Mental Health of Canadians

2011-09-05T18:07:00.000-07:00

Is Schizophrenia Suppressed?

The following article, by Susan Inman, was posted on August 29, 2011 in Health Delivery System by: TheTyee.ca – Their opinion follows, that Schizophrenia is invisible in Canada’s new mental health strategy.

"It is hard to imagine that life could get any harder for individuals living with schizophrenia (one per cent of the population) and the families who provide support to them. However, the controversial choices made by the Mental Health Commission of Canada (MHCC), in the latest draft of the new Mental Health Strategy, make it likely that their situations can actually get worse. These choices, which were not apparent in any earlier MHCC documents, are not receiving the public scrutiny that is needed because this draft is not available for the public. This draft, which was shared with a very small number of people, is currently being polished, and the Canadian public will not see it until it is unveiled in early 2012.

Through both what the strategy suggests and what it fails to support, this plan represents decisions that are dangerous to the well being of people with schizophrenia.

None of the MHCC documents have provided even the most basic information about this often misunderstood mental illness. For instance, the public has never learned that 40 to 50 per cent of psychotic people don’t understand that they are ill and so have no reason to ask for or consent to treatment. Nor does any of the educational material promoted by the MHCC in its Mental Health First Aid program mention that 90 per cent of people with schizophrenia who stop taking their medications will have a relapse. A clearer understanding of this neurobiological disorder can help people understand the mental health policies that are most appropriate.

One major problem with the strategy is its approach to legal issues. The new draft strategy promises funds for court challenges to human rights abuses. The public deserves to have open access to this document to find out exactly what the MHCC intends with this action. Since the MHCC has allied itself with groups opposed to involuntary treatment of psychotic people, it is likely that federal funds could be made available to challenge involuntary treatment orders that have been made under various provincial mental health acts. Some human rights activists insist that no one should be treated for psychosis unless they choose this option; however, the notion of choice does not make sense in this context because people experiencing a profound psychosis do not have access to their rational thinking processes. They are not able to act in their own best interest, which is why mentally ill people frequently end up homeless or, increasingly, in prison.

Limits to peer support

Another major problem with the strategy is the decision to turn over more responsibility for providing mental health services to peer support organizations. Opposition to anti-psychotic medications and to psychiatry in general is a major feature of some peer-run programs. People with some kind of mental health problem who self-identify as “consumers” (of mental health services) or as “psychiatric survivors” or as “people with lived experience” have played an active role in shaping the new draft. A common belief among many of these groups is that mental illnesses are not real illnesses, and that the use of diagnostic terms is oppressive. Therefore, it becomes impossible to know if people who claim the right to represent those with schizophrenia have ever actually been diagnosed with and had to learn to live with this disorder themselves.

In reading the literature produced by some of these groups, in hearing people who identify themselves as psychiatric survivors speak, and in having conversations with them, I’m often struck by how many of these people have suffered from terrible parents. Clearly these are people who have endured intense psychological problems and some have been inappropriately prescribed anti-psychotic medications. However, there seems to be an entrenched unwillingness to examine the vast research demonstrating the benefits of medication to countless people who actually do have psychotic disorders.

A brain disorder that is treatable

Anti-psychotic medications have given my daughter back her life. People like her, who understand that they have a treatable brain disorder, are not well represented in the psychiatric survivor movement, which is somehow assumed to have the right to represent their interests. My daughter and her friends depend on their families to ensure that, in case of a relapse, they are not left to flounder in an untreated psychosis. They have a solid, science-based understanding of their disorders and have learned how best to manage them from a perspective that includes this information. This is an approach to mental illness that is antithetical to the beliefs of many of these groups. Perhaps this is the reason the strategy never mentions the necessity of or even the benefits of this kind of science-based education in peer-run programs designed to help people cope with their disorders.

In transferring increasing responsibility for delivering mental health services to these groups, the strategy accepts the rights of these groups to abide by “voluntary standards.” What does this mean? And will these more inexpensively supplied services now be seen as adequate substitutes for the more expensive services of highly skilled clinicians, which remain unavailable to people with schizophrenia?

I completely support the idea that people who have schizophrenia and have learned to manage their disorder can make many valuable contributions to people who are still struggling. I deeply appreciate the work of Vancouver’s Peer Support Program, which is run under the auspices of Vancouver’s mental health services. The program carefully screens applicants and provides a lengthy training period which includes science-based approaches to understanding severe mental illnesses. These mental health workers offer individual support to people struggling to rebuild basic life skills like taking the bus, using services at local community centres and going for coffee. They certainly are never allowed to suggest that people should stop taking their medications. The ideas informing the creation of this program, however, are not the ones with which the MHCC is allying itself.

Besides making decisions that put the basic safety of people with schizophrenia at heightened risk, the strategy ignores their most basic unmet needs. People with schizophrenia lack adequate access to psychiatrists. Canada has too few psychiatrists and many psychiatrists restrict their practices to working with people with less severe illnesses. As well, the decreasing number of acute psychiatric beds means that even people who know they need help are unable to receive it. The MHCC is not actively lobbying for reversing the trend to reduce the number of acute psychiatric beds nor is it advocating for the training of more psychiatrists. The responsibility for caring for people with untreated or inadequately treated schizophrenia will continue to reside with families.

Blaming the families

If the new policies do lead to even more problems with untreated schizophrenia, the MHCC’s new annual report, which is available to the public, provides explanations. The message from the Family Caregivers Advisory Committee, the group that was supposed to, but has failed to, represent family caregivers’ perspectives, maintains that it is the families’ lack of skills with communication and problem solving that leads to problems for people with these severe illnesses. This assertion, based on faulty interpretations of relevant research, completely ignores the deep systemic flaws that lead to the poor outcomes for so many people with schizophrenia. There is robust new research demonstrating that the increasing number of assertive outreach programs in 44 U.S. states, which have the authority to mandate treatment, lead to reduced hospitalization, violence, homelessness and victimization. This kind of widely recognized research should be highlighted by the MHCC in its efforts to educate the public about the policies needed to address severe mental illnesses; instead, it is ignored.

The placing of blame on families makes another choice of the MHCC clearer. Family advocates have been lobbying the MHCC to directly confront the stigma that parents of people with schizophrenia experience and to address the ways this stigma limits them in their ability to be effective caregivers. They expected this would be a logical choice for the MHCC because anti-stigma campaigns have been at the core of their work. However, instead of acknowledging this unjust and unfounded stigma, the MHCC’s new annual report leads the public to assume that an increase in problems can be attributed to the lack of parental skills.

Rather than educating the public about the state of knowledge about the development of schizophrenia, which is related to an interplay of genetic and environmental factors, the environmental factors for which there is credible research are never accurately explained. Current neuroscience research continues to identify environmental factors like perinatal problems, birth complications and head injuries as contributing to the development of schizophrenia. Although the MHCC frequently uses the term “mental illness prevention,” it fails to alert the public to an environmental factor about which there is now significant research; because schizophrenia is linked to mothers who have the flu during pregnancy, women contemplating pregnancy should be actively encouraged to get flu shots.

Needed: Better professional training

Besides deciding not to address the damaging stigma that family caregivers experience, there are other key ways that the MHCC fails to suggest actions that are essential. The MHCC has decided to neither report nor respond to the lack of standards in programs training a variety of mental health professionals. Many programs do not offer or require science-based curriculum on severe mental illnesses. This need for improving the standard of education for all mental health professionals has been at the forefront of campaigns by family advocates in their unsuccessful efforts to influence the direction of the MHCC. Although the MHCC mentions the need for some kind of early intervention programs, the underfunded early psychosis intervention programs that exist in Canada depend on well-educated clinicians to make the necessary referrals. Substantial research demonstrates that early intervention in psychotic disorders leads to better outcomes. This research is not referring to teaching families better problem-solving skills but, rather, ensuring that individuals receive treatment with anti-psychotic medications early on in their development of psychosis.

Improving the education of mental health professionals would also address one of the biggest obstacles that family caregivers confront. Because of out-of-date training, families who try to support ill family members are often blocked by clinicians who blame them for these disorders. Though the MHCC documents mention the marginalizing of family caregivers, the draft does not address the major factor that will continue to produce it. According to Dr. Jon Fleming, the director of Postgraduate Education at UBC’s Department of Psychiatry, programs training psychiatry residents in Canada no longer teach that the development of schizophrenia has any connection to parental behaviour. However, parents still confront psychiatrists educated under earlier, now discounted paradigms. They also must deal with other clinicians trained in programs that have been allowed to avoid educating them about the science-based approach to understanding the development of schizophrenia. The MHCC could have chosen to advocate for up-to-date science-based professional development for all mental health workers; their failure to do so reveals a deep flaw in their vision of the kind of foundation that should inform Canadian mental health practices.

This flawed vision has led to another omission in the strategy and in the other MHCC documents, which is the lack of acknowledgement of the breakthroughs in neuroscience and their potential for shaping mental health policies. Dr. Thomas Insel, the head of the US National Institute of Mental Health (NIMH), the world’s largest research organization devoted to researching mental illnesses, refers to schizophrenia as a brain disorder. Under his leadership, the NIMH, which in previous generations was dominated by Freudian beliefs, now funds vast numbers of research projects leading to better treatments.

Ignoring a promising approach

One of these better treatments being promoted by the NIMH is cognitive rehabilitation programs for people with schizophrenia. Cognitive losses, such as difficulties with concentration, memory, and problem solving, are a common symptom of schizophrenia and the NIMH states that it is these symptoms that cause the greatest amount of disability among people living with this brain disorder.

Despite active lobbying by family caregivers for these programs, the strategy does not acknowledge cognitive losses, promote research on it, or suggest funding the cognitive remediation programs that have already produced promising results. In fact, the MHCC’s Knowledge Exchange Centre has so far refused to become the much-needed repository of information about research on cognitive remediation techniques and about the few Canadian programs that are trying to address this crucial problem. The draft strategy has dozens of references to its promotion of recovery but, disappointingly, the MHCC completely ignores the cognitive problems that constitute one of the biggest obstacles to this recovery for people with schizophrenia.

The ignoring of these neuro-biologically related problems stems from the broader philosophical foundation upon which the MHCC has decided to build its plan for the future of mental health care in Canada. Rather than educating the public about and responding to the problems associated with schizophrenia , the new strategy focuses on improving the level of mental wellness of every Canadian and combating stigma around mental health problems. This approach is predicated on a common assumption in which mental wellness is thought to be determined by various social circumstances and, if adversity caused by racism, sexism, poverty, homophobia, abusive parenting, and other social ills is addressed, then mental health problems and serious mental illnesses will be reduced or disappear. The scientific advances which make these theories not just irrelevant in relation to schizophrenia but actually destructive are ignored. Also ignored is the likelihood that the public’s stigma in relation to schizophrenia will only increase as they have to confront more people with untreated mental illnesses wandering the streets.

Families shut out of strategy

Some academics like Neree St. Amand, a University of Ottawa social work professor and MHCC Family Caregivers Advisory Committee member, believe that schizophrenia is an unnecessary label and that people given this diagnosis should not be led to think that psychiatry or anti-psychotic medications can provide help. His beliefs, and the outrage of actual family caregivers for people with schizophrenia at being represented by him, were well explored last year in the National Post article “Mental Block.”

Although this article led to a meeting of long-time family advocates with MHCC administrators, almost none of the suggestions made by families appear in the new strategy.

In looking over the new strategy, Dr. Bill Honer, the Jack Bell Research chair in schizophrenia at UBC, noted that the word “schizophrenia” never appears. Neither does the word “psychiatry.” For family caregivers who want the public to be better educated about this disorder, these omissions are signs of a dangerous future.

The impact of the MHCC’s lack of strong support for the role of science in understanding and responding to severe mental illnesses can be seen in how it is managing the access or lack of access to relevant information. Although its links site on its website encourages suggestions for useful organizations, the managers of this resource have so far refused to add a link to the National Institute of Mental Health, which supplies the most extensive and up-to-date information on these disorders. However, if confused families of people who have developed schizophrenia look for guidance in this collection of websites and select the first website listed under “Families and Friends,” they are directed to the Family Outreach and Response Program. In this program, developed by an anti-psychiatrist activist, they can learn that although their family member may be experiencing “what the medical community calls ‘the first episode of psychosis,’” families can learn other ways to understand what may be a “spiritual emergency” or “existential crisis.”

The failure of the Mental Health Commission of Canada to thoroughly support a science-based approach for understanding and responding to schizophrenia is not just a disappointment for people who live with this catastrophic illness and their families. Given the enormous financial and social impact of this brain disorder, the positioning of the MHCC in relation to schizophrenia will have negative consequences for the rest of society as well.

Up to half of people with schizophrenia aren’t aware they are ill and can be treated."

Susan Inman’s memoir, After Her Brain Broke, Helping My Daughter Recover Her Sanity, has been recommended by NAMI, which are the largest organizations in the world advocating for family caregivers of people with severe mental illnesses.

< http://thetyee.ca/Opinion/2011/08/29/Review-Mental-Health-Strategy/?utm_source=mondayheadlines&utm_medium=email&utm_campaign=290811 >

Ashley Smith and Stolen Apples

2011-08-04T20:05:00.000-07:00

The following book review shows that behind the well-known injustices many unknowns are languishing in jails and prisons and sadly only the obvious tragedies reach the ears and eyes of the public.
Case in Point: Ashley Smith, who stole some apples...

A review by Tim Pheotist of Dr. Gary Botting’s
WRONGFULLY CONVICTED: A cry from the heart from a victim of our Canadian Justice system

see http://brokensilence91.blogspot.com/2011/04/wrongfully-convicted-cry-from-heart.html

This heart wrenching brief account of David Milgaard's ... experience as a wrongly convicted person brought tears to my eyes. He uses the term "silence" , which is quite common in cases of wrongful conviction. While reading this overview, I felt as if I was reading the writing in my mind. Even though you know you are not guilty of a crime for which you have been charged, you are but one against a sea of very powerful people who can play with your life and the lives of your family...

An essay giving voice to the nightmares that haunt so many innocent people in today’s Canadian prisons.

David Milgaard, who spent 23 years in jail for a murder he did not commit, has written a compelling forward to a recently published book detailing nightmare cases of wrongful conviction in Canada.
“In prison, every horrible second seems to stretch forever,” he wrote. “A third of my expected life [has been] stolen from me forever.”

The essay kicks off Dr. Gary Botting’s Wrongful Conviction in Canadian Law, published by Butterworths LexisNexis, which reviews and cross-references every inquiry into wrongful conviction ever held in Canada. Botting’s legal practice, originally founded in Victoria in 1991, is now based in Vancouver.

Milgaard says he is only one of the many voices of the wrongfully convicted. “Of the hundreds if not thousands of convicted Canadians who have claimed to be innocent over the past half century, only eight of us have ever had our cases reviewed by Commissions of Inquiry,” he said. Six such inquires have been held so far, all within the last 20 years, in half of the ten provinces: Nova Scotia, Ontario, Manitoba, Newfoundland and Saskatchewan.

“Do not believe for a minute that the other five provinces lag far behind. For starters, there’s Ivan Henry in British Columbia – 26 years in jail for multiple crimes he did not commit. His 55 appeals and protests that he had been wrongfully convicted were ignored by the B.C. Court of Appeal for 20-plus years until the Pickton investigation revealed that the real rapist had gone on raping in the same way for years after Henry was put away. What went wrong there, where the police deliberately sat on evidence proving that the crimes were committed by a different person altogether? Surely British Columbians will want to find out?”

Milgaard pointed to cases in the other provinces as well. “Alberta has its wrongful prosecutions of Wilson Nepoose, Jason Dix and Daniel Wood, Quebec has Simon Marshal, New Brunswick has Felix Michaud, and Prince Edward Island has John Cooper. They all sued or negotiated settlements for wrongful conviction. But it was an uphill battle.

“That about covers the whole country!”

Milgaard points out the limitations of the inquiries into wrongful conviction, which so far have been limited to convictions for murder. “All eight of us received life sentences. If we had been wrongfully convicted of crimes with shorter sentences, it would have been much easier to do the time than to fight the system for years and years hoping to be exonerated.

“Which makes me wonder how many thousands of Canadians have been wrongfully convicted of crimes less serious than murder, but finished their sentences in sadness and silence because they knew their cases would never be heard? How many are forced to lick their wounds in private, and get on with their lives in shame, never again believing that justice exists in this country? Would they want to expose themselves to scorn and prejudice for years and years, like the eight of us have had to?”

Canada’s system of justice, says Milgaard, relies on lies. “That’s the advocacy system. Both sides can’t be true, so someone has to be lying. With wrongful convictions, the judge and jury have picked the lies over the truth. As long as the lies stand, the system feels good about itself. So Canada’s system of justice does not let the wrongfully convicted expose the lies.”

He says the Minister of Justice never of his own initiative applies the laws that Parliament has passed – laws designed to protect the innocent. “[The Minister’s] staff is concerned only with setting up roadblocks for years and years in the hope that those claiming that they were wrongfully convicted will get lost – in all senses of the word.”

He said the Minister seems to think that those who claim to be wrongfully convicted will give up their efforts to get exonerated once their sentences end and they have a chance to go home at last to what’s left of their “shattered and probably scattered families.” is set up so that innocent people, once they are convicted, simply cannot get a fair hearing, he said. Every day, inmates who have been wrongfully convicted see “guilty” men and women get out of prison because they have admitted their crimes and come to grips with their criminogenic factors. Meanwhile, inmates who have been wrongfully convicted cannot even get parole, because before the Parole Board will let them out of jail they have to “admit” to a crime they haven’t committed.

“Many innocent prisoners feel they are forced to lie to bring the torment of prison time to an end,” he said. Furthermore, sometimes lawyers advise their wrongfully convicted clients to lie and admit to the crimes they have been charged with to avoid further torment.

“Of course, the lawyers don’t ‘know’ that their clients are innocent, even though they may ‘believe’ it. Some lawyers may characterize that kind of ‘white lie’ as ‘coming clean.’

“What they forget is, a lie is never clean!”

Keeping a person in prison until he is forced to tell a lie by incriminating himself is a form of torture, said Milgaard. With no end in sight, the torment goes on forever: the person never knows when he can expect to be released.

“But when the lie ‘Yes, I did it!’ has been uttered, the whole system of justice, from police to judges, can give a big sigh of relief and say, ‘We knew it!’

“The reward held out to me if I chose to lie? Freedom! The punishment for my being innocent and honest and sticking to my principles and not lying? Almost 23 years of prison time!”

Some innocent prisoners cave in to the system and say they did the crime so that they can get out a few years earlier. But once they have admitted to doing the crime, there’s no turning back “This situation is very, very wrong,” he said. “But that’s the kind of justice and penal system we have in Canada.”

The cases to which he alluded in the foreword to Botting’s book are now well known. In Ontario, Romeo Phillion confessed to a murder in 1972, then within 24 hours tried to retract his false confession – given because he wanted to show the police that he was willing to be cooperative. But nobody would listen. Thirty-five years later, it became clear that he had an iron-clad alibi all along, and was innocent of murder.

More than half a century ago, when he was fourteen, Steven Truscott received the death penalty for the rape and murder of 12-year-old Lynn Harper. “You shall be hanged by the neck until you are dead,” he was told in 1959. Authorities commuted his death sentence to a life sentence, and let him out on parole after ten years, but as far is Milgaard is concerned, this was simply “a cheap way to ease their guilt. As in my case, nobody would listen to him, not the Court of Appeal, not even the Supreme Court of Canada.”

Told by a judge looking into the matter in 2007 that Steven Truscott had likely suffered a miscarriage of justice, the Minister of Justice referred the Truscott case back to the Ontario Court of Appeal, who, while not going so far as to finding him factually innocent, left the Crown without enough evidence to proceed to a new trial.

“But justice delayed is justice denied,” said Milgaard. “To my mind, it was wrong of the Ontario Court of Appeal to say they couldn’t find Steven ‘factually innocent.’ Put it all together and do the math, with the blowfly and flesh fly evidence and everything, all multiplied out with the help of someone who knows statistics, and the chances of Steve being guilty are way less than one tenth of one percent – not much different from DNA evidence.

“Seems to me the Ontario Court of Appeal didn’t do the math!”

He said the government and the justice system never admit they are wrong even when they know they can’t be right. Only when the injustice becomes obvious do commissions of inquiry get set up – in his case, 35 years after his conviction for a rape-murder that he had nothing at all to do with. The DNA evidence eventually showed that the murder was committed by a serial rapist, Larry Fisher.

“Fisher sat on his hands for 23 years, knowing that I sat in prison all that time for his crime.”

In Canada, anyone charged with a crime is innocent until proven guilty beyond a reasonable doubt. But as David Milgaard soon found out, once a person is convicted, that’s the end of it: he is considered guilty, period. In order to get out of prison without lying to the Parole Board, as the system requires, he said, the person has to prove his innocence beyond a reasonable doubt – which is next to impossible to do from prison.

“I was lucky enough to have a mother who believed in me. She worked hard for more than twenty years to convince people of the truth: that I was innocent. But it didn’t help that the Crown Counsel on my case was so blinded by his own tunnel vision that he spent the first ten of those years, at government expense, trying to undermine everything my mother did at her own expense. He told the Parole Board time and again that I was dangerous, at risk to “reoffend” – even though I had never offended in the first place!

“If that isn’t offensive I don’t know what is!

“How could the Parole Board let that Crown counsel say the same old thing over and over and over, year after year, like a parrot? Worse, how could it listen, and give his recycled opinions any stock?”

The law needs to be changed, he said, so that prosecutors can’t continue to prosecute their cases years after the trial with the same old wrong evidence. “Allowing that to happen brings the whole system of justice into disrepute.”

Milgaard said that he wanted to impress upon readers these four central points, drawn from personal experience:
1. It is horrible to spend time in prison for a crime you did not commit. Think of it: prison sentences are the worst punishment Canada has been able to come up with for the worst criminals committing the worst crimes. In the case of someone serving time in prison for something he or she did not do, the “punishment” is torture.

2. Fighting the Canadian Government for compensation long after being released from prison after exoneration feels like being in prison all over again. I was fighting for myself and for my family for years all over again. How would you feel? It was a long, long struggle, and it was degrading. I strongly recommend the government to make monies available to any man or woman struggling to prove they are innocent.

3. Seeking justice in cases of wrongful conviction and bringing cases such as mine to everyone’s attention is costly in terms of time and money, especially since Justice Canada, along with prosecutors and the police, drag their feet and dig in.

4. Justice delayed is justice denied. Canada’s system of investigating and reviewing miscarriages of justice is way too slow. We need a system where an independent Board that is not part of the criminal justice system or the government looks at all cases where anyone claims he has been wrongful convicted. When this Board finds that the person is innocent, the government should quickly free them and give them compensation.

David Milgaard concludes his essay by singing the praises of Wrongful Conviction in Canadian Law and its author. In the book, Dr. Botting looks at the seven different commissions of inquiry that have been held in Canada so far, to determine what they recommended and whether their recommendations have been followed or ignored. One inquiry in Newfoundland heard three cases at once, and the Gouge Inquiry uncovered several more cases of wrongful conviction in Ontario.

“For years Gary Botting has tirelessly devoted his time and his personal resources to the cause of the wrongfully convicted,” Milgaard said.

“Hopefully this book will allow the police and pathologists and prosecutors and lawyers and judges and governments to cross-reference the recommendations easily so they don’t repeat their mistakes of the past. And maybe it will help other wrongfully convicted people like me to see that they are not alone, and should continue fighting to be heard.”

Ashley Smith's Inquest: It's Our Call

2011-08-04T19:03:00.000-07:00

As reported in The Vancouver Sun July 19, 2011

"Two doctors were cleared of wrongdoing in relation to the care they provided Ashley Smith while she was incarcerated, the Ontario Health Professions Appeal and Review Board concluded in a recent decision.

"However, the review is critical of the treatment Smith received before her eventual death in an Ontario prison.

"From our perspective, it is difficult to understand how the resources of Correctional Services Canada and the numerous health professionals who were involved with (Smith), particularly within the last year of her life, could not have somehow appropriately treated her admittedly severe behavioural problems," the review, dated July 15, states.

"The review was brought to the board by the Elizabeth Fry Societies, on behalf of Smith's family, to appeal an earlier decision by the College of Physicians and Surgeons of Ontario that had previously cleared two physicians of any wrongdoing in their assessment of Smith while she was in prison.

"One of the physicians was a family doctor conducting weekly consultations at the Grand Valley Institute for Women, while the other was a psychiatrist who made similar weekly visits to the prison.

"The Smith family's original complaint wanted to ascertain why Smith was not referred to a psychiatric facility in the days leading up to her death and whether it was a result of inadequate care from one, or both, of the physicians.

"The College of Physicians decided to take no action against the two doctors. The Smith family requested the Appeal and Review Board go over that decision because they were "not satisfied" with the ruling.

"We have concluded that the (College of Physicians) did conduct an adequate investigation and its decision was reasonable," the review board concluded.

"Smith died at age 19 in 2007 after tying a ligature around her neck in a Kitchener, Ont., cell as prison guards watched. In the final 11 months of her life she was transferred to various prisons 17 times because of bad behaviour, overcrowding and staff fatigue.

Reported by
rhiltz@postmedia.com
Twitter.com/robert_hiltz

Results from assorted inquiries and inquests gather dust on desks across the country. Don't expect government agencies to improve their treatment of youth, indeed anyone, sent to jail but urgently in need of medical and spiritual attention. What can you and I do?

The following can be found at http://smithforensic.blogspot.com/2011/06/ashley-smith-beleaguered-inquest.html

BACKGROUND: Ashley Smith, 19, died in her prison cell at Grand Valley Institution near Kitchener, Ont., in October 2007 from self-strangulation. She had been transferred between federal institutions 17 times during her final 11 months, most of that time kept in segregation and often on suicide watch dressed in a highly restrictive gown. Jailed at age 13 for a crab apple-throwing incident in New Brunswick, Smith was eventually transferred to an adult facility after she kept getting into trouble behind bars by constantly kicking, grabbing and spitting at guards. Lawyer's for her family and the media have been fighting Coroner Dr. Bonita Porter's efforts to limit the scope and evidence to be called at the inquest which had been placed on hold. The inquest is of interest to this Blog because it relates to the openness of public death investigations - and the necessity to ensure that deaths warranting inquests get full scrutiny.

"The Ashley Smith inquest has a new coroner at the helm," the National Post story by Christie Blatchford published June 30, 2011, under the heading, "Coroner replaced in prison death inquest: Oral arguments presented to coroner Bonita Porter will now have to be repeated, Smith's lawyer says," see http://www.nationalpost.com/news/Coroner+replaced+prison+death+inquest/5027238/story.html

"Dr. Bonita Porter, who had presided over the oft-delayed and troubled inquest into the strangulation prison death of the mentally ill teenager, has been replaced by Dr. John Carlisle," the story continues.

"The Ontario government made the announcement in a brief press release Wednesday.

The announcement pointed to Dr. Porter's pending retirement this fall as the reason for the abrupt move.

Due to the expected length of the inquest, "Dr. Porter, who is scheduled to retire in November, would have been unable to complete the inquest when it resumes in the fall," the release said.

But a line in the announcement hints at another significant reason for the mid-race switch to a new horse -Dr. Carlisle is not only a medical doctor, but also a lawyer and veteran law professor.

If ever an inquest illustrated the need to have a lawyer or judge in the driver's seat, as some other provinces do, it was this one.

Dr. Porter had formally granted "standing" to about a dozen groups and individuals -meaning these parties are entitled to cross-examine witnesses -some of them represented by some of the fiercest advocates in the Ontario bar.

Almost daily, she faced procedural and evidentiary challenges from these lawyers, and from those representing the press, and was often clearly out of her depth.

Several times, lawyers appealed one or another of her decisions to the Ontario Divisional Court, most famously when Dr. Porter ruled that prison videos, showing Ms. Smith being forcibly injected with anti-psychotics and subjected to other harsh treatment at Quebec's Joliette Institution, weren't relevant to her state of mind.

Ms. Smith, then 19, strangled herself with a ligature in her cell at Kitchener's Grand Valley Institute for Women on Oct. 19, 2007, about three months after she had been repeatedly strapped to a stretcher and drugged at Joliette.

Last month, the court called Dr. Porter's decision not to seize the videos confusing, overturned her and told her to re-think the matter.

Neither did it appear Dr. Porter was getting particularly good advice from her own legal team, made up of three lawyers from the provincial attorney-general and a fourth who appeared occasionally to argue particular issues.

If originally coroner's inquests were medical investigations into a death, the high profile ones, particularly those involving matters that have captured the public's attention, have long since morphed into contests that are much more legal in nature than medical.

Dr. Porter adjourned the inquest late last month, and about a week ago, with her key decision about the Joliette videos and two others still pending, announced the proceeding would resume in September.

She promised at that time to deliver her rulings -critical to the scope and openness of the inquest -this week.

Instead, Dr. Carlisle will now "review and decide" on these issues.

Before joining the coroner's office in 2004, Dr. Carlisle served as a medical officer with the College of Physicians and Surgeons of Ontario and as a professor at York University, where he taught a course in law and medicine for more than 25 years. These credentials appear to make him almost uniquely well-qualified to steer the inquest back on the right course.

When the proceeding adjourned last month, the five member jury had heard only part of the evidence from only one witness.

Julian Falconer, lawyer for Ms. Smith's family, was furious at the announcement, calling the inquest "a colossal waste, a mess."

He said he and other lawyers have "wasted weeks and weeks" of oral argument on the three motions that were before Dr. Porter, and pointed out that now these will have to be reargued because Dr. Carlisle has heard none of what they have to say.

"It begs the question of what's going on at that office," Mr. Falconer snapped. "And remember what this delay does to the family."

Ms. Smith, originally sent to a youth facility in her home province of New Brunswick for throwing crabapples at a mailman, ended up spending most of the last three years of her life in isolation, or segregation, units of youth and adult facilities, provincial and federal prisons, and several hospitals.

She was transferred among these various facilities no fewer than 17 times in less than a year, once being strapped to her airplane seat in the process."

Read more:
http://www.citytv.com/toronto/citynews/news/local/article/144181--coroner-change-could-imperil-ashley-smith-inquest-family-says

http://www.canada.com/Difficult+understand+reasons+prison+death+Review+board/5127206/story.html#ixzz1U74tqPF5

Scott Simmie's story

2009-10-12T06:28:00.000-07:00

Read his book, The Last Taboo, written with Julia Nunes

Ministering to mentally ill difficult for many churches

2009-10-12T06:19:00.001-07:00

Ministering to mentally ill difficult for many churches

Shared via AddThis

Re: Clinical Pastoral Education .... Did You Know?

2009-07-02T10:04:00.000-07:00

... that certain types of mental illness could be understood as attempts to solve problems of the soul, and that some patients can find a cure in the power of religion?
At least according to Anton Theophilus Boisen, who lived from 1876 to 1965. His ideas served as the foundation of modern clinical pastoral education. Considering much current education and practice, one might enquire whether the edifice of counsel is off its Rock.

Boisen may have been quite right, but I prefer to defer to the power of God in the person of Jesus of Nazareth. I know ... that all things ... including incoherent speech, waking nightmares, seven months in a psychiatric hospital and eighteen months in rehab ... all things, work for good to those who Love God, to those who are called according to His purpose, mysterious though it may be!

The Church and 'The Mentally Ill'

2009-05-09T09:34:00.002-07:00

The following article by Peter Andres, written on Aug. 9th, 2007, can be found at
http://www.canadianchristianity.com/christianliving/070809ill.html

CHURCH RESPONSE TO THE MENTALLY ILL

'Are people of faith with a mental illness different from those who have a physical illness? Much about mental illness still remains a mystery. That's one of the reasons people are tempted to spiritualize the problem. They hope that the person with mental illness would be able to gain spiritual strength and thus gain victory over the illness.

What remains hard for many to understand is that having a mental illness and being a strong person of faith is no different than having a serious physical illness and being a strong person of faith.

How can church leaders encourage support of people with a mental illness? What does a person with a mental illness need to help him or her feel accepted and part of the congregation? How does the Christian message and experience take on meaning under these circumstances? What exactly is mental illness, anyway?

Marja Bergen, in her book 'Riding the Roller Coaster' (Northstone, 1999), describes her experiences living with bipolar disorder. She talks about the many important factors that helped make her life with this illness tolerable and manageable. Having a supportive husband, friends, and service systems were critical, but she also acknowledges the importance of a spiritual home.

Her church friends learned to understand her illness and provided spiritual nurture, especially during difficult times. She speaks about friendships which include a common belief as being the most valuable ones she'll have. But she also admits that she was fortunate in this regard.

Sadly, many people with mental illness who look for spiritual help during difficult times face ignorance, stigma, avoidance, and judgment. The spiritual counsel and prayer these people receive frankly do more harm than good.

Understanding mental illness, even from the professional, scientific perspective, is still very much a work in progress. Schizophrenia and its related disorders, bipolar disorder (also known as manic depression), major depression, panic and obsessive-compulsive disorders, are all considered mental illnesses. It is estimated that between 15 percent to 20 percent of North Americans will, at some time in their lives, experience a mental illness. Most of these will suffer debilitating depression.

Evidence suggests there are probably organic (biochemical) reasons for the illness, or psycho-social origins -- or a combination of the two. Treatments that deal with the symptoms include medications, psychotherapy or a blend of both.

What is clear to people working in the field is that the experience of the illness goes far beyond living with the symptoms. While a person who has a physical illness -- even cancer -- suffers discomfort and anxiety related to the illness, those who have a mental illness suffer from a constellation of additional issues. These all affect their ability to return to wellness. One of them is stigma, both internally and externally imposed. There's also the loss of self-worth and self-efficacy that might come with a loss of job, friends, marriage and the feelings of being separated from God.

How can the church assist someone in a situation as devastating as this?

1. Church leaders and church members need to know that a mental illness is not the same as a spiritual crisis. Nor is the absence of healing, especially after fervent prayer, a sign of judgment or lack of faith.

2. There should be no judgment about the use of mood altering medications. Medications are commonly needed to treat the bio-chemical causes for the disorder and radically help many keep their symptoms under control.

3. Quality of life for a person suffering from mental illness does not depend on a complete remission from the illness.

What church members need to know is that many experience a recovery which allows them to return to an active and fulfilling life -- but still continue to experience times that are difficult. Recovery from mental illness means: the return of a positive sense of self, usually through meaningful endeavour (work, vocation), a circle of meaningful relationships, a place to live that the person can call his or her own, and a spiritual life that feels a reconnection with God.

The recovering person can be experiencing personal brokenness and limitations, yet have valuable gifts to offer to the church community.'

Peter Andres is a regional director for MCC Supportive Care Services, a non-profit charitable organization which supports people with disabilities -- including people with mental health issues. He can be contacted at peter@mccscs.com.

On Mental Illness, Christian Education and Leadership

2009-04-22T18:42:00.000-07:00

Why does mental illness, and even suicide, afflict Christian families?

Have deficiencies in theological study and application contributed to the prevalence of mental illness among Canadians?

Anton T. Boison discussed his own psychotic breaks and suggested that they represented efforts to reintegrate his personality. He developed an empirical theology which sought to study the patient, his symptoms and the healing process. He became one of the founders of clinical pastoral education. This field has largely been taken over by secular psychologies which allow the patient to become a subject for experimental testing of theory. Pastoral theology has thus been transformed from the divine cure of souls into the pseudo-Christian effort to correct human flaws by human techniques.

Arno Gruen describes the folly of so-called normal behaviour when it is shown to be counter-productive. (see his book, 'The Insanity of Normality') Benoit Mandelbrot, the father of fractal geometry, has been pointing out, for several years, inaccuracies in the financial formulae used to predict market behaviour. Could there be similar errors in the spiritual formulae which our churches develop to meet their 'objectives'?

True leaders cultivate the ability to foresee events and potential circumstances. Robert Greenleaf claimed that it was actually "necessary (for a good leader) to live a sort of schizoid life, always at two levels of consciousness, both in the real world -- concerned, responsible, effective, value oriented and also above it, seeing the actual reality, being deeply involved in daily events, but having the perspective of a long sweep of history and looking to, and planning for, the indefinite future".

The schizophrenic features of our churches, and our various denominational divisions, are hardly conducive to good mental health in a society in which many families are split among different, often antagonistic, churches.

For those of us whose churches are more formal, we have an "inherited attitude toward the liturgical act (which) reflects a kind of schizoid state. We hear but do not really hear. The liturgy is an encapsulated experience, entered into in isolation from real human experiences. It does not connect with the real world because it has been shaped by a piety which is often consciously an escape from the pressures of the real world. Liturgical time is seen as ‘holy time’ working according to its own laws, and feeding our hunger and thirst for God. But it does not connect for the great majority of our people with the real choices of daily life." - from 'Sacraments and Liturgy: The Outward Signs', by Louis Weil.

Education involves much more than filling students with facts and theories. It is an attempt to lead out of darkness and ignorance into light and wisdom, an attempt to develop competence and ability in the area of study. In short, good leaders show the way as well as talk about it. Real teachers lead and real leaders are good at teaching.

But, do our schools value this reality based approach?

for more see http://globalchristianangst.blogspot.com

Discrimination and stigma plague Canadians with schizophrenia

2009-04-06T18:11:00.000-07:00

Evidence straight from those who know!
Would you wait 18 weeks to have a broken leg treated?

According to a national report released in Winnipeg, Manitoba, on March 30/09, by the Schizophrenia Societies across Canada, 60% of Canadians assume that people living with schizophrenia are likely to act violently toward others.

Schizophrenia in Canada: A National Report calls on Canadians, health care professionals and government to support a National Mental Health Strategy that addresses the disparities and inequities faced daily by those living with schizophrenia and their family members.

The report describes different factors affecting those with
schizophrenia, such as public perceptions and discrimination, quality of life, access to health care services, access to medications, wait times and government spending on mental health. These are key factors that illustrate the standard of schizophrenia care in Canada.

"While 92% of Canadians surveyed have heard of schizophrenia, most do not understand what it is or its symptoms. In fact, the majority confuse it with split personality disorder," said Chris Summerville, CEO, Schizophrenia Society of Canada. "Misconceptions such as these lead to negative stereotyping and stigma towards people living with schizophrenia."

The report examines how stigma negatively impacts the lives of people living with schizophrenia. Stigma causes gradual social isolation, making it harder for them to seek the help and treatment they need to manage their illness.

The report found that people with schizophrenia also experienced discrimination within the Canadian health care system. Schizophrenia in Canada calls highlights the findings of a 2008 report by the Fraser Institute on hospital waiting times, in which, physicians were asked to provide a reasonable wait time to receive various medical treatments. On average patients are waiting over six weeks longer for psychiatric treatment than is deemed reasonable. (Source: Fraser Institute, Waiting Your Turn: Hospital Waiting Lists in Canada, 2008 Report)

"It is simply unacceptable that people living with schizophrenia wait an average of 18.6 weeks from referral to receiving treatment for psychiatric care," said Mr. Summerville. "Mental health must be considered a top priority in the national and provincial wait time strategies."

The research for Schizophrenia in Canada: A National Report was conducted by Léger Marketing and supported through an unrestricted educational grant from Pfizer Canada Inc.

******************************************************************

The Schizophrenia Society of Canada began in 1979 and is dedicated to improving the quality of life for those affected by schizophrenia and psychosis through education, support programs, public policy and research. The Society works with 10 provincial societies in a federation model to: raise awareness and educate the public in order to reduce stigma and discrimination; support families and individuals; advocate for legislative change; and support research through the SSC Foundation and other independent efforts. All the Societies are united through each organization's efforts and share a common goal to raise awareness and educate the public in order to reduce stigma and discrimination.

For further information: or to book an interview with Chris Summerville, CEO, Schizophrenia Society of Canada, please contact:
Jennifer Gordon, Thornley Fallis Communications,
(416) 515-7517 x 348, gordon@thornleyfallis.com;
or
Marissa Lukaitis, Thornley Fallis Communications,
(416) 515-7517 x 324, lukaitis@thornleyfallis.com

Are You a Schizophrenic Christian?

2009-04-04T11:55:00.000-07:00

If so, you're in good company. The prophets of Israel often showed schizoid tendencies.

Hopefully your condition is under the control of the Holy Spirit by whatever means the Lord has given that works for you.

Click on the title above to read an article by Gary DeMar which critiques a less than healthy theology which advocates care for creation and then presumes to suggest that The Lord's imminent return excuses us from strenuous activity in the realms of social and ecological justice.

JESUS is both our Salvation and our Judge,
and HE is NOT schizophrenic.

Housing... At Last...A Start...

2009-03-29T09:09:00.000-07:00

Good to see this. May it spread across the country!
Too bad the Mennonites are the only Christian church with a national working policy on the creation of affordable housing.

On Dental Health, yes dental...

2009-03-25T18:45:00.000-07:00

His ashes don't lie
Within a couple of weeks of complaining about aching teeth, Ali Mohammed was dead

By MARK BONOKOSKI

From Toronto Sun: 22nd March 2009

One of Toronto's working poor -- homeless in his final moments -- died the other day at St. Michael's hospital, unnoticed by a greater world around him.

It was word of mouth that told of Ali Mohammed's passing, about how he could not be stirred from his cot at the Gateway hostel on Lower Jarvis St., and how staff members there did their best to keep him alive until the ambulance arrived for the short run to the emergency ward at St. Mike's.

Once there, doctors purportedly pumped him full of antibiotics to stem the poison emanating from obviously infected teeth and gums, even though he had gone three times to a walk-in dental clinic, and had at least one tooth extracted.

He hadn't been able to eat for days on end, so severe was his pain once the infection set in. As one friend said: "They got his heart going a couple of times at St. Mike's, but they could not keep him alive."

No obit appeared in any newspaper.

The coroner's office, which ruled that Ali Mohammed's death was from a heart attack, saw to his cremation.

He was 56.

As best that can be determined, Ali Mohammed's provincially funded cremation was the first time he has ever cost the taxpayer a dime, since there are no records that he ever took a dollar in welfare -- under any name.

For the 20 years he had been in this country -- arriving here as Addison James Soodeen, but living as Ali Mohammed, a nickname given to him by friends -- he had worked piecemeal as a handyman and contractor to learn the basics: Laying floors, putting up dry wall, painting interiors and exteriors, and even doing a little plumbing.

He lived, most of his life here, with friends -- ending up at Gateway when he tired of feeling beholding.

"He did good work. He was trustworthy. He was loyal," said Sam Sundar-Singh, an employee at the Scott Mission who only knew him a matter of months, and who employed Ali Mohammed to work on a house renovation.

"He was genuine -- gentle and kind is the way I have always described him," he said.

"Anyone who knew him would agree."

The Gateway, where Ali Mohammed lived for a little over a month, held a memorial service in its chapel a week ago Thursday and then ensured that his ashes will soon make their way home to a sister living in Trinidad.

Some 20 people attended that memorial. There was prayer, there were songs, and there was testimony from people who had met Ali Mohammed along the way.

"The Lord is my shepherd, I shall not want ..."

The executive director at the community health centre where Ali Mohammed was treated at its dental clinic was out of the province when the clinic was visited, but a director indicated that privacy laws negated the discussion of specific cases.

"No one is going to talk to you about specifics at the dental clinic," she said, stating that it would be best to call a dental office, or a community doctor, if one wanted to talk hypotheticals.

So we called Dr. Gary Bloch, who works out of St. Mike's and is a director for the Inner City Health Association, a group that helps fund doctors to deal with the homeless in 30 sites across the city -- from hostels, to drop-in centres, to makeshift walk-in clinics.

According to Bloch, some 60% of the homeless who come through his association's doors do not have a valid health insurance number -- meaning antibiotics would not be covered in any clinic other than a community health centre.

"And then antibiotics are not always considered necessary," he said, indicating, however, that unhealthy teeth and gums are the door openers to other health problems.

According to a study by a major U.S. dental school -- a probe of 18 years of medical histories involving almost 12,000 people -- people with infected teeth and diseased gums are twice as likely to die from a heart attack and three times as likely to die from a stroke.

"For low-income people, and for people like the homeless, the only dental coverage is for extractions," said Bloch. "And that's a huge problem because there is no coverage whatsoever for prevention -- like teeth cleaning.

"As a result, I've seen some pretty horrific looking mouths among the homeless."

According to Dion Oxford, director of the Gateway, Ali Mohammed returned three times to the dental clinic complaining about the pain and, each time, was given nothing more than Tylenol tablets, over-the-counter painkillers that require no prescription.

But not antibiotics?

"To get those, Ali found himself having to go to St. Mike's, and getting them there," said Oxford. "But he didn't get them at the dental clinic."

The exact time frame between Ali Mohammed's last trip to the dental clinic, his visit to St. Mike's to finally get some antibiotics, and the time he was found unresponsive in his bed at the Gateway is somewhat uncertain.

But, within a matter of a couple of weeks of his first complaint about his aching teeth, he was dead.

This is undeniable.

His ashes, in a cardboard box, do not lie.

MARK.BONOKOSKI@SUNMEDIA.CA OR 416-947-2445

A Story Shared

2009-03-25T18:29:00.000-07:00

John Stokdijk, Chief Financial Officer of the Mental Health Commission of Canada, tells his story. To read, click on the above title.

Canadian Mental Health Association urges governments to develop more appropriate solutions for the mentally ill housed in today's prisons

2009-03-09T13:48:00.000-07:00

see http://www.newswire.ca/en/releases/archive/March2009/09/c6738.html

Migraines linked to mental disorders

2009-01-26T19:01:00.000-08:00

Interesting! Click the following for the article.

http://www.news-medical.net/?id=45200

Hitting Where It Hurts: Schizophrenia linked to Alzheimer's Disease

2009-01-16T23:57:00.000-08:00

The following articles have special meaning for me considering that my father spent the last ten years of his life with Alzheimer's disease and I spent most of my twenties dealing with schizophrenia.

CHARLIE FIDELMAN, in The Montreal Gazette, of January 6, 2009 reports of a study warning that Dementia could become epidemic, and that Alzheimer's patients are getting younger.

The Alzheimer Society of Canada is warning that the number of Canadians living with Alzheimer's disease or dementia is expected to swell to epidemic proportions within a generation.

About half a million Canadians - 119,700 of them Quebecers - are affected. The new study, made public yesterday, predicts that within 25 years, the number of cases of Alzheimer's or a related dementia will more than double, ranging between one million and 1.3 million people.

Researchers stress that the findings, presented in a report called Rising Tide: The Impact of Dementia on Canadian Society, should be a clear signal that more effective treatment and preparation is needed in order to avoid a meltdown within the Canadian health care system. The initial findings report the first new prevalence data since the 1991 Canadian Study on Health and Aging.

"These new data only reinforce the fact that Alzheimer's disease and related dementias are a rising concern in this country, an epidemic that has the potential to overwhelm the Canadian health-care system," Ray Congdon of the Alzheimer Society said in a statement.

The most common form of dementia, Alzheimer's, affects one in 11 Canadians over 65. A degenerative disease that slowly destroys memory, reasoning and orientation, Alzheimer's affects how people think, remember and communicate.

But Alzheimer's is not just a disease of the elderly.

The new data suggest an increasing number of baby boomers are also being struck. About 71,000 Canadians under the age of 65 are living with Alzheimer's disease or a related dementia. Approximately 50,000 are 59 or younger. In Quebec, more than 17,140 are under age 65.

"It's urgent we come up with better treatment or there will be an epidemic," said cognitive neurologist Howard Chertkow, a McGill University professor and director of the Bloomfield Centre for Research in Aging at the Jewish General Hospital.

The rising number of cases is no hype, Chertkow said, which explains the push to get the topic on the front burner.

Research suggests Alzheimer's begins about 20 years before symptoms appear, Chertkow said. But despite better awareness and detection tools, there's still a gap between the number of people who are affected by dementia and the number that show up at clinics for evaluation and treatment, he said.

"Some people think it's normal for Grandpa to become senile and lose his memory. So why take a person like that to the doctor?"

There is no cure, but researchers have made progress in understanding the disease, its causes, what makes people susceptible and how it can be prevented.

The report set out to evaluate the economic impact the increasing incidence of the disease will have on the economy. That analysis will be made public when the full report is issued this year.

A provincial working group developing strategies on dementia is expected to complete its report next month.

Dementia causes cognitive impairment, resulting in the loss of memory, attention and reason.

According to en.wikipedia.org, higher mental functions are affected first in the process. Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are or others around them). Symptoms of dementia can be classified as either reversible or irreversible, depending upon the etiology of the disease. Less than 10 percent of cases of dementia are due to causes which may presently be reversed with treatment.

******************************************

Alzheimer's/Schizophrenia Link Discovered

ScienceDaily (May 9, 2008) — Neuroscientists at Johns Hopkins have discovered that mice lacking an enzyme that contributes to Alzheimer disease exhibit a number of schizophrenia-like behaviors. The finding raises the possibility that this enzyme may participate in the development of schizophrenia and related psychiatric disorders and therefore may provide a new target for developing therapies.

The BACE1 enzyme, for beta-site amyloid precursor protein cleaving enzyme, generates the amyloid proteins that lead to Alzheimer's disease. The research team years ago suspected that removing BACE1 might prevent Alzheimer.

"We knew at the time that in addition to amyloid precursor protein, BACE1 interacts with other proteins but we didn't know how those interactions might affect behavior," says Alena Savonenko, M.D., Ph.D., an assistant professor in neuropathology at Hopkins.

Reporting in the Proceedings of the National Academies of Sciences, the research team describes how mice lacking the BACE1 enzyme show deficits in social recognition among other behaviors classically linked to schizophrenia.

A normal mouse, when introduced to another mouse, shows a lot of interest the first time they meet. If the mice are separated then reintroduced, their interest drops because they remember having met before, a phenomenon the researchers call habituation. If they then introduce a completely different mouse, interest piques again at the newbie.

The researchers introduced mice lacking BACE1 to another mouse. The first time they met, the BACE1 mouse showed interest, the second time meeting the same mouse the BACE1 mouse showed less interest and even less interest the third time. The researchers then introduced the BACE1 mouse to a totally different mouse of a different strain and the BACE1 mouse showed no interest at all. "These mice were totally disinterested, normal mice just don't behave like this," says Savonenko.

Additionally, the researchers found that these BACE1-lacking mice also displayed many other schizophrenia-like traits. Most importantly, according to Savonenko, some of the deficits improved after treatment with the antipsychotic drug clozapine.

Because schizophrenia is a disorder likely caused by many different factors, Savonenko explains that BACE1 might contribute to an increased risk of schizophrenia in certain patients and the BACE1 mice will be a useful animal model. "We never thought we would see one mouse that closely mimics so many of the clinical features of schizophrenia," says Alena Savonenko, M.D., Ph.D., an assistant professor of neuropathology at Hopkins. "This could be a really useful model to study and understand the molecular contributions to the disease."

The research was funded by the National Institutes of Health, the National Institute on Aging, the Alzheimer's Association, the Adler Foundation, the Ilanna Starr Scholar Fund and the Bristol-Myers Squibb Foundation.

Authors on the paper are Savonenko, T. Melnikova, F. Laird, K.-A. Stewart, D. Price and P. Wong, all of Hopkins.

On Clergy and Mental Illness

2009-01-16T21:00:00.000-08:00

Mental Illness Often Dismissed By Local Church
see http://www.baylormag.com/story.php?story=006239

Has this happened to you?

With research consistently showing that clergy–not psychologists or other mental health experts–are the most common source of help sought in times of psychological distress, a Baylor University study has found that clergy often deny or dismiss the existence of mental illness.

This is believed to be one of only a few studies to look at the experiences which mentally ill people have when approaching their local church for assistance with their troubles.

In the recent Baylor study of 293 Christians who approached their local church for assistance in response to a personal or family member's diagnosed mental illness, Baylor researchers found that more than 32 percent of these church members were told by their church pastor that they or their loved one did not really have a mental illness. The study found these church members were told the cause of their problem was solely spiritual in nature, such as a personal sin, lack of faith or demonic involvement. Baylor researchers also found that women were more likely than men to have their mental disorders dismissed by the church.

In a subsequent survey, Baylor researchers found the dismissal or denial of the existence of mental illness happened more often in conservative churches, rather than more liberal ones.

All of the participants in both studies were previously diagnosed by a licensed mental health provider as having a serious mental illness, like bipolar disorder and schizophrenia, prior to approaching their local church for assistance.

"The results are troubling because it suggests individuals in the local church are either denying or dismissing a somewhat high percentage of mental health diagnosis," said Dr. Matthew Stanford, BS '88, MA '90, PhD '92, professor of psychology and neuroscience at Baylor, who led the study. "Those whose mental illnesses were dismissed by clergy are not only being told they don't have a mental illness, they are also being told they need to stop taking their medication.
That can be a very dangerous thing."

In addition, Baylor researchers found study participants who were told by their pastors they did not have a mental illness were more likely to attend church more than once a week and described their church as conservative or charismatic. However, the Baylor study also found those whose mental illness was dismissed or denied were less likely to attend church after the fact and their faith in God was weakened.

Dr. Stanford's results were published in 'Mental Health, Religion and Culture'.

see also
http://www.ethicsoup.com/2008/10/demon-or-disorder-clergy-dismiss-mental-illness.html

No doubt there needs to be more academic discussion and public education about the connections between mind and spirit. Are the various so-called mental illnesses only another name for classic spiritual disorders? The heart of the issue for Christians is whether to trust in worldly assistance, which is sometimes all even the church ends up actually offering, or to accept that a combination of prayer and counsel and medicine might be required. We must also not forget that clergy too are human and suffer from various psychological and/or spiritual conditions.

A witness that Jesus does heal through friends, family and... yes...sometimes through doctors!

Richard Alastair

Crazy or Genius?

2009-01-16T18:15:00.000-08:00

Back in 2002 it was reported (in ScienceDaily - May 22/02)
that Stanford Researchers had Established a Link Between
Creative Genius And Mental Illness

The report began with saying that for decades, scientists have known that eminently creative individuals have a much higher rate of manic depression, or bipolar disorder, than does the general population, and that few controlled studies have been done to build the link between mental illness and creativity.

Stanford researchers Connie Strong and Terence Ketter, MD, were reported as having taken the first steps toward exploring the relationship.

Using personality and temperament tests, they found healthy artists to be more similar in personality to individuals with manic depression than to healthy people in the general population. "My hunch is that emotional range, having an emotional broadband, is the bipolar patient's advantage," said Strong. "It isn't the only thing going on, but something gives people with manic depression an edge, and I think it's emotional range."

Strong is a research manager in the Department of Psychiatry and Behavioral Science's bipolar disorders clinic and a doctoral candidate at the Pacific Graduate School. She is presenting preliminary results during a poster presentation today (May 21) at the annual meeting of the American Psychiatric Association Meeting in Philadelphia.

The current study is groundbreaking for psychiatric research in that it used separate control groups made up of both healthy, creative people and people from the general population.

Researchers administered standard personality, temperament and creativity tests to 47 people in the healthy control group, 48 patients with successfully treated bipolar disorder and 25 patients successfully treated for depression. She also tested 32 people in a healthy, creative control group. This group was comprised of Stanford graduate students enrolled in prestigious product design, creative writing and fine arts programs, including Stegner Fellows in writing, students in the interdisciplinary Joint Program in Design from the Department of Mechanical Engineering and studio arts master's students from the Department of Art & Art History. All subjects were matched for age, gender, education and socioeconomic status.

Preliminary analysis showed that people in the control group and recovered manic depressives were more open and likely to be moody and neurotic than healthy controls. Moodiness and neuroticism are part of a group of characteristics researchers are calling "negative-affective traits" which also include mild, nonclinical forms of depression and bipolar disorder.

Though the data are preliminary, they provide a roadmap for psychiatric researchers looking to solve the genius/madness paradox depicted in the movie A Beautiful Mind, which tells the story of Nobel Laureate John Nash. The existing data need further review, Strong said. "And, we need to expand this to other groups," he said. How mood influences the performance of artists and genius scientists will be the subject of future research at Stanford. "We need to better understand the emotional side of what they do," Strong said.

The study was funded by grants to Ketter, principal investigator and associate professor of psychiatry and behavioral science at Stanford, from the National Alliance for Research on Schizophrenia and Depression, and Abbott Laboratories.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford.

See original article at http://med.stanford.edu/news_releases/2002/may/creative_gen.html

Just a Minute!

2009-01-14T22:17:00.000-08:00

From a Toronto Sun article of Thursday, January 15, 2009

entitled 'Mental child support'
Parents call to keep funds
By ANTONELLA ARTUSO, QUEEN'S PARK BUREAU CHIEF

Parents struggling to raise children with mental illnesses are calling on the Ontario government to protect and enhance services despite the difficult economic times.

Sarah Cannon, of St. Catharines, whose 12-year-old daughter has been diagnosed with bipolar disorder, told a news conference yesterday that only one out of six children with mental illnesses in the province are able to access services and then only after months on waiting lists.

Privately-obtained services are sparse and dauntingly expensive, and Cannon had to take a second job to cover the cost of her child's $750 monthly medication bill.

"I have been telling my daughter's story for nearly a decade and have been struggling with the daily emotional, financial and social struggles associated with having a child diagnosed with a mental illness," Cannon said.

"I have watched my child have to deal with the isolation and stigma that comes attached to her label. I have watched her struggle and suffer battling faceless demons that few can comprehend. I have learned that she shares this struggle with countless other children."

Suicide is a real risk for mentally ill children even though the vast majority have a psychological illness that could be treated, she said.

Cannon and other members of Parents for Children's Mental Health are asking the McGuinty government to increase spending on these services by 3% after years of flat-lined budgets and to work toward a seamless system of care as recommended in several key reports such as the provincially-sponsored Roots of Violence.

London parent Sean Quigley, whose 12-year-old daughter was diagnosed with bipolar disorder at age 7, said they pushed hard to get her the services she needed.

During the worst of times, they were getting calls every day from school to pick up their daughter who could be violent and verbally abusive when experiencing the mood swings associated with the disorder.

Now in Grade 7, their daughter Erynn has served as a national "Face of Mental Illness."
"She's on the student council and her grades rock," her proud father said.

But many parents of mentally ill children lose jobs, savings and even their homes as they attempt to meet the needs of their children in a complex, patchwork system, he said.

"The health system does not work with the education system which does not work with the social services system which does not really communicate with the justice system," Quigley said.

"And we as parents, we navigate these systems all the time."

Children and Youth Services Minister Deb Matthews said her government's 2004 budget brought in the first base increase in children's mental health services funding in 12 years.
The ministry is currently implementing a strategic framework for children's mental health services to bring more co-ordination to the system, and to use existing dollars more effectively for the care of children and youth, Matthews said.

I'm all for the work of Canada's Mental Health Commission. Yet these examples illustrate the need for more than just talk and research. Real help would go a long way towards reducing stigma for all concerned!
What we really need is a coordinated systems approach, which brings together various levels and departments of government, and which recognizes and collaborates with "informal service providers". We must as Canadians, find ways to stand with each other to obtain the service and respect we all need.

Richard Alastair

SO WHERE IS THE HOUSING?

2009-01-08T16:47:00.000-08:00

The Government of Canada would have us believe that it is 'helping' those who are homeless in Saskatchewan
see news.gc.ca dateline: SASKATOON, SASKATCHEWAN, December 19, 2008

Canada’s Government (claims to be) helping families and individuals in Saskatchewan break free from the cycles of homelessness and poverty and build a stronger future for themselves.

see http://news.gc.ca/web/article-eng.do?nid=428379

The report says that

“Our government is delivering on our commitment to help those who are homeless or at risk of becoming homeless. We are proud to support community efforts that help find local solutions to local issues,” said Mr. Komarnicki, who made the announcement on behalf of the Honourable Diane Finley, Minister of Human Resources and Skills Development. “By investing over $1.7 million in these 12 projects across Saskatchewan, we are supporting community efforts to help those in need.”

The announcement took place at the Salvation Army Community Centre in Saskatoon, a shelter, food provider and drop-in centre. The organization is receiving HPS funding to help create 42 emergency shelter beds and six temporary cots for women and children. Individuals will benefit by having a safe place to live in which they can access support services and transition out of homelessness.

Let's not hold our breath waiting.

Post-traumatic stress disorder

2009-01-03T14:07:00.000-08:00

CBC news reported in a Dec. 17, 2008 on-line article that 'more Canadian soldiers than ever are coming forward to make claims for psychiatric disabilities, such as post-traumatic stress disorder' and that of 31 recommendations made by the Military Ombudsman's Office in Ottawa, 18 had not been fully implemented.

The military are said to have made some progress in improving screening before and after conflict, providing national family support groups and aiming to hire 200 mental health workers by March of this year.

But the condition doesn't just affect soldiers. Paramedics, front-line nurses and victims of abuse, violent crimes or accidents have been known to develop symptoms. One in 10 people have post-traumatic stress disorder, according to the Canadian Mental Health Association. Often with time and support, people can get past a traumatic event.

PTSD can result from stressors such as seeing someone else threatened with death or serious injury, or killed, or from violent personal assaults, such as rape or mugging, from car or plane accidents, industrial accidents, natural disasters, such as hurricanes or tornadoes, as well as from military combat.

In life-threatening circumstances, the body goes into a "fight or flight" response. But when a person continually relives the traumatic event, this response is reactivated and it becomes a problem.

Symptoms usually start to appear three months after the traumatic event. But they can also appear many years later.

They fall into three categories:

Reliving the traumatic event: Some people experience such severe psychological stress that it affects them long after. They have flashbacks and nightmares or tune out for periods of time, making it hard to live a normal life.

Emotional numbing and avoidance: The person may withdraw from friends and family. They avoid situations that remind them of their trauma. They don't enjoy life as usual, and have a hard time feeling emotions or maintaining intimacy. They often feel extreme guilt. In rare cases, they can go through disassociative states where they believe they are reliving the episode, and act as if it is happening again. These can last anywhere from five minutes to several days.

Changes in sleeping patterns and alertness: Insomnia is common, and people with PTSD may have a hard time concentrating and finishing tasks. This can also lead to more aggression.

PTSD can also lead to other illnesses, such as depression or dependence on drugs or alcohol. Some physical symptoms, such as dizziness, chest pain, gastrointestinal and immune-system problems can also be linked to the disorder.

How is it treated?
The depression and anxiety can be treated with medication. Therapy with mental health professionals can help, such as:

Group therapy.
Exposure therapy, in which the person works through the trauma by reliving the experience under controlled conditions.
Cognitive-behavioural therapy, which focuses on the way a person interprets and reacts to experience.
Some people fully recover within six months, but it can take much longer. Cognitive-behavioural therapy appears to be the most effective treatment, according to research.
But PTSD research continues to determine which treatments work best.

How many people does it affect? Who does it affect?
About one in 10 people have PTSD, according to the Canadian Mental Health Association. It can affect anyone who has a traumatic experience. Children and adults alike can suffer PTSD, which is among the most common mental health problems.

But, some people can experience symptoms without developing PTSD. About five to 10 per cent of people may have some symptoms without developing the full-blown disorder, according to the B.C. Ministry of Health Guide. Women are twice as likely as men to develop the full-blown disorder.

In 2002, the Canadian Forces was surveyed by Statistics Canada to determine the prevalence of PTSD and other conditions. The survey found that in the year before the study, 2.8 per cent of the regular force and 1.2 per cent of the reservists had symptoms of PTSD. The more missions soldiers had embarked on, the more likely they were to develop the disorder or PTSD-like symptoms.

But, the rate might be much higher, says Dr. Greg Passey, a Vancouver psychiatrist who specializes in trauma and works with Canadian Forces patients. In the mid-1990s, Passey studied two battalions who had served in the former Yugoslavia and found a 12- to 13- per-cent rate of PTSD.

Because our military is so small, he told CBC News, the front-end combat people have to go on more than one tour. And, he added, the more traumatic situations a person is exposed to, the greater risk of developing an operational stress injury such as PTSD.

The Canadian Forces now screens soldiers three to six months after they return from a mission. The "enhanced post-deployment screening process" involves a set of standard health questionnaires and an in-depth interview with a mental health professional.

If you have symptoms of post-traumatic stress disorder, what can you do to cope? Veterans Canada recommends a few common sense tips.

Live a healthy lifestyle, eating healthy meals, exercising regularly and getting enough rest.

Set aside time to reflect on the trauma, rather than allow a constant stream of worrying thoughts throughout the day.

Join or develop support groups.

Educate yourself and your family about reactions to trauma. Understanding the condition is helpful in coming to terms with the trauma and dealing with its associated problems.

for the full article, see...
http://www.cbc.ca/health/story/2008/12/17/f-ptsd.html

for related article: 'Special help for stress disorders' see...
http://www.edmontonsun.com/News/Edmonton/2008/12/31/7886731-sun.html

My Story: Spiritual Healing really happens!

2008-08-17T17:20:00.000-07:00

Lord have mercy on us!
Help us to wake to the Power of Prayer

Memories from childhood can have a life-long impact. When I was born, my parents were living in Loughborough, a small city in the English Midlands. The cold winters meant being given hot water bottles by our feet just to get to sleep. Back then most people didn’t have central heating. Our toes would be chilled to the point of pain in the mornings. My Dad used to get up and fetch the coal from the cellar to start the fire in the dining room. Many mornings he had to take a blowtorch to the outside loo to melt the layer of ice that had formed in the bowl. My mother told me the stories of Jesus. Even then, I heard the call to seek Him. I had a brother and sister, but I was the oldest, the one to set the example. There were toys and jigsaw puzzles to play with. We had radio, but no TV, not even a fridge. I was allowed to play records on an old manually cranked phonograph. We would walk to visit my Nana who lived near a large park which had a marvellous carillon which could be heard from quite a distance.

We visited my great grandparents almost every Sunday for tea. I used to play with a wooden alphabet set. Each block had an animal picture to go with its letter, A for antelope, and so on. I distinctly recall the moment I realized that letters could be put together to made words. Amazing! Before I started school I was reading simple nursery rhymes.

When I was seven and a half, my parents decided to bring us to Canada. In Grade five, in Quebec, I memorized the 23rd Psalm for a poetry recital. When I stood up to speak, my teacher told me, ‘Sit down! That’s not poetry, that’s Scripture!’ In grade six, I got hold of a Gideons Centennial Edition of the New Testament. The book of Revelation and the Gospels caught my attention. I read the Hardy Boys, Jules Verne, Von Daniken, Velikovsky, science, modern sci-fi, historical romance, … One day while recovering from chicken pox I was given a book all about ghosts, mind reading, astral travel and other strange ideas. One night I experienced a very real personal attack. I felt physically grabbed by someone or something not of this world.

Throughout high school I was very shy and always managed to avoid speaking in class. At university, I took honors Physics and Engineering. Friends kept giving me copies of the Bible, some containing strange books with titles like Bel and the Dragon, and the Wisdom of Sirach. I was challenged to seriously consider the story and claims of Jesus, and began to attend Inter Varsity Christian Fellowship, where, for the first time, I clearly heard the message of the cross: the good news that Jesus had died for me. I discovered that I needed to make a personal response to his sacrifice. I helped to distribute copies of the New Testament in the Student Union building.

In the middle of my senior year, just after Christmas, I experienced a turmoil that required hospitalization. I asked God in prayer to reveal Himself to me if he really was there. Shortly afterward, I experienced His loving presence in a powerful way. I was pretty excited, 'high on Jesus'. I began talking to my friends at length even in the middle of the night. I asked my landlady if I could examine an old ceremonial sword, which hung in her living room. I took it up to my room and, later that night, baptized it in the bathtub. For me this was a powerful symbol of spiritual warfare. Fortunately a friend came by. If he hadn’t been there, I might have done something silly.

(Edmund Yu was a troubled medical student who, a few years ago, was killed by police on a TTC bus in Toronto, and all because they thought the little hammer he was carrying might have been a gun!)

In my case, my friends contacted the local Anglican priest and my mother and brother who together got me to see a local doctor, someone I already knew and trusted. He prescribed tranquilizers. But I was so hyper I was admitted to the local hospital for eight days. My Christian friends were all praying for me privately and in their churches. After spending two months at home with my family, I marked in my New Testament, March 9, 1978, as the date I chose to receive the Lord Jesus as my personal Savior. Three days later I was admitted to the Nova Scotia Psychiatric Hospital, where I languished for two months, pacing the hallways with increasing frustration. The rest of that year was a write-off. I had little neither motivation nor energy to do anything. I struggled just to get up each morning.

The following year I took two summer courses in Religious Studies at the University of Prince Edward Island. In October I heard Billy Graham preach on the Good Samaritan at the Halifax Metro Centre and I went forward as a public act of faith. I began to volunteer to work with handicapped adults and later that year began shift work as a residential counselor caring for handicapped adults. I held a second job, 35 miles away, as a research assistant in the University’s Spectroscopy lab.

In December, I received my Bachelor’s degree in Science, the two courses in the Christian faith having fulfilled my course requirements. During the next few years I spent five more months in hospital. I was often hyper, going from singing God’s praise in the halls to making an unruly nuisance of myself. One day I was placed, almost naked, in a locked ‘quiet room’. I felt like a caged lion. Someone had etched onto the wooden door the words, ‘Hello world!’ It seemed everyone was going crazy!
The enemy seeks to cloud our minds and steal our peace. I could have ended up another suicide statistic! When Jesus says, ‘Come to me all who are weary and heavy-laden and I’ll restore you,’ He really means it! He’s ready to give His peace if we really want it and faithfully seek after Him.

I spent a year and a half living in a depressingly decrepit Rehab Centre where I learned to operate an offset printing press. My healing has come slowly and is entirely due to the love of our Lord Jesus, my wife and the rest of my family, my doctors, as well as the support and prayers of many Christian friends, known and unknown. I’ve known the torment of dreams that turn to nightmares that gradually turn to waking reality. There’s an ecstasy in believing that Christ will surely come today and severe depression in enduring another day without seeing his face.
In spite of everything there’s really no need to remain isolated and depressed. An Anglican minister and his wife helped me, through the ministry of the Order of St. Luke, to experience a measure of healing.

Demons are real. Mental illness is real. Connections between these two concepts are difficult to establish. Surely we can admit that most mental illness probably has little or no demonic component. Can we not also admit that some conditions are unexplainable unless we accept the existence of ungodly wicked spiritual forces?

Joy Vassal’s book, Demons are Real, gives vivid testimony of the negative spiritual impact of belief in voodoo and wizardry.
Ron Armstrong, who was an Anglican missionary to parts of Latin America, talked about the power of prayer to bring healing to communities bewitched by so-called medicine men and witches. Many people have become followers of Jesus after finding that prayer in His name was the only effective way to receive help for their various afflictions. The occult practices of witch doctors usually only succeeded in temporary alleviation followed by worse problems later. Jesus gives freedom from entrapment to the lies that these people offer.

Too often in so-called advanced societies we believe a different lie, that formally trained medical practitioners, with their drugs and surgeries, can heal our diseases. We are released from the need to pray. Reliance on God becomes an option and only for those who already believe in Him. For me that early memory of hearing about Jesus was critical. Just as we were told as children to look for police if we were threatened or lost, so we were also told to look to the church for help with spiritual struggles.

O that our churches would respond to all illnesses with both prayer and medicine, referring both parishioners and enquirers to others until church members are properly trained and qualified.

Canada's National Scandal

2008-06-27T22:56:00.000-07:00

People are a bit like buildings. Sometimes they look sad and forlorn, sometimes comical and fresh. Looking from the outside doesn't say much about the inside. What strengths, surprises, costs and depravities remain hidden? Agents and friends can help to find self-identity; enemies, mis-directed friends and enviromental pests attack both foundation and structure.

Last year Canada finally established a Mental Health Commission to attempt to address the lack of attention given to those Canadians who suffer cracks in their foundations, that 10% of us who are likely to experience severe, debilitating distress at some point in our lives. The hope is that money will, at long last, be dedicated to research for treatment and cure for those things that afflict our minds and spirits. Canadians need to discuss realities which have been swept under the proverbial rug.

The most scandalous part of this story is that damaged people are shuffled from one government department to another as they attempt to find assistance. Specifically they are forced to travel back and forth between agencies providing 'social services' (really mainly money) and those providing health care, housing or shelter, food, clothing and sense of community.

The Ministry of Health is not set up to work together with Provincial or Municipal Social Services Ministries. There is no coordination between these agencies for people who do not fit neatly into the medical model for physical illness.
Would you accuse a person with diabetes or cancer of being responsible for his or her illness?
Would we send blind people to six different branches of the CNIB?
Why is it acceptible tell a mentally incapacitated person to 'just get a job'?

Why are our churches and other religious institutions largely silent on this issue? Thank God for the good work that is being done. Much, much more is needed.

Speak out! We, who have suffered schizophrenia, psychosis or depression need places to tell our stories. Well this is one such place. Please do so, here and elsewhere, before more of us, or our loved ones, suffer needlessly due to neglect, ignorance, or lack of awareness of the scattered but helpful resources that do exist.