Category Archives: Mental Health Awareness

When the Mental Health System Refuses to Listen

By  Maria Lorenzoni With Marvin Ross

Much of my writing on mental illness and the flawed system that we have to endure deals with privacy and the absurdity of keeping family and mostly parents in the dark about their loved ones diagnosis, treatment and progress. Maria Lorenzoni recently  gave this  edited presentation this past August to the Service Coordination Council on Mental Health and Addictions of the Central Ontario Local Health Integration Network (LHIN). The LHINs co-ordinate services in geographic areas.

She describes her families experiences with the secrecy of the treating officials and the impact that had on her family. Here is what she had to say:

Every serious sickness is stressful for family members, but caregivers of people with severe mental illness face challenges that are unique in some ways. Imagine for a moment that someone you love has been stricken with a devastating stroke and is in the hospital and can’t communicate, at least for the moment. Now imagine the doctors treating him or her and not giving you details of the diagnosis, prognosis, the exact information in their reports, or the treatment plan. Or just leaving you out of the picture completely. And then imagine the patient slowly recovering, but still not cognitively able to function properly, and perhaps unhappy that they are in hospital, and then being visited by a patient advocate to be informed that he or she doesn’t have to stay in hospital if they don’t want to.

You would argue that this is absurd.

According to a statement from the College of Physicians and Surgeons of Ontario, physicians can share information with others involved within the patient’s circle of care without asking for the patient’s consent if the doctor has no reason to assume that the patient would object.

Sadly, this does not apply to mental health!

In my case, it was only after three hospitalizations that I was able to press the family doctor to give me the diagnosis of my loved one. We finally got our son  into the Centre for Addiction and Mental Health and we were desperately trying to find the right meds and treatment plan. He doesn’t have insight into his illness, he doesn’t think he needs meds, so it took some hard work to get him to cooperate. And then, this vulnerable person that is in serious need of care is visited by advocates who tell him he doesn’t have to stay there.

Then what?

The onus is entirely on the family to persuade the person to stay in treatment. As a family member, you try to cooperate as best you can, BUT, you are not allowed to have any private discussions with the doctor unless the patient is in the room. Being spontaneous and giving some helpful comments is tricky when the person is right there. The doctors, therefore, make all their decisions based on communication with a patient who’s confused and will not share much because they don’t think they are sick.

He finally went to a Home for Special Care and was put under a team.  While we acknowledge the good work they did, there were a lot of misunderstandings and frustration due to a lack of communication.  No one is perfect, and families need to listen to constructive comments without being made to feel that they are just part of the problem.  In the time that he was there, we had three short meetings with the team , there were serious problems with reactions to meds, but we were not given input.  In fact, when I asked a question, I was told quite clearly…”look, you be the mother and we’ll be the treatment team.”  My family was shunned and made to feel that we were not cooperating, and in fact, we were discouraged from even visiting.

SO, POINT NUMBER ONE – family caregivers need to be able to give and receive information (unless there is a very clear reason not to), be given a diagnosis and prognosis, and consulted on a plan of action for the future.

SECONDLY, we definitely need a media campaign to focus on the obstacles faced by people with “hard core” mental illness. Sadly, the current campaign to destigmatize mentally ill is aimed at the people who have a more socially acceptable emotional problem like depression and who are in a position to ask for help. People are under the mistaken notion that everyone with a mental illness has easy access to good, consistent, hands on care. I’ve spoken to some in the health field who have asked me why my loved one isn’t in one of those residences that provide “professional rehabilitation”, and another health professional who recommended that I access a support group that helps caregivers with the tremendous grieving process that comes with caring for someone with serious mentally ill. They didn’t realize that there are no residences with professional staff, and while some support groups are good, none of them have a counsellor to help caregivers, and actually some of them are nothing more than lectures with information that you’ve read from a book a dozen times.

SO, POINT NUMBER TWO – we need to promote public awareness that people with illnesses like schizophrenia exist – that they are from every walk of life, they are people just like everybody else, they are not the dangerous individuals you imagine them to be and CONTRARY to popular opinion, they do not have easy access to services. Caregivers also need counseling as well to be able to deal with living with their loved ones on a day to day basis

NOW, THE THIRD POINT, and the most difficult, is the problem of housing. There are far too few residences and the ones that are available are overcrowded. A few are decent, others have low standards, and the people who live there are not in a position to stand up for themselves.

People with very serious mentally ill are most in need of supportive housing, yet they are the least likely to obtain it. They DO NOT GET MEDIA ATTENTION, AND DO NOT HAVE A VOICE. There is no easy solution, but with SOME BRAINSTORMING AND SOME PROPER REDIRECTING OF FUNDS, some pilot projects can begin to appear. Families would be delighted to help in any way they could, and IN FACT, THEY NEED TO BE PART OF THE PROCESS, so that a proper support system could be implemented.

I know so well that parents of adult children with serious mental illness are very concerned about the future of their kids and want to see them living in a place where there is hope, dignity and support.

If the public becomes more aware, and less afraid of mental illness, if there is more communication with families on the part of health professionals, more guidance and support for families and the hope for proper supportive housing, the future can be much more promising.

 

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Harambe the Gorilla and Mental Illness

By Marvin Ross

Like many, I was saddened to see Harambe shot. Was he helping the toddler as the initial photo may have suggested or was the toddler in danger as the subsequent video suggested? I have no idea! But I am astounded that there are seven petitions out there for people to express their dismay. One petition is approaching 500,000 signatures as I write this while another is getting close to 200,000 signatures.

That’s a lot of people who want justice for the gorilla.

Sadly, there is far less of an outcry when someone with untreated mental illness gets shot by the police. According to the Washington Post, a quarter of those shot by the police in the US were mentally ill. In Canada, according to a recent documentary on police shootings, 40% of those shot by the police are in a mental health crisis.

Here is one example of Toronto Police shooting a poor man in his hospital gown after he ran out of hospital https://www.youtube.com/watch?v=RbWUnzvAgb4

Shootings of those with untreated mental illness is only one small part of the injustices suffered by those who develop a mental illness in our society. In Canada, 38% of incoming prisoners suffer with a mental illness. Their offences often result from a lack of proper treatment. In Ontario, 40% of prisoners in solitary were locked away for 30 or more straight days. This is twice the limit permitted by the UN in its Nelson Mandela Rules. The main reason for the solitary was mental health or special needs.

Homelessness in Canada is accounted for by mental illness or addiction in between 23 and 67%.

In the US, a recent report found that there are 10 times the number of mentally ill in prison than in hospital. The consequences of not treatment, according to the Treatment Advocacy Center is homelessness, incarceration and violence.

And so few people care about any of this! Instead, we angst over one shot and killed gorilla.

To paraphrase Stalin one dead gorilla is a tragedy, a million maltreated and ignored mentally ill is a statistic.

Isn’t it time we showed some compassion for the mentally ill and gave them appropriate treatment and support?

What if Mental Health Awareness Was Successful – Chaos?

By Marvin Ross

Mental health awareness week/month/whatever is designed, in part, to reduce the stigma towards what is called mental health issues and problems – a politically correct phrase. One commenter on my last post that was skeptical of mental health awareness pointed out that stigma prevents people from seeking treatment. “If more individuals with mental differences (a politically correct phrase if ever I’ve heard one) seek help, they will be less likely to commit crimes, or end up homeless.”

Let’s say that’s true. All those people who were afraid of stigma actually began to seek help. Where would they find it?

They won’t because It is not there!

As I pointed out in my blog on Mental Health Awareness, the Mood Disorder Society of Canada found that 91% of people who were seeking help in Canada wanted to have greater access to professionals. Over one third had to wait for over a year to get a diagnosis.

This past winter, a 17 year old girl was discharged from an Ottawa hospital still suicidal after spending 8 nights in the emergency room waiting for a psychiatric bed. That same month, the emergency room in the Ontario city of Guelph was at a standstill because they had a psychiatric bed shortage. There were over 10 people in a psychiatric crisis with no beds for them. In Vancouver, a man is discharged from hospital early and given a bus ticket. Within an hour, he jumps off a bridge.

Inuk artist, Beatrice Deer has recently complained that “it was difficult to get therapy, because there weren’t any therapists,” as she pleads for a state of emergency to deal with suicides

In the US, the Substance Abuse and Mental Health Administration reported that only 35% of the reasons given for failing to seek help was because of what we could call stigma – negative opinions from others was at 10.6% and negative impact on jobs was 9.5%. The absolute biggest reason was that they simply could not afford to get help at 45.4%. A little over a quarter thought they could deal with the problem on there own.

What if the US had universal health care like other industrialized countries and cost was not an issue? From everything that I’ve read, they do not have sufficient resources. The Treatment Advocacy Center has begun a national campaign to lobby for more psychiatric resources in that country.

In Canada, we do have universal health care. Psychiatric services and hospital stays are free. The problem is that we do not fund psychiatric care to the same extent as we do other illnesses. In my last blog, I cited this from the Centre for Addiction and Mental Health in Toronto:

While mental illness accounts for about 10% of the burden of disease in Ontario, it receives just 7 per cent of health care dollars. Relative to this burden, mental health care in Ontario is underfunded by about $1.5 billion.

The provincial auditor in British Columbia has just released a report pointing out that mentally ill people in that province need more services than they are getting now.

So, let’s forget about stigma and focus on getting proper funding for those who suffer from mental illness. A mental illness is no less worthy than cancer, heart disease or any other illness.

It’s time for parity.

 

A Dose Of Reality Is Needed For Mental Health Week

By Marvin Ross and 1st published in Huffington Post May 11, 2016

In Canada, the first week in May is designated “Mental Health Week,” and according to the Canadian Mental Health Association, the purpose is “to encourage people from all walks of life to learn, talk, reflect and engage with others on all issues relating to mental health”. We are encouraged to #getloud for mental health.

In the US, the entire month of May is devoted to “mental health”.

However, I have to say that I am perplexed about the reason we “celebrate” mental health in both Canada and the US. I assume we are celebrating, but I’m not really sure what we are celebrating or what we are doing.

What is not “celebrated” is our abysmal record on providing treatment and resources to those who suffer from serious mental illnesses like schizophrenia, bipolar disorder, severe depression and other illnesses. And note, I said illness not health. There is a difference. A poster circulating on the internet expresses the problem extremely well. It says:

Saying “Mental Health” for schizophrenia is like saying “Physical Health” for cancer

You can substitute serious mental illness for schizophrenia above.

Justin Trudeau had this to say at the start of the week, “Let us use our voices this week to help change the way society views mental health issues and those living with them. Now is the time to GET LOUD for mental health.”

And of course, he uses the word issue as in mental health issues. Hamilton psychiatrist and fellow blogger on Mind You, Dr. David Laing Dawson, discussed the use of the word issue in one of his blogs and commented that “by calling mental illness an issue we are placating the deniers of mental illness and we are reducing it to an abstraction, a topic for discussion and debate, rather than a reality in our midst….”

And he ended his blog by stating “But let’s stop with the “issue” when we are naming or describing a painful reality.”

The painful reality of mental illness in both the US and Canada is that we do not have enough resources like hospital beds, community treatment, housing, etc to provide the proper treatment that is currently available for these who suffer.

Readers of my blogs on Huffington Post know that many of them deal with the inadequate services that those with the most serious mental illnesses receive in Canada. It is hard to pick out one as so many of them deal with this problem. If we were to have a realistic group of people representing the faces of mental illness in Canada, we would have someone who is in solitary confinement in a prison and someone who is homeless.

One of Correction Services Canada’s top priorities is to deal with the mental health needs of its population. They estimate that 38% of incoming prisoners suffer with a mental illness. In his June 2015 report, the Correctional Investigator of Canada, Harold Sapers, found that “mental health issues are two to three times more common in prison than in the general community”.

In Ontario, the Globe and Mail recently analyzed the long-term solitary confinement of prisoners in Ontario and found that 40% were locked away for more than 30 or more straight days. This is twice the limit permitted by the UN in its Nelson Mandela Rules.

The Globe reported that:

On 40 per cent of the files, staff gave mental health or special needs as part of the justification for their prolonged segregation, a figure that seems to clash with provincial policy stating that segregation should never be used for inmates with mental illness until all other housing alternatives have been considered and documented.

In the US, a recent report disclosed that there are 10 times the number of mentally ill in prison than in state psychiatric hospitals. Most of them, the report states, would have been in psychiatric hospitals before they began to be closed. The largest mental hospital in the US is Cook County Jail in Chicago.

And what about homelessness? According to the Centre For Addiction and Mental Health in Toronto, surveys of various Canadian cities put the percentage of homeless who suffer from mental illness at between 23 and 67 per cent. Furthermore, “While mental illness accounts for about 10% of the burden of disease in Ontario, it receives just 7 per cent of health care dollars. Relative to this burden, mental health care in Ontario is underfunded by about $1.5 billion”.

Again, in the US, about one third of the homeless are people who suffer from untreated mental illness

In a 2015 survey done by the Mood Disorders Society of Canada, the top priority for the respondents (91 per cent) was the need to have greater access to professionals. Over one third (38 per cent) said that the wait for diagnosis was over 12 months. In the most recent tragedy that took place in the middle of Mental Health Awareness Week, a 38 year old man was released from Burnaby, BC General Hospital where he had resided for three days due to suicidal thoughts. His mother had asked hospital staff to release him to her care but they did not do that. They gave him a bus ticket and sent him on his own. He committed suicide shortly after.

Clearly, as a society, we need more than simply being aware of mental health once or twice a year. We need a time when we can reflect collectively on how inadequately we treat those amongst us who have a brain illness. And we need to lobby to right that wrong. The money spent on these awareness campaigns could be put to better use providing more services for those who desperately need them.