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





 

Wednesday, November 20, 2013

SSW108: Mental Health - Mood Disorders

Video: Mood Disorder Spectrum: A Simple Explanation Of All Mood Disorders

5 Types of Bipolar Disorder (Mental Health Guru)


Feeling depressed VS Suffering from depression


A cartoon of public interest, not really funny but quite important, graciously prepared by Le Pharmachien.

21 Comics That Capture The Frustrations Of Depression

Buzzfeed, (2013).

[Editor’s note: This is by no means a definitive list. The comics featured here can not and do not represent everyone’s experiences. But there are some things they do capture. Part of the difficulty of depression is that it is a pain that is unnameable. Sometimes, art is the best way to capture the things we do not know how to say.]


Article: Public health approach to bullying and suicide prevention urged 

CBC News, (2013). Public health approach to bullying and suicide prevention urged: Links between bullying, depression and suicide in youth examined in study.

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Take This Test! What is Your Score? We will debrief it in class.


Stress Assessment

This test, based on the work of mental health experts Thomas H. Holmes and Richard H. Rahe, helps you identify the sources and amount of stress you encounter in your life. The following is a list of stress inducing events, in the order of their Life Change Unit (LCU), from high to low. Note all the items that apply to events you have experienced during the last year and add up their LCUs. Then take a look at what you can do about your stress level.

Monday, November 18, 2013

SSW108: Mental Health - Stress and Trauma

Stress, Portrait of a Killer - Full Documentary (2008) (56:04)







For a lot of us, success in life starts with learning the right habits. And for parents, it’s essential to start children off on the right foot by teaching them good habits from an early age.
In fact, there’s one “habit” in particular that parents can pass on to their children – one that can help kids in many different ways, and that’s mindfulness.
Parents who introduce mindfulness to their kids can help them experience emotions, rather than react to them, and give them a way to identify their mental states before they become overwhelmed by them.
Video: Mindful Change from an Early Age: How to Practice Mindfulness with Children





Effects of Traumatic Experiences 
From the U.S. website Athealth.com, which provides an overview of trauma and its effects and symptoms.



Centre for Addiction and Mental Health

CAMH’s brochure Common Questions about Trauma outlines what abuse-related trauma is, how the effects of trauma develop, and why healing and getting help are important.






Trauma-informed Care
Canadian Centre on Substance Abuse. 

Thursday, November 14, 2013

SSW107: Addictions - Intervention & Harm Reduction

What is the most effective way of holding an intervention?


Video: 5 Crucial tips for hosting your own drug intervention


We’ve just completed a new guide to help the family and friends of an individual who is struggling with a drug or alcohol problem. OurIntervention Guide, available as a free download below, offers information, tips, and advice for holding an addiction interventionand helping a loved one into treatment.
The guide lays out in simple terms:
  • What an intervention is
  • How to recognize over 20 “warning signs” that your loved one may be using drugs or alcohol
  • Who should be involved and what’s expected of each person
  • How to conduct the actual intervention discussion
  • How to write your own “intervention letter” (including a “fill-in-the-blanks” worksheet)
  • What to say to 14 of the most common objections that may arise
  • How to select the right treatment center for help
  • What friends and family can do to help themselves
Download The Free Intervention Guide


Harm Reduction

Yet they failed to do so: recommendations based on the experiences of NAOMI research survivors and a call for action

Susan Boyd* and NAOMI Patients Association, Harm Reduction Journal. 
Harm Reduction Victoria goes to Council


SALOME Study: Treatment for Heroin Addiction (2/7)




SALOME Study: Treatment for Heroin Addiction (6/7)


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By Allen Garr, A. (2013 ). Vancouver Courier.

The new rules introduced by the federal government Thursday as part of what it's calling The Respect for Communities Act will make it harder for health care activists to open more supervised injection sites in this country.
What the federal government was unable to do at the Supreme Court of Canada in 2011 to shut down InSite on East Hastings - Canada's only supervised injection site available to the general public in Vancouver and the proliferation of such institutions across the country- it is now attempting to do with this act.
Reading through the initial press release from the Tory Minister of Health Leona Aglukkaq, it's clear Ottawa is continuing an attack that willfully ignores the mountain of scientific evidence based on 49 peer-reviewed papers published in scientific journals.
That evidence shows undeniable health benefits to both injection drug users and their communities that have resulted from InSite's presence in the Downtown Eastside over the past decade.
The federal health minister says "our government believes that creating a location for sanctioned use of drugs obtained from illicit sources has the potential for great harm in communities." But the facts tell a different story in our city.
Because injection drug users have a supervised place to shoot up where they come in contact with health care professionals, there has been an increasing number of referrals to health and social programs. There has also been a reduction in overdose fatalities; a reduction in the transmission of blood-borne infections like HIV and Hepatitis C; a reduction of injection-related infections. And, the police will tell you, a reduction in public disorder.
As well, obviously, there has been a reduction in health care costs.
InSite legally exists because of a special exemption from Ottawa so they can have illicit drugs on the premises. The Supreme Court ruling in 2011 said that failure to grant that exemption was a violation of Section 7 of the Charter of Rights that guarantees life, liberty and the security of the person. In other words, refusal to grant an exemption would endanger people's lives.
Ottawa continues to take the opposite view in The Respect for Communities Act. And the minister is clear that her government intends to "raise the bar" for applicants.
What they are asking for before an application for an exemption can even be "considered" is a demonstration of support from local law enforcement, municipal leaders, public health officials and provincial or territorial ministers for health.
The applicant would also have to include documentation showing that treatment options are available for those dealing with addiction. As far as Vancouver's InSite goes, it has had and continues to have support from all those areas. But what is now unknown is just how high the bar will be set by Ottawa in terms of the support. Would it require every elected official, every member of a community and every regional police force to sign on, for example?
And even then, applications could be rejected once considered.
The irony here, and one that Dr. Evan Wood with the B.C. Centre for Excellence in HIV/AIDS points out, is this: There are hundreds of needle exchanges in Canada supported by the federal government. These collect used needles and give out clean ones. Surely the government doesn't think this is a service that only meets the needs of diabetics.
So while it is willing to approve a service that allows addicts to shoot up in back alleys, unsupervised and often using water from puddles in their syringes, it's hesitant to approve a much more controlled environment.
In supervised sites, the user cannot take needles out into the street. They must fix in the presence of a health care professional. They must deal with drug counsellors who will engage them and encourage them to move on to treatment. And they must conduct themselves in an orderly fashion.
For some ideological reason that defies science and experience, Stephen Harper's government would rather support a system that puts people's lives at greater risk and is more damaging and costly to our communities.
Watch for this one to end up in court.
agarr@vancourier.com
© Copyright 2013.

Video: B.C. health provider, patients file lawsuit over heroin access

CBC/The Canadian Press Posted: Nov 13, 2013. 

Wednesday, November 13, 2013

SSW107: Concurrent Disorders

Concurrent Disorders
Canadian Centre on Substance Abuse (CCSA)


Trauma and Addiction - Michael Krausz 1/3

Trauma and Addiction - Michael Krausz 2/3


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CMHA. 

This issue of Visions explores the theme of co-existing mental health and alcohol/drug use problems from a number of different angles and includes personal stories, approaches and models, regional programs in the community, and resources.

Substance Abuse in Canada: Concurrent Disorders
Canadian Centre on Substance Abuse (CCSA) (2010). 

BC Partners for Mental Health and Addiction (2009). Concurrent disorders.

BC Partners for Mental Health and Addiction (2009). Depression, anxiety, alcohol and other drugs.


Centre for Addictions and Mental Health. (2004). Youth and drugs and mental health: A resource for professionals