The Mental Illness Awareness Week blog, sharing stories of recovery, personal experiences, and mental health/mental illness news.

5/30/14

Criminal Justice System; the largest mental health provider in the country

The law affects nearly every aspect of our lives. We have laws that regulate common activities such as driving a car and renting an apartment and laws that deal with crimes such as robbery and other threats and challenges to society. The criminal justice system represents any interaction with the justice system from police officers, court rooms and prisons to state run rehabilitation programs, probation services and half way houses. The economic impact of the criminal justice system in Canada represent an average cost of incarcerating of a federal prisoner per day is $259.05. Given that the length of stay in a federal penitentiary is a minimum of 2 years, each inmate costs the Canadian taxpayer $189,106.50 annually. The goal of the criminal justice system should always be rehabilitation and reintegration to life outside of prison.

However, the number of people with mental health problems entering the criminal justice system has been increasing, and the prevalence of mental illness in prisons is significantly higher than the general population.  Canada’s jails and penitentiaries are rapidly becoming the largest mental health providers in the country.  

Mental health care in Canadian jails and prisons is insufficient and many offenders with mental health concerns are moved into correctional segregation for protection due to their inability to cope with regular prison settings. Individuals being released from correctional institutions, who report experiencing stigma due to their criminal justice involvement, find themselves being ‘bumped’ or ‘overlooked’ by community mental health services. Take Trevor as an example.

 Trevor has been in and out of jail since he was a teenager, and is now 35 years old. He has been diagnosed with fetal alcohol spectrum disorder, schizophrenia, and antisocial personality disorder. He also has an acquired brain injury. While living in a halfway house, Trevor’s mental health care professional helped him to gain employment through a supported employment agency for persons with mental illness. Trevor was able to develop a personal daily routine that included going for walks, reading, and cooking for himself. The mental health care professional educated Trevor to help him better understand mental illness, and has taught him coping skills to help adjust to life outside of prison.

With the available research evidence showing the effectiveness of services for people with mental health problems, and improved mental health reducing involvement with the criminal justice system, “the issue is not whether effective treatment exists but whether it is consistently available to the people who need it, and whether or not these individuals continuously avail themselves of treatment” When the services are available and an offender has access to them, the return to life outside the criminal justice system can be successful. There is a need for federal investment to insure that a vulnerable population is not left without the mental health services they need.


Provided by the Canadian Association of Occupational Therapists, for more information please visit www.caot.ca

2/14/14

Treatment for Mental Health Problems/Illnesses is more than just Medication

Truth Number One:
Equitable access to psychological services across Canada for people living with mental health problems and mental illnesses does not exist!  The availability of different forms of treatment varies greatly from place to place.

Truth Number Two:
The services of psychologists are not funded by provincial health insurance plans which make them inaccessible to Canadians with modest incomes or no insurance." This is in spite of the fact that some of the most effective treatments for common mental disorders are psychological ones like cognitive behaviour therapy.

Antipsychotic drugs have proven to be crucial in relieving the psychotic symptoms of schizophrenia and psychosis (hallucinations and delusions). But they are not consistent in relieving the behavioral symptoms of the disorder. Many still have extraordinary difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. Moreover, because patients with schizophrenia frequently become ill during the critical career-forming years of life (ages 18 to 35), they are less likely to complete the training required for skilled work. As a result, many with schizophrenia not only struggle with thinking and emotional difficulties, but lack social and work skills and experience as well.

It is with these psychological, social and occupational problems that psychological and psychosocial treatments may help most. Numerous forms of psychosocial therapy are available for people with schizophrenia, and most focus on improving the patient’s social functioning — whether in the hospital or community, at home or on the job. Some of these approaches are as follows.

Rehabilitation. This includes a wide array of nonmedical interventions for those with schizophrenia. Rehabilitation programs emphasize social and vocational training to help patients and former patients overcome difficulties in these areas. Programs may include vocational counseling, job training, problem-solving and money management skills, use of public transportation, and social skills training. These approaches are important for the success of the community-centered treatment of schizophrenia, because they provide discharged patients with the skills necessary to lead productive lives outside the sheltered confines of a mental hospital.

Individual psychotherapy. This involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker or nurse. The sessions may focus on current or past problems, experiences, thoughts, feelings or relationships. By sharing experiences with a trained empathic person — talking about their world with someone outside it — individuals with schizophrenia or psychosis may gradually come to understand more about themselves and their problems. They can also learn to sort out the real from the unreal and distorted.

Recent studies indicate that supportive, reality-oriented, individual psychotherapy and cognitive-behavioral approaches that teach coping and problem-solving skills, can be beneficial for outpatients with schizophrenia. However, psychotherapy is not a substitute for antipsychotic medication, and it is most helpful once drug treatment first has relieved a patient’s psychotic symptoms.

Family “psychoeducation,” which includes teaching various coping strategies and problem-solving skills, may help families deal more effectively with their ill relative and may contribute to an improved outcome for the patient.

Very often, patients with schizophrenia are discharged from the hospital into the care of their family; it is important that family members learn all they can about schizophrenia and understand the difficulties and problems associated with the illness. It is also helpful for family members to learn ways to minimize the patient’s chance of relapse — for example, by using different treatment adherence strategies — and to be aware of the various kinds of outpatient and family services available in the period after hospitalization.


(Adapted from “Psychosocial Treatments for Schizophrenia” by the NATIONAL INSTITUTE OF MENTAL HEALTH)

1/29/14

Meet the 2014 Campaign Chair

As Co-Chairs for the Canadian Alliance on Mental Illness and Mental Health (CAMIMH), it is our privilege to introduce the new CAMIMH Campaign Chair for 2014:  Florence Budden!  Florence brings an enthusiasm to the role that will surely translate in the campaigns this year and will undoubtedly inspire more Canadians to join the conversation. 


-Dave Gallson and John Higenbottam, CAMIMH Co-Chairs.





Hello!  My name is Florence Budden and I am a psychiatric nurse from Newfoundland and Labrador.  It is my pleasure to introduce myself today as the 2014 Campaign Chair for CAMIMH.  I began my nursing career in NL at the Waterford Hospital in 1988 after graduation from Memorial University School of Nursing. In 1998 I began teaching at the Centre for Nursing studies where I teach mental health clinical to Bachelor of Nursing and Practical Nursing students along with other teaching that includes health promotion and seniors care. I am certified by the Canadian Nurses Association as a psychiatric/mental health nurse. In September, 2012 the Canadian Nurses Association recognized me as a nurse to know in the area of mental health.

I have been a volunteer all my life. In 1999 I became involved with the Schizophrenia Society of NL (SSNL). I have held numerous positions with SSNL and the Schizophrenia Society of Canada (SSC) since. These have included, Vice President of SSNL (2002-2004), President of SSNL (2004-2011), Chair of the Advocacy Committee of SSC (2003-2009), to name a few. I am the current President of SSC and also a board member of the Schizophrenia Society of Canada Foundation.

I have represented SSC with the Canadian Alliance of Mental Illness and Mental Health (CAMIMH) since 2011.  I am involved with the Public Affairs Committee at CAMIMH. In 2013, I was part of the Mental Illness Awareness Faces Campaign selection committee.

This connection to volunteer work summarizes why I want to be involved with CAMIMH in my new role as Campaign Chair for 2014. I believe lives can be changed, recovery is possible and the mental health system in Canada can be better, but only if we work together as a country to make this happen. Throughout my life I always believed that I must be the change I want to see in the world.

The Champions of Mental Health campaign recognizes exceptional Canadians who have made outstanding contributions to the field of mental health in Canada. Through this campaign CAMIMH can spread the conversation about mental illness through every region. I believe I am well suited in this role because anyone who knows me knows how much I like talking!!! We need to continue the public discussion on mental health and mental illness to reduce stigma and improve access to mental health services. This campaign creates a network of inspiring advocates in mental health and highlights the positive “can do” approach of Canadians.

Through the Faces of Mental Illness campaign and Mental Illness Awareness Week (MIAW) activities we will continue the conversation on mental illness and mental health by introducing Canadians to five inspiring individuals who represent positive examples of recovery from mental illness who share their stories to help other people on their recovery journeys and to create an environment across Canada that supports recovery from mental illness.

I am very excited to be a part of this year’s campaigns and to help move the mental health agenda forward as Campaign Chair for 2014. 

12/6/13

Member Blog: Canadian Psychiatric Association



As we approach the holiday season, it’s fitting to reflect on the year that was 2013. It was a year of changes and challenges that the Canadian Psychiatric Association (CPA) met head on, alone and with our partners.

Our advocacy efforts have been strengthened since we welcomed Glenn Brimacombe as the Association’s new Chief Executive Officer in August.

Founded in 1951, the CPA is the national voice for Canada’s psychiatrists. The Association is a well-respected and active medical organization committed to serving the needs of its members and furthering the overall health of the population. It is the leading authority on psychiatric matters in Canada.

On a national level, the CPA has called for national mental health standards for our health system and dedicated, equitable funding for mental health. It also has been a leader in the call for action to reduce the stigma associated with mental illness. CPA represents the profession of psychiatry to governments, the public, universities, medical associations, licensing and certifying bodies, and other healthcare organizations.

Some of our “hot files” in 2013 included off-label prescribing, mental illness among Canadian Forces members and veterans, suicide prevention, and Bill C-14, the Not Criminally Responsible Reform Act (formerly known as Bill C-54).

We often work in collaboration with others to advance the mental health agenda. To this end, the CPA is proud to be a founding member of the Canadian Alliance on Mental Illness and Mental Health (CAMIMH), which brings together diverse organizations that share a common vision of a country where Canadians’ mental health is a priority and those with a mental illness are treated with respect, provided with support, and can access care.

Last year, the CPA and other partner mental health organizations, supported the passage of Bill C-300, which requires the government to establish a federal framework for suicide prevention. Now the Public Health Agency of Canada is consulting with stakeholders nationwide, including the CPA, on what the framework should include. 

The CPA is also part of a National Collaborative on Suicide Prevention, along with the Mental Health Commission of Canada (MHCC) and the Canadian Association for Suicide Prevention, tasked with building suicide prevention capacity, promoting knowledge exchange and informing public policy.

Collaboration has also helped us amplify our voice on Bill C-54, now Bill C-14. We are part of a Coalition made up of 12 mental health organizations, which continues to voice our concerns about the Bill.

This past year, the CPA formed a Military and Veterans section, bringing together researchers and clinicians working with the military, veterans and their families to collaborate on and foster evidence-based care and research.

Combating stigma and discrimination is also an important aspect of advocacy and the CPA continues to support Mental Illness Awareness Week. The week was founded by the CPA and is now administered through CAMIMH.

The CPA promotes research and continuing education among its members by establishing and maintaining standards of practice and facilitating maintenance of competence in the practice of general and specialized psychiatry. It is working with the Royal College of Physicians and Surgeons of Canada, MHCC and the College of Family Physicians of Canada to identify the mental health core competencies for family doctors and specialists.


We expect 2014 to be just as eventful as we move forward together to advance the mental health agenda in Canada. Happy holidays to all.

11/21/13

Face-to-Face with Arthur Gallant



I’m a firm believer that everybody who lives on this planet has a mission; they have a calling. I am no different. I’ll never forget my grandmother sitting down with me when I was 4 years old and saying “Arthur, when you grow up you’re going to be somebody someday.” For a long time growing up I spent a lot of time wondering what she could have possibly meant by that. I summoned other family members and friends too. What could have my grandmother possibly seen in me as a 4-year old that made her think I was so special? What made her so confident that I would grow up to do something so positive with my life?

My life has no doubt had its unique challenges; I’ve lived through a journey that even the most talented of writers couldn’t come up with such a story. It all started when I was born to an intellectually disabled mother, my father left before I was born, and my aging grandmother decided to support my mom in raising me. When I was 5, my grandmother took sick and later diagnosed with Alzheimer’s Disease and my mother was forced to care for me full-time or should I say I was forced to care for her?

With this massive responsibility stowed upon me I didn’t feel like other kids my age. I didn't know a childhood of not having to worry about money or whether my mom’s taxes were filed on time. The responsibility began to take its toll on me and I remember being as young as 8 years old, feeling so anxious and depressed that I began to make myself vomit just to avoid going to school.

When I was 9 years old Children’s Aid Society took custody of me and a judge awarded Crown Wardship to CAS, which meant they became my legal guardian. Throughout those next few years my symptoms continued and I soon became confused as to why I was feeling like that. Why didn’t I want to get out of bed in the morning? Why was I wanting to cry yet not knowing why? Why did I think I was on the verge of being kidnapped every time I locked eyes with somebody on the subway?

After I got my diagnosis of depression and anxiety disorder I had a lot of energy. Even as a teenager I was very vocal as to the care and treatment I was receiving and didn’t always think my healthcare team and caregivers knew best. Ontario’s Provincial Advocate for Children & Youth helped me to advocate for my rights in CAS but also in regards to my mental health treatment. That led to me sitting on the first of many advisory panels for their office.

As time passed by, other organizations and branches of government began to take notice. Executives of agencies I was a client of were asking for my advice and consulting me as to potential changes in policies and practices.

I had always wanted to be a journalist; so I could tell the stories of others. I never imagined that I’d be sharing my own in a very public way. I do a lot of talking, advising, and consulting. I even spark the occasional debate as to direction this country is going when it comes to the treatment of those with mental illness.


That is how I’m moving from awareness to action!

11/7/13

Face-to-Face with Marli Brown



My symptoms started very young, and first presented as anxiety.  As a toddler, if someone came into our house that I didn't know, I would curl up under my mom's chair and fall asleep.  I lost my hair going into Kindergarten, then as a school age student, experiencing panic attacks, which led to hyperventilation, which led to seizures, which led to lots of ambulance rides.  My first conscious thought of suicide was at the age of 8 - I thought everyone's brain worked like mine; worrying about what would happen if the school bus rolled over, how would I get out?  Worrying about my dad while he would wash the combine windows, visualizing him falling and what would I do?  Worrying about everything, all the time, looking to the stars for hope that someone/thing would end my pain.

In high school, I started with self-harming behaviours to cope.  Binge drinking, banging my head against walls, cutting - all while maintaining honour roll marks, being on extracurricular activities, and planning my post secondary education.  I worked very hard to hide the level of psychological pain that had become "normal" for me, and searched for my value in achievement.

The start of university brought a series of events - rural kid graduating from a class of 11 going to live in a large city, the university soon following with a staffing strike, a family cancer scare, and a massive loss from a vehicle accident.  Over a short amount of time, I became home bound; I became convinced that others could see how horrible of a person I was and I dreamed/planned/lived every moment on how I could die.  Soon after I experienced my first psychotic episode with a large antlike creature standing behind my couch telling me I had to die as I was so horrendous, so worthless, that I was taking my loved ones down with me.  The only way to save them was to kill myself.  Soon after, I had my first psychiatric hospitalization.

I struggled for over 10 years in the system, with revolving door admissions, many different medications, side effects, treatment plans, gathering new psychiatric diagnosis as I encountered different doctors on my journey.  I continued to try to find who I was, attending university classes, working 4 part time jobs when I could work, homebound during the times when I couldn't. I really thought that if I could just work harder I would just get into life.  Somehow, no matter how hard I worked, it just didn't work.

I would have longer periods of time of stability, although never being able to dump the never ending feeling of absolute worthlessness.  I learned coping strategies to do things anyway, and then would deal with the pain behind closed doors.  My husband and I (who I started dating at the age of 17), had to learn to navigate the changes within the relationship - sometimes he was the one who had to "watch" me to keep me alive, while other times we would be equal partners in life.

After much thought and discussion after a long period of stability, we decided to get married and have children after being together for 10 years.  Our first child was born after using fertility medication, and I experienced mild post-partum depression.  I worked very closely with my case manager to do everything I had to ensure attachment; all was well with work as I discovered social services and found I very much enjoyed community volunteering (and a strange knack for constitution and bylaws - always a nerd at heart!).  A few years passed and we decided to try for another baby.

We became pregnant with our first daughter, but that pregnancy was wrought with difficulties from the start.  We found out mid-pregnancy that she had triploidy (which the medical community considers "not compatible with life").  She was born still on April 18, 2007.  That was by far the most difficult process for my husband and myself.  I thought I had grieved as I had a little cry after she was born; little did I know the depths of pain that I had yet to encounter.

We got pregnant again soon after, miscarried, then pregnant again with our second daughter.  She was born April 10, 2008.  Eight days later, we signified the first anniversary loss of the stillbirth.  6 weeks later, I was in the midst of the most painful post partum depression episode, that lead into psychosis soon after.  I had the supplies I needed to end my life, the plan on where I was going to do it, just needed a safe place to put my daughter.  She had colic, and wouldn't stop crying so I couldn't leave her.  I drove for seemingly hours to get her to stop, she didn't, and fate lead me to my case manager at the time and I ended up in the ER.

I was in the hospital for 10 months over that first year.  Tried ECT, medications, different treatment plans; all seemed to lead nowhere.  I became profoundly broken - unresolved grief, mixed with pre-existing mental illness, mixed with post partum issues compounded to the point where I would sometimes be catatonic, writing codes on my hospital room walls, and seeing a man in a black coat that would follow me around the ward.  I could tell you the respiration rates of the patient 2 doors down as my senses were on fire.

The local psychologist was consulted - I had seen her on the ward with her dog (who attended as a therapy dog), and given my high love of animals, she intrigued me off the start.  As we met, she spent time developing trust.  She asked me about me, not just about the symptoms.  As the assessment ended and the recommendations evolved, we met regularly for therapy.  Due to the high level of trust I had developed, more "roots" of my pain were able to be shared, and for the first time in my life, I was able to start to process the trauma I experienced while being sexually abused as a young child.  The pain was exquisite, and I would often have to have the garbage can close by as nausea was overwhelming.  I would be angry at her, feeling like I could never go back - but then realized that the anger was not at her, but at the pain of the situation.  I knew that I had hit the end - either keep going back to slice this pain and figure my way through it, or die.  It was that complicated and yet that simple.

I was able to share the guilt I felt at losing our daughter, the guilt I felt of being a crappy human being, share my shameful inner core of knowing that I was a palliative psychiatric case.  Slowly, ever so slowly, I started finding my way again back into life.  The staff on that unit were amazing through that year, with high levels of collaboration, people thinking outside the box (I would have day passes to attend university class in the midst of this mess, as that was a sanctuary for me), and they were my cheerleaders as my husband would bring our children to visit daily so we could do the attachment work that needed to be done.  I was able to graduate with my social work degree in 2011, and continue to contribute back to my community through volunteering in any way I can.

As this campaign has rolled out, I have been asked if I'm cured.  Not even close....  I still experience mental illness symptoms - in particular dissociation, psychosis, and mood changes when stressors get too high.  The difference now is that I have a team (in particular the psychologist) who I trust 10000%, and I have worked very hard to identify symptoms as they first come up so we can deal with them right away.  I held onto the thought for many years that if I could just get my head wrapped around my symptoms, then they would go away.  I know now that insight does not stop symptoms from occurring, but rather allows me to access support much more quickly, leading to a shorter time of illness.  I accept the fact that my brain works differently than other people, and am acutely aware when I can feel things change in the way I think or perceive things.  I realize that I can compound that change with destructive thinking patterns and take it deeper into illness, but the initial change can be connected to changes in stress, sleep, or just plain random.  It is my job on the team to let others know when that initial change is happening, so the care plan can kick in to ensure it doesn't get exponentially worse.


Most recently, I had our third daughter.  My risk of PPD was profound.  It did come, but due to the team preparation and response it was a tiny little blip on the radar.  I was able to have the experience of feeling my newborn baby in my mama heart immediately after birth for the first time.  I am so thankful; the hours they have put into my care have not been easy, but the idea of recovery as I envision it is now in my life.  Recovery for me is not the absence of symptoms, but living a full life in the midst of managing them.  I was the walking dead for so many years, putting on a mask of expectations that I thought society should see.  By removing the mask, inviting team members to help me, I am working everyday to see through my differently wired brain.  Do I think I'm fabulous?  No, far from it - I actually think that part of my brain just doesn't work.  Do I struggle through that feeling to do things anyway?  Yes - and for that, I am forever grateful.


10/25/13

Face-to-Face with Bernard Saulnier



Help.  This is what From Awareness to Action means to me. Action contributes to my recovery. I am becoming aware of the things I need to improve. I hope to grow in my move toward the best in recovery and demonstrate that it can be done. This is a sometimes long and winding road, with ups and downs, but it's important for me to persevere. I also want people to be aware that they are often surrounded by people who are suffering. I hope to help make the stigmas surrounding mental illness disappear. Moving From Awareness to Action contributes to my recovery; action is empowerment, power over my life. Yes, I have a mental illness, but this is the start of the great adventure of recovery, civic action, rights and duties. Doing my best contributes to this empowerment. Action is important. It's often said that when we get busy, we get better. Action, discussion with peers, leads one to see that recovery is possible. Holding out a helping hand—that's what I think needs to be done. Turning to each other, letting go of our own will. The adventure of recovery, to me, also means making the right choices in all aspects of my life. Developing a spiritual life, that too is important in recovery, trying to be aware that there is something greater that can help me. Recovery also helps me see my strengths and weaknesses, and accept them, too.

All this is a great adventure where I hope to find a little serenity and humility. I want to try to be honest, an honest citizen, that's what counts. I've been in recovery for twenty years and life is forever bringing me wonderful surprises. I still suffer, but this suffering is not the same as it was. I try to grow with it, to make it a life lesson. We also have to talk about mental illness, and not be afraid of asking for help to see clearly, instead of having eyes bloodshot from tears of pain. Recovery is a grand adventure. I've tried to believe in it. I am reaping the benefits and I thank you for being a part of it.