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The Self-Help Connection
SYDNEY — For the past few weeks, Linda Alderson [pictured] has been working long hours to make sure an international conference on mental health goes off without a hitch.
Psychosocial Rehabilitation Canada, a national association of individuals and organizations committed to the provision and growth of psychosocial rehabilitation services to support the recovery of persons with serious mental health issues.
Enhancing Recovery: Community, Culture and Family is the theme of the conference, which takes place from today until Thursday at the Membertou Trade and Convention Centre. Participants from across Canada as well as the United States, Sweden, United Arab Emirates and Singapore are taking part in the conference.
“The conference is not only a wonderful opportunity to network and share information,” says Alderson, “but it also allows people from Cape Breton to attend a high-quality event that features the latest research and advancements in the field.”
The conference is open to Cape Breton District Health Authority staff, anyone with mental illness and their families, community agencies and employers who have staff with mental illness.
Bursaries to help with registration are available for district staff, people with mental illness and/or their families. So far, fundraising efforts have managed to raise enough money to allow more than 30 Cape Bretoners to attend the conference who normally wouldn’t have the resources to pay the $350 needed for the entire registration package.
“We are really good at fundraising,” she says. “We were committed to giving the general public a chance to attend the conference.”
About 250 people are expected to take in the conference, a number which Alderson says reflects well on Cape Bretoners.
“That’s a statement in itself,” she says. “At last year’s conference in Ottawa, they had the same number of participants. Here we are, attracting the same number as in a major centre.”
The first full day of sessions on Tuesday begins with a presentation from Keith Anderson, a local lawyer who will discuss his journey through depression. Louise Bradley, president and CEO of the Mental Health Commission of Canada, will give an update on the commission. Concurrent presentations and workshops will take place throughout the afternoon.
Ambassador Awards will also be given out that day, including one to Alderson herself. Alderson will receive an Ambassador Award for making Cape Breton a leader in psychosocial rehabilitation in Nova Scotia. She is founding member of PSR Canada, past member of PSR Canada’s board of directors and past-president of PSR Nova Scotia. Alderson also currently sits on the PSR policy committee as well as several other committees and boards, locally, provincially and nationally.
“I’m quite humbled to be receiving this award,” she says. “I’ve been in the the mental health field for more than 30 years. My passion is in supporting people to live better and have more fulfilling lives. To receive an award like this is fabulous.”
Dr. John Higenbottam, clinical associate professor in the schizophrenia division of the University of British Columbia, will receive the other Ambassador Award.
The second day of the conference on Wednesday features presentations, concurrent sessions and workshops.
The final day of the conference on Thursday is a half-day session that features Sheila Morrison’s presentation “Lessons I Have Learned — A Mother’s Story.” In her presentation, Morrison will talk about how she helped and encouraged her daughter to move forward following treatment for a difficult psychosis. Jocelyn Greene from St John’s, N.L., will discuss social enterprise and building a community where those with mental illness are included. There will also be a presentation from the First Nations culture perspective.
Conference sponsors are include Addiction Services, Mental Health Services, Department of Psychiatry-Cape Breton District Health Authority, Family Working Group and the Department of Psychiatry-Capital Health/Dalhousie University.
Michael Kimber, a King's College graduate, speaks about his personal experience with mental illness at the King's College media symposium.
Michael Kimber suffers from intense anxiety and isn't afraid to tell anyone. He writes about his experience in a personal, heart-felt and riveting blog and receives thousands of hits daily. Today Michael is still blogging, writing a book, and continuing to attract attention on the impact of stigma and mental health.
Respect and recovery from a mental illness are inextricably linked, said Dr. Frank Shelp, Georgia's Commissioner of Behavioral Health and Developmental Disabilities. Dr. Shelp was addressing the 20th annual conference of the Georgia Mental Health Consumer Network at St. Simons Island, August 2011.
Clarksville, TN – In 2005, Los Angeles Times columnist Steve Lopez [pictured] strikes an unlikely friendship with Nathaniel Ayers, a homeless musician with schizophrenia who slept each night on one of skid row’s most dangerous streets.Photo by Giles Mingasson
The friendship that Lopez formed with Ayers eventually helped the musician get off the street, settle into an apartment and find help for his schizophrenia.
This story since has inspired newspaper columns, a book titled The Soloist and a movie of the same name starring Robert Downey Jr. as Lopez and Jamie Foxx as Ayers.
Lopez will share his discovery of Ayers and how their relationship left a profound impact on the writer’s life at 7:00pm, Thursday, September 29th in the Dunn Center at Austin Peay State University. The talk is free and open to the public. A book signing will follow his talk.
Lopez joined the staff of the Los Angeles Times in May 2001 after four years at Time Inc., where he wrote for Time, Sports Illustrated, Life and Entertainment Weekly.
Prior to Time Inc., Lopez was a columnist at the Philadelphia Inquirer, the San Jose Mercury News and the Oakland Tribune. His work has won numerous national journalism awards for column writing and magazine reporting. In addition to The Soloist, Lopez is the author of three novels.
Lopez’s book and September 29th appearance are part of a reading initiative at APSU called The Peay Read, designed to provide a unifying experience and contribute to the academic experiences for freshmen students. However, the reading program also offers opportunities for sophomore, junior and senior students.
A committee reviewed several books and chose The Soloist as The Peay Read’s common reading book, with homelessness as the theme. Committee members also have worked with other academic departments to plan activities culminating in Lopez’s keynote address, all supporting the current theme of homelessness. For instance, student organizations have been encouraged to plan and implement campus-wide, theme-based programs related to homelessness. In addition, piggy banks have been distributed to all APSU 1000 First-Year Experience classes to raise money for organizations that support Clarksville’s homelessness population.
Other examples of The Peay Read student activities and memorabilia include the following:
- T-shirts with “The Soloist” printed on them and given to freshmen students enrolled in the APSU 1000 First-Year Experience program, which is including the book in its classroom discussions.
- Bookmarks with book quotations, which will be used in student discussion groups focused on those quotations.
- Faculty-student class discussions, including how to help the homeless population and the issues that affect them.
- Student book reviews, with authors of the “best 10” essays invited to a dinner with Lopez.
A mobile app detailing all events and activities associated with The Peay Read has been developed and can be downloaded via Apple’s iTunes.
- A showing of the movie The Soloist.
For more details about this year’s book reading selection or The Peay Read, visit www.apsu.edu/Read/ or visit Peay Read on Facebook.
For more information about Lopez’s upcoming talk, contact Dr. Dixie Dennis, chair of The Peay Read committee at APSU, by telephone at 931.221.7415 or by email at firstname.lastname@example.org.
To the Editor: Many people with schizophrenia exhibit poor insight into and lack of acceptance of their illness (1,2). The absence of objective proof of this disease contributes to this problem. Investigators have been interested in developing a blood-based biomarker test to help identify a biological signature to aid in diagnosis of schizophrenia, particularly in the prodrome of the illness (3,4).
VeriPsych, uses a multiplex immunoassay technology that profiles a proprietary disease signature comprising 51 analytes. The test has been found to be 83% sensitive and specific in distinguishing persons with schizophrenia from those without the disorder; the study in which the test's validity was established included more than 500 patients in the development phase and more than 800 patients in the validation phase (5). However, little has been subsequently published about this test, and its clinical utility remains unclear.
Our treatment team administered the test to a 30-year-old woman with a five-year history of schizophrenia who did not accept the fact that she had schizophrenia and who had problems remaining adherent to antipsychotic medications. The test yielded a positive result for the diagnosis of schizophrenia (score of –9199), with a conditional probability score that indicated a 95% chance of having the illness. After being informed of these results, our patient began to accept that her symptoms could be attributed to schizophrenia. For the first time, she expressed interest in learning about schizophrenia, acknowledged a personal connection to her family history of the disorder, and accepted her need of antipsychotic medications. Her therapeutic alliance with her psychiatrist and treatment team has improved, she has enrolled in a college-level class, and her attitude toward antipsychotic treatment remains positive. Her psychiatrist notes that this remarkable change was the result of her confidence in the blood test results—for the first time she had objective data about her illness.
Improving insight and illness acceptance among patients with schizophrenia has proven to be no small task. Psychoeducation, meta-cognitive training, cognitive therapy, and family intervention aimed at developing an understanding and acceptance of schizophrenia have shown only some success (1). Our interest in the test was not to confirm a clinical diagnosis of schizophrenia but to help a patient with schizophrenia accept her illness. We feel that if this test or future serum tests are more widely utilized, then their use as an aid in helping people who have no illness insight or who lack acceptance of their illness may be an important application. We hope that our letter will bring attention to this new test and encourage further research to replicate and validate our results. We also need to develop a better understanding of the clinical and research uses of this blood-based diagnostic aid and of its potential role and place in the treatment of patients with schizophrenia.
Deanna L. Kelly, Pharm.D., B.C.P.P., Sheryl Thedford, Pharm.D. and Gopal Vyas, D.O.
Dr. Kelly is affiliated with the Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore.
When the test was administered, Dr. Thedford was with the Department of Pharmacy Practice, School of Pharmacy, University of Maryland. She is now with the Bernard J. Dunn School of Pharmacy, Shenandoah University, and the Pharmacy Department, Winchester Medical Center, Winchester, Virginia.
Dr. Vyas is with Spring Grove Hospital Center, Baltimore.
Acknowledgments and disclosures
Rules Based Medicine supplied the VeriPsych test but had no involvement in the use of the test, the results, or publication.
The authors report no competing interests.
- Lysaker PH, Buck KD, Salvatore G, et al: Lack of awareness of illness in schizophrenia: conceptualizations, correlates and treatment approaches. Expert Review of Neurotherapeutics 9:1035–1043, 2009 [CrossRef][Medline]
- Buckley PF, Wirshing DA, Bhushan P, et al: Lack of insight in schizophrenia: impact on treatment adherence. CNS Drugs 21:129–141, 2007 [Medline]
- Schwarz E, Guest PC, Rahmoune H, et al: Identification of a biological signature for schizophrenia in serum. Molecular Psychiatry epub ahead of print PMID , 2011 [Medline]
- Dudley E, Hassler F, Thome J: Profiling for novel protemonics biomarkers in neurodevelopmental disorders. Expert Review of Proteomics 8:127–136, 2011 [CrossRef][Medline]
- Schwarz E, Izmailov R, Spain M, et al: Validation of a blood-based laboratory test to aid in the confirmation of a diagnosis of schizophrenia. Biomarker Insights 5:39–47, 2010 [Medline]
By André Picard (pictured)
Copies of the “confidential” draft of Canada’s highly anticipated mental health strategy are circulating widely among “targeted stakeholders.” So let’s take a look at what’s being offered up.
Canada is the only G8 country without a mental health strategy, so the document – and, more important, the underlying philosophy that we need to make life better for those with psychiatric and psychological illnesses – is long overdue.
After all, one in five Canadians will suffer a bout of mental illness; it is the principal cause of absenteeism and disability, and costs the economy a staggering $51-billion annually.
A strategy is essentially a way of setting priorities, of ensuring that no group is overlooked or neglected, that services are co-ordinated and that voices are heard in the corridors of power.
The Mental Health Commission of Canada, whose role it is to draft and implement the strategy, more or less has its priorities right, as evidenced by its six “strategic directions”:
The commission and the strategy have their genesis in a landmark 2006 Senate report entitled Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada. The 567-page report was thoughtful, reasoned, forward-looking and, sometimes, even bold in describing the shortcomings of mental health treatment, dubbed the orphan of the health system, and in proposing solutions.
- Shift upstream and across sectors. This means emphasize the promotion of mental health (not merely the absence of mental illness), intervene early when people are sick – at school, at work or wherever – and tackle the stigma of mental illness.
- Transform relationships and uphold rights. The draft document emphasizes recovery (most, but not all, people with psychiatric illnesses get better) and the need to get the sick out of the criminal justice system.
- Strengthen capacity in the community. The strategy calls for a shift to community-based care and underscores the importance of housing and income support to aid the recovery of those with mental illnesses.
- Improve equity. Access to mental health services varies markedly across the country and among various age groups (with access to care for children being particularly abysmal), and the gaps need to be closed.
- Seek innovation with first nations, Inuit and Métis. Some communities, such as aboriginals, have specific challenges like sky-high rates of addiction and suicide that need particular attention.
- Mobilize leadership. The strategy calls for a “whole of government” approach, meaning mental health is not strictly a health issue – it affects the workplace, housing, justice and so on. The draft also calls for a strengthening of the mental health infrastructure.
The committee, headed by then-senator Michael Kirby (who now heads the MHCC), made 118 recommendations, most of which find echo in the new document.
But there are some subtle, yet important differences between the tone and content of Out of the Shadows at Last and the draft strategy.
First, the language is more bureaucratic and wishy-washy. Mr. Kirby and his senatorial colleagues were refreshingly blunt on what needed to be done; the anonymous drafters of the strategy are far more circumspect.
Far more troublesome is what you can read between the lines of the proposed strategy. There is far too much emphasis on the “recovery model” – the notion that everyone will get better with support – and not enough emphasis on brain science. It’s a legitimate approach for those with mild and moderate mental health problems but not those with severe conditions such as schizophrenia.
In fact, reading the draft strategy, one is left with an unpleasant aftertaste: the distinct feeling that psychiatry and medications have no place in Canada’s approach to tackling mental illness.
There are distinct – and sometimes clashing – views in the mental health field. But the strategy gives too much credence to social science and not enough to neuroscience.
It also pays far too much attention to the views of “psychiatric survivors” who hide their vehemently anti-treatment views in the promotion of “peer support” and the language of “rights.”
But hope – and false hope – cannot be allowed to take the place of care. Where in the strategy, for example, is the call for investment in brain research, psychiatric beds and more addiction treatment facilities?
The draft also gives short shrift to the sickest of the sick, those with severe (and often intractable) cases of schizophrenia and bipolar disorder, who often suffer from anosognosia (where people don’t even recognize they have a mental illness).
This group, while small (less than 1 per cent of those with mental illness), are those who populate our streets and prisons. They don’t need the right to refuse treatment, they need the right to be well. And their families need to be empowered to help them, not cast aside.
Susan Inman, author of the memoir After her Brain Broke: Helping my Daughter Recover her Sanity, offers up a detailed critique of the strategy’s shortcomings in this regard in her article Suppressing Schizophrenia, published this week by The Tyee.
One of the MHCC’s key goals has been to help create a social movement, one that empowers people living (or having recovered from) mental illness. This is how women with breast cancer, men with prostate cancer and people living with HIV-AIDS have brought their issues to the forefront and made great strides.
But the mental health movement has to learn an important lesson from these other movements: You have to be inclusive, you have to embrace science, you have to be mainstream and you cannot allow those with ulterior motives to set the agenda.
There is a lot of good in Canada’s draft mental health strategy. But it’s not good enough yet.