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.

//www.cbc.ca/i/caffeine/syndicate/?mediaId=1845384259972

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.”

Anti-Psychiatry in British Columbia – The Need for Continual Vigilence

By Marvin Ross

Over the past few years, I’ve been writing about the attempts by what I consider an anti-psychiatry group in British Columbia to derail that provinces excellent mental health act. They are still at it. I first wrote about it in the Huffington Post back in 2016 and again later that same year when someone fled BC to Ontario claiming she was a refugee from the BC Act.

In 2019, Susan Inman did a guest blog on this site on the attempts in BC to do away with involuntary treatment for those who are hospitalized under the act. The initial challenge to the Act was tossed on a technicality but the attempts still persist as Susan wrote recently in a Vancouver newspaper. The latest assault on involuntary treatment is from a report by the Representative for Children and Youth (RCY) called Detained: Rights of Children and Youth Under the Mental Health Act.

The key to their complaints is that people who are involuntarily committed are assumed to be consenting to treatment and they are then treated even if they do not want to be treated. The RCY argues that BC is the only jurisdiction in Canada that treats involuntary patients. BC, in fact, has the best provision to enable treatment to start immediately. Ontario is the only jurisdiction that allows an involuntary patient the right to refuse treatment with dire consequences which I will get to.

In Nova Scotia and Manitoba, if a patient, while competent, instructs a substitute decision maker (SDM) to refuse treatment, the SDM must follow those requests when the patient is involuntary unless doing so will result in significant harm. If that becomes the case, the SDM must make decisions in the best interest of the patient. Nova Scotia and Saskatchewan have raised the bar for capability to fully capable in order to refuse treatment. In Alberta and the Yukon, review boards can overcome refusals to treatment. In New Brunswick, the review board can overturn a refusal to treatment if it means that no treatment will result in the patient remaining in hospital as an involuntary hold.

The purpose of involuntary treatment (or any treatment for that matter) is to help the patient get better. If they are involuntary, the point should be to get them better so they can get out of hospital. If you deny treatment for the person as the BC advocates want to, will they get out? The answer to that can be found in the stupidity of the Ontario Act which allows someone declared involuntary to then refuse treatment and to remain in hospital, ill, for years.

As John Gray 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)

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.

And one sidebar on the Professor. He was not a professor and his name was not Starson but he called himself that because he believed himself to be a son of the stars. He was always referred to as Professor Starson even by the Supreme Court of Canada so you really have to wonder who is crazy.

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.

Returning to the most recent BC report, it should be said that the study is not what anyone would call proper research. The conclusions the author made are invalid in my opinion.. They interviewed 14 young people about their experiences in the system – hardly a systematic evaluation. The report makes this statement:

Although the Mental Health Act features protective safeguards – including requiring the provision of information about rights, notification of a near relative, second medical opinions, re-assessments, Mental Health Review Board hearings and access to legal counsel for Review Board hearings – this report finds that young people are apparently not being informed of and certainly not being supported to exercise their rights under the Act.

And they are correct in that the Act states in its guide that:

the Act also contains protections to ensure that these provisions are applied in an appropriate and lawful manner. Safeguards for the rights of people involuntarily admitted to a psychiatric facility include rights notification, medical examinations at specified time periods, second medical opinions on proposed treatment and access to review panels and the court.

The report suggests that this is not happening or at least they say apparently and that seems to be based not on a review of the statistics kept on children and youth who go through the system but on the recollection of the young people themselves. It seems they did look for the data but found it to be inconsistent and/or missing. That is a relevant finding and they should insist that the departments involved get their acts together and ensure proper statistics. It does not mean they can come to the conclusion that these safeguards are ignored.

The one other thing that I want to mention is this comment that there is a:

“lack of opportunity for young people detained under the Mental Health Act to have a say in treatment options that are more trauma-informed, relational and diverse rather than exclusively medical, and to stay connected with family and culture to help deal with underlying causes of their symptoms.”

This reflects their anti-psychiatry stance particularly with the mention of the need to get away from treatments that are “exclusively medical”. These are treatments that are evidence based and ones that have demonstrated a level of efficacy. They go even further with the suggestion that treatment staff must “Ensure First Nations, Métis, Inuit and urban Indigenous children and youth detained under the Mental Health Act receive trauma-informed, culturally safe and attuned mental health services.”

All staff in whatever system need to be culturally sensitive to the above groups and to all racialized groups to help counter systemic racism. The attitudes of staff can be discriminatory unfortunately but evidence based treatment modalities or mental illness are non discriminatory. The one caveat to that might be the problem with drug trials not having sufficient representation from a diverse enough population.

The issue of traditional treatments for Indigenous people came up in Ontario a few years ago with disastrous results. Two young Indigenous girls insisted that their cancer be treated by traditional methods and not western medicine. Maykala Sault, an 11 year old from the New Credit First Nations was being treated with conventional therapy at McMaster Children’s Hospital in Hamilton. She was given a 75 per cent chance of survival when she was diagnosed with acute lymphoblastic leukemia (ALL). Doctors stated that no one survived this form of cancer without chemo but Maykala decided to stop in order to pursue traditional Indigenous medicine. She died. So much for the efficacy of traditional healing. But then again, some of her treatments were carried out by a clinic in Florida which was actually licensed as a massage establishment and is being sued – not exactly traditional culture.

In a similar case, another Indigenous child aged 11 from the Six Nations decided to forgo traditional medical treatment for Indigenous care. Doctor’s treating her appealed to court to be allowed to continue scientific therapy but the judge ruled that she and her family had the right to decide to have other therapy. The name of the child was withheld so I have not seen what the outcome was in that case. The so called traditional therapy was also carried out at the same facility in Florida.

That treatment cost the family $18,000 and involved being taught to “heal themselves” from cancer by eating raw, organic vegetables and having a positive attitude. You can read about this clinic in this article from the CBC.

I’ve digressed a bit with this description but the intent was to show how ludicrous it is to abandon evidence based therapy whether for mental illness, cancer or any other condition.

Sadly, this BC report is nothing but another anti-psychiatry, anti-science piece of fluff which gets far too much attention from the public and politicians. If I may be allowed, if you want to read a comprehensive refutation of all that anti-psychiatry holds dear, my book, Anti-psychiatry and the UN Assault on the Mentally Ill will be available shortly.

The Age of Unenlightenment – Part Two First Scientific Thought

By Dr. David Laing Dawson

A story told to me by an excellent teacher was of the first recorded scientific thought in history. The story might be apocryphal but it is still a clarifying moment. It goes like this: In the middle ages in a village in Germany a young woman was known to be alive and active but not eat. The story spread far and wide, the girl who lived but did not eat, and soon the home of the young woman became a shrine.

The doctor in the village (though medicine was far from scientific at the time) asked himself and documented this first scientific thought. It was, “How do we know she does not eat?” He then devised a simple experiment to find the answer to his question. He managed to get an invitation to stay a few days and nights in the family home to observe. And, of course, he discovered that the young woman rose from her bed in the night to eat.

The question, more famously, could have been “How do we know the sun revolves around the earth?”

There was a time, to which Galileo could testify, that for the resolution of that question we had to contend with answers like, “Because the church says so.” or “The priest says so.” or “My Dad told me.” or “It’s in the bible.” or, later, “I read it in a magazine.” or, as Trump would say, “Many people are telling me.”

But we made progress through the 19th and 20th century, at least in regard to asking that question and formulating experiments to answer it objectively. But suddenly, as a possible reason for the backsliding Marvin is observing, we have Facebook and blogs and podcasts and anonymous sources with incredibly broad and powerful reach. So now the answer to that question can be: “I saw it on Facebook”.

And these sources are sometimes simply stupid, sometimes unwitting abettors, but sometimes have money, notoriety or power as motives.

So it has become very important to teach, and demonstrate, along with the methodologies and achievements of science, over and over I think, the foundational question of science:

“How do we know that to be true?”

The Age of Unenlightenment – Part One

By Marvin Ross

The 17^th and 18^th centuries saw what became known as the age of enlightenment. This was preceded by and closely aligned with the Scientific Revolution. Sadly, today in the 21^st century, we have regressed to what can be considered the age of unenlightenment.

According to Wikipedia “Scientific progress during the Enlightenment included the discovery of carbon dioxide (fixed air) by the chemist Joseph Black, the argument for deep time by the geologist James Hutton and the invention of the condensing steam engine by James Watt.The experiments of Lavoisier were used to create the first modern chemical plants in Paris and the experiments of the Montgolfier Brothers enabled them to launch the first manned flight in a hot-air balloon on 21 November 1783.” “Enlightenment science greatly valued empiricism and rational thought.”

Science has brought us advances in medicine so that human longevity has increased significantly and many infectious diseases that have plagued man for generations have been eradicated with the discovery of anti-biotics and vaccinations. Science has brought us air travel, cars, television, the internet and I could go on and on. But, today, we are living in a world of unenentightenment and opposition to science.

The US had a president who disdained science and scientists and the population is suffering with uncontrolled covid and enormous loss of life. Dr Anthony Fauci gave a recent interview to the New York Times talking about his experiences with Trump. As we all know, Trump had no understanding of science or of the scientific process and if someone told him something worked, he would tell Fauci about it as a solution. Who can ever forget the suggestion we inject ourselves with disinfectant. In his interview, Dr Fauci said that he tried to explain to Trump that because someone told him that X worked for whatever, it did not mean this was proof of anything. It may have worked because the person was already getting better and that true proof only came from a blinded placebo trial.

But much as we want to blame it all on Trump and the Americans, this unenlightened stupidity exists everywhere and seems to be growing. It is all part of the anti-vaccine movement now being directed against the covid vaccine and the need to wear masks, keep a social distance, and close commercial stores, entertainment and sporting events.

Anti-maskers exist in many countries aside from the US. There have been demonstrations in various Canadian cities, the torching of a vaccine clinic in the Netherlands, Orthodox Jews rioting in a Tel Aviv suburb and politicians in many places putting forth inane ideas. My favourite is the Georgia representative in the US Congress who thinks that Nancy Pelosi should be shot and the California fires were caused by Jews firing lasers from outer space. That is, by far, the craziest.

There have been a few Canadian politicians speaking out against the lockdowns but, in a few instances, they have been kicked out of the party. I cannot imagine how the lady from Georgia has not been expelled from the Republican Party. In the Canadian province of Alberta, the premier, is ranting about the cancellation of the Keystone XL pipeline that would have carried filthy Alberta tar sands oil to the US. The premier has not yet realized that the worldwide demand for oil is down and going down as we move to greener products. While he rants, the car makers and the Canadian auto union are announcing billion dollar projects to convert cars to electric.

Today, someone sent me an e-mail link to an article claiming that the covid vaccine is killing seniors in care homes in the UK but that their deaths are being attributed to covid and not as the result of side effects from the vaccine. Later, that person told me the story was believable because it was written by a doctor. Sadly, having an MD after your name does not protect you from stupidity (or maybe it is the desire for fame or just money).

These crackpot ideas and concepts are growing and will continue to grow until we make it mandatory that students start learning about the scientific method. Advances in science result from the the development of a theory, formulating hypotheses and testing them based on the theoretical model. Then, having other scientists repeat those studies to either replicate or refute.

This educational process will take time but until we have a population versed in the scientific method, we can expect more of what we are seeing today.

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.

//www.cbc.ca/i/caffeine/syndicate/?mediaId=1845384259972

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.

Nature and Nurture in Schizophrenia Etiology

By Marvin Ross

Nature versus nurture has long been an argument swirling around the causation of schizophrenia but a new genetic study moves that argument closer to nature. One of our readers let me know about a new twin study just published in Nature Genetics called “Differences between germline genomes of monozygotic twins

Up to now, it has been known that if one identical twin develops schizophrenia, then the chances of the other twin developing it is about 40-50%. One study in 2017, however, suggested that the concordance is actually as much as 79% but regardless of the actual percentage, some identical twins escape and the question is why. There have always been suggestions that the environment and experiences of the twins has been somehow different leading one to develop schizophrenia but this new study demonstrates that identical does not mean identical.

What happens according to these Icelandic researchers is that one twin begins accumulating genetic variation from the earliest stages of development meaning that one twin harbours variants that aren’t present in the other. These mutations occur as or before embryos form from the mass of cells inside the blastocyst, a structure that implants in the uterine wall according to an interview with the researchers. Based on an analysis of 381 identical twins and their families, the researchers found a number of mutations during this period so that genetically, the identical twins were not really identical.

The researcher mentioned twin studies of people with autism who had been raised apart with the assumption made that differences were due to environment. That is not necessarily the case as the difference could be accounted for by de nuvo mutation. The study estimated that about 15% of twins have these early mutations. Of course, the anti-science deniers who form the anti-psychiatry mob will poo poo these genetic findings and claim that as geneticists cannot pinpoint one specific gene that is responsible for schizophrenia, there is no proof.

I do think this is a function of the lack of scientific literacy we give people in school. I recently saw an infectious disease specialist comment on this very thing when talking about the anti-maskers. They point to the evolving recommendations being made about covid as an indication that medicine and science is making things up. Science evolves as hypotheses are tested and are then either replicated or refuted in further studies and experimentations. Finding truth in science is a lengthy process that cannot be simplified. These elements of the scientific method really need to be taught.

For more on genetics, I found this interesting video which you might be interested in seeing.