through understanding: A way forward
Presentation to Ontario
Select Committee on Mental Health and Addictions
Thursday June 18th 2009
am not here to praise the system of care for the seriously mentally ill.
It is derailing and is in for a big crash. I hope that you, as elected
officials, listen carefully to what I have to say, and act upon it. This
mess was not created by one party. It was a long time in the making. If
you all survive the next election you could help to put in place
something that might work for those 3 percent of the population with the
most serious mental illnesses. Families and their loved ones will be
eternally grateful if you do so.
three decades I have seen activists who call themselves consumer
survivors aggressively push some very scary agendas. People paid by the
system and bureaucrats have supported these agendas often out of self
interest. You will hear from these people often. Much of what you hear
will be dead wrong and very
dangerous for the 3% with brain diseases. Some courageous professionals
have spoken out against the nonsense, but have often been side-lined.
Compassion through real
understanding would be a step in the right direction. Those
consumers who deny that schizophrenia and manic depression are not
medical illnesses should not speak for those who need medicine to put
their lives back on track.
of those who use phrases such as mental health issues, anti-medical
model, medicalization of the mentally ill, alternative therapies, and
wellness models. These people go on about labels and choice. Some of
them even say that stigma is worse than the illness itself! Absolute
came across the following:
“Consumers have a personal responsibility for their own self-care and journeys
of recovery. Consumers must strive and give meaning to their experiences
and identify coping
strategies and healing processes to promote their own wellness.” Where does this come from? Concept 9 (Mental Health
Services Administration. Department of
As Dr. Sally Satel MD says, “if any psychiatrist followed
the ten fundamental principles of recovery elaborated in the statement
from NIH to the letter, he/she would be at risk of malpractice.” (See
utterances have displaced more important priorities like careful
diagnoses, state-of-the-art medical treatment, and much needed
stabilization for those with these serious illnesses. The silly
politically-correct talk has so far won the day, and many who have the
more serious diagnoses are left to fend for themselves, on the streets,
and in our jails. The mess is clearly here to stay unless families have
the courage to speak the truth, and professionals and politicians act on
will likely be many more chronically ill, unless someone heeds these
warnings. This will place a bigger burden on families and on the long
term care system.
and Manic Depression must be accepted as no-fault illnesses. Those
afflicted have lost in genetic roulette. These are physical
illnesses just like Multiple Sclerosis. The much touted “recovery
movement” clouds the issue. It would be more honest to talk about
stabilization and management, as one does with insulin-dependent
diabetes. We must counter the
discrimination that leads to
dollars and services being denied to the seriously mentally ill. Other
serious neurological conditions (Multiple sclerosis, Lou Gerig’s
disease) are readily accepted as no-fault conditions and do not require
us to demonstrate that they need healthcare dollars.
FAMILY BLAMING IS STILL GOING ON.
It now comes with a new twist. See email in your material.
This was written by someone who did a survey for the Canadian
Schizophrenia Society. I was stunned and flabbergasted by this one.
EVIDENCE OF SYSTEM
evidence indicates total system failure. We see more mental health
courts, increasing police involvement, and less hospital beds. In
droves, the seriously mentally ill are landing in jail instead of in
hospitals. The numbers in jail instead of hospital are mind-boggling. (I
refer you to the Simon Fraser data on BC incarcerations. This 111 page
document comes with a breakdown on diagnoses.)
professionals who are trying to do an exemplary job caring for those
with the most serious diagnoses – Schizophrenia, Manic Depression –
are given little encouragement to do what they were originally trained
to do. Many opt out to look after the more frequent milder psychiatric
conditions. The currant mantra is that 1 in 4 people have a mental
illness. Using statistics in such a way is bound to eventually backfire.
Do we give service to the common cold or do we treat pneumonia? Both are
important, but the question is which takes precedence? Ignoring those
with Schizophrenia and allied disorders places a very heavy burden on
society, families and taxpayers. For make no mistake, the public pays
one way or another.
knowing a bit of my training, drafted me to participate on a Canadian
Mental Health Association (CMHA) committee in 1980. They were just
getting going here in
to having children I had been a State Registered Nurse (SRN) in
have sat on multiple focus groups and committees, both at Queen’s Park
and here in
left the SSO this year with some sadness because I believe that it has
strayed from its original purpose. Initially it was grassroots up. In my
view it is now top-heavy and muddled in its thinking. Family members
once had some power to affect things (see attachments by H Lamb: Family
Movement in Jeopardy).
Bill Jefferies had two brothers with the illness and one of his four
children was also afflicted. One of my four children is afflicted with a
serious mood disorder. Alas this did not become evident until 5 years
ago. Again there is some family history in generations past.]
THE MENTAL HEATH COMMISSION OF
It seems to have little sense of
direction and its priorities are questionable. Please see my response to
their recent draft. Appendix A
quick online trip to a recent British Mental Health Commission will show
that if the MHCC follows in those footsteps they will end up with
exactly the same mess (see One day survey by British Mental Health Act Commission … Few
hospital staff and extremely ill people being looked after by too few. Appendix
B ). Note that recently the British have allocated 18 million pounds
to battle stigma! Rather the money should have been allocated to address
the most pressing problems.
there is stigma but decreasing it should not be overplayed as a
cure-all. There is a naive assumption that removing stigma would take
people to treatment. Lack of
insight (anosognosia) is the biggest problem in terms of accepting
treatment. If you do not think that you are ill, why would you agree to
treatment? Stigma is not part
of this equation. As for anti-stigma campaigns, one beheading on a bus
will reverse any public gains they are attempting to make.
treatment seldom happens. Michael Wilson co-chaired an enquiry which
stated that only 25% get the treatment that they needed. It
would be lovely to reduce wait times, but if the system is clogged with
the ever-revolving door and lack of trained staff, what can anyone
who cannot speak for themselves are at the mercy of those who can. Those
calling themselves “consumer and sometimes survivors” are taking
over the system. This other population will continue to hold the high
ground along with those professionals who have a vested interest in
following along with such agendas. Those with very serious forms of
these illnesses are often let go by the very teams that are supposed to
look after them.
remains to be known about these devastating diseases, but enough is already
known to tell us that these sufferers have been unlucky in genetic
roulette. Yet, the MHCC goes on about prevention! Since we do not
understand the mechanism of these disorders, how can we possibly prevent
them? But we should be able to put services in place that will minimize
Society has a lot to answer for, but one’s personal biochemistry is not
one of them.
It should be stated and understood by those planning services
that these are no-fault diseases. The commission should stop going on
about primary prevention. It could, however, argue for adopting better
and more truthful strategies and promote better outcomes by proposing
realistic services that put beds
back into the system. Repairing the Mental Health Acts must be a top
AND MENTAL HEALTH LEGISLATORS often
fail to appreciate that
people who are in the throws of an acute psychosis lack insight to make
decisions that are in their best interests. Families have been denied
any right to aid their loved one in getting the care they so desperately
Eg. Scott Starson, Vincent Li.The recent
case here in Kingston of Toni Rossato.
Anyone who saw him on the stand knew that he was a time-bomb
waiting to go off. A handful
of lawyers were fired by this very sick man and many judges were
involved before he finally went to hospital. He spent nearly two years
in jail. He was not made
N.C.R because the defence lawyer argued that the patient would not be
able to work in the
untreated psychosis is always potentially dangerous. (Elevated life time
risk for suicide in schizophrenia 10-15%). Families suffer the brunt of
aggression if the condition is not stabilized. The danger is often
played down but its about time someone told the truth. June Conway Beeby
knows a lot about danger. Mathew, her young delusional son, drove two
ordinary dinner knives through his eyes. June will tell you about
danger. She is here today. When he was released from hospital she was
told never to be alone with him when he was released from hospital
because he was dangerous! Mathew was not taking his medication.
mental illnesses run in families. Their medical care must be state of
the art care and it must be a top priority. Those who say that stigma is
worse than the disease itself do not know what they are talking about.
Yet it is true that there is discrimination to those with these brain
diseases by some in the healthcare system even from healthcare
professionals. But stigma has
become a weasel word. Spending too much money trying to eradicate it
will lead nowhere. One beheading on a bus will do more to stir up stigma
than any big campaign will do to get rid of it. Compassion through
understanding would be a step in the right direction and repairing some
of the nonsense that has been peddled. If one suggested to an insulin
dependant diabetic that he did not need insulin, malpractice suites and
culpability would follow.
(a good report) but was put on the back burner.
The Graham Report paid
lip service to the top priority group but predictably strayed from its lip service because it had
another agenda. The local Crisis Centre in
Striking A Balance, and so on, were just more paper And now we have:
Moving in the right
out by mostly the foxes watching the chicken coop. Its report
is a waste of expensive paper, yet even it could not ignore the growing
numbers of people involved with the courts and the shortage of beds. I
suspect the presenters of this report really believe that if only there
was more community care funding all would be well. As for safe
non-hospital beds …! Will these patients be observed by trained staff,
or is it just a step up from a hostel bed?
happened to the report by the Conservatives
This report was co-chaired by Canadian
Ambassador to the U.S Michael Wilson. It disappeared with the new
Government! We have had enough reports. We need action.
What should be the correct number of acute and long term beds? Some
have suggested 100 beds per hundred thousand. A few years ago 32 beds
per hundred thousand was the aimed-for benchmark.in
To get a handle on what is needed one
has to look outside the country as well as from Province to Province.
Look at the prison population. These are the current beds. The
only place where I have uncovered serious data is in a report from Simon
Fraser about the mentally ill in prisons and jails in B.C.
Health and Human Services. CARMA (Centre for Applied research in mental health
and Addiction). This hundred page report has a lot of data. Diagnoses
within this prison population in B.C are well documented. This tells
precisely what happens when you take out too many beds. Someone
should pay attention to the fact that HIV, hepatitis and TB are serious
risks to the mentally ill who have slipped into poor life styles as a
result of their illness.
Society may have a lot to answer for,
but it is not responsible for the personal biochemistry which
predisposes someone to major mental illnesses like Manic Depression and
Schizophrenia. The walking wounded are quite different from those with brain diseases.
To muddle these two groups up does disservice to both.
When There are Almost No Beds Left.
H. Lamb MD et al.
A Family Movement in Jeopardy. Lamb MD and Hoffmans
response to the draft commission document.
One day survey of Psychiatric Hospitals.
Fight Stigma, Start with Treatment.
Schizophrenia: Medicine’s Mystery Society’s Shame. $10 dollars a
Madness in the Streets: How Psychiatry and
the Law Abandoned the Mentally Ill
by Rael J.
Isaac & Virginia C.
The Catalyst. The Treatment Advocacy Centre.
A Statement of Madness: The new guidelines for treating mental illness
Budgeting People to Death by Dr Jeffrey Gella
Schizophrenia. Breaking the Silence by Patricia Forsdyke
For transcript of P. Forsdyke's presentation to Ontario Legislature Committee Click Here
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This page was established in June 2009 and was last edited on 19 Sep 2010 by Patricia Forsdyke