be discharged where there is "risk from aggression, violence or other reasonable conditions exist ... in the interests of public or officer safety."

NDP justice critic Bill Estabrooks said the measure is merely a stalling tactic and fails to provide any clear guidance on when the weapons are used.

"I'm disappointed in the delay, I'm disappointed in the lack of clarity," he said.

"I was expecting that they were going to make some clear decisions, particularly when it came to restrictions, use and accountability. I mean, the buck stops at the minister's desk."

Clarke called for the two-phase review by a panel of health, police and justice officials eight months ago, following the death of Hyde. The 45-year-old man died about 30 hours after he was Tasered by Halifax police.

Hyde, who suffered from paranoid schizophrenia, was arrested at his home for spousal abuse and was taken to police headquarters where he was shot with a Taser more than once.

He died after struggling with guards in a Dartmouth jail, leading to calls for an examination of the devices.

Stephen Ayer of the Schizophrenia Society of Nova Scotia said he was also disappointed with the review because it didn't include a ban or adequately study the issue of mental illness and how people with disorders are affected by stun guns.

He said the review should have included a recommendation that paramedics be on scene when someone with a psychiatric disorder or who suffers from acute agitation is hit with a stun gun.

"In my mind, there should be a moratorium," he said, noting that it's not known what caused Hyde's death since the autopsy results have yet to be released.

"The minister talks about violent or aggressive resistance. I'm concerned about that because someone who's acutely agitated would probably be putting up aggressive resistance."

The 50,000-volt weapons can be shot from a distance or in up-close stun mode - a pain likened to leaning on a hot stove, sometimes blistering the skin.

Nova Scotia's review is one of several across Canada ordered in the wake of the death of Robert Dziekanski, the Polish man who died after he was Tasered by RCMP officers at Vancouver International Airport on Oct. 14.

Reviews have also been ordered in British Columbia, New Brunswick, Newfoundland and Labrador, and nationally by the Canadian Association of Chiefs of Police and the Canadian Police Research Centre.

RCMP Supt. Blair McKnight of the Halifax division said the province's new restriction doesn't differ greatly from the Mounties policy on usage and that they're trying to align several different policies on when the devices should be used.

The RCMP announced last month that it will restrict Taser firings in the face of mounting public pressure on the national force to rein in what critics call "usage creep."

The Mounties said officers will have clearer direction on how and when the weapons should be wielded following renewed calls for action by the RCMP complaints commission.

Commission chairman Paul Kennedy released a final report echoing his interim call to limit Tasers to clashes where suspects are combative or risk serious harm to themselves, the police or the public.

Nova Scotia also announced it will appoint a co-ordinator who will establish new standards for the use of stun guns by law enforcement officers and conduct a full policy review.
Also see:
Nova Scotia restricts Taser use until review completed

Clarke tightens Taser use

Limits applied to Taser use

Image
Nova Scotia Justice Minister Cecil Clarke announces restrictions on the use of stun guns. The Canadian Press/Andrew Vaughan

Wednesday, July 9, 2008

Death Of Psychiatric Patient At New York Hospital Underscores Mental Health Care Crisis


A July 4th posting by Medical News Today:
The reported death of a woman at King's County Hospital in Brooklyn, N.Y., illustrates the dire need for more public services for individuals with mental illness, according to the American Psychiatric Association.

According to news reports, a woman who was suffering from agitation and psychosis, was kept waiting in the emergency room for almost 24 hours because the hospital reportedly did not have a bed available for psychiatric patients. She collapsed onto the floor and then lay there for approximately one hour before emergency room personnel tried to revive her. Tragically, the woman died of causes that have yet to be determined.

"The question is how and why hospital personnel could ignore a person who fell to the floor in an emergency room and stood by or walked around her while she died," said APA president Nada Stotland, M.D. "Still, the lack of emergency services for psychiatric patients is only one part of an overall health care crisis, which extends to and includes mental health services."
To read the entire article, click here.

Monday, July 7, 2008

Worsening of Symptoms Prevented by Early Detection

From the July 4th edition of Psychiatric News:
By Mark Moran

Negative symptoms such as cognitive deficits and lack of affect and volition have long been considered unmodifiable and appear to represent core neurobiological deficits of schizophrenia.

Reducing the duration of untreated acute psychosis in first-episode patients appears to prevent the worsening of negative symptoms—such as cognitive deficits and lack of volition, among others—at two-year follow-up.

That finding, from analysis of a public health intervention in Norway, suggests that early identification and treatment of acute psychotic symptoms may affect the core neurobiological deficit process of schizophrenia, and through this alter the course and prognosis for the better.
To read the entire article, click here.

Also see:
Prevention of Negative Symptom Psychopathologies in First-Episode Schizophrenia: Two-Year Effects of Reducing the Duration of Untreated Psychosis.

Insel: 'Different Kind of Science' Poised to Transform Psychiatry

From the July 4th edition of Psychiatric News:
By Mark Moran

Understanding genomic variation and how it affects normal or abnormal development of brain circuits in different ways at different points in time will help push psychiatric diagnosis and treatment into the 21st century.

Psychiatry is still awaiting the "disruptive innovations" in scientific research that have helped to reconceptualize disease in other areas of medicine, said Thomas Insel, M.D., director of the National Institute of Mental Health (NIMH), at APA's 2008 annual meeting in Washington, D.C., in May.

The study of genomic variation and its role in leading to changes in complex brain circuitry, recognition of the longitudinal and developmental nature of disorders, and the discovery of biomarkers linked to a more precise understanding of the pathophysiology of disease are the tools of a 21st-century science promising to transform the treatment of mental illness.

Insel said those same tools have been applied in other areas of medicine to reconceptualize the nature of disease and to reduce mortality dramatically for people with such disorders as cardiovascular disease and cancer.

In contrast, the diagnosis and treatment of mental illness, he said, have been stuck in a 20th-century model.
To read the entire article, click here.

NIMH Director Thomas Insel, M.D.: "Genes code for proteins that play out in particular brain areas at particular times to change the way brain circuitry develops. It's all about variation and how it plays out at each of these levels."

Photo credit: Mark Moran

Thursday, July 3, 2008

Milestone for this Weblog


Today this weblog had its 25,000th visit since November 25th, 2006. That works out to an average of 1,320 visits per month!

The first post to this weblog can be viewed by clicking here.

Thank you for visiting!

Painting by Louis Wain.

Wednesday, July 2, 2008

A new vision for mental health


From the Future Vision Coalition (United Kingdom):
Cabinet champion needed for better mental health for all, says new coalition

20 June 2008

The Prime Minister should appoint a Cabinet-level champion for mental wellbeing, according to a report produced by a coalition of seven leading health organisations.

'A New Vision for Mental Health' from the Future Vision Coalition, calls for action to build on the successes of the National Service Framework (NSF) for Mental Health, to put mental wellbeing at the centre of public policy and to improve the quality of life of all people with mental health problems.

It argues that action is needed to promote better mental health for all and to identify children at risk of mental distress for targeted support. It calls on mental health services to focus on helping people to get their lives back, not just to manage their illness, and to give those who use services more control over how money is spent on them.

A New Vision for Mental Health says that mental wellbeing is the business of the whole of government, not just the Department of Health. It needs a champion in the Cabinet to ensure all departments are working together to promote good mental health and to bring the voices of those who have mental health problems to the centre of government.
To read the entire press release, click here.

Tuesday, July 1, 2008

Recovery from Schizophrenia: An International Perspective


To read Rachel Jenkins' review of this book, published in the July 2008 edition of The British Journal of Psychiatry, click here.

To purchase Recovery from Schizophrenia: An International Perspective, click here.