Sunday, August 29, 2010

Committee Recommends the Creation of Mental Health and Addictions Ontario



Please click on the image to magnify it.

An August 26th media release from the Select Committee on Mental Health and Addictions of the Legislative Assembly of Ontario:
The Select Committee on Mental Health and Addictions of the Legislative Assembly of Ontario today released its final report, "Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians". This follows the release of an interim report (March 2010) that provided an overview of the hearings and activities of the Committee to that date.

Key Recommendations

The final report includes 23 recommendations. The main recommendation is the creation of an umbrella agency, Mental Health and Addictions Ontario, to design, manage, and coordinate the mental health and addictions system, and to ensure the consistent delivery of programs and services across Ontario.

The Committee's other recommendations include:
  • The consolidation of all mental health and addictions programs and services in the Ministry of Health and Long-Term Care
  • The availability of a core basket of services in all regions of Ontario
  • Access to system "navigators" who can connect people with the appropriate treatment and community support services
  • The provision of additional affordable and safe housing units
  • Increased respite care to provide more support for families and caregivers
  • The creation of a task force to examine Ontario's mental health legislation
Each member of the Committee, regardless of their political convictions, recognized that all Ontarians must get the mental health and addictions care they deserve.

Members' Statements

"We have been privileged to work collaboratively with our fellow Members of Provincial Parliament, mental health and addictions experts and, most importantly, individuals and their families, to develop this comprehensive plan for mental health and addictions services in Ontario," said Christine Elliott (PC) and Sylvia Jones (PC). "It is our sincere hope that these recommendations will result in wellness, dignity, and opportunity for all Ontarians."

"As a Committee we were challenged by the people whose lives have been so completely altered by mental illness and addiction to be creative and innovative," said Maria Van Bommel (LIB) on behalf of the Liberal Members of the Committee. "Their stories forged the determination of Committee members from all political parties to develop a plan that will better the lives of so many deserving Ontarians. We are hopeful and proud to recommend the creation of a provincial agency that will change our approach to mental wellness and addictions recovery."

"I agreed to join the Select Committee because I knew we needed to do better," said France Gélinas (NDP). "Listening to all the testimony was very difficult. Our existing system has failed so many people, often with catastrophic consequences. Our recommendations will make Ontario an example of excellence for people facing mental health and addictions issues. I look forward to the implementation of the report."

The release of the final report marks the conclusion of the Committee's work. The report now moves forward to await debate by Members in the Legislative Assembly, and implementation of the recommendations by the Government of Ontario.

Background on the Select Committee

The Select Committee was struck on February 24, 2009 with a mandate to consider and report "its observations and recommendations concerning a comprehensive provincial mental health and addictions strategy". Over the intervening 18 months, the Committee heard over 230 presenters from all regions of Ontario and received more than 300 written submissions. The Committee also conducted site visits to mental health and addictions facilities as well as First Nations communities.

Each of the province's three political parties was represented on the Committee. The members of the Committee were: Kevin Flynn, Chair (LIB), Christine Elliott, Vice-Chair (PC), Bas Balkissoon (LIB), France Gélinas (NDP), Helena Jaczek (LIB), Sylvia Jones (PC), Jeff Leal (LIB), Liz Sandals (LIB), and Maria Van Bommel (LIB).

Copies of the report are posted on the web site of the Legislative Assembly of Ontario at www.ontla.on.ca under "Committees" - "Committee Reports".

For further information:

Office of Kevin Daniel Flynn, MPP, Chair of the Committee, Tel. (416) 325-1856, kflynn.mpp@liberal.ola.org; Susan Sourial, Clerk of the Committee, Tel. (416) 325-7352, susan_sourial@ontla.ola.org

Also see:

The right to refuse wellness

Three Provincial Umbrella Organizations Applaud Newly Released Select Committee Report on Mental Health and Addictions

Coyle: Mental health ‘crisis has arrived’ say MPPs

Next step is funding for mental health

Overhaul mental health relief and services, says Sandals

Report urges changes to mental health care in Ont.

Saturday, August 28, 2010

Province, psychiatrists sign two-year contract


An article published in today's edition of The Chronicle Herald:
Specialists to get $147.99 an hour

By DAVID JACKSON, Provincial Reporter

Halifax-area psychiatrists have reached a new funding deal with the Health Department, one the government hopes will help keep the specialists in Nova Scotia.

The province just signed off on the two-year deal, called an academic funding plan, this month. It will help ensure that doctors are actually getting paid for the hours they work, said Victoria Goldring, director of physician services for the Health Department.

Psychiatrists had complained that they were working a combined 20,000 hours more a year than what the previous contract would pay them for, she said.

Goldring said the new contract focuses on hours of service, for both clinical work and teaching. It says the department will cover 156,000 hours a year, with 80 per cent for clinical work and 20 per cent for teaching, research and administration.

That number of hours is the equivalent of 75 doctors working 40 hours a week for the 52 weeks in a year.

The hourly rate increases to $147.99, a 2.9 per cent increase from $143.78. The ballpark salary for a psychiatrist, depending on whether they’re a full professor and other factors, is about $300,000 [per year], Goldring said.

The deal adds about $3 million to the $20-million budget under the previous interim agreement.

Goldring said the new agreement would cover up to 75 psychiatrists, but they are currently several doctors short of a full complement. They work at the Queen Elizabeth II Health Sciences Centre and the IWK Health Centre and teach at Dalhousie University.

She said recruiting and retaining psychiatrists, who are in demand across the country, was top of mind during contract negotiations. She said the province aimed for the new deal to put psychiatrists’ pay here in the middle of the pack nationally.

"They are now at a more competitive rate compared to their counterparts across the country," Goldring said.

"There are shortages of psychiatrists all across the country, but this will help in providing a bit of stability to their numbers here."

A spokesperson for the psychiatrists could not be reached Friday.

Last November, they had threatened to withhold services from the new mental health court after they said the province missed an Oct. 31 deadline for a new deal.

It wasn’t clear Friday whether they had followed through.

The psychiatrists’ last contract expired in 2007, but there was an interim agreement to 2009. This new deal is effective from April 1, 2009 to March 31, 2011.

(djackson@herald.ca)

Wednesday, August 25, 2010

Vancouver Coastal Review Sidesteps the Main Issue


An August 24th media release from the North Shore Schizophrenia Society:
Vancouver Coastal, in a review of the death by suicide of Marek Kwapiszewski, has ducked the leading question they needed to answer: Why is “dangerousness” still considered a requirement for involuntary admission rather than “to prevent the person’s... substantial mental or physical deterioration,” as spelled out in the Mental Health Act?

What was promised by CEO David Ostrow [pictured] to have been an “independent” review, moreover, turned out to be not so independent after all, with senior managers under question in the review taking part in drawing up its recommendations.

Kwapiszewski, 54, of Vancouver, who suffered from schizophrenia, jumped off the Granville Street Bridge to his death June 29, 2008. His sister, Halina Haboosheh, together with her lawyer, had made 16 different attempts to get him the treatment he needed – treatment which required involuntary admission since Kwapiszewski, like many suffering from schizophrenia, did not have insight into his own condition.

Instead of dealing with the factors leading to Kwapiszewski’s death, the review came up with three brief items in a so-called action plan, which involved no changes or improvements in practice, nor was any fault determined although it was an obvious case of clinical failure.

“The ‘action plan’ should have been called an ‘inaction plan,’” NSSS president Herschel Hardin commented. “It was as if a review had not taken place.”

The so-called action plan was presented to Haboosheh and the North Shore Schizophrenia Society, which made the original submission in the case, at a meeting July 26, in Vancouver Coastal’s boardroom.

The first item, to facilitate a discussion to consider development of an operating definition of “deterioration,” makes no commitment to ultimately do anything, and is highly questionable to begin with in any case. Nor does it apply to the Kwapiszewski case, where the deterioration was quite clear and substantial.

The second and third of the three items were bureaucratic filler, not representing anything new and showing no grasp of what the problem was.

The review also completely missed two other crucial factors in the case: the failure of Vancouver Coastal staff to involve the sister, Halina Haboosheh, as an integral member of the treatment team, following best practices, and the concomitant failure to share clinical information with her. If that had been done, Marek Kwapiszewski might well be alive today.

It was also learned that the items were not the independent work of the external lawyer and psychiatric consultant hired to undertake the review, but were a consensus arrived at with senior community mental health managers and, possibly, Vancouver Coastal’s risk management officer. In effect, they had a veto over what would be presented.

As well as forfeiting the review’s independence, this meant that a major shake-up of senior mental health management, called for in NSSS’s 2009 submission, could not even be addressed. Instead, the primary subjects of the review, as NSSS considered them, were parties to the review’s outcome.

In response to Vancouver Coastal’s items, NSSS has presented four recommendations of its own to Vancouver Coastal and has asked Ostrow and his Board for leave to speak directly to the recommendations at a Board meeting.

Attached [please click here and here] are the NSSS recommendations and the Vancouver Coastal items. The NSSS submission on the case, June 26, 2009, is available on our website at www.northshoreschizophrenia.org/marek.pdf. A brief background analysis of the Vancouver Coastal items, such as they are, is also available on the NSSS website.

Media Contact

Herschel Hardin
North Shore Schizophrenia Society President
604-922-7153
herschel@northshoreschizophrenia.org

Photo credit

Tuesday, August 24, 2010

Serum S100B: A Potential Biomarker for Suicidality in Adolescents?



Structure of the S100B protein. Based on PyMOL rendering of PDB 1b4c.


The abstract of a paper published online by PLoS One:
By Tatiana Falcone, Vincent Fazio, Catherine Lee, Barry Simon, Kathleen Franco, Nicola Marchi, and Damir Janigro*

Cleveland Clinic-Lerner College of Medicine, Cleveland, Ohio, United States of America

Abstract

Studies have shown that patients suffering from depression or schizophrenia often have immunological alterations that can be detected in the blood. Others reported a possible link between inflammation, a microgliosis and the blood-brain barrier (BBB) in suicidal patients. Serum S100B is a marker of BBB function commonly used to study cerebrovascular wall function.

Methods

We measured levels of S100B in serum of 40 adolescents with acute psychosis, 24 adolescents with mood disorders and 20 healthy controls. Patients were diagnosed according to DSM-IV TR criteria. We evaluated suicidal ideation using the suicidality subscale of the Brief Psychiatric Rating Scale for Children (BPRS-C).

Results

Serum S100B levels were significantly higher (p<0.05) and correlated to severity of suicidal ideation in patients with psychosis or mood disorders, independent of psychiatric diagnosis. Patients with a BPRS-C suicidality subscores of 1–4 (low suicidality) had mean serum S100B values +/− SEM of 0.152+/−0.020 ng/mL (n = 34) compared to those with BPRS-C suicidality subscores of 5–7 (high suicidality) with a mean of 0.354+/−0.044 ng/mL (n = 30). This difference was statistically significant (p<0.05).

Conclusion

Our data support the use of S100B as an adjunctive biomarker to assess suicidal risk in patients with mood disorders or schizophrenia.


Citation: Falcone T, Fazio V, Lee C, Simon B, Franco K, et al. (2010) Serum S100B: A Potential Biomarker for Suicidality in Adolescents? PLoS ONE 5(6): e11089. doi:10.1371/journal.pone.0011089

Copyright: © 2010 Falcone et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

*E-mail: janigrd@ccf.org

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

Also see:

Serum Biomarker May Help Predict Suicidality in Adolescents

Identifying Suicide Risks in Adolescents


Image courtesy of Emw. This image is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.

Busy first year for chief C.B. Crown



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

MacRury headed inquiry into jail cell death of mentally ill man

By LAURA FRASER Cape Breton Bureau | FIVE QUESTIONS

Dan MacRury [pictured] spent most of his first year as chief Crown attorney for the Cape Breton region juggling his new job with his responsibilities as counsel for the Howard Hyde inquiry.

The inquiry into the death of the mentally ill man while in custody was one of the province’s longest fatality probes.

But MacRury said he is used to tackling more than one job at a time. He will be the incoming vice-chairman for the criminal justice section of the Canadian Bar Association, and treasurer of the Nova Scotia branch.

He has also sat as president of the Legal Information Society of Nova Scotia and the Canadian Criminal Justice Association. And in his spare time, he goes fly-fishing and makes pasta.

He recently sat down with The Chronicle Herald to talk about his 24-year career shortly after he won the Canadian Bar Association’s 2010 John Tait Award of Excellence.

Q: What sparked your interest in public prosecution?

A: I’ve been involved in public service pretty well my entire career. First, I was at (Nova Scotia) Legal Aid and then moved over to the Crown.

I think it was sort of natural for me because public service and volunteerism are sort of virtues of my family. My entire family works as public servants.

My father worked as a hospital administrator and a city councillor here in Sydney. My mother was a nurse in detox. Both sisters work in health care, and in fact, I married a public servant. My wife’s a public servant.

It’s certainly something that was instilled in my family as being very important, to give back to your community and try to make a difference, and that’s really what I’ve been trying to do throughout my career.

Q: So what was it initially that interested you about law?

A: I had a very good professor who was sort of a mentor and went on to be a senator. John. B. Stewart was my professor at St. F.X., and he was somebody that always encouraged people to go into law, and I guess that was where my interest was tweaked at that point in time.

And certainly as a lawyer, I’ve had some great opportunities. I’ve been involved as a defence counsel in two murders and as a Crown in seven murder cases. I’ve appeared before the Supreme Court of Canada three times, one being the (John Robin) Sharpe case that dealt with the constitutionality of the (child) pornography provisions of the Criminal Code.

And I was a legal adviser in 2002 to the G7 finance ministers conference in terms of the law and its relation on lawful assembly and protests.

Q: Recently, you were the counsel for the Howard Hyde inquiry regarding the death of a man with schizophrenia who died 30 hours after he was Tasered while in police custody in Halifax. Can you tell us about that?

A: The Hyde inquiry, of course, was the longest fatality inquiry in Nova Scotia history, and that dealt with issues of how the mentally ill are dealt with by the criminal justice system and the mental health system. We’re now awaiting Judge (Anne) Derrick’s report and certainly hoping that there will be recommendations in relation to those areas as well.

One thing that I’ve found both as a legal aid lawyer and as Crown over the last 20 years is that, really, there are too many people that suffer from mental illness that are being dealt with by the criminal justice system instead of the mental health system. That’s something that I always felt was important to try to improve if we can.

Q: What do you remember about your first case?

A: When I first started out in New Glasgow (as a lawyer with Nova Scotia Legal Aid), you dealt with a lot of people, and you realize that people don’t choose, and don’t have control over some of the circumstances (that affect criminal behaviour), whether it’s poverty or substance abuse. So a lot of times what you found as a legal aid lawyer is that people are just looking for help.

I guess one case that sort of stuck out in my mind is I represented a young man who had been institutionalized for most of his life, and disabled. It certainly brought home to me that sentencing sometimes has to be flexible because it was a serious offence that he was charged with and the jails couldn’t cope with him. We were able to speak with (the) correctional services (division of) Nova Scotia at the time and we were able to have him transferred to a hospital setting, which was more appropriate for him. He was able then to get at rehabilitative programs, and it was the only time he’d been involved in the criminal justice system that he was able to get programs to assist him. Certainly, that was very rewarding from my point of view. What we find is that when things aren’t as simple, you have to be a little innovative in terms of coming up with solutions to problems.

Q: You said that you’ve prosecuted seven murder cases.

A: One I got parachuted into. I think what you learn in this business is things happen on short notice. I had a vacation booked for New York City, and a colleague became very ill. With two weeks to go, I ended up being involved in the case in Halifax (R. vs. Assoun). And that was a long case where the accused fired three lawyers and was then self-represented, which was certainly a challenge.

I was involved in another case (R. vs. Tran) that was simultaneous translation in Vietnamese. In fact, while I was dealing with the Tran case . . . at the same time we were prosecuting another case called Simpson, which was somebody on a Cuban vessel that murdered somebody in Halifax Harbour. So, literally, we were going to jury on one case, and then up at the provincial court starting the other case, which was translated in Spanish.

The challenge in the case in the gentleman from Cuba is that all the witnesses were in Cuba and so we had to deal with Foreign Affairs to try to get them back in the country to testify . . . so it wasn’t your standard subpoenas. Certainly, that was a challenge, but an exciting case as well."

(lfraser@herald.ca)

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Old Vancouver motor hotel gets new life as part of homelessness experiment


An article published in yesterday's edition of The Vancouver Sun:
By Todd Coyne

Downtown Vancouver’s old Bosman’s Motor Hotel is once again filling up fast. Not with the road-weary travellers of earlier days, however, but with people whose paths in life have led them, wearily, to the streets.

Now renamed the Bosman Hotel Community, the four-storey former inn at 1060 Howe St. officially opened its doors Monday as the Vancouver site of a five-city federal research project studying the relationship between homelessness, mental illness and addiction.

With similar facilities in Winnipeg, Toronto, Montreal and Moncton, the Mental Health Commission of Canada is studying the effects of a “Housing First” approach to treating the mental health problems of chronically homeless people in Vancouver. This model means providing suitable candidates with housing and food as a first priority before trying to address their mental-health problems and their goals for recovery.

Inside the Bosman, the rooms are small and bear all the furnishings immediately familiar to anyone who’s ever stayed in low-cost, continental breakfast-included lodgings anywhere in North America. There’s a heavy-blanketed bed, a lamp, a bathroom on the left and even a Bible in the nightstand.

For a hundred of Vancouver’s hardest to house, it will be home.




“If it was not for this place, I do believe I would not be here today,” said new Bosman resident Nicola Keate [pictured].

In front of a crowd of city politicians, university researchers and homeless-outreach workers in the Bosman’s cramped main room, Keate told of how at age 14 she started using drugs and immediately became hooked.

Later, she found out she had a bipolar disorder — which, she said, led to more drugs and a life of crime.

It’s a cyclical refrain among the Bosman’s 67 residents — drugs leading to illness leading to drugs — and one which the federal mental health commission, in association with the Portland Hotel Society in Vancouver, is trying to end in the homeless population nationwide.

Jeff West, the Bosman’s project manager, said that 500 of Vancouver’s homeless with addictions and mental health problems were selected as potential candidates for residency at the Bosman Hotel. One hundred of them were then offered residency at the Bosman — something one resident compared to winning the lottery — for a maximum stay of three years.

That’s when the national study ends and when West said the Bosman Hotel’s owners, Prima Properties Ltd., plan to build condominiums.

Of the other 400 study participants in the city who will not be moving into the Bosman, 200 will not receive housing as the study’s “treatment as usual” control group, and 200 will be put into “scatter housing” around the city and connected to case managers and mental health support workers, West said. Nationwide, 2,285 people are participating in the three-year “At Home” study; of these, 1,325 will receive housing.

tcoyne@vancouversun.com

Photo credit

Monday, August 23, 2010

Surviving Schizophrenia Video

Posted August 3rd by HealthyPlace.com:
Schizophrenia video interview with Dr. Fred Frese. Diagnosed with paranoid schizophrenia, renowned psychologist shares insights on living with schizophrenia.

Although schizophrenia is one of the most debilitating mental illnesses, it is treatable. With the right treatment, people suffering from schizophrenia can reach a productive and stable life.

Dr. Fredrick J. Frese was our guest on the HealthyPlace Mental Health TV Show. Dr. Frese has been living with schizophrenia for 40+ years. In this schizophenia video, he shares anecdotes about his diagnosis and how he's managed to be successful despite it.








Share Your Thoughts or Experiences on Schizophrenia

We invite you to call us at 1-888-883-8045 and share your experience in dealing with schizophrenia. How has it affected your life? What treatment has worked for you? (Info on Sharing Your Mental Health Experiences here.)


About Dr. Fredrick J. Frese, Our Guest on "Sane and Living with Schizophrenia" Video


Fredrick FreseFredrick J. Frese, Ph.D., Secretary at the Treatment Advocacy Center, was diagnosed with paranoid schizophrenia in 1966 while he was serving in the U.S. Marine Corps. Dr. Frese was involuntarily hospitalized in several hospitals and judicially determined to be an insane person in 1968.

Despite his disability, Dr. Frese has been able to function as a psychologist and an administrator, serving mentally ill persons in Ohio. A prolific writer and outstanding speaker, revered both for his sense of humor and his remarkable ability to translate research and public policy into usable information, Dr. Frese has lectured widely in the United States, Canada, and Japan. Dr. Frese has been featured in The Washington Post, The Chicago Tribune, The Wall Street Journal and on CNN, NPR, ABC World News Tonight, Nightline’s Up Close, and in the documentary film, I’m Still Here: The Truth About Schizophrenia.

Visit Dr. Frese's website here: www.fredfrese.com

Treatment Advocacy Center: www.treatmentadvocacycenter.org

Sunday, August 22, 2010

More students than ever feeling the strain


An article published in the August 20th edition of Kelowna Capital News:
Sitting in a capacious lecture theatre at university for a first-year student can be daunting.

In the stiff chairs around you are a hundred faces you don’t know. You have to be attentive to the professor because you need a good grade in this class to take the next course, but you just can’t follow what he’s saying.

You keep thinking about how you’re going to pay for your books this semester. Your laundry hasn’t been done for weeks. Your work schedule has you stressed with not enough time to study and your caffeine intake has tripled. Your girlfriend is upset you don’t see her enough.

Add into the mix, you’re being treated for depression and anxiety disorders.

•••

According to a 2009 study by the American Health College Association, 84 per cent of the college students polled said over the past year they had felt at some time “overwhelmed by all they had to do” and 81 per cent “felt exhausted.”

As many as 49 per cent felt “overwhelming anxiety” and six per cent said they had “seriously considered suicide.”

It’s understandable. Some students are away from home for the first time, without their supports and high school friends and have to manage a heavier school and life load independently. It’s a sharp shift from the cocoon of home and high school.

But, the report also noted that college councillors are noticing more students showing up at their door and coming with more severe mental health issues.

Anecdotally, Okanagan College counselling services chairman Glendon Wiebe says the results of the American study are reflected at the college.

“I do feel the severity of the presenting issues has increased,” he says.

That’s not necessarily something to be alarmed about; in fact, it may be that students are more likely to seek help and college staff and faculty are more aware and supportive of helping the students in their mental health.

Wiebe says, “I don’t see a lot of evidence of mental health issues in the general public increasing. I don’t think the report suggests there are more mental health disorders. But, there is more awareness.”

“There is less stigma to self-identify,” explains Wiebe. “There are fantastic initiatives to educate people early.”

To read the entire article, please click here.

Also see:

College students exhibiting more severe mental illness, study finds

Mental Health Services and Choosing a College: Striking a Balance (NAMI)

Image credit

Thursday, August 12, 2010

CMA awards Medal of Honour to the Honourable Michael Kirby



An August 11th media release from the Canadian Medical Association:
Ottawa, August 11, 2010 - The Canadian Medical Association (CMA) will present the 2010 CMA Medal of Honour to the Honourable Michael Kirby, who has demonstrated outstanding public commitment to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

“The CMA Medal of Honour recognizes personal contributions to advancing medical research and education,” said CMA President Dr. Anne Doig. “Mr. Kirby [pictured] has worked diligently to bring awareness to the mental health issue.”

Mr. Kirby is well known to physicians for his landmark Senate reports on health care reform. Now retired from the Senate of Canada after 22 years of service, Mr. Kirby chairs the Mental Health Commission of Canada where he has demonstrated the same outstanding public commitment – this time, to raising awareness of mental health issues and diminishing the stigma and discrimination faced by Canadians living with mental illness.

“I have been privileged to have worked on major Canadian public policy issues for more than forty years. In that time, nothing has been more gratifying than my work on health care in general and mental health care in particular,” said Mr. Kirby. “I believe that, with the help of all Canadians, it will be possible to substantially reduce the stigma and discrimination faced by people living with a mental illness, and to put in place a system of services and support that will enable them to lead a much more satisfying and productive life.”

Mr. Kirby’s personal interest in health care delivery was evident during his seven-year term (1999–2006) as chair of the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s focus was to develop a federal health policy that would support a financially sustainable health care system over the long term.

The committee published six reports on health care, culminating with Recommendations for Reform, in 2002. The report included numerous and varied recommendations: the need for better accountability through an annual report on the health care system and the health status of Canadians; the need for improved efficiency measures, including primary care reform; the need for timely access to health care in the form of health care guarantees; and the need to close gaps in the safety net by expanding coverage for catastrophic drug costs, and acute and palliative home care.

Following publication of the report, the Social Affairs Committee, chaired by then-Senator Kirby, turned its attention to the issue of mental health, mental illness and addiction. The committee published three background reports in 2004 and its final report, Out of the Shadows At Last, was released in 2006. One of the principal recommendations of this report was that the federal, provincial and territorial governments should establish the Mental Health Commission of Canada.

Mr. Kirby retired from the Senate in 2006 and was appointed chair of the newly created Mental Health Commission of Canada in 2007. The commission’s mandate is to develop Canada’s first national mental health strategy and to launch a decade-long, anti-stigma program to change public attitudes and behaviour toward people living with mental illness.

While the goals of the Mental Health Commission are certainly no small challenge, Mr. Kirby has a proven track record of successfully developing and implementing public policy for governments and the private sector. He served as principal assistant to Premier Gerald Regan of Nova Scotia (1970–73), assistant principal secretary to Prime Minister Pierre Trudeau (1974–76) and president of the Institute for Research on Public Policy (1977–80). While he was Secretary to the Cabinet for Federal-Provincial Relations and Deputy Clerk of the Privy Council (1980–83), he was the senior public servant involved in the negotiations that led to the patriation of the Canadian Constitution and inclusion of the Charter of Rights in the constitution.

He has been a professor at Dalhousie University, has taught at the University of Chicago and University of Kent, has served on the boards of numerous public companies, is a regular media commentator on public policy issues, and is a featured speaker at many national conferences.

In recognition of a lifetime of outstanding achievement on major public policy issues and his current commitment to confronting the challenges related to mental illness, Mr. Kirby was appointed an Officer of the Order of Canada in 2008.

The Honourable Michael Kirby is the 27th recipient of the CMA Medal of Honour, the highest award bestowed upon a person who is not a member of the medical profession. He will receive this award at a special ceremony at the Crowne Plaza Hotel, in Niagara Falls, Ont., on Aug. 25 as part of the CMA’s 143rd annual meeting.


For more information:

Lucie Boileau, Manager, Media Relations
Tel.: (613) 731-8610 or 800-663-7336 ext. 1266
Mobile : (613) 447-0866
lucie.boileau@cma.ca

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Wednesday, August 11, 2010

Mental Health Commission of Canada: Annual Report 2009-2010



Please click on the image to magnify it.

To view the very interactive online report (which includes videos), please click here; or click here to download the entire PDF version (38 pages).

Also see:

Mental Health Commission of Canada

Monday, August 9, 2010

Peer Project - Mental Health Commission of Canada



A posting on the Mental Health Commission of Canada's website:

The Mental Health Commission of Canada has launched the Peer Project to enhance the utilization of peer support through the creation and application of national standards of practice. It is also designed to encourage a change in societal attitudes towards mental illnesses through peer based education strategies specifically targeting youth in schools and adults in workplaces. The project supports and shares in common a number of the objectives related to key initiatives and other projects of the Commission and its advisory committees.

The use of peer based approaches is founded on the belief that people who have faced, endured, and overcome the adversity of mental health conditions can offer beneficial support, encouragement and hope to others facing similar situations. Peer based services, i.e., peer support delivered in conjunction with mental health education delivered by peers can greatly enable Canadians to better understand and accept the realities of mental health challenges, leading to a more supportive society.

It is recognized that there are valuable and effective variations regarding the way peer support is provided in Canada and a “one size fits all” approach is not what the peer project intends to develop. A chief concern is to not lose sight of the grass roots, community based practices that have characterized the success of this type of mental health intervention.

The Mental Health Commission believes, however, that before organizations of different types and sizes are willing to further invest in peer based initiatives, evidence-based frameworks will need to be developed. The literature on peer based services in Canada and other countries suggests that the lack of adequate empirical evidence supporting the effectiveness of peer delivered interventions has impeded their growth and wider-scale use. Consequently, the design of both project components will be underpinned from the very outset with performance measurement and evaluation strategies.

Developing standards of practice will provide frameworks to enhance the credibility of peer based services. Standards of practice are established by identifying the competencies, experience, training/education, and values, which together constitute the hallmark for providing effective services.

Obtaining the views and input of stakeholders is a prominent feature of this project, particularly in relation to the peer support component at this stage. The Project Team is currently planning a comprehensive consultation process with the initial goal to develop standards of practice for peer support that will be implemented and tested beginning with workplaces.

As the Peer Project evolves, updates will be posted to the web site to allow interested parties to follow the development of this endeavour.

Also see:

Definition of ‘Peer

Peer Project Outline

Tell us about yourself

Sunday, August 8, 2010

Kaleidoscope of the heart: Coming forward and talking about illness


An article published today by The Mainichi Daily News [Japan]:
By Rika Kayama, psychiatrist [pictured]

I invited two members of the BALBAL Club -- an organization that is engaged in activities in which those who have suffered from mental illnesses talk about their experiences -- to deliver speeches during my lecture at a university in the Kansai district. Male member Naohito Inamura and female Daria Sugano, talked about their experiences of schizophrenia.

Inamura experienced auditory hallucinations and delusion when he was a high school student. He said he was initially confused and did not understand what had happened to him.

After being hospitalized several times, Inamura took part in a workshop for those who have suffered from mental problems. He then made friends with many former patients and now his condition remains stable. Inamura has now recovered to the extent that he visits hospitals for those with mental illnesses and tells other patients about his experiences to encourage them.

"Hospitals that provide detailed care to patients are good, but you can relax at institutions that leave you alone," he jokingly says.

Sugano, who appears to be serious and intellectual, suffered from schizophrenia when she was in her teens. She and her family were initially unable to accept the fact that she suffered from schizophrenia, and were reluctant to receive social welfare services. In a desperate bid to be independent and self-reliant, Sugano attended a post-graduate school while working part-time, and was involved in stressful work in the social welfare sector. She suffered a relapse of her illness several times after being overworked. Now she has fully accepted the fact that she is a patient with schizophrenia, and can live at her own pace.

Sugano told students in my class that when she was 17, she was told by her doctor that she would need to regularly take medicine for schizophrenia for the rest of her life. On her way home from the clinic, she was concerned for her life, thinking that she was different from the people around her.

The students appeared impressed with her heartbreaking speech. I think students occasionally feel sad when they think all people except themselves are happy, but the degree of their despair is completely different from that Inamura and Sugano experienced.

Nevertheless, Inamura and Sugano found ways to deal with their disease by adopting lifestyles that suited their conditions, by going to places where they can truly be themselves and making friends after struggling for 10 to 15 years.

Their messages that, "You can certainly recover from your illnesses" and "If you find mentally ill people around you, please understand them," have a ring of truth because they experienced despair.

I wonder how the guest speakers' words sounded to the students of today, who tend to be sensitive and easily abandon their own goals. The two guest speakers wanted to advise the students not to give up hope even if they are in despair and to be patient, believing that anything takes time to solve. Their experiences give a lesson to everybody.

It is not easy for anybody to talk about their illnesses. But some people willing to do that help a growing number of people understand the illnesses and give courage to more and more people. Activities like those of BALBAL Club are now widespread throughout the country. If you have an opportunity, I would like you to listen to what its members have to say.

Photo credit

An Update from Nova Scotia



Please click on the image to magnify it.

To view the PowerPoint slides (PDF) of the presentation that Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, made during the Schizophrenia Society of Canada's 2010 National Conference, please click here.

Saturday, August 7, 2010

Shift to Community Care Slowing in Many States


An article published in the August 6th edition of Psychiatric News:
By Rich Daly

Eleven years after the Supreme Court required that community-based treatments be offered to people institutionalized with major health conditions, including serious mental illness, that promise remains unfulfilled and may need legal action to get back on track.

Numerous initiatives by Congress, federal agencies, and mental health advocates have greatly expanded access to community-based treatment for people with serious mental illness in the 11 years since the Supreme Court required such alternatives for qualified people in institutional care. But some observers warn that those efforts are stagnating or even receding.

The Supreme Court's 1999 Olmstead v. L.C. decision declared that “unjustified institutional isolation of persons with disabilities is a form of discrimination” under the Americans With Disabilities Act (ADA) and obligated states to serve those individuals in the most “integrated” setting possible. Since then, mental health advocates have sought to move most people with serious mental illness out of institutional settings and into community treatment where they would have opportunities to work, socialize, and move freely in society.

Those efforts have resulted in community-based treatment and assisted-living programs throughout the country that usually cost states much less than the institutional programs they succeeded, according to Robert Bernstein, president and director of the Bazelon Center for Mental Health Law.

To read the entire article, please click here.

Thursday, August 5, 2010

Photographs from the SSC National Conference in St. John's, NL


The Schizophrenia Society of Canada's (SSC) National Conference took place from July 26th to 28th, 2010, in St. John's, Newfoundland and Labrador.

To download PowerPoint slides from some of the presentations made during the conference, please click here.




Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia (left), Greg Zed, past president of the Schizophrenia Society of New Brunswick (centre), and Cecilia McRae, president of the Schizophrenia Society of Nova Scotia (right).




Anita Hopfauf, executive director of the Schizophrenia Society of Saskatchewan. At the far right is Phil Rogers, treasurer of the Schizophrenia Society of Nova Scotia.




Laura Burke, peer support facilitator with the Schizophrenia Society of Nova Scotia, performs spoken word poetry during the conference banquet. Laura also received the SSC's 2010 Flag of Hope Award during the banquet.




Laura Burke at The Rooms, an art gallery and museum in St. John's.




View of the entrance to St. John's harbour from The Rooms.




At a conference with a theme of Social Inclusion: Well Beyond Recovery, we didn't have too look very far for signs of social prejudice.




The Supreme Court of Newfoundland and Labrador.


Please click on any photograph to magnify it.

EEG predicts response to medication for schizophrenia



Pictured left to right are Dr. Gary Hasey, Department of Psychiatry and Behavioural Neurosciences; Professor James Reilly and Ph.D. student Ahmad Khodayari‑Rostamabad, Department of Electrical and Computer Engineering; Prof. Hubert de Bruin, McMaster School of Biomedical Engineering. Missing: Dr. Duncan MacCrimmon, Department of Psychiatry and Behavioural Neurosciences.


An August 4th media release from McMaster University:
A commonplace electroencephalography (EEG) test may hold the key to predicting whether a person will respond to certain prescribed drugs, particularly those related to psychiatric conditions.

In a study to be published by Clinical Neurophysiology, and now posted online, engineering and health sciences researchers at McMaster University applied machine learning to EEG patterns and successfully predicted how patients with schizophrenia would respond to clozapine therapy.

Clozapine is recognized as an effective treatment for chronic medication-resistant schizophrenia but can produce serious side effects such as seizures, cardiac arrhythmias or bone marrow suppression. Some patients can develop blood problems that are life-threatening. Weekly to monthly blood sampling is required.

"Some people can suffer terrible side effects from clozapine," said Dr. Gary Hasey, associate professor at McMaster and director of the Transcranial Magnetic Stimulation laboratory at St. Joseph's Healthcare Mood Disorders Clinic in Hamilton. "The logistic difficulties for the patient and treatment team are also substantial. A method to reliably determine, before the onset of therapy, whether a patient will or will not respond to clozapine would greatly assist the clinician in determining whether the risks and logistic complexity of clozapine are outweighed by the potential benefits."

To conduct the study, EEGs were taken from 23 patients diagnosed with medication-resistant schizophrenia before they began taking clozapine. Twelve were men and 11 were women, all of middle age. The brainwave patterns and response to the clozapine therapy of these patients were used to "train" a computer algorithm to predict whether or not a specific patient will respond to the drug. The prediction accuracy was approximately 89 per cent. This algorithm showed similar predictive accuracy when it was further tested in a new group of 14 additional patients treated with clozapine.

This innovative work grows out of the close collaborative relationship between members of the Department of Electrical and Computer Engineering (Prof. James Reilly, Ph.D. student Ahmad Khodayari-Rostamabad), the School of Biomedical Engineering (Prof. Hubert de Bruin), and the Department of Psychiatry and Behavioural Neurosciences (Drs. Gary Hasey and Duncan MacCrimmon).

"The computational power available today supports new machine learning methodologies that can help doctors better diagnose and treat illness and disease," said Prof. Reilly. "Large amounts of data can be processed very quickly to identify patterns or predict outcomes. We're looking forward to applying the findings to other areas."

EEG records the brain's electrical activity close to the scalp. Traditionally, it has been used to monitor for epilepsy, and to diagnose coma, encephalopathies, and brain death. EEG is still often used as a first-line method to diagnose tumors, stroke and other focal brain disorders.

"EEG is an inexpensive, non-invasive technique widely available in smaller hospitals and in community laboratories," explains Dr. MacCrimmon. "Also, EEG readings take only 20 to 30 minutes of a patient's time, with no preparation required, so pose minimal inconvenience."

Funding for the research was provided in part by The Magstim Company Ltd., a developer and manufacturer of medical and research devices for the neurological and surgical fields. The company is based in Wales, U.K.

The researchers now plan to test their findings on a larger sample group. They have successfully demonstrated the application of machine learning methods for analyzing EEG signals to predict the response to various treatments available for patients with other psychiatric conditions, specifically major depression. They have also demonstrated the effectiveness of machine learning methods as a diagnostic tool for distinguishing various forms of psychiatric illness. It may also be possible to incorporate a range of other clinical and laboratory data such as personality inventory scores, personal and demographic information and treatment history to improve performance.

Image credit

Sunday, August 1, 2010

A New Kind of First Aid


Monday, September 27th & Tuesday, September 28th!



From the Nova Scotia Department of Health website:
Research shows that at some point in their lives, mental health problems affect one in three Canadians. So the chances are good that each of us knows someone with a mental health problem such as a substance-related disorder, depression, anxiety, or a psychotic disorder.

While thousands of people across the country know how to provide first aid to someone with a physical injury, a lot fewer people are able to recognize the signs of and support someone needing mental health first aid. But that’s changing thanks to a new mental health first aid training program for the general public, being offered coast-to-coast by Mental Health First Aid (MHFA) Canada.

“Mental health first aid is help for a person experiencing a mental health problem or a mental health crisis. Just like physical first aid, the goal is to offer a person immediate assistance until they can receive appropriate professional treatment or until the crisis is over,” says Tony Prime, Instructor MHFA .

MHFA Canada is an interactive course for anyone and no previous mental health experience is necessary. It can benefit teachers, health care professionals, emergency service workers, human resource professionals, employers, managers and supervisors, community groups, and the public.

The 12-hour course provides general information about what is meant by mental health problems and illnesses, how to identify signs of mental health problems in yourself and others, effective interventions and treatments, and how to support an individual and help them find out about and access the professional help they may need.

It also dispels common myths surrounding mental health problems and reduces the stigma around mental illness, since estimates suggest that more than half of people with a mental health problem will never seek treatment.

“The course doesn’t train people to diagnose mental illness or be a therapist or counselor,” says Prime. “It provides the first aider with actions to guide a person in need to appropriate professional help when a problem first arises. We know the sooner a person with a mental health problem gets help, the better their chances of recovery.”

More information about mental health first aid can be found at www.mentalhealthfirstaid.ca.

For more information, contact:

Tony Prime, Instructor
Phone: (902) 424-7235
Email: primets@gov.ns.ca


Schedule

MHFA Canada (12 hours)
Monday & Tuesday, September 27 & 28, 2010
Boardroom 11
Joseph Howe Building
1690 Hollis St., Halifax, Nova Scotia

Adults Interacting With Youth (14 hours)
Monday & Tuesday, October 4 & 5, 2010
Same location as above.

MHFA Canada (12 hours)
Monday & Tuesday, October 25 & 26, 2010
Same location as above.

MHFA Canada (12 hours)
Monday & Tuesday, November 1 & 2, 2010
Same location as above.

MHFA Canada (12 hours)
Tuesday & Wednesday, November 23 & 24, 2010
Same location as above.

Adults Interacting With Youth (14 hours)
Monday & Tuesday, December 6 & 7, 2010
Same location as above.


Registration

Registration Fee:

Mental Health First Aid Canada
Registration fee: $120.00; Nova Scotia Government Employees: $50

Adults Interacting With Youth
Registration Fee: $50

For workshops in your community or workplace:

If room rental and catering for breaks is required and/or travel for instructor the registration will be determined and negotiated with the party requesting the workshop.


Register by phone or email:


Instructor: Tony Prime
Phone: (902) 424-7235
Email: primets@gov.ns.ca


MHFA Canada Instructor Training Course

Mental Health First Aid (MHFA) Canada is an evidence-based training program designed to enable people to recognize the symptoms of a person in mental health crisis and to provide support as a first aider until professional help available.

The next MHFA Canada Instructor Training - Basic (5 Days) in Nova Scotia will be held Monday, April 26, to Friday, April 30, 2010, location TBD.

Youth Instructor Training Course

The next MHFA Canada Instructor Training - Adults Who Interact with Youth in Nova Scotia - will be held Sunday, September 12, to Friday, September 17, 2010, location TBD.