Monthly Archives: May 2021

Q’Anon and Bitcoin

By Dr David Laing Dawson

A couple of weeks ago Bill Maher went on a rant about Cryptocurrency. Looking at the camera he said he had asked two experts to explain it to him, and he “Still does not understand it and neither do you.”

He’s right, but I have always been secure in the belief that if I try, and listen to a few explanations, I will be able to comprehend it. This belief was based on the fact that over the years, with each new-to-me technology, I have acquired a fundamental, or at least a very basic knowledge and understanding: Radio, television, quantum theory, relativity, the uncertainty principle of Heisenberg, internal combustion, computers, MRI’s, software, the atomic bomb, the internet…..

So I watched and listened to a few explanations of Bitcoin and cryptocurrency. And now I can say that I have a slight inkling, but only slight, of the world to which Mr. Satoshi Nakamoto has taken us. Of course, it is entirely fitting that nobody is sure it was Mr. Nakamoto on his own, or several other shady characters.

Well, I no longer have a fourteen or twenty-four year old brain, so that might be part of the problem. But for the record, my take on cryptocurrency is that it is a brilliant combination of Ponzi scheme, tulip bulb craze, 256 bit machine code block-chain geek “mining” camaraderie, gambling, money laundering and tax avoidance.

But this is a mental health blog and the connection here, for me, is that increasingly we all live in a world we do not understand. And I think it an irony that over the last few centuries, as we began to actually understand the natural world, the earth, the solar system, plants, animals, and the atomic particles that adhere to or repel one another to create this universe, (and fewer of us needed an alpha male in the sky as a way of understanding our world) – no sooner did we reach that stage of evolution, when our inventors and engineers began making things that a smaller and smaller percentage of the population actually understand.

So let’s face it. Qanon makes more sense than bitcoin.

Reading Huxley’s Brave New World years ago I thought it unlikely we would devolve to his vision of the future but now I am not so sure.

On the other hand we have these wonderful new vaccines. And instead of the immune system having to send cells to reconnoiter with the invading (live or dead) virus, study it and bring back specs for the design of antibodies, we skip the first part and just inject lying messenger RNA to go directly to our immune system and tell it we’ve been invaded by a new Corona virus, and here are the specs.

Which made me wonder about autoimmune diseases. Perhaps we could make another mendacious messenger RNA to go directly to the immune system and tell it to lay off, your joints are fine, they are on our side, really, they’re harmless, if a bit worn and damaged.

But can we live in a world we don’t understand without excess anxiety or satisfying delusions?

Something a Little Different for World Schizophrenia and Psychosis Day

By Marvin Ross

May 26 is the day set aside for support of those who have schizophrenia and/or psychosis. Treatment has come a long way in recent years but still has a long way to go. Society’s attitudes have hopefully improved in understanding these maladies but there is still resistance by many to even recognizing these as diseases. We can thank the anti-science attitudes of the many proponents of anti-vaccine, anti-psychiatry and covidiots who seem to be increasing in numbers.

Improvements for those suffering is something that takes time and the involvement of many – doctors, other mental health staff, friends, families and relatives. It was my old friend, Ed the Sock, who introduced me and others to this video of one persons progression to improvement. Called Robbie Stevenson Destroys Schizophrenia, the video depicts Robbies progression from his early days as a sufferer and stand up comic to his return to “normalcy” as a VJ.

Some of his antics are a bit off the wall and the music is too loud for my aging ears that grew up on early rock and roll and folk music but it is an interesting journey. And while he does not say at the end, Mr Sock assured me that he faithfully takes his meds.

Enjoy

The Reality of Developing Government Mental Health Strategies

By Dr David Laing Dawson

About 40 years ago the physician lead in North Western Ontario (a family doc who worked as an intensive care expert, geriatrician, internist, and psychiatrist for a Northern Ontario town), called to ask if I would join him in drafting a plan for delivering mental health services to Northern Ontario. He had been asked to do this by the present government.

I said, “Wow, that is a big job. Could take months.”

“No,” he said. “I’ll fly down for the weekend and we can put it together in two days.”

“What? How do you figure we can do that?”

“Two days is what it’s worth,” he answered.

“But…”

“It will be put on a shelf with all the other plans and proposals and forgotten.”

But…”

“This isn’t about providing mental health services to Northern Ontario, this is about the government appearing to be doing something about it.”

And he flew down and we put together a comprehensive if not detailed proposal. It is surprising what can be accomplished in two days. I’m sure this proposal, if not digitized, is sitting on a shelf to this day.

On the other hand, he talked me into providing fly-in psychiatric services to North Western Ontario for the next 5 years.

So note to Kathy: You are doing really good things with Home on the Hill. That other level of government/bureaucratic planning is governed by politics, appearances, image, self-preservation, and ego. Don’t let it discourage you.

Guest Post – Dealing With the Mental Health bureaucracy

By Kathleen Mochnacki, Chairperson of the Board of Directors of Home on the Hill Supportive Housing. at Home on the Hill Supportive Housing.

I wrote an earlier blog about “Suggestions to improve the Family Caregiver Experience on Councils” https://mailchi.mp/d7c071fef63e/fundraiseront-mental-health-act-advocacyfrozen-odsp-rates-4859714 which came about from my experience as a Family Caregiver sitting on the Service Coordination Council on Mental Health and Addictions of the Central Ontario Local Health Integration Network (LHIN) between 2016 to 2019. I had replaced a colleague who was killed by his undertreated son with schizophrenia. Unfortunately, this tragedy and its implications were never discussed at the Council, even though I brought it up with the Co-lead CEO many times.

In that earlier blog, I wrote a rather sanitized version of my experience at the Service Coordination Council and attempted to put a positive spin on it, hoping that my message would reach the decision makers. But the reality of sitting on that Council was much more brutal. In fact at the last meeting on March 14/2019, the Co-lead from the LHIN did approach me and the other independent family caregiver and conceded that our experience “had been rough”.  And although I and the other family caregiver did attempt continually to bring our concerns to the Central LHIN and later the Patient Experience Department of St. Michael’s Hospital, I am writing this with the hope that it will inspire some entity of accountability so that a safer environment can be provided for family caregivers who are asked to give the family perspective on councils and committees. This is especially important now with the development of Ontario Health Teams. Here are some issues that need to be addressed:

Bullying and Intimidation

Twice I was summoned to the office of the CEO who co-facilitated the Council. I had no idea why I was called the first time but during the meeting, I was given a presentation (later presented at the next Council meeting) about how the work of the Council would lead to the development of recommendations. I felt that it was a little condescending. I had brought along a friend who was a retired school administrator and mother of a daughter with bipolar disorder, who finally out of frustration asked if the CEO had a loved one in her family with a serious mental illness. Her response was vague.

The second time I was summoned to discuss the ‘tone and tenor’ of the meetings as I had complained that it seemed that no one was listening. I refused to go. Somehow, I had been accused of a “conflict of interest” which is ironic considering that the Co-lead organization was charged with the responsibility of running the Council which included me and another family caregiver whose loved ones had received services from her organization. Was there not a conflict of interest in this situation? How comfortable were we family caregivers in bringing issues forth with this reality? At a later Council meeting, I was given a lecture by the Co-lead from the LHIN about how I needed to defer to the leaders and (I suppose) return to my token position of being a family representative. I and the other independent family caregiver then lost our transportation allowances. We had to fight to get them back. We were told “as a courtesy” that a re-imbursement was arranged for us, but in the future, we had to apply to be re-compensated.

Unequal access to putting items on the agenda

I had requested at some point that we come together as group and decide what needed to go on the agenda. This came about because the Council really had not come together as a group and I thought we needed to look at areas we had in common. This suggestion actually mirrored one of the recommendations of the excellent Interim Report which had been conducted by St. Michael’s Hospital. But as soon as I mentioned this, I was shot down by the Co-lead from the LHIN who said condescendingly that everyone was welcome to put items on the agenda. Personally, I would have liked to have discussed using a “family model of care” which appeared to work successfully with the grassroots organization, Home on the Hill, of which I was a member. 

In the family model of care, the whole family is the client because when one person has a serious mental illness the whole family is affected. This is particularly helpful if the ill person has “anosognosia” which is a symptom where the client is unaware that they have an illness and therefore will not recognize that he/she needs help. In such cases, the family does need support and information in order to support the ill relative. At Home on the Hill, the adult children of the families we support have been successfully engaged in a respectful manner and participate in our programs. As a result, their risk for re-hospitalization or homelessness has been lessened.

 One time, I asked for an item to be put on the agenda three weeks before the next meeting and was told that I needed to give them more time! When it came for the opportunity to have a family caregiver speak before the Council, the other family caregiver who had prepared her presentation and was about to speak, was suddenly interrupted. Her presentation was bumped for a ‘feel good’ movie about depression without explanation! On another occasion, we had arranged that another family caregiver give a presentation but then we were informed that her presentation had also been bumped for a speaker suggested by one of the CEO’s. We also noted that the consumer survivor agency at the Council appeared to have no trouble having their people present and it did not appear that they had to give much notice either.

Different perspectives of people with lived experience

Home on the Hill, which we represent, is a family driven volunteer initiative built to address the gaps in the mental health system such as supportive housing and appropriate support services. Our Robert Veltheer Lecture Series addresses one of the biggest gaps which is lack of information about serious mental illness. We attract well known psychiatrists and other mental health professionals to give lectures. We believe that the more knowledge there is about mental illness, the less stigma there is. We are concerned that the medical component of severe mental illnesses is not emphasized enough. We do not have enough psychiatrists or hospital beds so our loved ones can stay long enough to get well, and we do not have adequate supportive housing. 

The consumer survivor organization. who also had representation on the Council, operate from a different perspective and is funded by the Ministry of Health and Long Term Care. They state:

“We believe that people will and do recover from mental health extremes, and can lead fully self-determining and actualized lives with or despite mental health labels.” They “respect self-determination and autonomy without conditions” which could refer to life saving involuntary treatment. And they ask that we “expect recovery and wellness, and do not believe inherently on lifelong disability or illness”. 

I’m sure governments love to hear this as it means that they really do not have to recognize the severity of serious mental illness, as families experience it and, therefore, they do not need to pay for appropriate treatment and supports.

In contrast, the families of Home on the Hill know that people do not necessarily “recover” and our loved ones can end up in homeless shelters, streets or prison and we keep advocating for proper treatment and support service to prevent this from happening. We pay taxes yet many of our loved ones do not receive services, and we have had to build our own organization to meet the unmet needs.  Many of our loved ones are not able to speak for themselves because of the severity of their illness, leaving families to advocate for them.

This difference in perspectives needed to be fully addressed at the beginning because it caused unpleasantness. Even the leaders at the Council were confused as one of them asked towards the end of the three years, if we were “duplicating service”!

Anosognosia and the need for mental health literacy

The term “anosognosia’ means lack of insight which can cause the person to believe that they do not have an illness and therefore will not ask for help. The system insists that service be given on a voluntary basis, yet appear to have no concern for those that are unable to ask for help and become homeless. I had wanted to introduce the concept of using a family model to address this reality, where the family who is supporting the ill individual gets support and information. The resistance to accepting the reality of “anosognosia” resulted in a comical episode where the Co-lead from the LHIN stated that the College of Physicians and Surgeons of Ontario (CPSO), a regulatory body only, would have to determine that “anosognosia’ was a symptom of mental illness! 

This is not CPSO’s mandate and the leaders only had to look at the medical literature to learn that anosognosia does exist and that it has a negative effect on providing treatment to patients.

I also had used this term in conversation during one meeting, and as I was leaving, I overheard one of the CEO’s mentioning the term in a tone of “derision”. It was during the same meeting, that I had been given my lecture on deferring to the “leaders”. I felt so uncomfortable that I did not go to the next meeting. That particular CEO now holds a position of power in a local Ontario Health Team. This fact does not inspire confidence. In fact, one of the complaints of families is the lack of knowledge of serious mental illness that exists among many service providers.

The need for standards in how meetings are conducted

Many of us have attended meetings in various capacities in the past and are familiar with Roberts Rules of Order. Meetings at the Service Coordination Council were not conducted in this way. If minutes of past meetings were available, they were not voted upon and accepted by the Council. This lack of structure added to our unease and as one member said the “meetings were run in a shoddy manner’.

Ethical Issues.

The most egregious occurrence happened around the way the Interim Report on the functioning of the Council, written by St. Michael’s Hospital, was handled. The completed Report was dated August 2017, but for some inexplicable reason was presented to us at a September 20th meeting in the form of an edited power point. According to the minutes of that meeting, we were told that “the Interim Report was in draft mode and could not be shared at this time”!

It was a perplexing experience and I carefully checked to see if any of my input had been recognized. I had suggested having a psychiatrist sit on the Council and having more opportunities to hear the family voice. Hard copies of the Interim Report were not dispersed until the final meeting of the Service Coordination Council almost two years later on March 14/2019.

No Final Report was made available!

The question remains, why did we not review this Report and incorporate its valuable recommendations. After all, we taxpayers paid for it. It appeared that this valuable report had been buried for two years, never finalized and the recommendations were never implemented. If they had, our time as family caregivers would have been more worthwhile and perhaps services would have improved for the better.

Tomorrow, see just how governments actually develop a plan.

Maintaining mental health during the pandemic.

By Dr David Laing Dawson

During the beginning of the pandemic and through the first lock-down I did have some patients unaffected, even cheerful. These were people who normally resisted any socialization, refused to join any group activity, were always reluctant to leave home. One or two even chuckled on the phone, telling me, “Now everybody has to live the way I do.” and, “I don’t get it. Why do people like eating in restaurants anyway when you can eat the same food in the comfort of your own living room?” (I didn’t have a ready answer for that one.)

A few were already much more adept than the rest of us ordering everything online. Several were quite pleased that psychiatrists, social workers, parents were no longer pushing them to get out and join something, a social gathering, training, education, a counseling group, volunteer work, actual paid work, anything.

The pandemic rolled on, the full lock-downs came and went and came again. It is clear it has taken a toll on all of us. Anxiety has risen across the board and statistics show us where it has pushed people over the line: separations, domestic abuse, drug overdoses and homicide.

And that group from the first wave who were pleased “everybody else is living like me now” – even they are now experiencing some of the pain of total isolation and the reduction of even the possibility of social encounters.

Which brought to mind various theories of hierarchy of need, and the one from which I usually borrow, concocted by Norris Hansell in the 1970’s.

He wrote (not in these exact words) that we all need, in order to remain mentally healthy and stable:

1. Basic housing, clothing, food, water, and information.

2. A sense of identity (from family, job, interests, community, tribe)

3. At least one relationship “that approaches intimacy”.

4. At least one connection to a group that gives us a sense of membership, belonging.

5. A skill or activity that provides us a social role and a sense of usefulness.

6. Currency: money or skill, some negotiating power.

7. A system of meaning, or at least an organizing principle that gives us some sense of predictability.

Norris also pointed out in his book, The Person-in-Distress, that a threat to any one of these attachments, as he called them, is a threat to all of them, or loss of any one of them could cause a collapse of the others.

He wrote this in the early 1970’s so when he talked of the loss of information he was thinking of the absence of information that comes with social isolation or withdrawal, rather than today’s problem of social isolation combined with massive amounts of, but potentially false and definitely skewed information, available to all of us in this digital age.

Similarly, he could not have anticipated “membership” in virtual groups, or online dating sites.

Still it is easy to see how the pandemic and the lock-downs can threaten any one of those seven “attachments”. And how, if one is threatened, all are at risk and why such a high percentage of people are reporting a deterioration in their mental health.

But that list also suggests the things we need to do to get through this period relatively unscathed:

1.Ensure everyone has housing, adequate food, and accurate, clear information.

2. In some manner maintain even more contact with family, friends, community.

3. Single person households pairing in a bubble with one other person or family.

(note the increase in pet ownership through the pandemic)

4. Regular virtual contact, or outdoor socially distant contact, with a group.

5. An activity, a new regular activity, building something, art, cooking, gardening….

6. Learn how to share a skill virtually, or learn a new skill.

7. And for those of us who do not have firm religious convictions, it is time to walk in the woods, meditate, practice mindfulness, watch the leaves unfold, and contemplate.

Note to self: There cannot possibly be as many serial killers in the real world as I have watched being tracked by fictional detectives on my television the past year. Oh, and for God’s sake, get some exercise.

The Complete Demise of SMI Advocacy in Ontario – A Warning to Others

Marvin Ross

I’ve written about the former Schizophrenia Society of Ontario (SSO) and its venture into the dark side but this is the ultimate end for what once was a good organization. I had written before that they had become the Institute for Advancements in Mental Health – IAM which I’ve normally thought of as dog food. But they have descended even further in abandoning support for the families of people with schizophrenia and it is a warning to other family advocacy groups on just how bad it can get if you are not vigilant.

What particularly perturbed me was their activity for this year’s Mental Health Week. This is what they did on May1 in their own words:

Kick Off Mental Health Week With A Virtual Wellness Event! Join us for IAM’s first-ever “Mental Health is Everyday Health” digital event on Saturday, May 1st, from the comfort of your home. The virtual sessions are dedicated to prioritizing your mental health and wellness, and will be available online so that you can take part at your own pace! Making time daily for the maintenance of your health and happiness is more important than ever. Register for IAM’s Mental Health is Everyday Health event for free and learn about tools and strategies to improve and maintain your physical and mental state. Take part in virtual yoga, guided meditations, live music, maintaining a home garden, workshops on anxiety & stress, and much more! Can’t tune in on Saturday? All sessions will be available for your viewership during Mental Health Week, May 3-9th. Reserve your spot today by clicking the button below! Register Today! Sponsored by: ‌ ‌ ‌ ‌ Institute for Advancements in Mental Health | 95 King St. , Suite 300, Toronto, ON M5C 1G4

What does any of this have to do with schizophrenia or advocacy for better services or support for families? Not only is this very sad and an abandonment of what the organization was established for by families but I purposely left in the address they gave for themselves – 95 King St in downtown Toronto. King St is a very long east-west thoroughfare that runs through downtown and the business/financial section of the city. It has an east and a west so any mail sent to 95 would be returned to the sender by the post office. It is close to the head offices of major banks and the stock exchange so I suspect the rent is quite high.

This is 95 King St E courtesy of google:

This is 95 King St W


I mention this only because this sloppy reporting is not unusual. Years ago, before I quit along with the entire executive of our local chapter because of the direction the organization was going, they put out a report to the public that spelled schizophrenia wrong.

It is a sad reality of organizations that they often get hijacked from their original intent and become something else entirely. I see that happening with NAMI as well but hopefully not to the extent that SSO did. Originally established by family members as the Ontario Friends of Schizophrenics, SSO was a dynamic organization that fought very hard for improvements in mental health care.

One of their major accomplishments was lobbying for the implementation of Community Treatment Orders which came about close to 20 years ago. The health care sector was not a fan because they were continually challenged to do better by irate family. I learned of this fear when my son was first diagnosed in the late 1990s. He was in the hospital undergoing assessment and we were called in to meet with the psychiatrist.

We found ourselves in a large room with his shrink, her resident, nurses, and a whole bunch of staff. I was familiar with schizophrenia but asked if they had literature with more detail on treatments and prognosis. They didn’t and suggested I find some information myself although I have no doubt that if the diagnosis was cancer, they would have. Also being a bit familiar with the schizophrenia group, I said I would call them for help.

The reaction was astounding as the entire room went silent and they all looked at me. I felt like I had loudly farted while being introduced to the Queen. When they finally came around, they said that might be good. And so we joined. Any organization that can elicit that sort of reaction because of their advocacy and support is OK with me. Fortunately, today, the psychiatrists I know are far more proactive about treatment and the need for services for those with serious mental illness. I doubt very much if any of them would push for yoga sessions or gardening.

What the Audio from Body Cams Can Teach Us.

By Dr David Laing Dawson

With the trial and conviction of Derek Chauvin, plus the new attempts at transparency and the quick release of body cam footage and 911 calls, CNN has been able to report and discuss a new piece of police violence almost every evening. Usually the discussion focuses on culpability, racism, lethal force, grieving families, and the law, with an emphasis on racism.

But it is the audio of these events I find most revealing.

Over the years when I have had the opportunity to teach crisis intervention or de-escalation, a couple of times with police but usually with mental health professionals, I have emphasized two basic things. These are:

SLOW DOWN – and,

For Crisis Intervention (de-escalation) to work at least one person needs to be NOT IN CRISIS.

The only time, and these events must be rare, that SLOWING DOWN is not advised is when the mental health worker or police officer is actually witnessing one person attempting to kill another person. Not talking about it or threatening, but actually in the act with a serious weapon. That would be a moment, rare as it must be, when quick action is required, and perhaps force, or potentially lethal force.

Otherwise, SLOW DOWN. Then calm down. Back up even. Breathe.

But in the audio of the recent events you can hear that the officers are in a state of crisis, or high arousal, in fight-flight mode. There is fear and urgency in those voices as they scream, “Taser, taser, taser.” or “Show me your hands. Raise your hands, raise your hands.”

It is not the least surprising that the sounds we hear after these screams of urgency and fear are the sounds of multiple gunshots.

Perhaps the fear in those voices is linked to racist attitudes, a whole culture of racism and the guilt, fear, anger, and suppositions racism leads to. It might also be linked to PTSD suffered by these particular officers on the front line. Perhaps these officers should never have been put in crisis situations.

Or, at the very least their training and culture need an overhaul.