Time to Social Distance From the United States

By Dr David Laing Dawson

Can we move Canada? I’m thinking we could incorporate New Zealand and settle in next to Australia in the South Pacific.

This wish comes from watching yet another white house coronavirus task force briefing. I am tired of hearing, watching, listening to a most incredible (Trump managed to use that word nine times in the first few minutes) melange of failure, lies and boasting. His other favourite (and lazy) superlative is some variation of “Like the world has never seen before.”

On the other hand, along with lessons in virology, the history of infections and epidemics, the manner in which (scientifically) medicines are developed and tested, how vaccines work, some human biology and ecology, we also are all watching the persistence of a personality disorder.

Donald Trump’s voracious narcissism and psychopathy served him well during his campaign, and then in the first three years of his presidency as he bluffed his way through. The lying, boasting, bragging, the blaming of others in a persistent child-like manner, the “all about me” and “l’etat c’est moi”, all worked for him. The fact he knew little, cared less, and said whatever came to mind, worked for him, astonishing most of us. Even when saying something a little less provocative or narcissistic should have been an easy and strategic choice, he persisted in the same vein. And still it worked for him.

Along comes the pandemic, COVID -19. Now while big lies, inaccuracies, non-sequiturs, nonsense, ignorance, exaggerations, blaming others, boasting of fantasy successes – while, to not make too fine a point of it – absolute bullshit – is apparently a successful way of stick handling through economics, immigration, health care, wars, climate change, trade, military matters and foreign policy, I thought a pandemic would require some actual knowledge and selfless consideration from a leader.

But the reason certain traits and persistent ways of behaving become labeled “personality disorders” is precisely because the pattern of behaviour persists even when, to any other sane observer, this particular context requires, demands a different response, if only for self-preservation.

And in Trump’s case the pattern persists even in the face of a world pandemic.

Some thought that this would be his undoing, that his display of ignorance coupled with his grandiosity and narcissism in the face of this global threat would cause an unraveling, or, at the very least, expose him for the fraud that he is.

But maybe even here he has stumbled onto a formula that will work for him: He steps to the microphone, brags and lies randomly (his popularity, his saving of a million lives, his brilliance, his fine leadership, his poll numbers, his TV  ratings, even going back to his election win, the “Russia hoax”, the sacrifice of his billions to become president), lashes out at any criticism, repeatedly compares himself favorably with all others, displays a petulance worthy of a 13 year old,  even tries to sell a little snake oil and usurp medical science, and then steps aside to let the experts (and a couple of sketchy choices) do the actual work, most of whom know well enough to praise and thank him every step of the way, while he waits impatiently to take the microphone again.

Unfortunately there are many in his country who listen to Dr. Trump rather than the experts, the sane, the sensible, the compassionate.

And hence my wish to move Canada to the South Pacific. Please. I suppose we’d have to flip it to maintain our melting ice fields.

Kudos to The Heroic Underpaid Health Care Workers

By Marvin Ross

Some of the most heroic figures in health care are the lowly personal support workers. They often tend to be the least well trained and the worst paid but they do a vital job day after day. I say some are less well trained because it is a job, in Canada at least, for recent immigrants. Some are nurses, technicians and even doctors from their country of origin who don’t qualify to practice here. Their country of origin changes depending upon the latest wave of immigration. Today, most are from the Philippines but when my mother was in a nursing home, they were from the West Indies and one was even a pediatrician from the Soviet Union.

My friend with Alzheimer’s is now confined to his dementia care home and cannot go out and cannot receive visitors and it is driving him to extreme frustration. He does not understand and keeps phoning me to complain and demand I end his isolation. He becomes quite agitated and borders on being violent. Other than dementia, he is in excellent physical health and his PSW’s routine is to take him out where he meets people in a coffee shop, goes for long walks, buys the New York Times and walks the streets and trails around the area.

That keeps him happy and, as I monitor his spending, I see in the course of a day debits from all of the coffee chains in the area along with the bookstores and food places in the area. It must be difficult enough for them to manage all that with him day after day but now they are locked in the home with him trying to keep him occupied. And for the most part, they do and with good cheer. Their efforts are amazing and to be applauded. I have no idea what they earn but they are worth double that.

During this current epidemic, their jobs are both more difficult and dangerous.

They are, as I said,  all from the Philippines but when my mom was in a nursing home, they were mostly West Indian. One day, I visited and this very large West Indian lady yelled at me. “Your mother needs brassieres”, she said. “Why do you not get them for her?” “ I didn’t know,” I replied, “but I will speak to the desk and have them ordered”.

“No that’s too expensive. I know her size so I will get them and you can pay me back.” I was totally amazed with her offer. She went out, bought them for my mom and I paid her back.

Another time, my mother was scheduled to go see an eye doctor but the disabled transport cancelled at the last moment so the appointment had to be postponed. The night before her next appointment, the night nurse called to say she was worried that the transport would not show up again so did she have my permission to send her by taxi. I approved but said I could not get her the money in time. “Not to worry. I’ll pay for it and you can pay me back when you visit next”.

Again I was dumbfounded and made sure to get there as soon as I could to reimburse her and to thank her in person.

So, lets’ hear it for the truly essential, brave and lowly paid medical staff who keep the system going.

The Covid-19 Pandemic and Involuntary Treatment

By Marvin Ross

The extraordinary measures being used to deal with the current pandemic have implications for involuntary committal procedures for the mentally ill. Thanks to my fellow advocate DJ Jaffe of the Mental Illness Policy Org for bringing this to my attention.

At the moment, for the good of society, our liberties are being infringed upon. We are being encouraged to stay at home and to keep a safe distance from others in order to slow the spread of the virus. I have had three theatre performances cancelled in April, I cannot go out to dinner nor can I go watch a flick at my local cinema. Non essential businesses are ordered to shut down and the government is threatening to invoke more stringent emergency wartime measures and the quarantine act if people do not comply.

According to the Canadian Quarantine Act, a person who presents a danger of spreading a communicable disease can be arrested without warrant and detained. This is not something that we have seen for a long time but when I was a kid, it was common to see houses with quarantine signs plastered on the front doors for those with scarlet fever or whooping cough – two diseases along with polio that have been pretty much eliminated thanks to vaccinations since my childhood.

Where are the civil libertarians who are so adamantly opposed to involuntary treatment for serious mental illness? I assume that they are quiet because they see the benefit of governments taking these extreme measures for the benefit of all.

But involuntary treatment is also carried out (not lightly) for the benefit of society and the ill person. If someone is a potential danger to themselves and/or to others because their brains are sick with a mental defect and that defect prevents them from understanding they are ill, they should be treated and confined until they are better. They deserve the right to be well and they should be treated.

People with Alzheimer’s and other forms of dementia are also incarcerated for their own good and protection. The civil libertarians and society also accept that because they know it is for the good of the patient. I have a friend, a PhD and a fine writer and editor, who has Alzheimer’s and is in a dementia care home. He is incapable of accepting his diagnosis and is locked in. He has never recovered from his hatred of the locked doors and cannot leave without being accompanied. Because he has gotten lost a few times, he has a GPS device on him so he can be tracked. Society accepts this as necessary but many do not accept the same for those with a serious mental illness.

Maybe it is time for them to reconsider their opposition and for us to change the term involuntary committal and treatment to quarantine.

More Perspective on the Year of the Plague

By Marvin Ross

I had hoped that the one benefit to come out of this pandemic would be the demise of the Donald. I fear that I am wrong. According to a recent poll conducted by ABC News and Ipsos 54% of Americans approve of Trump’s handling of the outbreak. Just last month, he claimed there was no problem and that covid-19 would be curtailed. It was, after all, a hoax and reports suggest that he ignored the warnings from his own intelligence officers. Now, he is defying science and proclaiming a cure in an untested medication for malaria.

Of course, the experts have debunked this idea and suggested that the evidence is “thin to nonexistent”. Public health is limited in the US and the office for pandemic services had been scrapped or severely curtailed by Trump when he came into office along with funding for the CDC..

I think the best description of Trump in this time of crisis was written on the blog Respectful Insolence penned by a surgical oncologist in Detroit. He said:

Meanwhile, under the “leadership” of an arrogant incompetent orange ignoramus with a massive ego that requires constant sycophancy and stroking, who spouts misinformation on an hourly basis and will never, ever try to relieve his black hole density ignorance with actual information that experts have been desperately trying to dangle in front of him to get his interest by coupling it with “Dear Leader”-style overblown praise of his awesomeness, the COVID-19 pandemic appears, by every measure, ready to explode out of control.

This is a golden opportunity, the doctor states, for quackery and outlined many of the absurd suggestions being made by the natural remedy proponents. That is not something unique to the US as we, in Canada, have our own scammers and nutbars.  This is an example:

Ontario merchant calls COVID-19 a ‘hoax’ and tells coughing customers to visit

Testing in the US is limited and even some politicians who have been symptomatic have refused to self isolate. Georgia Senator, Brandon Beach turned up at the office with symptoms before getting a positive test result and now the entire Georgia Senate is in quarantine as a result.

Despite the dangers of this virus, the value of a vaccine has not dented the thinking of the anti-vaxxers. The candidate for Governor of Vermont, David Zuckerman, is an active anti-vaxxer and opposed to mandated vaccinations. He is upset that his political opponents are using his opposition to vaccines to score political points during this crisis. Meanwhile, Texas anti-vaxxers are preparing to actively oppose any covid-19 vaccination. The Texas group is one of the largest in the US. One member suggested they hide their kids from forced vaccinations by hiding them under the floor boards like Jews were hidden under Nazi occupation.

With support for Trump increasing and the anti-science and anti-socialism attitude of so many Americans, I see little hope for them surviving this epidemic. When I say anti-socialism, I mean anti such things as a good safety net like universal health care. Projections are that if the US does not smarten up, there is the potential for up to 2.2 million of its citizens dying. What I feared is that Trump would use this disaster to consolidate his authoritarian powers and it is being attempted. There are reports that the Department of Justice is working on a plan to suspend the US Constitution  along with Habeus Corpus.

Thus far, Canada is faring better despite right wing governments like that of Ontario’s Doug Ford who tried to reduce funding for public health. As of today, Tuesday, the infection rate in Canada is 55 per million people while in the US, the rate is 139 per million. The silver lining might just be waking Americans up to the dangers of Trump and the value of  health care that is not based on making money but on serving its people. And for Canadian politicians to pay more attention to health care and public health.

The other potential might just be an increased awareness of the need for a minimum income for all. Most people live from check to check and the Canadian government is pouring billions into enhancing unemployment insurance for those laid off and other measures to help workers and small businesses. People are being encouraged to work at home where that is feasible which will help the environment and some grocery chains have raised wages for their staffs to reward them for the danger they are facing.

The concept of a guaranteed income has been proposed for years but is resisted by right wing politicians. Despite promising not to cancel the minimum income pilot project in Ontario if he won the election, Dough Ford did that as soon as he got in. He also reinstated the requirement for workers to have a doctor’s note if off sick but, because of the current crisis, he has rescinded that.

A guaranteed minimum income would ensure that everyone had an income above the poverty level and would wipe out the need for an unemployment insurance bureaucracy, and a welfare and disability support system. Given the shift to the gig economy, it would be very valuable. If you work, the amount of the minimum income is clawed back but if you lose your job because of times like this, you are still guaranteed a certain amount. The reduction in bureaucracy would partially pay for this.

Out of desperate times come innovations so let us hope that some positive innovations will come out of this..

Looking for Perspective and a Silver Lining During the Year of the Plague.

By Dr David Laing Dawson

I watch the panic, the drama, the anger, the boasting (no matter the subject or the dismal news, someone in the USA manages to boast about the USA) on CNN, then switch to the calmer, more nuanced and thoughtful news on CBC. The difference between our two countries is growing.  But we are all in this together and COVID-19 does appear to be more deadly than regular flu and more contagious.

Then for perspective I look for those statistics that are now at everybody’s fingertips:

In the USA 100 people are killed by gunfire per day. 300 in total are shot per day and most of those require treatment in Emergency wards and surgical units.

2.3 million people per year attend/are brought to emergency wards for serious injury from car accidents. 36,000 die in car accidents per year in the USA. That means about 200,000 people are being brought to emergency wards with serious injuries from car accidents per  month. Canadian stats on this are better: about 2000 killed and 10,000 seriously injured (250,000 total injuries) in traffic accidents per year, with a solid downward trend over the past 20 years.

In China car accident fatalities are over 65,000 per year. As of this day Covid-19 has caused 3,261 deaths in China. Their peak in active cases was reached in mid February.

The news from Italy is especially depressing with close to 1000 people per million infected with COVID-19, a death rate currently at 9%, many health care workers infected, and with still at least two weeks to go on the uphill side of their trajectory.

Now for COVID- 19 in the USA: As of this date there are 27,630 active cases in the USA with 700 listed as serious or critical. These numbers will be on a steep uphill trajectory for the next 2 to 6 weeks before leveling off and then dropping, or on a lower but longer curve if containment measures are moderately successful.

The difference in perception, attention, and anxiety, I suppose, comes from the fact that COVID-19 is new and invisible, we are all tracking it, and we have no control over its behaviour, while we all imagine (the operative word here) that we have control over the damage that guns and vehicles might cost ourselves, and seasonal influenza and measles have been with us a long time.

The world death toll from Covid – 19 is still a long way off that of measles, while the other types of flu in Canada infect about 40,000 people per year with a death rate between 500 and 1500 per year. So far Covid-19 accounts for 1385 cases and 20 deaths in Canada.

Now, my optimistic silver linings:

1. The action taken to “flatten the curve” of covid-19 means dramatically less traffic on the roads and, presumably, fewer car accidents.

2. Self-isolating, social distancing and bar closures should decrease gun violence.

3. These in turn will free up the emergency and ICU resources needed to deal with Covid-19 in the US and Canada (apart from  equipment shortages).

4. The lessons from Covid-19 may be learned, and in future the countries of the world, in concert, may be much better prepared for the next pandemic.

5. The USA may learn first hand the advantages of a universal health care system.

6. This may put a serious dent in the dangerous beliefs and rhetoric of the anti-vaxxers.

7. Which in turn may make it easier to turn back the resurgence of measles and polio and the continuing presence of many other infectious illnesses and their consequences.

8. We are are all getting lessons in biology, ecology, epidemiology,  the smallness and fragility of our planet, and of our interdependence.

9. Perhaps we will learn to save during the good times in anticipation of some bad times to come.

10. Perhaps this event will change our perspectives and behaviours with respect to international relationships, our own needs and consumption, our use and abuse of the internet, how our well being and “economy” is measured……

10. Perhaps after defeating COVID-19 we can turn our attention seriously to global warming. Although we really should have done that when our economies were strong and before  tanking and heading into a long recession, our RRSPs and RIFFs decimated, travel options suddenly limited, oil suddenly cheap, borders closed, jobs lost……

Nope, didn’t work, I’m still depressed. But at least our boxers are happy to have us home.

 

Eckhart Tolle, Global Warming, and the Coronavirus

By Dr David Laing Dawson

Someone asked Eckhart during one of his Youtube performances, “What is the purpose of mental illness?” Now to understand the question we first have to accept the guru’s premise that there is “purpose” in everything. And his answer was something to the effect that mental illnesses were aberrations in consciousness, blockages to achieving true consciousness. And to understand this we need to accept the premise of collective consciousness seeking to be both one and enlightened. But he couldn’t help himself from commenting that someone in India going through and achieving this level of consciousness might be revered as a spiritual teacher while the same person in the Western world might be locked up in a “Mental Home”. Then he back-tracked a little on that one, but continued his basic premise that all this suffering (he brought in the millions killed by other humans in the past hundred years) was, collectively, just part of the human struggle to full collective enlightened consciousness.

The news today and last night was all about the Coronavirus, Covid – 19. Calming words, frightening words, cautionary words, conspiracy words. And I am struck by the fact we know, can know, almost instantly, the number of new cases reported overnight in countries all over the world, along with the opinions of both the informed and uninformed. I am struck with the fact that this information being available to us, along with ice melting in Antarctica, deserted streets in Wuhan, Turkey unleashing killer drones in Syria, the words of the Ayatollah in Iran, in such breadth and volume, is a new thing. Not new to the kids born after 1990 perhaps but new within my life time, and very new in the evolution of Homo Sapiens.

My dogs and all other animals are programmed to recognize danger and to react. If they see, smell, or hear it coming, they can communicate this to their immediate pack. Perhaps a whale can warn distant pods, and birds pass the warning along.

But we humans are the only species that evolved to the point we can imagine and anticipate danger in the much larger environment, explain it in words, spend much time thinking about it, planning or worrying about it, and communicating these facts and fears widely and quickly. Obviously this has provided us with a great evolutionary advantage, as well as the tragic opportunity for those fears being exploited or misdirected.

And only in the last 50 years or so our imagination, our awareness, has expanded to the point of truly being conscious of our world as but a fragile ball orbiting a burning sun within a galaxy, within an unfathomable universe, and then suddenly this: – instant unfiltered communication between all humans on this planet no matter the distance.

I’m sitting in a clinic waiting room now and a large screen TV is scrolling stock market reports. But along with the market prices I count seven distinct areas of rapidly changing news being covered in separate boxes on this screen. These include the coronavirus and Super Tuesday.

Eckhart would have us give up the egoic mind as he calls it, to settle into a here and now collective, passive, and enlightened consciousness. And no doubt a little mindfulness practiced now and then can be a calming influence. But that is really not the problem.

Every advantage evolution has given us has come with a cost and a danger. The ability to imagine threat in our near and far environment has, along with our need for organization and predictability, in extreme, brought us anxiety disorders and schizophrenia. The ability to imagine threat combined with mass communication has brought us confusion, more anxiety, conspiracy, misplaced fears,  panic, and a petri dish for delusions. The ability to imagine threat combined with mass communication and an unscrupulous leader has brought us war and genocide.

So here’s the deal: Yes, Eckhart, it would be good for each of us to achieve the ability, now and again, to allow our minds to give up the worry narrative, the egoic as he calls it, and enjoy only the moment, the beauty of the sunset or a streetlamp and the person (or dog) by our side. To give up, for that moment at least, our striving to control.

Still, our greater task is to ensure our evolutionary advantages and our clever inventions are used, at least mostly, to improve our lives and the life of the small planet we share, with the occasional time-out to enjoy the sunset and the sunrise.

And then this moment in time: Our “new” ability to imagine the world as a single eco system, coupled with our evolved ability to imagine threat, coupled with our amazing scientific advances, coupled with instant mass communication, means we can follow the spread of a virus around the world in real time, do everything reasonable to prevent further spread and ameliorate the consequences, especially for the vulnerable, while waiting for this pandemic to run its course and waiting the requisite year or so to develop a vaccine, or, or, or, we can panic  and make matters much worse.  And this current pandemic could turn out to be an excellent wake-up call for global preparedness for the next one.

Something a Little Lighter

By Dr David Laing Dawson

I was walking a few blocks from my home when a man cycling by wheeled around and pulled up to me. “Hi Doctor Dawson,” he said, balanced astride his bicycle, “Wanna hear a joke?”

“Sure,” I said.

I was trying to remember his first name. His last name had come to mind, perhaps because it began with an unusual Vu. I had not seen him for a good ten years, when I had sometimes met him at a picnic table on the grounds of the hospital, in part because he was too paranoid to enter the building, and in part because once in he could be loud and threatening and was known to have destroyed a full block of parking meters early one morning.

“What’s the difference between a hippo and a zippo?” he asked.

“I don’t know. What is the difference?” I said.

“Well, one is really heavy,” he told me. “And the other’s a little lighter.”

I laughed and he laughed and then he was off, cycling north toward the lake. He looked healthy, complete with long wild black hair, and in good spirits, and I was not really surprised by the lack of small talk and pleasantries and catch-up one usually expects in such an encounter.

Now don’t expect a linkage here other than I, while reading Donald Trump’s tweets and the news, was thinking our Blog occasionally needed something a little lighter:

And first, I need a 12 step program to quell my habitual reading of Donald Trump’s twitter feed. I sit down for breakfast and there it is. My fingers go straight to @realdonaldtrump as my brain asks me obsessively, “What nutsy thing is he saying this morning.” I suppose the 12 steps would require me to acknowledge my addiction, and later to apologize to my wife for ignoring her crossword questions, but I think it should forgo the higher power part, for surely this is a human problem requiring a human solution.

And I wonder how it would play in Canada, so I try it out:

Justin Trudeau

@realJustinTrudeau

Stevey Del Duca is running for Premier of the great province of Ontario. Stevey was a terrific union leader for the Carpenters. He is a REAL LEADER who will never let TRUDEAU or our country down! Stevey will protect your right to own several guns…. …. (which is under siege), is strong on Crime and on the Border, and truly LOVES our Military and our Vets. He will be a great Premier for the people of Ontario. Leader Stevey Del Luca, a winner, has my Complete and Total Endorsement. I love Ontario!

The Covid-19 Blues

Sitting here all alone

Chewing on an empty bone

Toilet paper in the hall

Waiting for the man to call

Don’t trust the air I’m breathing

Don’t trust the news I’m reading

Now I have this tickle in my throat

Thinkin’ it’s time to build that boat

I got the Covid nineteen blues

I got the Covid nineteen blues

I’m busy searching for some clues

But I got the Covid nineteen blues

They’re rushing the Island shores

They’re rushing the grocery stores

This seems to be a time of dread

With a tiny virus in my head.

Just Got the Covid nineteen blues

Got the Covid nineteen blues.

I’m searching for some helpful clues

But I got the Covid nineteen blues.

Can the United States be Fixed?

american-flag-301167_640
Image by shawn1 from Pixabay

By Marvin Ross

The other day, we posted a blog by Susan Inman critiquing Bernie Sander’s mental health platform but there is a bigger picture when it comes to the US. So much is wrong with that country that I am not sure it can be fixed without some very drastic changes.

I’m just reading Tightrope: Americans Reaching for Hope by New York Times writer Nicholas Kristoff and journalist Sheryl Wudunn.

They begin by pointing out that the US, compared to other countries, ranks at:

#40 for child mortality

#50 for personal safety

#61 for high school enrollment

#25 in the overall well-being of its citizens

The US is one of only a very few countries that has regressed based on the Social Progress Index. The US spends more on health care than any other country but its outcomes are comparable to that of Ecuador. The school system is on par with Uzbekistan. The US working class has collapsed into unemployment, broken families, drugs, obesity and early death. Not a pretty picture.

Kristoff looks at some of the kids he grew up with in rural Oregon who died early from chronic medical conditions whose illnesses he says would have been well managed in Europe and Canada where there is universal health care.

And yet, many of these people support Trump. A woman in Oklahoma he interviewed had been saved from a very abusive husband by a social agency. She became a kindergarten teacher and was living happily with her son and voted for Trump. She was not pleased when the funding to her social agency was slashed but felt that maybe Trump was right to save tax money and plans to vote for him again.

Another was an old friend who had endured seven bouts of homelessness, voted for Trump and will vote for him again. He is opposed to any social safety net as he feels that recipients are irresponsible. His main love of Trump, however, is guns. He goes nowhere without a revolver on his hip and will not give that up.

I just watched the episode on Netflix’s documentary Dirty Money on Jared Kushner. A working class family in Baltimore being squeezed for every penny by their landlord (a Kushner company) with escalating dubious late fees and court costs. revealed they had voted Trump. They did look a little sheepish when told their landlord was Kushner but will they vote Trump again in 2020?

One of the most compelling comparisons between the US and Canada mentioned in the book was a study done on the reaction to the layoffs in the auto industry in 2008-09 between Detroit and Windsor. The two cities are across the river from each other and have large auto plants. Detroit workers were worse off partly because of a lack of a social safety net such as that in Canada. But in Windsor the Canadian government jumped in within 24 hours to try to ameliorate the impact of layoffs.

An action centre was established to help with job searches, retraining and obtaining benefits. A number of laid off workers wanted to enroll in nursing training but the program at the local college was full. The government encouraged the college to add more spaces so workers could train.

The attitude in the US is that outcomes are a reflection of the persons personal responsibility. If you lose your job and become poor, destitute and/or homeless, its your fault. There is little that society can or should do to help.

Reversing what is happening in the US is a gargantuan task and I doubt we will see any changes in the near future. The only candidate of the two still standing who puts forth a true reformist policy (mental health aside) is Sanders. His policies are similar to that of the NDP in Canada or leftish social democrat parties in Europe but to many Americans, he is scary and a threat. From what I’ve read, he is most popular among the young who are not frightened by the concept of social democracy and who realize they have little future in the new America. Should Biden win the nomination which is likely, they may not even bother to vote thus assuring the world of 4 more years of Trump.

 

Guest Blog -US Democrat in Canada Opposes Sander’s Mental Health Platform

bernie-sanders-1274425_640
Image by Dean Moriarty from Pixabay

By Susan Inman

American-Canadians like me can vote in American elections, and also in the primaries that select nominees. Now that Bernie Sanders has released his disability platform  I’m hoping he doesn’t end up being the Democrats’ choice to run against Trump.

As the mother of a daughter living with schizophrenia,  I’ve learned over the past twenty years how much Canada is influenced by American trends in mental health care. The controversial positions that Sanders has recently endorsed reflect beliefs that have become increasingly influential in Canada. These positions harm the people they are meant to help.

People new to thinking about the most responsible, socially just positions regarding mental health care might be very impressed by the language in Sanders’ platform. The platform teems with references to human rights and offers an array of services that would be available in a Sanders administration for people able to voluntarily make use of them. However, readers need to dig deeper into the controversial positions he’s adopted to understand why my American community of family caregivers are alarmed. Underlying these positions is minimization of the severity and nature of psychotic disorders like schizophrenia for most people who live with them.

Here are Sanders’ stances on three crucial issues:

1. Sanders believes that treatment must be voluntary.

Psychotic disorders at some points involve psychosis, which is an inability to distinguish between what is real and what isn’t. A common feature of psychosis is anosognosia,  a brain-based inability of many people in psychosis to understand that they are ill. This is the main reason these people refuse treatment.

Too many human rights advocates refuse to acknowledge the existence of this condition. Policies ignoring anosognosia have had catastrophic consequences for people with psychotic disorders; people with untreated mental illnesses have increasingly ended up homeless, victimized, and in jails and prisons.

Sanders’ disability plan does reference the fact that 1 in 5 inmates has a serious mental illness. However, he insists that just providing more voluntary services will fix the problem: “As president, Bernie will fight to end the criminalization of disability, while also defending the rights of people with disabilities to make their own choices about treatment.”

Sanders narrowly limited the kinds of advocacy groups he listened to. He hasn’t listened to the many people, like writer Julie Fast, who are living with psychotic illnesses and don’t want to be left untreated under the banner of protecting human rights. Fast writes, “The concept of individual rights doesn’t apply to someone who is not in his or her right mind. We are not in our right minds when we are sick.”

Canada has been influenced by the same kinds of advocacy groups that have advised Sanders. Currently, access to both inpatient and outpatient involuntary care, available through British Columbia’s strong Mental Health Act, is being legally challenged. The plaintiffs are the Council of Canadians with Disabilities. Proponents of the court challenge argue that the use of involuntary treatment promotes the idea that people with mental illness lack capacity; it seems it is unacceptable to acknowledge that some people have illnesses that, at times, can interfere with capacity.

2. Sanders opposes reforms that would create desperately needed acute psychiatric beds.

The US has a statute, the Olmstead decision, which prohibits hospitals from accessing Medicaid funding if they have more than 16 psychiatric beds. Sanders supports the Olmstead restriction which has resulted in a massive shortage of acute psychiatric beds.

Canada also has too few psychiatric beds. Complaints from patients, family caregivers and mental health providers about the shortage of beds led the BC Psychiatric Association and the BC Schizophrenia Society to investigate the problem and issue a joint report  with recommendations to address the shortage.

3. Sanders will continue to block family caregivers’ access to crucial information.

Sanders opposes the reform of legislation (called HIPPAA) governing privacy of information. This legislation means that families can’t find out if their family member is in a hospital, what plans there may for discharge (even if the person lives with them) and what follow-up care is needed. Research  demonstrates that family involvement during inpatient care is key in helping patients access outpatient treatment.

Canadian families also struggle with privacy rules that hurt their family member. However, BC’s Mental Health Act  allows clinicians to share information when it’s necessary for families to provide continuity of care.

I am part of a group of American families working to bring about a mental health system that offers the best support for people living with psychotic disorders. These families are much more organized and outspoken than similar groups that I am involved with in Canada. They have repeatedly shown me that it’s essential to educate political leaders about policies that offer the best help.

Over the past year, the Democratic primaries have provided opportunities to help candidates learn essential information about psychotic disorders and the many changes that could improve outcomes for this marginalized population. Kamala Harris, Cory Booker, Pete Buttigieg, Amy Kobuchar and other Democratic candidates have offered strong support for these sensible approaches. Members of our group found it impossible to engage Bernie Sanders who repeatedly ended conversations by proclaiming that a single payer medical system would solve the problems they tried to describe.

One member of our group is prominent writer Ron Powers whose memoirNo One Cares About Crazy People, describes the harrowing ordeals of both of his sons who developed schizophrenia. Ron lives in Vermont, Sanders’ home state, and wrote an open letter  trying to persuade him to reconsider the policies he’s supporting. So far, we aren’t seeing changes in his platform.

If Sanders becomes the nominee, I will vote for him. I’ll hope that family caregivers can eventually get him to see that just spending more money won’t provide the help that’s needed. At least we now have other Democratic leaders who are willing to support a more informed and complex view of human rights.

Susan Inman is a Bridgeross author of the best selling book After Her Brain Broke:Helping My Daughter Recover her Sanity. She lives in Vancouver, BC.

 

 

 

 

 

 

 

 

Covid-19 and Guns

By Dr David Laing Dawson

This morning (March 7) the death toll from COVID – 19 in the USA has reached 17. Most contracted the virus off shore with a small number from “community spread”.

The last two nights I have watched specials on CNN, numerous experts speaking, the VP and the task force. All told an amazing amount of attention, argument, hype, and also diligence brought to bear on COVID – 19. I have also watched the somewhat calmer Canadian response to this new epidemic.

And of course we should do what we can to prevent spread, contain this epidemic, and then prevent, where possible, future transmission of animal pathogens to human hosts.

While the actual death rate from contracting this virus is not certain (.5 – 3 percent) we know the elderly with serious underlying illnesses are at greatest risk, and the overall cost of this pandemic and/or the panic it has caused is already huge.

But then I am struck by the attention, the money, the panic, the hype, the arguments, the number of experts, the immense resources brought to bear on this one little virus for which we will have a vaccine in a year or so.

And I contrast this with some other data:

Measles (for which we do have a vaccine): 413,308 reported cases in 2019, 140,000 deaths from measles in 2018 world wide.

And then back to the USA: while deaths from COVID – 19 have reached 17 within a few weeks, the number of people shot and killed by guns has averaged 103 per day. The total number shot is an average of 313 per day (average over three years), making the death rate 33 percent and I doubt there are any cases of mild or asymptomatic gun shot wounds. The total death rate per year from guns in the USA is an average of 37,603. Thirty-seven thousand.

(I am imagining a gunfight breaking out in WALMART over the last bottle of hand sanitizer)

We humans have the capacity to anticipate threat from afar, from the invisible, from the future. We also have an immense capacity to focus our anxieties and our resources on the wrong things, or at least, disproportionately.