Tuesday, December 10, 2013

SSW109 - Families: Selected Family Topics

Gross-Loh, D. (2013).Huffington Post. 

Article: Please Don't Help My Kids
Bassford Baker, K. (2013). Alameda Patch. 

Dear Other Parents At The Park:

Please do not lift my daughters to the top of the ladder, especially after you've just heard me tell them I wasn't going to do it for them and encourage them to try it themselves.

I am not sitting here, 15 whole feet away from my kids, because I am too lazy to get up. I am sitting here because I didn't bring them to the park so they could learn how to manipulate others into doing the hard work for them. I brought them here so they could learn to do it themselves.

It is not my job — and it is certainly not yours — to prevent my children from feeling frustration, fear, or discomfort. If I do, I have robbed them of the opportunity to learn that those things are not the end of the world, and can be overcome or used to their advantage.

I don't want my daughters to learn that they can't overcome obstacles without help. I don't want them to learn that they can reach great heights without effort. I don't want them to learn that they are entitled to the reward without having to push through whatever it is that's holding them back and *earn* it.

French children don't need medications to control their behavior.
Wedge, M. (2012). Psychology Today. 

In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological--psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children's focusing and behavioral problems withdrugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child's brain but in the child's social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child's brain.


Article: Society Tells Men That Friendship Is Girly. Men Respond by Not Having Friends

Waldman, K. (2013). Slate. 

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CTV News, (2013). 
A new study suggests more of the women who go to hospital with broken bones have been the victims of domestic violence than previously thought, yet few are being asked whether they’re being abused.

The study comes from researchers at McMaster University in Hamilton, Ont., who looked at close to 3,000 women who went to 12 fracture clinics in five countries: Canada, the United States, the Netherlands, Denmark, and India.

All the women involved in the study agreed to anonymously answer questionnaires about abuse.

One in three of the women revealed they had experienced physical abuse at the hands of their partners at some point during their lives. One in 6 admitted they had been assaulted within the past 12 months.

What’s more, one in 50 disclosed they had arrived at the clinic as a direct result of domestic abuse.
The researchers also found that of those with the worst broken bones and dislocated joints, two-thirds were linked to domestic violence.

“What surprised us the most is the severity of the physical violence was much higher than we expected,” says Dr. Mohit Bhandari, an orthopaedic surgeon at Hamilton Health Sciences Centre and one of the study’s researchers.

The researchers were also struck by the fact that only a handful of the women said a health-care professional had ever asked them whether they were being abused.
BBC News (2013). 
More than one in three women worldwide have experienced physical or sexual violence, a report by the World Health Organization and other groups says.
It says 38% of all women murdered were killed by their partners, and such violence is a major contributor to depression and other health problems.
WHO head Margaret Chan said violence against women was "a global health problem of epidemic proportions".
The study also calls for toleration of such attacks worldwide to be halted.
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Video: Intimate Partner Violence (7:35 min.)


Violence - a family tradition: Robbyn Peters Bennett at TEDxBellingham 


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Ruth Pearson | Working with resistant, hostile & uncooperative families

Video: Family Counselors Experiences with Multiculturalism - Part One

Sunday, December 8, 2013

SSW109 - Families: Families & Family Counselling

Video: Functions of the Family


Video: 2010's American Family Defined





An Introduction to Genograms


Family Therapy

Family Systems Therapy with Monica McGoldrick


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Mallee, M. 

Clinical Application of Theories: Understanding the Family as a System
H.
Dan Smith, EdD, MFT.

Thursday, December 5, 2013

SSW108: Mental Health - BC's Mental Health System of Care

Comic: If physical diseases were treated like mental illness

BC Mental Health Act (1996)

Vancouver Sun, (2012).

  • 1850: First reported case of insanity in B.C.
  • 1872: Victoria Asylum opens.
  • 1873: The Insane Asylum Act is introduced. It specified that a person deemed a “lunatic” should be committed to an insane asylum upon certificates issued by two doctors who examined the patient in the presence of each other.
  • 1878: Asylum for the Insane opens in New Westminster.
  • 1900: The principal causes of insanity are thought to be genetic, intemperance, syphilis and masturbation.
  • 1913: The Hospital for the Mind opens, housing 340 male patients. The name was later changed to Essondale and then Riverview Hospital.
  • 1954: The first psychiatric drug, chlorpromazine, used at Riverview in 1954.It replaced shock treatment therapy for severe depression and lobotomies for schizophrenia, mania and psychotic disorders.
  • The use of anti-psychotic and tranquillizing drugs transformed patient therapy theories, allowing patients and doctors to realize the mental illness was not untreatable.
  • 1955: Riverview reaches peak population of 4,726 patients and about 2,200 staff.
  • 1965: A new B.C. Mental Health Act encouraged locally operated mental health services, which led to the downsizing of Riverview and the transfer of patients closer to their home communities.
  • 1997: The 190-bed Forensic Psychiatric Hospital was built on the remaining Colony Farm land. It houses people in conflict with the law who at one time were deemed criminally insane, but the term has been changed to “not guilty by reason of a mental disorder.”
  • 2002: It was decided Riverview would eventually be phased out in favour of community-based psychiatric treatment.
  • July 2012: Riverview to close. Dr. Soma Ganesan, who spent a decade as the lead physician at Riverview and now is head of psychiatry at Vancouver General Hospital, suggested one building at Riverview be preserved as mental health museum.
Source: Riverview Hospital: A Legacy of Care & Compassion (2010)
© Copyright (c) The Vancouver Sun.

Mental health cuts disturb doctors

Vancouver Sun, (2013). 

As members of the Department of Psychiatry at Lions Gate Hospital, we are responsible for servicing the needs of those with serious mental disorders.

Our in-patient and community mental health services assist thousands of active patients every year. Anyone picking up a newspaper will find tragic reports of the mentally ill assaulting people, committing suicide, and clogging our prisons and hospitals.

This is why we were very shocked to be informed Vancouver Coastal Health (VCH), which manages Lions Gate Hospital, plans to cut $500,000 from the budget for community mental health on the North Shore.

This is a significant proportion of our budget and will result in staff layoffs and fewer services to the very patients who are causing such concerns.

These cuts will result in longer length of stay for patients in hospital, as well as make the integration of these patients back into the community much more difficult.

Longer lengths of stay on the in-patient unit will also unfortunately lead to a congestion of psychiatric patients in our emergency department.

The irony is not lost that mental health is moving to the Hope Centre next year, a multimillion-dollar building largely supported by private and community donations. It makes no sense that we will be moving into this multimillion-dollar building and yet be cutting positions.

The undersigned strongly urge that VCH reconsider these cuts in view of the damage it will inflict on the most vulnerable of society.

Thomas W. Barnett, MD
Allan Burgmann, MD

And seven colleagues at the Department of Psychiatry at Lions Gate Hospital

Drugs and lack of safe housing part of Vancouver's mental health crisis: experts (BC)

Luk, V. (2013). Montreal Gazette. 

VANCOUVER - A man wielding a knife threatens to kill passersby, another man says he'll burn down an apartment building and kill everyone inside, and a third man is taken to hospital after trying to throw himself off a bridge for the second time in one night.

The incidents happened within one week last month, and Vancouver Police say they're part of the shocking statistics that show a dramatic spike in such scenarios over three years involving the mentally ill and their subsequent contact with law enforcement and the city's hospitals.

Police say 21 per cent of their calls involve someone who is mentally ill, and apprehensions under the Mental Health Act have risen 16 per cent between 2010 and 2012.

Rising drug use and a lack of safe housing are major factors in the problem that is overwhelming limited resources, experts say.

St. Paul's Hospital, which sees most of Vancouver's psychiatric emergencies because of its proximity to the impoverished Downtown Eastside, has seen a 43-per-cent increase in people with severe mental health issues during the past three years, police say.

A recent review of the hospital's emergency department suggests that increased use of amphetamines, such as crystal meth and ecstasy, may help explain the increase in mental health patients.

"There is this interesting trend towards what appears to be increased drug-related (emergency room) visits, and drug-related psychosis," said Dr. Eric Grafstein, regional head of emergency medicine with Vancouver Coastal Health and Providence Health Care.

Grafstein said the St. Paul's emergency room saw about 4,700 patients with mental health-related complaints last year, up 1,500 visits from three years earlier.

But forensic psychiatrist Shabehram Lohrasbe believes the gradual closure over the last two decades of Riverview Hospital, a mental health facility in suburban Vancouver, plus the simultaneous "explosion of drug use" could have created the perfect storm.

"The mentally disordered are prime targets for the drug trade," he said.

"We dump these people on the streets, but even if they're provided housing, they're still very vulnerable to predators particularly within the drug trade. So the constant battle is not only to keep them on their prescribed medications, but to keep them away from drugs."

Lohrasbe said health officials probably did not anticipate deinstitutionalization followed by increased drug use when the government decided to close down Riverview in favour of community-based care.

At a roundtable discussion on mental health and addictions last month, the City of Vancouver estimated about 70 per cent of the city's homeless or single-room occupancy residents are seriously addicted and/or seriously mentally ill. Many also have brain injuries due to physical trauma, medical causes, or drugs.

A 100-bed facility in Burnaby currently offers treatment to people who are both mentally ill and suffer from substance abuse.

However, an affiliated pilot project that provided supportive housing for people with mental health, addiction, and chronic diseases was shut down last year.

The program operated out of Riverview Hospital, which closed down at the same time.

"Riverview has been in the process of closing for over 20 years," he said.

"If there was a specialized facility on Riverview grounds for this population it would be beneficial, but I don't think the closure of Riverview had anything to do with (the increase in the number of incidents involving people with mental illnesses). Most of the people who left Riverview in the last 10 years went to purpose-built new facilities that were appropriate for their needs."

A three-year, cross-Canada supportive housing program called At Home/Chez-Soi, funded by the federal government, had housed homeless people with mental illnesses and addiction, but it also ended last March.

"The most important thing when managing seriously mentally ill people is safe, secure housing," Lohrasbe said. "If you can guarantee that, everything else follows."

A five-point plan announced by Vancouver's mayor and the police chief includes calls for an additional 300 long-term, mental-health treatment beds, the establishment of a crisis centre, and more housing facilities to help the mentally ill.

Video: B.C. mental health system failing teens, watchdog says

CBC News (2013). 

In many cases, youth who were receiving mental health care were shunted off to shelters, emergency rooms or even jail.

"A young person described it as falling off a cliff. All of a sudden you're 16 and there's no treatment bed, there's no support [because] you're an adult," she said.

Instead, families are faced with a fragmented and under-resourced system that can be confusing and traumatic, Turpel-Lafond said.

Her report on youth mental health in the province found serious shortcomings and poor communication in a mental health system she described as a patchwork of services that was inconsistent from region to region.

The report says promises from a 2003 report to improve the mental health system for children have gone unfulfilled.

She wants to see the creation of a Minister of State for Youth Mental Health, responsible for building a three-year plan to create coherent mental health programs for teens.

Health Minister Margaret McDiarmid says such a plan will have to be discussed after the election, but she agrees that health care for mental illness needs to be seamless.

"There's a particularly vulnerable population that have two transitions: an age transition and a between ministries transition that we are not managing well enough today and we need to address that," McDiarmid said.

In the meantime she says 2,000 GPs in B.C. have received extra training to deal with mental health in their practices.
Video: What happens when a killer is found not criminally responsible?
16x9.

“I was standing right here and I hit the floor,” recalls Carol de Delley. “I went out the door and just screamed ‘No”!”
De Delley’s son, 22-year-old Timothy McLean, was killed in 2008 aboard a Greyhound bus just outside Winnipeg, Man.
In 2009 a court ruled Vince Li, the 40-year-old Edmonton man charged with the brutal slaying and decapitation, Not Criminally Responsible (NCR), meaning he was in a psychotic state at the time of the murder. Li, who has schizophrenia, was remanded to the Selkirk Mental Health Centre and is under the care of a psychiatrist.
Lori Triano-Antidormi also lost her son to a killer found NCR. Sixteen years ago her two-year-old son, Zachary, was stabbed 10 times by neighbour Lucia Piovesan, in Hamilton, Ont. Like Li, she has schizophrenia and is housed in a mental health facility receiving treatment.

“People think about punishment, right. And that these people need to be punished. But they don’t commit the crime out of ill intent. They commit it out of an ill mind,” says Triano-Antidormi.

Video:Improv is a safe space’: Laughs help treat mental health issues (NS)

Wong, J. (2013). Global News. 

SSW108: Mental Health - Assessment & Treatment & Neurological Disorders

Experiential: Mental Health Assessment Part 1


Experiential: Mental status examination, therapeutic and non-therapeutic


Experiential: Psychiatric Interview Pt. 2 Standard


Lecture: Mental Status Exam (1 of 3)


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OUR MISSION STATEMENT – “To provide a voice to promote a better quality of life for those living with acquired brain injury through education, information, prevention and systemic advocacy.”


Tuesday, December 3, 2013

SSW108: Mental Health - Personality Disorders & Psychopathy

All 10 Personality Disorders | Overview & Symptoms


Time For A Divorce Husband Films His Wife Throwing A Tantrum When He Says No To Her (ORIGINAL VIDEO)



What is Borderline Personality Disorder? (Mental Health Guru)

How BPD Forms in a Child
What is Narcissistic Personality Disorder? (Mental Health Guru)
How to spot a PSYCHOPATH (2 min.)
Signs of Psychopathic Behavior
Labyrinth of the Psychopath 7 - Key Traits
How to spot a PSYCHOPATH (12 min.)
Thomas Sheridan: Labyrinth of the Psychopath 8 - Gaslighting
 
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Australian man has been found guilty of throwing his Canadian fiancée off the balcony of their high-rise Sydney apartment
Pearlman, J. (2013). The Telegraph.

A dramatic murder case in Australia that captivated the nation has ended with Simon Gittany being convicted of throwing his fiancé, Lisa Harnum, a glamorous former ballerina, from the balcony of their luxury apartment in the centre of Sydney. 

The case made national headlines, not least because Gittany, 40, arrived in court each day with his new girlfriend, Rachelle Louise, a 24-year-old model who bears a striking resemblance to his dead fiancé. 

The dramatic case involved a sad tale of “insane jealousy”, obsession, manipulation and a dysfunctional relationship in which Ms Harnum felt desperately confined but unable to escape. 

In the weeks and months before her fatal plunge from the 15th floor of their apartment opposite Hyde Park on a bright Saturday morning in 2011, Gittany used a computer program to spy on her fiancé’s text messages and installed tiny security cameras inside and outside the apartment. 

By the end, she was frantic and told her mother in their final phone conversation to contact her counsellor “if something happens to me”.

The New South Wales Supreme Court today rejected Gittany's plea of innocence, finding that he had a violent temper and killed Ms Harnum in a "fit of rage". 

"I'm confident to the point of actual persuasion that he maintained his rage, carried her over to the balcony and then dropped her over," said Justice Lucy McCallum. 

As the verdict was revealed, Gittany’s loyal girlfriend, Ms Louise, screamed “You're wrong!".
Announcing the verdict before a packed court, Justice McCallum said Gittany left his fiancé "in a state of absolute fear and despair". 

"There can be no doubt the accused was controlling, dominating and at times abusive of Ms Harnum," she said.

"The force of his jealous and controlling personality met mixed reaction from Ms Harmum, who was at times defiant and at times submissive to an inexplicable degree.”

The judge found Gittany reacted with "nothing short of rage" when he learnt that Ms Harnum was secretly was making plans to leave him.

On the morning of Ms Harnum’s death, footage taken from a secret camera showed the couple had a violent quarrel outside the apartment and she yelled “Help me – god help me!” as he dragged her inside.

"At many times in his evidence, the accused struck me as being a person playing a role, telling a story which fitted with the objective evidence but which did no more than that," Justice McCallum said.

"His account of what happened appeared to exist on borrowed detail. It lacked originality and the subtlety of actual experience." 

Monday, December 2, 2013

SSW108: Mental Health - Psychotic Disorders

What is Schizophrenia? (Schizophrenia #1)



ABC 20/20 Schizophrenia




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My Battle with Schizophrenia: "Rats Were Eating My Brain"
Hawkes, E. (2013). My Battle with Schizophrenia: "Rats Were Eating My Brain." Huffington Post Canada.

Over a period of six years (when I was in my early to mid-20s) whenever I was hospitalized for my schizophrenia, restraints and seclusion were used repeatedly, readily, and beyond necessity. Also, I was over-medicated, probably not for my own sake, but to make me a more manageable patient. I was lost in my psychotic world, to the point of bashing my head on the concrete walls on the psych ward. For this, I understand the use of restraints. However, they, along with seclusion, were over-used, to the point of being a punishment rather than for my safety.
By my 12th certification (forced hospitalization) for schizophrenia they would outfit a stretcher with restraints while I was still waiting in Emergency. As soon as I was admitted, they would call a Code White -- aggression -- and within seconds, it seemed, a group of four to five Security officers was there, holding me down as I flailed and kicked and screamed with rage as they restrained me. Wrists, ankles, chest; I couldn't even wipe my falling tears away.
I wept not only because of being tied up; I cried for the high doses of sedatives and anti-psychotics the nurses injected into me, for the strip-search, for the forced changing from street clothes into hospital pajamas in front of all those (mostly male) Security guards.
Then, the stretcher-bound, pajama-clad, medicated me was placed in solitary confinement.
This did not happen just once. Or twice. Try over dozens of incidents. Restraints would last hours, hours, hours; later, when untied, I would be locked in a seclusion cell for as long as a week at a time. Cell, not room: a thin mattress on a concrete "frame," silver toilet in the corner, camera, and a door with no knob on the inside reminds one of a jail cell.
They did all this because I was bashing my forehead bloody on the concrete walls. See, in my schizophrenia, I strongly believed that miniscule rats were eating my brain and, reminiscent of leeching, bleeding them out was most effective.
What else could they do?
Restraint and seclusion: banned?
What would they do with me now?

National study links adolescent marijuana use with higher risk of psychosis

Prest, A. (2013). Winnipeg Free Press. 

"... a four-year national study that revealed that smoking marijuana, particularly heavy use in early adolescence, increases the risk of psychosis by as much as 40 per cent. Psychosis, one of the symptoms of schizophrenia, is often characterized by hallucinations and delusions.
The study, called the Cannabis and Psychosis Awareness Project, showed marijuana use in youth who are prone to psychosis -- mental illness in the family -- makes them four times more likely to develop psychosis."
The study involved 50 young Canadians who then created a video Awareness Strategy for Youth (www.cannabisandpsychosis.ca).
Chris Summerville, executive director of the Manitoba Schizophrenia Society and the CEO of the Schizophrenia Society of Canada, said the youth in the study found the use of cannabis hindered their recoveries and interfered with the effectiveness of medication.
"Here’s the bottom line, from various studies, is that if you have mental illness in your family of origin you are at a greater risk of developing psychosis and schizophrenia being triggered if you use cannabis," Summerville said.
"Kids need to know. Guidance counselors, youth pastors, anyone working with adolescents, they need to give youth this information as part of Health 101, so to speak."
Dramatic growth in anti-psychotic drug use even targets infants, experts say

Kirkey, S. (2013). Dramatic growth in antipsychotic drug use even targets infants, experts say. Postmedia News.

According to Panagiotopoulos, a pediatric endocrinologist at BC Children’s Hospital, so-called “second-generation” antipsychotics, or SGAs, are being prescribed to two- and three-year-olds for aggression. Doctors have become so used to seeing side effects in children on these drugs — including sudden and massive weight gain and diabetes  — that they no longer bother reporting them to Health Canada.

“A lot of parents come to me as a specialist and say, ‘No one ever told me about the side effects, and I didn’t think to ask,’ ” said Panagiotopoulos, an associate professor at the University of British Columbia“They can’t understand why their kid went from drinking water, to seven litres of Coke every week.”

There appears to be no limit to how much we’re willing to allow doctors to medicate our apparent psychological angst. Last year, more than 74 million prescriptions worth $2.6 billion were filled for psychiatric drugs in Canada — more than 203,000 prescriptions a day, and up from 58 million prescriptions in total in 2008, according to data compiled by prescription drug research firm IMS Brogan for Postmedia News.

The growing embrace of medications to treat “broken” minds is a triumph of drug company marketing, experts say, the selling of new diagnoses and overzealous prescribing of pills for conditions for which they have never been approved.

Second-generation antipsychotics are increasingly being prescribed to children for attention deficit/hyperactivity disorder, “conduct” disorders, “frustration intolerance” and even poor sleep. The drugs can cause side effects such as elevated blood fats and abnormal blood sugar levels. As of Dec. 12, 2012, Health Canada had received 17 fatal reports in children related to SGAs, and, despite guidelines to doctors, experts say the risks to children are going largely unmonitored. Only one of the drugs, aripiprazole, or Abilify, has been approved for use in children, and only then for schizophrenia in teens aged 15 to 17.

At UBC, Panagiotopoulos’s research has shown that children exposed to second-generation antipsychotics have three times the risk of developing pre-diabetes or Type 2 diabetes compared to children never treated with the drugs; more than double the risk of becoming overweight or obese; and 30 times the risk of metabolic syndrome — a cluster of health problems that increases the risk of heart attack and stroke later in life.

No one knows what the long-term effects might be on a child’s developing brain. Still, prescriptions for the drugs to children under 14 increased 10-fold in B.C. alone between 1997 and 2007. Across Canada, from 2005 to 2009, antipsychotic drug prescriptions for children and youth increased 114 per cent. Surveys suggest that 12 per cent of all prescriptions are for children aged eight and under.

The drugs — which are being used for symptoms and diagnoses in children that have never been studied — can cause potentially irreversible movement disorders if untreated, such as uncontrollable spasms and tremors, involuntary movements of the jaw and tongue, puckering of the face, and frowning. In older adults, the drugs have been linked with an increased risk of sudden cardiac death. Another rare but life-threatening side effect, neuroleptic malignant syndrome, or NMS, is fatal in about 10 per cent of cases, said David Gardner, a professor of psychiatry and pharmacy at Dalhousie University in Halifax.

Postmedia News. 
Inman, S. (2013). For Psychotic People, Medication Means Survival. Huffington Post Canada.

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What is Delusional Disorder? - Mental Health Guru


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Organizations & Resources