Excerpts From When Neurons Tell Stories – A Layman’s Guide to the Neuroscience of Mental Illness and Health

A new book coming soon from Erin Hawkes-Emiru

Many of you may remember Erin for her 2012 book When Quietness Came: A Neuroscientist’s Personal Journey with Schizophrenia. That book was published by me (Bridgeross) and is still selling I’m pleased to say. Her book on Amazon has 4.4 stars out of 5 from 27 reviews. In 2019, Erin was awarded the prestigious Courage to Come Back Award from Vancouver Coastal Health (my second author so honoured. The first being Sandra Yuen MacKay who wrote My Schizophrenic Life).

Erin has been a frequent speaker for various groups in BC such as the BC Schizophrenia Society, police, health professionals and others.

Erin has a master’s degree in neuroscience and was the recipient of a number of research grants including two from the prestigious Natural Sciences and Engineering Research Council of Canada. Unable to continue with her PhD because of her schizophrenia, she has been working as a peer counsellor on an Assertive Community Treatment (ACT) Team in Vancouver.

In her latest book, she states that:

“I’m hoping to bring you on a tour of the neuroscience of schizophrenia and other related topics. The people who will bring this neuroscience to life are my clients, people who experience mental health and addiction challenges. Their stories form the backbone of this book. “

I realize that the value of peer support can be controversial but when done properly and as intended, it can be helpful. This is Erin’s definition of her role:

“Empathy, the compassionate understanding what someone’s feeling, is what peer support is all about. Other members on the ACT team, while highly compassionate, cannot know what it’s like to live with a mental illness, as peer support workers do. True, no one can ever empathize with every person’s exact circumstances and past experiences, and I, compared to most of our ACT clients, have had a very different, privileged life. I do, however, draw alongside them in their frustration with symptoms, their intolerance of medication side effects, or their feelings of helplessness when certified to hospital. I can empathize with meeting these challenges at times with despair and helplessness, other times with the satisfaction of regaining mental wellness. I know how much someone helping you accomplish small goals can make you feel heard and validated. However, I cannot know what it is like to be very poor, addicted to street drugs, and/or “housed” in an SRO downtown. I feel my privilege acutely and ask for the humility to be quiet and listen when I cannot speak from experience. Somehow, sometimes, it works. As Miguel said, and as I quoted earlier: “We have fuck all in common, but you’re my best friend.”

I have no doubt that people will find Erin’s new book a fascinating and informative read. It will be available in print very shortly and, you can pre-order the kindle version now at https://www.amazon.com/dp/B092P7HCP9.

When Neurons Tell Stories A Layman’s Guide to the Neuroscience of Mental Illness and Health Erin Hawkes-Emiru, ISBN 978-1-927637-38-8, 281 pages, $19.95

And, in case you are wondering, Erin is now Hawkes-Emiru as she married since her last book and she and her husband and baby daughter live in Vancouver, BC

Covidiots and the Lack of Care for the Mentally Ill

Marvin Ross

Like most advocates for the seriously mentally ill, I often feel like I’m bashing my head against a wall trying to improve understanding of mental illness and to get better care for those who are ill and their families. We just have to look at the number of mentally ill people who are homeless and the frequent tragedies involving this group to realize how little is being done.

Thanks to the reaction by many against measures to help minimize the spread of Covid-19, I began to see the common thread underlying the opposition to masks, social isolation, proper psychiatric treatment, and vaccinations. That thread is anti-science and the huge growth in the past number of years in what is called alternative medicine. There is no such beast as alternative medicine according to a 1998 editorial in the New England Journal of Medicine. Drs Kassirer and Angel pointed out that:

There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments”

Unfortunately, there are many who distrust modern medicine and science and refuse to or are incapable of understanding the evidence. When it comes to psychiatry, this anti-scientific belief has become widespread. The very existence of mental illness is often denied and the work of medical professionals is looked upon with skepticism. As a result, in my new book, I decided to review all the common myths promulgated by the many anti-psychiatry advocates out there and demonstrate the fallacy of those beliefs.

This has resulted in my latest book just released in March, 2021 called Anti-Psychiatry and the UN Assault on the Mentally Ill.

I fully anticipate being savagely attacked for what I’ve written just as I’ve been for my articles in Huffington Post that ran for 7 years from 2011 to 2018 and for the blogs I’ve written on this site since mid-2014. I was not a favourite of a lot of the anti-psych types who consider me to be a pawn of big pharma and a “drug em up, lock em up” advocate. One group selling vitamins to replace psychiatric medication even threatened to sue me and crashed a meeting where I was giving a talk. One of Robert Whitaker’s bloggers on Mad In America felt compelled to write about my opposition to the Open Dialogue strategy in Finland and one of his followers read my last book Schizophrenia Medicine’s Mystery Society’s Shame to give it a bad rating on Amazon.

“Rasputin” said I so disagreed with so much of the first part of the book that I wanted to give this book 2 stars. However, I agree with the author’s belief that far too little is being done to treat schizophrenia and his sincere approach to the illness. For that I give it a 3.”

He or she then pointed out that “If you want a real history of schizophrenia and it’s treatment try “Mad in America”. This book is more for the proponents of schizophrenia as “brain disease”. There is very little convincing evidence provided. Indeed, the author spends the first third of the book outlining studies which purportedly show major differences between “normal” and schizophrenic brains.”

By now you are probably wondering where the UN comes into all this and here is the answer. When I first conceived of this book, I talked to my friend Dr John Gray in Victoria, BC who is an expert on the mental health acts.. He pointed me towards the UN and the fact that many of the anti-psychiatry advocates were instrumental in helping that body develop its Convention on the Rights of People with Disabilities.

Countries that ratify this convention must agree to ratify section 12 which would have countries abolish all involuntary hospitalization and treatment and end the criminal defence of Not Criminally Responsible. Canada, the UK and Australia have ratified the Convention but refuse to accept the ban on involuntary treatment and committal. Pressure is being put on Biden to ratify the Convention as the US has not done so yet.

For the health and benefit of mankind, we must all oppose these anti-science “covidiots” and make sure that our health policies are based on science.

Insanity as a Criminal Defence

By Marvin Ross

I had always considered that the M’Naughton Rule as developed in England in 1843 marked the first time insanity was used to absolve someone of criminal responsibility for committing a criminal act. The practice actually goes back much further in time and demonstrates that our ancestors had more sense than the United Nations does.

The UN in its Convention on the Rights of Persons with Disabilities wants signatories to abolish insanity as a defence. They are also opposed to any form of involuntary committal or treatment as they have been, as I discuss in my new book Anti-Psychiatry and the UN Assault on the Mentally Ill, been taken over by anti-psychiatry advocates.

Daniel M’Naughten was tried for the murder of Edward Drummond who he mistook for the British Prime Minister, Robert Peel. M’Naughten has been the standard under common law for the defence of insanity with minor differences between jurisdictions. When the rules are satisfied, the verdict is not guilty by reason of insanity (Not Criminally Responsible in Canada) and results in a sentence to a secure facility for an indeterminate time or at the discretion of the court. The insanity defence is recognized in England and Wales, Canada, Australia, New Zealand, India, Hong Kong, the Republic of Ireland, Norway and most US states. Only Idaho, Kansas, Montana, Utah and Vermont do not recognize this. Those states, however, still allow for a defence of not able to form intent due to a mental illness.

According to the British House of Lords at the time:

“the jurors ought to be told in all cases that every man is to be presumed to be sane, and to possess a sufficient degree of reason to be responsible for his crimes, until the contrary be proved to their satisfaction; and that to establish a defence on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was labouring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or, if he did know it, that he did not know he was doing what was wrong”

I was surprised to learn that insanity has been considered going back to pre-Norman times (before 1066). While there was no distinct criminal code in that period, a murderer could pay compensation to the victim’s family. If the murderer was insane, then his family paid on his behalf. During Norman times, insanity was a special circumstance in which the jury would deliver a guilty verdict and refer the defendant to the King for a pardon.

In 1800, England introduced the Criminal Lunatics Act and the reason is quite interesting. James Hadfield was a respected officer in the British Army who attempted to kill King George III at the Theatre Royal Drury Lane. Hadfield had been badly wounded in battle at Flanders in 1794. While in hospital recovering, he told another patient that he was George III. Later, he claimed to be Adam from Adam and Eve fame and then the “Supreme Being”. He recovered enough to rejoin the army but was soon discharged due to insanity. In 1800, he went to the theatre to kill King George but missed. He was tried for high treason but was acquitted on the grounds of insanity. He was the major reason for the introduction of the Act.

There was fear that Hadfield would only be kept locked up until he regained sanity and then he would deteriorate and again attempt murder or possibly even succeed. As a result, the new law stated that “If [the jury] shall find that such person was insane at the time of the committing such offence, the court before whom such trial shall be had, shall order such person to be kept in strict custody, in such place and in such manner as to the court shall seem fit, until His Majesty’s pleasure shall be known.

This act was in force in England until it was repealed in 1981 and replaced with the Mental Health Act of 1983. The new Act allowed for people to be detained and treated against their wishes. This was replaced in 2007 when various refinements were made including Community Treatment Orders. These acts were and are specific to England and Wales although other jurisdictions have acts that are similar. The point is that some people with untreated mental illness do commit horrible acts that, were they sane, they would not commit. It is for their protection and the protection of society that they be committed and treated as quickly as possible so they can return back to society.

A civilized society should not allow someone to continue in a state where they can do harm to others without taking action. And a civilized society does not invoke punishment on them for doing something they have no control over. There are, I’ve read, people with schizophrenia on death row in various US states because of what they did when ill. Many of them are still ill and I suspect are not aware of what they did. Execution is never right and it is even less right when it is someone being killed by the state for committing an act they had no control over.

But the UN endorses that. I am slightly biased but I think you will find Anti-Psychiatry and the UN Assault on the Mentally Ill an eye opener for the unscientific beliefs that have become so well entrenched.

Homelessness

By Dr David Laing Dawson


Margaret is frugal. She takes great pride in this. In season she survives on the edible fruits, berries and mushrooms she finds in backyards and boulevards. She would like to teach her survival skills to mental patients. In the winter, she dresses in many layers and sleeps whenever and wherever she is taken in. She will not accept a boarding home, or psychiatric treatment. She defaces her disability benefit cheques and does not cash them. These represent charity and are abhorrent to her.


She would like to see the Premier, "The Highly Placed One," who could, she is sure, correct certain past injustices, and then reissue her cheques as salary. She is a woman of great dignity to whom God delivers explicit instructions, which she is expected to follow and convey to others.

On one of her attempts to gain direct audience with the Premier, she spent a full weekend hiding in a closet in the Ontario Legislative Building. When she tells me this she smiles and seems to recognize both the comedy and tragedy of her life.

When, in the past, she was hospitalized and treated, treated against her will with neuroleptic injections, she spoke less of God, of herbs, elixirs, and the Premier of the Province, and her conversation became easier to follow. But the moment she left the hospital she stopped her treatment and recalled, bitterly, the receiving of The Needle, as a wrong and immoral act, an assault on her autonomy, her specialness, and her humanity. At times she visits with her mother, a short, stocky peasant woman now in her eighties living in a small house not far from the hospital. Old photos of a small German-speaking Romanian village sit on her mantle piece. She has little English but it is clear she is bewildered by our inability to make everything right.

During a very cold January I give Margaret fifty dollars to buy a pair of winter boots. She speaks to God for a moment before accepting. Apparently, He tells her it is all right to take this money and go to the mall. When she returns she shows me the boots she has bought and she gives me twenty dollars in change, for she has found a bargain, which pleases her greatly.

Another day she arrives looking ill and tired, emaciated. I can smell acetone on her breath. She has not eaten for days. She is  capable of foraging for food but this is a hunger strike, which only a word, a concession, from the Premier, the "The Highly Placed One", will forestall. It is hopeless trying to convince her that I have no access to the Premier's ear. She has her own knowledge of how the world works. And in her world, within her reality, it is not so far-fetched that the Chief Psychiatrist of the Mental Hospital might stand very near "The Highly Placed One."

Now Margaret drops in unannounced quite regularly. She usually stays a while and sings a hymn. Sometimes she babbles incoherently. Sometimes her ramblings are interrupted with asides to God. Upon His silent instructions she continues, or alters her current discourse. Sometimes she brings jars of liquid, which she claims she has distilled from berries and plants and herbs and which contain all the nutrients any human should need. She gave me a jar, which remains on a shelf unopened. She wants to teach the patients of the hospital her survival skills, her nutritional knowledge. Sometimes when she has sung loudly I realize she is drunk, and the ingredients in her jars are preserved in alcohol. I am always fascinated by the way she constructs a sentence. She uses some combination of Germanic inversion and schizophrenic association

But this time she is dying. Or she will die within days if she does not start eating again. I take her to a hospital ward, escorted by nurses. I tell her I will be giving her a needle in the buttock and that she must start eating. She pauses for a moment, then looks at me, and shakes her finger at me, and says, "All right. You may give me the needle. But not as a husband to a wife." I can feel Freud smiling down upon me. She accepts the syringe of anti-psychotic medication. She begins to eat immediately. This is not the result of pharmacological treatment, but the product of some kind of detente. She stays a few weeks in the hospital, gaining strength and a modicum of sanity, and then she departs.

It is another time, another year, and I find Margaret has been cut off from welfare. Her purse is full of defaced cheques, yet some she has cashed and put in her bank account, which now totals, to my amazement, eleven thousand dollars. With a bank account that large she can no longer receive benefits. But she has no money to use. She is destitute, again not eating. For, in her mind, the money in that bank account belongs to God. She cannot use it. She speaks to God for a moment and apparently He will not alter His policy. She cannot spend His money.

On the telephone, I explain to the Welfare Officer that Margaret has no money, that she cannot access the account of eleven thousand dollars. It belongs to God, and God alone can release the funds, and He has chosen not to. The Welfare Officer, it seems, lacks the capacity to imagine parallel universes with different immutable laws. I then appeal to common sense and economic reason. I explain that unless her office releases Margaret's welfare money, Margaret will not eat, I will have to put her in hospital, and this will cost the taxpayer seven hundred dollars a day rather than seven hundred a month. But the welfare officer is adamant. She will not release funds until Margaret spends the eleven thousand dollars in her bank account. Margaret returns to a diet of boulevard berries and the discarded foods she finds in bins behind grocery stores.

Another year and it is the dead of winter once again; the temperature has dropped to 35 below zero, record lows. It is even colder than that, they say, when the wind chill has been factored in. Margaret is living on the street. She makes her way through the city to the hospital and then to my office and spends the day in a chair in the corridor keeping warm. The deep freeze is not letting up. Non-essential employees are allowed to leave their work an hour early. We worry that our cars won't start, that pipes will freeze and burst, that black ice will make the roads impassable. A storm is coming.

At the end of the day, Margaret is still sitting in the corridor, bundled in her coats. I offer to admit her to the hospital so she might spend the night in a warm bed after an adequate meal. She refuses. She will not allow me to assign her patient-hood. She is not mental she tells me several times. But when I broach the idea of sleeping at the hospital as a guest, rather than as a patient, she accepts, after her usual aside with God. The wards are full though, and the best we can do is offer her a mattress on the floor in an empty room.

The institution sputters here. On the ward that I have chosen as the most suitable, the nurse in charge tells me that moving mattresses is the job of Housekeeping, not Nursing, and the Housekeepers have left for the day to avoid the coming storm. On the telephone I tell the nurse in charge that I will come over and place the mattress myself if I have to, and this appears to motivate a temporary change in job description. They agree, reluctantly, after first warning me of various legal consequences should anything go wrong during the night, conjuring images of Margaret attacking somebody, running amok, or simply dying. The mattress and blankets are placed in a side room on the ward. Margaret finds her way there. She stays a few days, behaving well. She remains quiet, polite. She tidies up after herself. When the cold spell dissipates and a thaw is in the air, she puts on her coats and leaves.A month passes before I receive a formal letter from the president of the union, copy to the Ministry of Health, demanding that I write a letter absolving the nurses of any responsibility for allowing a non-patient to sleep on one of the wards. I had some sympathy for their concerns before the events in question, but now it is over, without tragedy, without incident, without lawsuits, I have trouble understanding the motivation for their request. For a few moments I contemplate their attachment to specific words and how these word symbols can accrue more substance than the physical reality to which they refer. Much like Margaret. As Margaret will only accept my help as long as it is not called `treatment', or `counsel', or `charity', and as long as we don't call her `mental', or `patient', with the same rigid eye on symbol and definition, the nurses, or their union, can only offer help and charity to someone called, officially documented that is, `patient'.

I write the letter they have requested. It is not hard to do. In fact, I find myself taking some perverse pleasure typing in bold, "I and I alone take full responsibility for allowing a homeless woman to sleep in the hospital when the temperature was 35 degrees below zero, Celsius.

Margaret disappears for months at a time. Occasionally I might see her bent against the wind in her kerchief and multilayered coats, making her way along an urban street. And then she would appear again, in my office, asking again if I would put her in touch with The Highly placed One

I have been calling her Margaret in this writing, but my secretary and I never addressed her as Margaret. She would correct us. It must be `Ms.' followed by her last name. Ms. Rossel. With emphasis on the second syllable. Ms. Rossel is here to see you. Ms. Rossel is singing in the corridor. In turn, she always addressed me as Chief Psychiatrist Dawson. Sometimes she added the modifier, a highly placed one. Not The Highly Place One, a title she reserved for the Premier of the Province.

When I left the hospital I had not seen her for some time, and I have not seen her since. It is pleasant to think of her camped out somewhere, cooking her herbs and roots and fruits over an open fire, distilling her elixirs, singing her hymns, communing with God. Or it would be nice to think she found a way of accepting patienthood, organized housing, welfare cheques, food banks, and social workers as highly placed ones who might direct her life in a less eccentric manner. But between these two hypothetical outcomes, I must confess, I am most fond of the first.

Excerpt From: The Autobiography of a Professional Schizophrenian, Artist, Singer, and Public Speaker

By Jude Mersereau

So I’ve been asked to elaborate on Schizophrenia and those waxing Schizophrenian. Keep in mind that this illness can be worldwide in scope whilst remaining comfy in somebody’s compact personal brain. A city within itself. Those who have been granted this unfortunate citizenship are members of an elite yet most misunderstood club in their cranium. This particular metropolis is uniformly a run-down unkempt ghetto with unseen stagnant thought poverty. Even if a schizophrenian is adept at expression, the echo sounds like “poor me” instead of “understand me”, and so all is interpreted as a climate of destitution. We just cannot win. Common belief concludes that we barely are able to scrape two thoughts together, and if we can…we are rendered delusional.

So what keeps us going? In one simple statement, “we exist”. It’s more akin to starting out by saying ”I AM” and then immediately shuddering with the stark conclusion “I am SCHIZOPHRENIAN” Pretty bleak. A lifetime of poverty: poverty monetarily, poverty of diet, poverty of living arrangements, abundance of rejection, poverty of thought and conversation, regulated supplies of cigarettes (up to 90% of us smoke) But in our hearts there is soaring of the mind with stubborn rejection of this outer world’s down pressing of the disabled.

We dream big. And since this wry condition cannot be pried away without medication, psychotherapy, and familial intervention, for example, since it cannot return to a happier past and still calmly reject the hopes permanently left behind, Schizophrenian becomes an elephant in the room. But there is hope for the burgeoning Schizophrenian. It does take something with the force of another elephant to clear the room of its elephant in the room(get it?) The problem is that all too often the second elephant is more resistant to vacate than the first. And so on. Perpetual perception problems. The elephant-filled room.

And what is this room?

It is a box where we exist. It is usually closed to the public until one of us citizens discovers a secret ceiling and escapes upwards for a time. When those guarding the box see this freed “clown” happy and bouncy, they frantically stifle and smother said clown down into the box. Again. Then, their particular job resumes, mindlessly cranking through life like a mass-lever round and redundantly round expecting no surprises. Alas.

Another nut gets out.

Okay. That actually is a Jack-in-the-box memory from my childhood.

Here is the precise allusion. Many of us earthlings can relate to this world as containing three “worlds”.

The first…that’s the number-one best… is specially for the rich, overdeveloped, overweight “countries” Although some patriots are not habitually fat during their daily skinny-money marathons.

The second world, sadly enslaved by chaotic hellish communism is poor but maintains the capacity to incinerate the entire planet several times over.

The third: world music, lots of love, and no money at all in their perpetual paradise. Yay

But wait—could it be??? A fourth world? A fourth one not made up of psychiatric patients, but maybe revering them in a way. You see, the Indigenous people worldwide: the first nations…and therefore the last, hold ownership of an invisible clime, unseen by those blinded by self. No wonder it is considered magical. Anyway, these natives hold mental types as harbingers of danger, sentinels to the wind’s whispers, and special with their unique gifts, even more completely unseen by other money chasers or nuclear bomb happy power mongers. But maybe observed by chance by those poor enough to relate in that third world aforementioned as poor.

And so…the Schizophrenian seen in greater accuracy by first nation ones, do really have a place to thrive and therefore are citizens by right on this orb called earth. Care to vacation in our “land?”

  • Jude.

What so Funny? An Autobiography of a Professional Schizophrenian, Artist, Singer and Public Singer, 2021, Published by Bridgeross Communications, ISBN 978-1-927637-37-1, $19.95 print, $9.95 e-book, distributed by Ingram and available from most retailers.

The Mental Health Act From different Perspectives

By Dr. David Laing Dawson

Some years ago I wrote and produced a play and then a video depicting a young woman suffering from schizophrenia, eventually hospitalized, and then appearing before a Review Board Hearing. She and her lawyer claim at this hearing that she should be allowed to leave the hospital and not receive treatment. The psychiatrist and her parents plead to keep her in and give her treatment.

The girl says, “I can look after myself.”

And her lawyer adds, “And if she can’t, her parents will take her in.”

I think the Review Board Chair then asks the parents if they would take her in if she can’t cope on her own. After a tiny hesitation the mother says, “Of course we will. She’s our daughter.”

The play and video end when the findings of the Review Board are being delivered to the young woman. We don’t see them.

Not long after this my son, clever but a tad lazy in his last year of High School, had been procrastinating on a major assignment. He decided to show my video to his class and after they had watched it, hand out a simple questionnaire. Randomly half the questionnaires asked simply if the viewer thought the young woman with schizophrenia should be held in hospital and treated, or released.

The other half asked the same question but added: “She is your sister.”

This is a particular demographic, 17 to 19 years of age, known for their idealism but not necessarily their empathy for others.

Still the half who were given the simple question voted approximately 40/60 favouring release.

The other half, told simply, “She is your sister” voted overwhelmingly to keep and treat.

And there you have the dilemma. In the abstract, absolute freedom of choice and movement is ideal. In the abstract, a long, drawn out, multi-layered careful, expensive process to decide if and when we should override a person’s freedom of choice and movement is admirable. In reality the numbers of untreated mentally ill homeless grow. They are nameless and faceless and not members of our family. They often live short and brutal lives.

Ontario’s mental health act, in an abstract paper form, makes some sense and provides enormous safeguards against “wrongful” incarceration and involuntary treatment. But in human practice it leads to such absurdities as the Supreme Court of Canada in formal documentation calling someone “Professor Starson”, a man who believed he was a University professor (though he was not) and born of the stars, and another, at one time my patient, formally recognized by the Courts of Canada as “Joseph Pergalian, King of Kings”. It leads to the absurdity of someone being held indefinitely in the hospital because they meet the criteria of “imminent danger to self or others”, but untreated because they are deemed capable of making treatment decisions.

In human practice it means that after a long shift in the emergency ward the doctor will parse the word “imminent” to mean “during the next 24 hours” and the word “danger” to mean “death”.

Perhaps it would work better if all the forms ended with the phrase, “She is your sister.”

Enough Talk of Defunding the Police – I Prefer Them to Many of the Professionals

By Marvin Ross

I’ve written about this numerous times before but the cops do a great job with the mentally ill while many so called mental health professionals should be fired. My latest crisis explains. Over the years, we have come into contact with police and have always been amazed at their compassion, professionalism and concern for the ill person. I know, I know that there are some horrendous screw ups but they make the news and the good works do not. Dog bites man is not news but man bites dog is.

We have dealt with the Toronto Police Service, the Peel Regional Police and the Hamilton Police. The Toronto cops showed empathy and counselled our son. In the one experience with Peel Region, the cop bought my son a coffee. The Hamilton police have been amazing, understanding and have shown good humour. They have defused difficult situations and transported to hospital after convincing of the need to tweak medication.

On two occasions over the years, I’ve had the hospital call to ask where my son was when he was in their care. The first time, many years ago, my son got up and left and walked home about 20 miles so while I was on the phone with the hospital wondering where he was, he walked in the front door. The second time was when the hospital would not talk to me or even to my son’s case manager in the same building. He was gone for days and found by the police 60 miles away.

Due to a move he made and some other stressful issues, my son was experiencing periodic paranoia and was in and out of psychosis. His doctor planned to switch him back to an injectible and was in the process of making the arrangements but for the second time in 6 days, my son felt sufficiently unwell to call an ambulance and go to the psych ER. At the first visit, both the psych nurse and then the resident called, got my input as I am my son’s substitute decision maker and were quite competent and concerned. The resident felt that this was a case of a few missed days of meds combined with stress and discharged him but arranged for a pharmacy to deliver a week long blister pack of pills to him.

Unfortunately, six days later, he became very paranoid again and I advised him to call 911 and go back to the ER. No one called to get my interpretation of events as they did the previous week but I was called by the psychiatrist with her intended outcome. She was discharging him even though she admitted he was psychotic. Her rationale was that there are lots of people wandering the streets who are psychotic. I pointed out that my son was being switched to an injectible decided upon the day before by his treatment team and they were in the process of arranging that. It will be in his computerized notes, I told her.

She told me that the hospital does not give injections which rather floored me. You are in a hospital, I said, so I would suspect you have access to syringes. You also have a pharmacy where you can order drugs so what is the big deal?

We don’t give injections she said and I’m discharging him with a prescription to hold him over till Monday and she hung up. I tracked my son down at home, took him to the pharmacy where the prescription was sent and got him sorted out. He has stabilized and is fine and received his injection a few days later. To the credit of the hospital, since covid, they have nurses drive around the city in mini-buses giving their injections so patients do not have to expose themselves getting to the hospital.

Meanwhile, the doctor is being investigated by her higher ups who responded very quickly to my complaint. But then they do know me. I’m a frequent flyer and they know I write stuff in the local paper about them. Why is it that we family members have to be such insistent pests in order to get competent service? What other disability area requires this level of attention?

A few years ago, my late wealthy philanthropist friend wondered what he could make a donation to at the hospital and I suggested a family resource centre. We put a proposal together and submitted it but got a very cool reception. Being wealthy has its privilege so my friend arranged a secret meeting with one of the vice presidents of the hospital to put our plan forward. We were able to meet with a few psychiatrists who supported us and eventually the chief of psychiatry. At the same time, I wrote an article critical of the hospital’s lack of response to the needs of the community compared to the other hospital in town.

It took a few years but they finally accepted his money, established a resource centre for families and it is very successful. The hospital is happy with the success and no one knows what we had to go through to get them to take a family member’s money (his son has schizophrenia) to benefit other families.

As a result of this, one of the psychiatrists who helped us with the lobbying, let me know that the hospital was planning to secretly close a satellite out patient office and fold it into the main hospital building. This satellite had been set up initially to bring services closer to patients so they did not have to take a number of buses to get to the hospital.

I called the media relations people to ask about this and they were shocked that I knew as they had no plans to let anyone know. Who told you, they demanded and, of course, I refused to reveal my sources. Again, I ended up exposing this in the local paper. My article elicited a response from the husband of the head of media relations at the hospital. He pointed out that the clinic was not being disbanded but moved and it was only being moved 4 1/2 Km.

According to google maps, it’s about 12 km and will take 18 minutes by car which these patients do not possess. Depending on where they live, it would take a couple of buses and likely an extra hour and a half each way. The doc who tipped me off let me know that the hospital administration confronted her and she received a considerable dressing down from the hospital president. I told her she did not have to admit she told me as I would not have revealed my source but she said she did not care and had left the hospital to return to private practice.

It wasn’t till a few years later when I discovered that the clinic had not been moved after all. The unfavourable publicity I hope helped force the hospital to do the right thing. There are many excellent front line staff doing an excellent job and showing compassion for their clients and families. The problem, as is often the case, is the bureaucracy. In one of my 2015 articles about the hospital, I pointed out that for its 786 beds (for all medical conditions), there were 31 directors including two executive directors. Their average salary was $139,000 and there was one director for every 25.4 beds.

In addition, there were 6 vice presidents earning a total of $1.5 million. At that time the president of the hospital’s salary was $509,779.11 a year and the CEO got $724,741.30. More recently, the CEO of the hospital took a lengthy trip to a Caribbean Island where he has a home in the middle of the pandemic at a time when officials were told not to take non essential foreign travel. Front line hospital staff were working overtime in danger as they sought to control covid cases. The day before he left, the hospital appealed to the government for help as infections and hospitalizations were rising rapidly. As the result of a public outcry, he either resigned or was terminated and walked away with over $1 million in severance because he was terminated without cause.

That was built into his contract. As far as I’m concerned, the members of the board who negotiated his hire should be made to pay that money our of their own pockets. What’s even worse is that the man they hired to run the show had been kicked out of a Toronto Hospital in 2013 when it was found that he paid another doctor $256,000 in public money to be a consultant with no proof the work was done. The doc he paid the money to also paid him $436,000 over the course of a few years. That other doc, Chris Mazza, had been hired to set up the air ambulance service which made him $9.3 million over the course of 9 years.

Imagine what all that money could buy in services for people. A lot of homeless and those with serious mental illnesses could get affordable housing for that money.

The Origin of a Bad Mental Health Act Provision

By Marvin Ross

An obscure Zoom video presentation given to interested members of his Synagogue Congregation in Toronto reveals why Ontario has what is considered to be the worst Mental Health Act in Canada. The presentation was by the lawyer who developed the Act.

Gilbert Sharpe , according to the Faculty of Law at the University of Toronto, “has influenced some of the most important legal issues and policy matters affecting modern health care. This includes the development of legislation and policies to improve the Ontario and Canadian health care system. This context is invaluable for those who seek to impact change in healthcare.”

The stupidity of the Ontario act allows someone who has been declared mentally ill and a danger to self or others and is detained for those reasons to then refuse treatment and to remain in hospital, ill, for years.

As John Gray, one of Canada’s leading experts on Mental Health Law, said in a presentation he gave to an Ontario committee in 2009 studying this:

Treatment refusal leads to unnecessary loss of liberty, continued suffering, unnecessary health costs and harm to others (e.g. assaults on nurses).

In his talk to his fellow congregants, Sharpe explains the rationale for this. He said that the Act only talked about detention and not treatment. So, “from my perspective” he said, he thought that common law should apply. Over and above detention, he felt that consent would have to be sought from the patient because suffering from a mental disorder and posing a safety risk does not mean you aren’t capable of making a treatment decision. You will find these comments about 12 minutes in on the video.

I have to wonder if Sharpe ever talked to anyone who was mentally ill and detained. If they are in such a state as to be a potential danger, it is hard to believe that they could put that paranoia, anger, delusion, fear, etc aside and then rationally weigh the pro’s and con’s of various treatment options.

It does not make sense!

In my blog on the efforts to change the BC Act to be like Ontario’s Act, I said:

Gray pointed out that on average, people can be discharged after about a month with treatment but refusal to allow treatment can result in years and years in hospital. He and two others wrote a paper called Treatment Delayed – Liberty Denied. In one case, Professor Starson was held untreated for 5 years in an Ontario hospital while his case made its way up to the Supreme Court. And those people who appealed a Review Board finding waited 253 days until the courts dismissed their appeals and the doctors could treat. The courts uphold the Review Boards so the patients wasted 253 days.

But what is worse are the examples given in that particular study. There were people being detained for 5, 10 and even 25 years because they refused treatment and so remained a danger to themselves or others. At $600 per day, or $219,000 for 1 wasted year and 4.38 million for 20 years that is a lot of taxpayer’s money not to treat people and to also deny them their liberty. That is the Province of Ontario but that is not something that could happen in BC with its mental health act which these anti-psychiatry types want to abandon in favour of Ontario’s flawed legislation.

Sadly, Mr Sharpe is still in the game and is now helping Ontario’s Associate Minister for Mental Health and Addictions, Michael Tibollo, “improve” mental health care in Ontario. According to Tibollo’s legal practice website, Gilbert is working in his legal practice. .

Last March, before it was cancelled due to the Covid lockdowns, Home on the Hill was to put on a presentation by Dr. Thomas Ungar, chief of psychiatry at St Michael’s Hospital in Toronto, on the Mental health Act. Home on the Hill attempted to get the Health Minister or the Associate Minister to come with no luck. Dr. Ungar suggested that Gilbert Sharpe could attend, present the Act and then Dr Ungar could critique it from the point of reality. Tibollo’s chief of staff thought that was a good idea and went to discuss it with Sharpe. Nothing further was heard as I wrote in the Hamilton Spectator.

Discrimination Against the Mentally Ill by Medical Professionals

By Marvin Ross

One of the major problems that people with mental illness face is discrimination from other medical professionals. That has been a theme I’ve written about for years and is likely a major contributing factor for those with mental illness having significantly shortened lives. The anti-psychiatry types would have us believe shortened longevity is the result of taking psychiatric medication even when studies show those who are treated with anti-psychotics live longer.

I did not think that anything could top the case I’ve always used from years ago but it has been surpassed although, fortunately, without death. The first case I became aware of happened years ago in the hospital tasked with providing psychiatric care in my own city of Hamilton, Ontario. A man with schizophrenia was sent to the ER because his family doctor diagnosed him with pneumonia. Emergency facilities at this hospital have two separate components – one for medical and one for psychiatric. The hospital knew the man had schizophrenia because he was a volunteer and they knew that his address was a group home for the mentally ill so they decided he needed to be processed through psychiatry rather than medicine despite being told the reason for his being there.

While waiting for service, he complained about lack of breath and that he was having difficulty breathing but he was given a paper bag to breathe into since it was decided he was having a panic attack. Shortly after that, he arrested and died in the waiting area. The hospital was, of course, sued successfully and they changed their triage protocols as a result. Little consolation to the man who died but at least they smartened up.

Before talking about the case that tops that, there is another tragic and preventable death in the same city but where the bias was towards mental illness and away from a medical problem. A young university student planning on going into medicine came out of a downtown Mosque one evening with his family. He spotted two young thugs harassing an old man and he went to the aid of the old man and chased the thugs. One of them turned around and shot the rescuer. When the paramedics arrived, they detected a small entry wound in his abdomen, little blood and decided he had been shot with a pellet or BB gun. It was a 22 and it severed two internal arteries.

The paramedics took there time and tried to convince the young man that he was alright even though he was demonstrating considerable distress. the distress they dismissed as his acting. He began flailing and they told him to stop and after wasting a half hour, they dragged him into the ambulance and restrained him. They decided to take him to the Emergency psychiatry unit rather than to the trauma centre which was much closer. He died by the time they got to the hospital, the paramedics were fired and are now being tried for neglecting to provide the necessities of life.

The example that takes the cake in discrimination towards those with mental illness seeking medical help for non psychiatric problems occurred in suburban Toronto and the video made the rounds on the internet. Once the hospital staff learned the man had bipolar disorder, they falsely made the assumption that there was nothing physically wrong with him and turfed him from the ER.

He was there to complain about severe pains in his legs but no one believed him. The pain was so bad that he could barely walk and so was forced to literally crawl on his hands and knees out the door. His progress was coached by a nurse who stood by him and watched his slow agonizing crawl out the front door of the hospital. When he was finally able to get medical help, it turned out that he was suffering from Guillain-Barré Syndrome.

This all took place in 2018 but only came to light recently because he was trying to get the video of his struggle to leave. The hospital claims they fired the nurse but they do not say if her actions were reported to her regulatory college for action. I suspect not and can only assume she working at another hospital.

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This medical bias against those with psychiatric illnesses was just written about in the Globe and Mail newspaper based in Toronto. Thomas Ungar is psychiatrist-in-chief at St. Michael’s Hospital of Unity Health in Toronto and Louise Bradley is president and CEO of the Mental Health Commission of Canada. They stated that:

Too often, having a mental illness stamped in your file is like having it tattooed on your forehead. It biases medical professionals – who, after all, are only human – and overshadows valid and serious physical symptoms, allowing them to be dismissed as nothing more than a figment of your diagnosis.

Structural stigma – how institutional rules, policies and practices unjustifiably and arbitrarily limit the rights of people with mental illnesses – plays on this unconscious bias. It flourishes in darkened corners and it hides in plain sight. To the untrained eye it’s invisible, but the threat it poses is no less real.

The solution to this problem, they say is that “We need to measure and monitor the barriers, big and small, that put treating mental illness at a perpetual disadvantage. If we can get them on a mandatory quality performance dashboard, or easy to see report card, a red-light indicator will scream out for attention. It’s the only way we can halt structural stigma in its tracks.”

So, next time you hear someone say psych meds kill off psychiatric patients, you can point out that they are being killed off by biased and discriminating physicians who should no better but don’t.

And if you received this twice, my apologies. I should not try to schedule something when I’m tired.

Understanding the Need for Involuntary Treatment

By Dr David Laing Dawson

There is a moment in untreated or under-treated schizophrenia when someone with this illness is simply lost to reason. At that moment the chance of any discussion, partnership, even argument over the pros and cons of taking medication, of dosage, of side effects, of goals and wishes, of health and well being, are lost. At that moment all words, or gestures, even facial expressions are seen as hostile.

Our lives are full of complex nuances; our brains work overtime scanning and filtering and organizing information to allow us to think and act in a way that will maintain some equilibrium and get us through the day. When the brain falters in this complex process, it tends to fall back on primitive, delusional interpretations of those social parameters that normally form the glue of interpersonal life: power, control, worth, status, sex, good, evil, trust…

Sometimes just before that moment, when this person is perplexed, struggling, staring, halting, we can find the words to reach him and convince him to take some medication.

He had gone off his medications for schizophrenia. He phoned to ask me if I would call the Chief of Police, whom he assumed I knew on a personal level, to call off the many police officers who were watching his every move, night and day, in the house and outside. I told him I would definitely do that for him but in return I would like him to go back on his Olanzapine. And he did.

But just past that moment there develops a cloud of delusional thinking from which one cannot emerge without medical help, without medication, and decisions made by others.

Over the years I have tried in many ways to catch that moment in time, spending hours waiting, listening, meeting someone on the park bench outside the hospital, in the cener of an empty auditorium, sharing tea in a kitchen, standing on a back porch, negotiating in the middle of a field, sitting on the floor of a small room, even admitting someone to the hospital as a “guest” because she would not accept the title “patient”. But sometimes it is too late for even this level of patience to break through the fog of insanity.

She stood in my office screaming invective at me, for being part of some cabal, face red with anger, convinced of a conspiracy against her. I failed to reach her and filled out that notorious form I (Ontario) and called the police to help escort her to the psychiatric hospital. Two months later I was walking the long corridor of a community hospital when I saw this same woman approaching from the other end. The last words she had said to me were profane. She recognized me and as we passed one another and made eye contact she said, quite simply, “Thank you for saving my life.”