Smiling Through - New York Times

By Dick Cavett - June 28, 2008,

Who decided that it’s variety that’s the spice of life?

I submit that, rather, it is contrast that is life’s piquant condiment.

Last week, I attended two events in my home state of Nebraska that supplied both variety and contrast on successive days. A bit like the Mafioso some years ago who got married one day and began a 10-year jail sentence the next (a cynic might consider them both “sentences”).

On the one hand, I addressed a group of noble citizens whose job is aiding and counseling poor devils suffering from depression. “Cavett Returns Home to Discuss ‘The Worst Agony Devised For Man’ ” read the next day’s headline in the Lincoln paper. Despite the subject matter, I got quite a lot of laughs. My credentials? Having been there myself.

The year before I had talked to a similar group of care-givers in Omaha in front of an audience that included what you’d think would be an entertainer’s nightmare: a hundred or more people in the throes of the disease. I expected no laughs.

I had just gotten started telling the grim faces that I knew what they were going through when a large man — in pajamas, as I recall — stood up and slowly made his way toward me.

“Paranoid schizophrenic,” someone stage-whispered to me. There was general tension in the room as the man continued to approach. When he stopped two feet in front of me, and stared at me, I heard myself say, “Come here often?” Loud general laughter broke the tension. He returned peacefully to his seat — probably without having heard me or the laughter.

Miraculously, I kept them laughing for perhaps an hour. Clearly the fact that I knew about their plight from my own experience had a lot — or maybe everything — to do with it.

I was able to say to them, I know that everyone here knows that feeling when people say to you, “Hey, shape up! Stop thinking only about your troubles. What’s to be depressed about? Go swimming or play tennis and you’ll feel a lot better. Pull up your socks!” And how you, hearing this, would like nothing more than to remove one of those socks and choke them to death with it. (Laughter mixed with some minor cheering.)

The reward from this was unique in my experience. Afterwards, those in charge seemed amazed and delighted. One said, “See Clara over there? She hasn’t moved a muscle in her face for six months and you had her laughing out loud.”

(Such inane advice of the “socks up” variety, by the way, can only be excused by the fact that if you’ve never had it you can never begin to imagine the depth of the ailment’s black despair. Another tip: Do not ask the victim what he has “to be depressed about.” The malady doesn’t care if you’re broke and alone or successful and surrounded by a loving family. It does its democratic dirty work to your brain chemistry regardless of your “position.”)

My time with them in Omaha a year ago was not recorded but I would rather have a tape of that day with that audience than just about anything I’ve done. Of the things I said to them I can recall only this story:

Personal item: Once I said to a doctor during a “session” that I wished he could get inside my head for just a minute because there’s no way of imagining what this feels like. “Oh, I know,” he said, “I got pretty sad when my father died.”

Defying standard protocol on the couch, I arose on one elbow, turned to him — he was seated behind me — and said, “Do you think grief is even close to this?” To his credit he replied, “I’m sorry. I shouldn’t have said that.”

(The anger you feel at such a moment pumps a shot of adrenaline that can make you feel symptom-free . . . all too briefly.)

The fact that these afflicted people in Omaha knew me to be a “celebrity” had a good deal to do with the unexpected success of the whole thing. Some had even seen me talk about the nasty illness on television in the early ’80s, or in People magazine. While not wishing to become the poster boy for depression, I still found the rewards undeniably pleasant, gratifying and touching.

As in: Dear Mr. Cavett, You don’t know it but you saved my dad’s/ wife’s/daughter’s life. Followed by various forms of, My dad’s seeing that Dick Cavett could have it made him feel he wasn’t a freak, and he finally went for treatment. We are so grateful.

Apparently one thing I said on “Larry King” back then hit home hard. It was that when you’re downed by this affliction, if there were a curative magic wand on the table eight feet away, it would be too much trouble to go over and pick it up.

There’s also the conviction that it may have worked for others but it wouldn’t work for you. Your brain is busted and nothing’s going to help.

The most extreme problem that depression presents is suicide. It’s the reason you don’t dare delay treatment. Don’t mess with it. Run for help — whether it’s talk therapy, drug therapy or the miraculous results of ECT (electroconvulsive therapy, erroneously labeled “shock therapy”). The shock involved is closer to insulin shock than electric shock. It’s a toss-up whether more people have been scared off it by “One Flew Over the Cuckoo’s Nest” than have been scared off medication by Tom Cruise’s idiotic braying on the subject on “The Today Show.” (Matt Lauer should have hit him with a wet turbot.)

I guarantee that one result of this week’s Supreme Court decision on guns will be the deaths of people who have a gun at home for the first time while in depression. In the depths of the malady, getting a stamp on a letter is a day’s work. Going out to somehow arrange for a gun would be way beyond your capability while stricken. But having one near at hand is another matter. There were times when I longed for my ancient .22 single-shot squirrel-hunting rifle. Luckily it had been given away years earlier.

Suicide rarely happens when you are all the way down in the uttermost depths. Again, it’s too much trouble. Perhaps the saddest irony of depression is that suicide happens when the patient gets a little better and can again function sufficiently. “She seemed to be improving,” is the sad cry of the mourners.

Two prime victims of the disease are your libido and your ability to read. Five times through a paragraph and unable to say what it’s about. But, oddly, you can read a book or article about depression with full comprehension. The two best books I know of are William Styron’s monumental account of his own case, “Darkness Visible,” and Kay Redfield Jamison’s “An Unquiet Mind.”

Damned if I had meant to rattle on so long on this subject, depriving you of my contrasting event, the Johnny Carson Comedy Festival in his hometown of Norfolk, Neb. (I’ll get to that.)

And pardon me for teasing you last time about a promised tale of espionage and murder. The case is more complex than I imagined and will take some time.

And is anyone still wondering about the error by the test-makers on that exam that American students performed so dismally on?
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Witnesses offer details of arrest in W. Warwick - Providence (RI) Journal

By Lynn Arditi

WEST WARWICK — A couple who witnessed the struggle between police and a mentally ill man who died in police custody Friday night says they saw five officers on top of the man as he lay face down on the ground, his legs kicking, while the officers tried to handcuff him.

Nicole Frink yesterday recalled standing at her bedroom window with her boyfriend, Mark Fiore, at about 11 p.m. and watching the man getting “elbow jabs to the ribs” as the officers pinned him down on the parking lot pavement behind Joyal’s Liquor Store, at 90 West Warwick Ave.

At one point, the man on the pavement turned his head to the right, said Fiore, and an officer “smashed him in the face with his knee.”

The officers were responding to a call from a motorist who reported seeing people damaging the liquor store’s sign. The first officer on the scene found 47-year-old Mark Jackson, who had been staying at his mother’s apartment next door, walking behind the liquor store.

The West Warwick police said in a statement issued Saturday that Jackson “did not comply with officers’ requests” and that as they approached him he became “combative.”

The officers struck Jackson with their batons on his “lower extremities,” according to the police statement. Jackson was “speaking with officers as he was being placed in the police vehicle.”

Upon arriving at the station within two minutes, the statement says, the officers “discovered Mr. Jackson was no longer breathing.”

The police yesterday declined to make any statements about the cause of death pending a scheduled autopsy today by the state medical examiner’s office.

Yesterday, local officers and state police detectives canvassed the neighborhood, questioning witnesses. The five officers involved in the arrest have been assigned to “administrative duty,” said West Warwick Capt. Mark Knott. The police declined to identify them.

Inside the West Warwick apartment where Jackson had been staying with his mother, family and friends gathered yesterday in grief and shock.

“It’s all wrong,” Jackson’s mother, Juanita “Anita” Jackson, said. “He was headed home — walking home.”

His sister, Karen Petro, of Warwick, said her brother had never been in any trouble before. The man described in the statement by West Warwick police, she said, was not the brother she knew.

“They killed him. They killed him,” Petro said, her voice cracking. “And, as his sister, I’m not gonna let this go away. I know my brother and he’s never done anything …”

MARK DAVID JACKSON, of 777 Cowesett Rd. in Warwick, grew up in Pittsburgh, the youngest of five children. He attended high school and later worked as an auto mechanic. It wasn’t until the mid-1980s, after his parents separated and his father died, that he became “very withdrawn,” his sister said.

It was after he came to live in Rhode Island in the mid-1980s that Jackson was diagnosed with schizophrenia. For a time, he was on medication, his mother said, but in recent years he had stopped taking it.

He received federal Supplemental Security Income payments, his mother said, and managed his own money. But he spent most of his time at his mother’s apartment, sleeping in the bedroom that she’d given up, she says, because she preferred the living room couch.

“He was very quiet; he never said anything,” his mother said. “I’ve never known him to put a hand on anybody.”

She said her son spent his days lazing in the bedroom, watching TV or lost in his own thoughts. Occasionally, he played an electronic keyboard she had bought him. She didn’t drive, so she’d given him her 1993 Mercury Sable and he drove her to doctor’s appointments and to the grocery store — usually preferring to wait in the car until she returned.

Jackson was a familiar figure to people who worked in the nearby stores. He’d stop in each morning at the Dunkin’ Donuts to buy a large iced coffee—with cream and sugar—and a “supreme pizza,” said Julie Monteira, 21, who works behind the counter. He’d often stroll over to Joyal’s Liquor Store to buy Phillies miniature cigars, said Patricia Rajotte, a store employee. He’d sometime sit quietly by the liquor store loading dock, smoking.

On Friday night, it was warm in his mother’s apartment and Jackson went out for a walk, his mother said. He wore black trousers and a navy dress shirt. His mother waited up for him.

AT ABOUT 11 p.m., from the window of her second-floor bedroom overlooking the parking lot of Joyal’s Liquor Store, Frink, who works the night shift at the store, said she and Fiore were in bed watching TV when they heard a commotion outside. The couple said they went to the window, shut off their air conditioner so they could hear better, and watched as five officers pinned down a man they later learned was Mark Jackson.

The first officer to arrive called immediately for backup, said state attorney general spokesman Michael Healey, yesterday recounting information from a state police detective investigating the incident. After the second officer arrived, the two requested additional backup, he said. Three additional West Warwick officers responded. Jackson “had his hands in his pockets,” Healey said, “and the police commanded him to take his hands out of his pockets several times and he wouldn’t.”

Officers were knocked to the ground while scuffling with him. They then used pepper spray but it “seemed to have no effect,” according to the statement released by the West Warwick police. “Officers then used their expandable batons to deliver strikes to Mr. Jackson’s lower extremities. It was not until additional officers arrived that they were able to handcuff Mr. Jackson and place him in the rear of a police vehicle and transport him to the police station.”

Frink said she recalled hearing officers shout “Get your hands down! Put your hands down on the ground now!”

During the struggle, she said, Jackson kept screaming, “I love you. I love you.”

She said the episode she witnessed lasted about 10 minutes.

After the officers handcuffed Jackson, she said she saw a cruiser pull up to where he was lying, face down and motionless. One officer went around to the door on the opposite side to open it, she said, while three other officers lifted Jackson—two holding his legs and a third his upper body — and shoved him into the cruiser.

“He was not moving when they put him in the car,” she said. “He literally looked lifeless.”

Frink said she went to the state police barracks on Saturday and gave a statement about what she saw that night. At the time she made the statement, she said, she did not know who Jackson was or that he had died.

The state police and the West Warwick police are conducting a joint investigation into the death with the assistance of the Attorney General Patrick C. Lynch’s office.

If the state medical examiner cannot conclude from the autopsy that Jackson died of natural causes, Healey said, then a grand jury probably will be convened.

larditi@projo.com Read more!

Punitive school set to change -Athens (GA) Banner-Herald

By Ryan Blackburn | ryan.blackburn@onlineathens.com

The Clarke County School District will add a therapeutic element to the punitive alternative school, based on a successful elementary school program that's reduced behavioral problems in a small group of students.

Last year, the school district began a pilot program called Project Grow after noticing some elementary school students were misbehaving repeatedly.

Instead of suspending students, the school district contracted with Advantage Behavioral Health Systems and assigned 15 students in kindergarten through fifth grade to a program that emphasizes personal responsibility and is designed for young people suffering from behavioral and psychological disorders.

At the end of the 15-day program, teachers reported fewer discipline problems with those students, said Ernest Hardaway, the school district's deputy superintendent and student hearing officer.

As administrators plan to revamp the district's punitive alternative program - and combine it with the voluntary Classic City High School at a renovated H.T. Edwards Building - they will add that therapeutic model to help older students.

The overall plan for the alternative school, which the school district will rename Project Soar, includes at least two new employees, a therapist and a family engagement specialist - a social worker who helps families monitor their student's progress and communicate with the school, said Monica Knight, the school district's director of student achievement and educational equity.

"We need someone to investigate what kinds of needs (students) have, and those two people, the therapist and the family engagement specialist, would help with that," said Knight.

Working together, the family engagement specialist and therapist might help parents find the services they need - such as a food bank or medical clinic - along with organizing group and individual counseling sessions.

The school district already sends students with diagnosed emotional or mental health problems to Rutland Psychoeducational Center, a school designed to deal with those students' problems.

But alternative school students are removed from their regular middle or high schools as punishment, and until now, didn't get any counseling help beyond the services available to them before they got into trouble.

"We weren't providing (students) with what they needed before," Knight said. "They were provided with strictly academic services, not comprehensive services for a variety of behavioral and therapeutic needs.

"What we're saying is a Project Soar kid deserves to have the same level of teaching as a Classic City High School kid and a Clarke Central High School kid," Knight said.

The new therapeutic program is part of a massive overhaul of all of the school district's alternative programs, including the alternative school and Classic City, as well as a defunct program to help failing eighth-grade students catch up and rejoin their peers in high school.

The changes come as the school district prepares to spend between $11 million and $15 million renovating the H.T. Edwards Building, which once was the all-black Athens High and Industrial School but today houses school district offices, the alternative school and some pre-K classes.

Officials hope to begin construction this year and complete work by the beginning of the 2009-10 school year.

As a part of those changes, middle school students may be able to attend Classic City High School, a successful nontraditional high school that allows students at risk of dropping out a more flexible schedule and hands-on classwork.

"Just like we have high school kids who can't function in the traditional high school, we have middle school kids who can't function in the traditional middle school," Hardaway said.

The first middle school students might be eligible for Classic City beginning in fall 2009.

Administrators also will try to direct more alternative school students to Classic City, a program that could be a better fit for them than the traditional high school, Hardaway said.

"What we do is we assign them to the alternative school and when their term is up, they are sent back to the same environment," Hardaway said. "And we're trying to change that - we're going to give them another option."

Published in the Athens Banner-Herald on 063008


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Veteran suicide rates highlight heroes’ tough battle at home - Kansas City Star

By LEE HILL KAVANAUGH

Cara Davis knew her husband was still at war.

In the night, he would yell out his name — Dwayne D. Davis! — followed by his rank and serial number. He’d shout that he would never be taken hostage. Four times he tried to choke her because, in his nightmares, she was al-Qaida.

She knew what she had to do.

As gently as she could, she told him: I think maybe you have that disease, that post-traumatic stress thing. I think maybe you need some help.

“We talked about it,” she recalled. He had never told his buddies. “He said he was afraid if he did, the other soldiers would call him a coward.”

Finally, the pain was too much.

In December, a year after he got out of the Army, he asked for help. He spent 30 minutes talking with a psychology intern at a Veterans Affairs hospital. He told how he felt edgy and had trouble sleeping. He told about his rage and depression, his fatigue, his difficulty with crowds. He told about keeping a gun under his pillow and carrying a blade everywhere he went.

He had cleared the first hurdle, taken the first step.

But he never took a second.

Instead, two days after his 30th birthday, the Raytown native and Army veteran of four tours of war — two in Iraq, one in Afghanistan, one in Kosovo — became part of a grim litany of veteran suicide statistics.

Each day, 18 veterans kill themselves, according to the latest estimate from the Department of Veterans Affairs. No firm numbers are available, such as breakdowns of veterans’ suicides by the decade in which they served. There’s no unified nationwide system to track veterans’ deaths.

But 18 suicides each day translate to more than 6,500 deaths a year — and 21 percent of all U.S. suicides. Veterans make up about 8 percent of the U.S. population.

Now, with the fighting in Afghanistan and Iraq lasting longer than World War II, the number of troops returning home with some form of mental illnesses is increasing.

On April 22, Sgt. Davis came home after an 80-hour week in an Oklahoma oil field. He’d had car trouble. In a rage, he grabbed a rifle and shot out the windshield of his wife’s car outside their Elk City, Okla., home. Then he asked where his handgun was. She had hidden it earlier.

When she looked into her husband’s normally crystal-blue eyes, she shuddered. They “just looked black,” she said. She ran outside and hid in the backyard bushes. Before police arrived, she heard one shot.

And knew.

Her husband had killed himself.

•••

Cherie Durkin knows the hurting souls are out there.

Ten months ago, she became Kansas City’s suicide prevention coordinator for the VA. She goes to work each day hoping to connect with just one more veteran.

She smiled as she told about three Kansas City veterans alive today because of a telephone call each man made.

“They were rescued,” she said. The men had called the National Suicide Prevention Lifeline, 1-800-273-TALK (8255).

Durkin’s message to veterans and their families is to make the call for help.

“It’s a hurdle, I know. I’ve heard the word ‘cowardice’ so many times. But if your loved one can’t make the call, you as their spouse can,” Durkin said.

Spouses need to know that someone believes them when they say their military hero seems on the brink of mental illness, she said.

“We will try to help them any way we can.”

A recent Rand Corp. study of veterans of the Iraq and Afghanistan wars concluded that 19 percent of veterans suffer depression or stress disorders — an estimated 300,000 veterans among the 1.6 million who have served in those wars. By comparison, the American Mental Health Association estimates that about 6 percent of the U.S. adult population suffers depression.

Many veterans go without treatment. And the Rand study noted that mental disorders are more widespread and deeply rooted among vets than health care professionals had previously thought, often surfacing long after a veteran returns to civilian life.

Suicide among veterans “has been a moving target in the news lately,” said Janet Kemp, the VA’s national suicide prevention program coordinator. In the past few months, almost every week has brought new information regarding veterans, post-traumatic stress and suicide. Among them:

•The “Shh!” e-mail by Ira Katz, a top VA official for mental health, on the subject of the number of suicide attempts among veterans. Katz wrote: “Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among veterans we see in our medical facilities.”

That contradicted the number the VA reported publicly: 790 attempted suicides in 2007.

“Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?” Katz wrote.

•A congressional hearing this spring titled “The Truth About Veterans’ Suicides.” Rep. Bob Filner, a California Democrat and the chairman of the committee, was highly critical of the VA’s handling of mental health patients. The VA admitted at the hearing that its suicide numbers were higher than it previously had thought.

•Since the VA opened its suicide hot line last year, it has assisted more than 49,500 people who indicated they were veterans and has performed more than 1,000 rescues.

• Earlier this month, the VA put together two panels of experts to share ideas on ways to improve suicide prevention, research and education.

“Despite what the media has been saying about us, we’re working really, really hard and trying to hit every angle, trying to listen to everybody we can to reach our veterans,” Kemp said. “Hopefully, the message is getting out to veterans. … If we can touch just one life today, it’s worth it. It takes the courage and the strength of a warrior to ask for help. That’s our motto around here.”

One change the VA instituted is to have its suicide coordinators meet veterans at the door or elevator, trying to make a personal connection.

In Kansas City, that person is Durkin. She’ll greet veterans, walk them to their appointment and introduce them to their initial psychologist. She also is the one who will call back a veteran who reached out to the suicide prevention hot line.

“I try to make (getting help) as easy as possible for them,” she said. “Helping them feel comfortable here is important. If they feel like there’s a personal investment, that’s what will keep them coming back.”

She’ll talk with spouses about other ways to find help if the veteran doesn’t trust the VA or fears his medical records won’t remain private from the military.

She hears about the veterans who didn’t make it, like Davis. Looking at his medical records, which his family provided to The Star, she points out that he stopped going for treatment.

“Veterans need to follow through, too,” she said. “Getting them back here is hard, especially once they start feeling better.”

Depression doesn’t turn off like a switch, she said.

“It’s not off one day and on the next. It’s there, but nobody notices, except maybe close family members.”

•••

Donna Davis looked down, her eyes puffy and red.

In her Raytown living room, she caressed stacks of photos and newspaper clippings of her oldest child, along with an American flag, neatly folded into a triangle.

There’s a CNN photo of him manning a machine gun. Dwayne Davis was fighting in Afghanistan.

“He told me he was in Pakistan. And then I saw him on the news,” she said with a little laugh. “He thought he could fool me.”

And there’s a snapshot of a grit-covered Davis, the driver of a Humvee, carrying perhaps his most famous passenger, Geraldo Rivera. Both are mugging for the camera.

Donna Davis has plans to make a scrapbook. Her stack is growing daily. She’s already dug out many of Dwayne’s school photos. First grade: grinning so wide that the gaps caused by his missing baby teeth show. High school: a football player, down on one knee, dimples deep, eyes glinting. He graduated from Raymore-Peculiar High School in 1998.

She paused at each, memories crashing into her thoughts. But then her eyes grew dark, her brow furrowed.

Being in war “killed him just as surely as any bomb,” she said. “All those bodies he saw in Iraq, Afghanistan and Kosovo.”

Her voice trailed off. She wonders what she could have done. How she could have changed this. She had plans to see him. Maybe if she’d been there.

Almost the same thoughts come from his grandparents. Eleanor and Jim Poindexter of Belton had helped raise Dwayne since his 14th birthday — he was too wild for his single mother. They, too, are saddened beyond words. Not a day passes without tears.

“I think our government owed him to help him out as much as possible,” Eleanor Poindexter said. After some of his deployments, “he couldn’t even stand firecrackers on the Fourth of July.”

“This has been a horrible experience for us. I hope no other family has to go through it.”

•••

The grass at Fort Leavenworth National Cemetery rippled like waves on the ocean.

The widow squinted into the sunshine, shielding her eyes, searching. She recited its location from memory: “Section 53, row nine, 11th grave.”

There. Her eyes focused on one headstone, on a name her hand had written so often: Sgt. Dwayne D. Davis. She stared, seeing the sign, erected just days ago, for the first time.

“So strange to see it,” Cara Davis said, unable to catch a tear. Unable to explain how stark this feels, how strange, how final.

Workers nearby stopped digging the newest grave. Stopped talking. Interlopers in her private moment, they cast their eyes downward as if trying to render themselves invisible.

“Sometimes I’m angry at what he did, you know? Then I’ll remember how lovable he was.”

She twirled the wedding ring he gave her. She touched the gold locket on her neck. She traced her fingers across his name on the stone, feeling its chiseled coldness.

“I will never, ever be the same.”

She is now seeing the same counselor who would have talked with her husband, if he’d continued. She’s on medication to make her feel better.

“She’s helping me,” said Davis, but she struggles with wanting to sleep a lot.

“I’ve been going through all those stages of grief, and I’ve been thinking about suicide, too. But I’m not going to act on it. Those thoughts are normal after this.”

She feels the pain. Tries to roll with it. Let it out. Grieve.

“I’m like a lost little girl, taking one day at a time.

“That’s all I can do.”

What is PTSD?
Post-traumatic stress disorder affects many people who have lived through traumatic events. These events can include:

•Combat or military exposure.

•Child sexual or physical abuse.

•Terrorist attacks.

•Sexual or physical assault.

•Serious accidents.

•Natural disasters, such as a fire, tornado, hurricane, flood or earthquake.

For more information, go to www.ncptsd.va.gov .

Call for help
•The National Suicide Prevention Lifeline at 1-800-273-TALK (8255) is available for anyone. Additional resources are available if you press 1 and identify yourself as a member of the military.

•The Crisis Intervention Hotline, 1-888-899-9377, is for Missouri and Kansas residents who need assistance for anything from prescriptions to counseling, not just suicide issues. Calls will be redirected to helping agencies.

@ To read the report from Sgt. Dwayne D. Davis’ mental health interview, go to KansasCity.com. It was provided by his wife in hopes it might help others.

To reach Lee Hill Kavanaugh, call 816-234-4420 or send e-mail to lkavanaugh@kcstar.com.
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AMA meeting: Increasing use of Tasers prompts safety review - American Medical Association News

By Victoria Stagg Elliott

Chicago -- In response to concerns about the expanding use of Tasers and their possible impact on health, the AMA's Council on Science and Public Health will gather scientific data on injuries and deaths that may be connected to these electronic control devices for a future report, according to policy adopted at the AMA's June meeting.

"There remains controversy around the safety of Tasers," said AMA Board of Trustees member Steven J. Stack, MD. "Further study is in order to ensure that Tasers present the least possible harm to the people being subdued."

* Discuss on SermoDiscuss on Sermo
* Meeting notes: Public health
* See related content

Delegates are seeking this report because Tasers are increasingly used beyond law enforcement.

"Tasers are being used in some school settings and health care settings without any knowledge of the consequences," said Carol Berkowitz, MD, speaking for the American Academy of Pediatrics.

Some people are stunned by the devices as part of the how-to-use training. Background checks are required, but the devices can be legally carried as concealed weapons in many jurisdictions. A version is available to the public in nine colors, including two shades of pink.

"I would caution everyone about arming the world with Tasers. We need the science, and I hope we don't end up killing more people than protecting them," said Robert E. McAfee, MD, a former AMA president and general surgeon from Portland, Maine.

More widespread use also means more questions about whether these devices are overused and how dangerous they might be. The Commission for Public Complaints Against The Royal Canadian Mounted Police, a government-created independent agency, issued a report last month supporting continued use. But, because of public concern raised by several related deaths, the Canadian report urged Taser use be restricted to experienced officers.

The report also found Tasers were most likely to be used on unarmed males aged 20 to 39 who had been drinking alcohol. The document recommended the stunning devices only be used on people who were combative and presented a risk of inflicting death or grievous bodily harm. Medical attention should always be sought afterward.

In the scientific realm, several prospective studies have failed to find any negative cardiac impact, but case reports have documented a handful of associated injuries. A paper in the November 2007 Annals of Emergency Medicine reported details of a police officer who was stunned during training and sustained spinal fractures from the severe, Taser-induced muscle contractions. This possibility is included in the safety information accompanying the device.

"We need to let the public know that they are not as undangerous as they think," said Corliss Varnum, MD, a family physician from Oswego, N.Y., and a representative of the Medical Society of the State of New York.

Delegates were particularly concerned about Taser use outside of law enforcement, and the possibility that the devices could be used to control children or the mentally ill.

"Tasers have now been implicated in several deaths, and those with mental illness seem to be 'Tasered' with disproportionate frequency," said David Fassler, MD, a child and adolescent psychiatrist from Burlington, Vt., speaking for the American Academy of Child & Adolescent Psychiatry.

"When used properly," said Steve Tuttle, vice president of communications for the manufacturer, TASER International, "medical and law enforcement experts have concluded that Taser technology is among the most effective use-of-force interventions available to law enforcement officers to halt violent situations that pose a safety risk."

Statements on the company Web site indicate that 71 wrongful death and injury lawsuits brought against Read more!

Speak your mind - Toronto (Canada) Globe & Mail

Page upon page of letters responding to The Globe & Mail's weeklong series on mental health are printed below. The extensive multimedia series can be found here: http://www.theglobeandmail.com/multimedia

"One in five Canadians will experience a mental illness in his or her lifetime. It is a pervasive presence in almost all of our lives. And yet we rarely speak of it," writes Globe and Mail editor-in-chief Edward Greenspon.

"The mentally ill are not different; they are us. As a society, we have thrown off many of our social stigmas, but not yet those surrounding mental illness."<

People with mental illnesses face a stigma that can prevent them from getting care. It also stops the public from seeing the problem. Has mental illness affected your life or that of a loved one? Share your experiences with globeandmail.com readers and let us know what single change in society or policy would help the most.

As Globe readers submit their ideas and stories, check back here to read what they have to say. We'll post the latest offerings at the top.
At least one in five Canadians will experience some form of mental illness in their lifetimes.

At least one in five Canadians will experience some form of mental illness in their lifetimes.
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From the archives

* The working wounded
* The lonely madness of Alice G
* Some are born to endless night
* 'We must never give up on the potential of people to recover'
* 'A very designed life'
* The son who vanished …
* Meet an adolescent dedicated to speaking out
* Hockey star lends his name to mental-health campaign
* Editor's note: Speak your mind – and erase a stigma
* Excerpt from The Globe in 1890: 'At the Asylum'

Internet Links

* Resources: who to contact in your area
* Glossary: Mental health terminology

The Globe and Mail

Suzanne Solnik from Toronto writes: Nine years ago my husband took his own life at the age of 40, leaving behind me and my two children who were 2 and 8. He had been diagnosed with depression 3 years previously, and was successfully treated with medication. However, he changed medications to try and minimize side effects, and quickly spiralled out of control. He had never been suicidal during the entire course of his illness, until the last few weeks. We had recently moved to Toronto from Hamilton, where he was an accomplished physician. Because of the 'connections' we had with the medical community in Hamilton, as soon as he became ill, which was very suddenly, he received immediate care. This was not the case in Toronto, which I feel contributed to his death. He was still being followed by his psychiatrist in Hamilton, but when it became clear that his condition had become extremely serious, my family doctor told me that if I wanted to get him help in Toronto, the only way was to show up at an emergency department. There was no other way to be seen by a psychiatrist. He viewed a hospital admission as his last bastion of hope, and voluntarily admitted himself to a local facility. This turned out to be nothing more than a holding cell. The staff was anything but warm and caring, and the whole experience was humiliating and demoralizing. This was, if not the last, a huge nail in his coffin. He was released from the hospital on a Thursday, and they could not even find a psychiatrist to do follow up. Friday afternoon he jumped in front of a subway. Not a day goes by without feeling the pain of his absence, and wondering how things would be different for my children if he were alive. But I saw how much he suffered, and how little help there was available for him, and so I understand why he did what he did. No one is handing out awards to the mentally ill, as they do for others who struggle with physical conditions, but their efforts are just as heroic.

Posted Sunday, June 29

K. Shepherd from Toronto writes: In 2005 I developed major depression. I lost all my creativity & couldn't work as a freelance artist anymore. Family & friends distanced themselves. Others said, "Snap out of it!" My savings and credit maxed, and without disability insurance, I was in trouble. I appealed to the Ontario Disability Support Program (ODSP). They sent me to Ontario Works, (OW) where I received only $520 a month. I felt shamed to be on welfare but the depression wouldn't "leave" so I could make things better. My memory suffered and I became unsure and timid. I could only afford to buy cereal so I developed anemia. I fell behind in my rent, Hydro, Bell and cable. I needed to act but was too sick to pack my house and business and move everything into storage. Finally, I was evicted and over the following week, the landlord threw everything I owned in a dumpster parked in my driveway. He wouldn't allow me to get my property out. He destroyed over $25,000 worth of furniture, $20,000 worth of my art business and over $10,000 in art. My beds, dishes, carpets, drapes, clothes, food, etc., all went out. I was homeless for two months. I cried in bus shelters and people's basements. Nobody wanted me. In July 2005, I found a tiny room with a lumpy bed, for $500 a month. The landlady was a tyrant. Once, her boyfriend made improper comments to me but I just "took it" as there was nowhere else to go. One day, I entered hospital emergency, with quiet, tearful thoughts of suicide. I was shocked at the stark lack of concern shown by doctors. They sent me home, untreated. Three other times, I visited different hospitals' ER's. The staff treated me contemptuously each time. I had to find my own help. I'm now being treated for Post Traumatic Stress Disorder and with the compassionate aid of my expert therapist, I'll join this cruel world again. But today, at my age, I doubt I will ever be able to restore my business and reclaim the standard of living I had before depression changed my life.

Posted Sunday, June 29

Tricia W. from Calgary writes: Fifteen years ago I had a choice of perimenopause or depression. My doctor did the tests and decided on the latter, and prescribed medication. In 2006 I started missing work because I would wake up in the morning and literally could not force myself to get out of bed. My supervisor told me to fix my problem and stop missing work. She obviously thought I was faking my problem. My work attendance did not improve and last November she sent me for a 'fitness for work' assessment. The doctor who assessed me got it and put me on restricted hours. My supervisor still did not believe. I have seen 5 doctors, 3 counsellors and a psychiatrist. None of them has questioned the fact I am depressed; they are interested in finding out why and helping me fix what is dented and broken. Every time I brought in an updated fitness for work form from my doctor, my supervisor asked me when I would be back to full duties. Her support and concern has always boiled down to 'fix it'. Employers need more education to help them understand that people do not want to be depressed, but some of us are. It is a sickness, not an excuse to stay home from work. It helps to know that you are believed when you ask for help. I am back at work full time now but only because I decided by myself - and subsequently with my doctor - that it was time for me to do it. My supervisor continues to be as abusive as ever. I am waiting for her to ask me how I enjoyed my 7-month holiday.

Posted Sunday, June 29

Jean-Victor Côté from Saint-Bruno-de-Montarville writes: Workplace support for people suffering from mental health problems is a great idea in theory, but in practice it is like prompting the sorcerers to report to the Great Inquisition. Stand up and be counted among the excommunicated, i.e. those who will hit a wall whenever they want to be in the know and hold meaningful roles in the workplace. If rumour has it that you suffer from a mental illness, then you must obtain clearance either from a psychologist or a psychiatrist, but the stain of the insinuation on your reputation might stay on anyway, foremost in the minds of your co-workers. Especially if you do not want to submit to a professional investigation, whatever your reasons since there will be nobody to hear about them. There are no doubt many high minded individuals in those professions, but there are also many self serving ones. It is the latter that will misdiagnose treatable but incurable illnesses that will justify their protracted intervention and pander to the prejudices of those who will foot the bill. One may very well recover from mental sickness, if there was any to start with, only to be overcome by prejudice stickiness or the ensuing professional malpractice. Weaning from that kind of medication can make you sick. Legislation against workplace harassment is a laudable initiative in this regard, but the burden of proof is on the victim, if I am not mistaken. If the victim's testimony can be discounted because of a suspected mental sickness, then harassment can continue unabated and become a self-fulfilling prophecy. Constructive dismissal is what you do to someone when you have no grounds to fire him. And protection against discrimination in hiring practices for those who appealed to authorities against wrongful dismissal is non-existent. No witness protection program for them. Fortunately, it is still a criminal act to push someone who is out of his mind to suicide, whether or not the harassment is what brought the victim out of his mind.

Posted Saturday, June 28

Lori Savory from St. John's writes: I applaud the Globe and Mail for this series, and what it is doing to lessen the stigma of mental illness in Canada. Unfortunately, a significant category of mental illnesses has been left out of the discussions. Eating disorders affect a large number of households in Canada, yet the resources available for treatment are minimal. Many of the people suffering are teenagers and young adults. Eating disorders are misunderstood, misdiagnosed and mistreated. They affect every aspect of the sufferer's life and that of their family. They are life-destroying, life-threatening and lifelong. It wasn't until my family was touched twice by this horrific disorder that I realized the plight of those afflicted and the nightmare that families face. As with the other mental disorders you've profiled, eating disorders need to be discussed and understood.

Posted Saturday, June 28

Sylvia Paris from Toronto writes: I have been depressed on and off since adolescence, with no treatment until my thirties. I missed my teen years (the happy times anyways) because of this. Suicide has been thought of often as a way to end the pain. I have a strong family history on both sides, but my parents never recognized it in me and neither did I at the time. I was just sad most of the time and found it difficult to get from day to day. I always felt 'different' from others, as if I was leading a parallel life with a glass between me and the rest of the 'happy' world. I have 3 children, and I have made them aware of our shared history and have encouraged them to talk to me or to seek professional help on their own if they are feeling as I did. So far, all 3 seem to have been spared. With the help of therapy and medication, I am now in my 60's, and am doing OK, but the depression is always at the door for me, so I am ever diligent. This is a life-long illness but it can be managed and life can be better. It takes time and effort, but also understanding and assistance from others, especially spouses and parents. It is too hard to do all by oneself.

Posted Saturday, June 28

Elisabeth Robinson from Ottawa writes: I couldn't agree more with today's editorial in the Globe and Mail: Efforts to eliminate the stigma of mental illness are important, but they will be of little use if effective services are not available. Like many who have written in already, I have had a protracted struggle with mental illness - in my case, depression - and, until recently, received insufficient, inadequate, and sometimes downright retraumatizing 'help.' The main reason that I am now, in my forties, receiving better support is because I can afford it (and just barely, since my 'excellent' benefits cover only a tiny portion of the cost of therapy). It's a sad statement on our 'public' health care system. Since my early twenties when I first sought help, 'mental health professionals' of various sorts have: refused me help because I 'didn't qualify'; browbeaten me for being angry; given me long complex psychological tests, and told me little to nothing about what they revealed: 'It shows that you are impulsive'; made me take an IQ test, told me that it came out really high and that I could do anything I wanted, so just get on with it; told me I'm a privileged middleclass kid who has nothing to complain about and just needs to stop feeling sorry for herself (after, I went to work, burst into tears, and lost my job); told me, after one visit, they don't want to do therapy with me because I'm too negative; after finding me drugs that helped, refused my request for referral to therapy because 'therapy doesn't work'. Enough. I have finally controlled my troubles with drugs, dietary changes (I was diagnosed celiac and environmentally sensitive) and therapy. I think that people like me should be invited to be involved in fixing the present system. This system re-victimizes people with mental health issues by making them fell like hopeless rejects. It provides too little, too late, at too great a personal expense. Thank you Globe and Mail for providing this forum.

Posted Saturday, June 28

Fran Kordoski from Canada writes: I will probably be dismissed as unsympathetic and unenlightened. However I feel compelled to say that your statistics refer to those 'diagnosed' with a mental illness. This does not always mean they actually HAVE one. Far from being a stigma, this has grown to be almost a status symbol. Teenagers are sharing news about their latest bi-polar medication like they would about a new shampoo. I know several who have gone to a clinic, to a doctor who is meeting them for the first time, and walked out with a prescription and a diagnosis. Anyone who suggests that one can use logic to recognize irrational thoughts, and develop the ability to face them down with behavioural techniques, is vilified, unless they are a psychiatrist or counsellor who labels this advice 'Cognitive Behaviour Therapy.' I do realize that people are suffering and may need intensive help. But a reality check is needed. True mental illness is being trivialized when every episode of distress causes alarm bells, hysteria and self-identification as 'someone with a condition' that will require life-long medication. How depressing must that be?

Posted Saturday, June 28

Mark Roop from Canada writes: Hi, first thanks to this newspaper for taking a huge step to bring all this out into the open. For me, mental illness has been part of my life about as much as physical illness. Cancer got me at 5 ... how I survived is still strange to me. Unfortunately as a kid growing up with this I had to keep everything sterile clean at home... Separate bathroom.. separate towels etc... Somewhere along the line a switch went on and couldn't turn off... OCD was the result. Being afraid of going anywhere much less school was next to impossible. Treatment was spotty at best, psychiatrists were either too willing to shove pills down my throat or were too preoccupied on their theory on how to help (i.e. its all 'stress related'). Finally I went to college and seemed good for about five years and seemed to improve on my own. Around year six, with other factors involved, I wanted to end it all and sought help for it. Depression was what the campus medics thought, so again more pills. At that point I tried numerous times that I thought it was more than depression, but again I was ignored. At the end of that year I moved and again for a while things were good. Then i crashed again. This time I was hospitalized and given a diagnosis of bipolar disorder. Finally someone got it right. Unfortunately then though I had to move again for work reasons and have new people treating me. Not so good. I don't know which is worse, waking up in the morning not knowing who wears your face, washing like crazy or having doctors and therapists that just shove pills at you, not listen to you, treat you as person, not a disease. If we want to fix the system we need mental health professionals who are willing to listen to us fully and not just whip out the Rx pad and to treat us as individuals and tailor programs to meet out individual needs. For example, CBT is treatment plan and does not work for everyone.. and medication... well... don't say because you have this or that you have to be on 'x' mgs of medication 'X'.

Posted Saturday, June 28

Laura Nagel from Kingston writes: My only sibling killed himself 10 years ago when he was in his early thirties. I told my friends at that time that he died in a car accident, because it was easier than explaining that he developed schizophrenia when he was 15, and lived a difficult, lost life until his death. Now I tell people the truth: that he died because I failed him, his psychiatrist failed him, his family doctor failed him, his family and friends failed him, his school failed him, his country failed him. I would like to think that, if my children develop schizophrenia, it will be different for them.

Posted Saturday, June 28

Paul de G from Toronto writes: At long last, a very welcome addition to the true crisis that is besetting Canada. Mental health which has been ignored to our great detriment these past few decades is now exacting an incredibly heavy toll. As someone who works in the Criminal Justice system, I am continually appalled at the way in which the mentally ill are criminalized and warehoused. One wouldn't have thought that this would occur in Canada in the 21st century, but it does. This series does a long overdue service to those who suffer from mental illness by suggesting some very worthwhile remedies. The fear, echoed by other writers, is that this concern will just dissipate once the series is over. My question would be why there is such a proliferation in mental disorders in terms of prevalence as well as in variety of disorders. The standard response is that it is just because it is now more out in the open, but I wonder if there is something else at work here. Social breakdown, for one, would seem to be a contributing factor, as is disconnectedness and isolation. If this is the cost for the type of society that we are creating, then one wonders if it is worth the price. After all, we all collectively suffer if the mentally ill among us, are treated in such a unsatisfactory manner. Our humanity is really at stake.

Posted Saturday, June 28

Diane Dawber from Kingston writes: Dear Globe and Mail, I have witnessed a friend's son changing instantly from rational, commonplace conversation to wild, delusional talk. The trigger was a whiff of gasoline fumes. I have witnessed my friend change, from depressed and unable to accomplish anything to upbeat and forging ahead, by eliminating wheat from her diet. I have myself changed, from weeping at the drop of the hat to cheering on myself and everyone else, by adding minerals and vitamins in carefully selected types and amounts according to my genetic requirements. Since my mother committed suicide, I was in a high risk category and now I'm far from that. Nowhere in the series have I seen anyone suggest that simple things, like environment, diet and nutrition, have an impact on mental health. Wouldn't it make sense (and be cheaper) to do these things first before boring holes in skulls, applying electric shocks or spending years on medications and talk therapy? Our support group has just been studied (by the Environmental Health Clinic with U. of T. Medical School) and found to be one of the only successful models, simply because we address these simple issues. Please don't let your readers down by missing out on the most basic . Simple is good.

Posted Saturday, June 28

Jaeger Polotzski from Canada writes: I wanted to thank The Globe for publishing such an in-depth series on mental health issues in Canada. I am a young physician who has struggled for many years with depression and PTSD stretching back into my teens, and finally I am receiving help after almost hanging myself just after finishing my medical degree. Even though as part of my work I dealt with numerous patients with mental health issues, I feared being 'found out' by my peers and colleagues. I still fear it to some degree. One of the biggest issues in treating patients with mental health issues in the community is the lack of resources for counselling. I find myself often unable to get my patients therapy unless they have private means of paying for it. At over $140/hr for a qualified psychologist, patients are often medicated instead. Provincial health plans will pay for physicians' services but many psychiatrists do not provide psychotherapy and are focused more on psychopharmacology. The last patient I referred for counselling at a provincially-funded centre was placed on a one-year waitlist. The problem of the mental health crisis spares no one. In my very short career, I have already lost colleagues to suicide. I hope that The Globe's series will wake the government up to the cancer of the mind, and that finally this problem will receive the attention it needs and deserves.

Posted Saturday, June 28

Jose Gonzalez from Edmonton writes: My 25-year-old son was diagnosed with bipolar disorder a year ago, and the life of each member of the family has been affected since then. All of us have been in a roller coaster during the past year, seeing him stopping a promising professional career, losing his possessions one by one, friends, etc. I was also out of work for four months because of severe depression last fall. In our Hispanic culture, it is a big shame and stigma to recognize ourselves with a mental health problem; for some of our people, mental health problems do not actually exist. I truly thank you The Globe and Mail for this series because publishing stories from real people is a proper approach. Mental health in Canada can be addressed in an effective way by all stakeholders: Government, health providers, agencies, patients and their families and friends.

Posted Saturday, June 28

Arlene Saunders from Elora writes: Why? Why are psychiatrists at the bottom of the doctor pay scale? Why are dermatologists at the top of the doctor pay scale? Why did it take over six months for my son to see a psychiatrist? I think there is a co-relation. Why did the police assume my son was lying? Why did the police almost kill him in the booking room? Why didn't the police notify us that he was in custody? I think there is a co-relation. Why did my son enter a psychotic state? Why did he loose all his friends and his ability to do any task? Why did all of our worlds crumble around his? I think there is a co-relation. Why did it take over two years to prove his innocence? Why was he on curfew for over two years? Why was life stolen from my 16-year-old son? I think there is a co-relation. Why is he now living on his own? Why are there support workers helping him? Why is he working, whenever he can? I think his is very strong, and.... there is a co-relation. I made myself a promise that I would do everything in my power to make sure that he did not end up on the streets, in jail or dead - and because of the sorry state of our mental health and justice system he was heading like a runaway train to all of those scenarios. It has taken four years. He is diagnosed schizophrenic. He is on medication that keeps him thinking more clearly. He has not touched a sip of alcohol or pot in a year and a half. He is amazing. His reality is not conventional - but it is not harmful, he is unique. We need more help.

Posted Saturday, June 28

B. S. from Toronto writes: I have been immersed in the world of mental health not as an individual suffering from depression, but rather as a sister, sister-in-law, aunt, wife, mother and daughter of those afflicted with various mental illnesses. At times my life has been turned upside down as I attempted to be a supporting relative to my loved ones. Due to the importance of privacy because of the stigma of mental illness, I have often been isolated during those periods which led me to seek professional help and to confide in only the closest of friends. I am very happy and joyous in my own existence but sometimes the weight of supporting those around me has been heavy. Often friends assume I suffer from a mood disorder because I am depleted. I silently accept this but it is something I struggle with. Sometimes I'd like to climb to the top of a hill and share my reality with all those who sit in judgment. I can't begin to imagine if I feel this way how someone suffering with mental illness feels. We have a long way to go. One suggestion I have would be to gradually do away with the term 'mental illness' as it is too closely associated with visions from the movie One Flew Over the Cuckoo's Nest. I'm not sure what term should be adopted, but if we are to view it the same as other biological diseases, let's give it a name like 'Diabetes' or 'Parkinson's'. 'Mental' is like Kleenex--it's not going to change it's perception easily.

Posted Saturday, June 28

Walter Wilmot from Ottawa writes: Here's some of my story. My journey of recovery has taken me through the "stages of grief" - shock, denial, despair, anger, acceptance, hope and now, a level of empowerment. During the first five years of illness I looked outside myself for solutions (change occupations, change cities, change relationships etc.). The second five years, out of desperation, I searched for medications; I tried about a dozen of them, to no effect. I settled on Nardil (an old fashioned MAOI), the only one that worked, somewhat. On this medicine I gained 50 pounds, began smoking and was so agitated and wired I hardly slept. I took this for three years. The next five years I began taking responsibility for my healing, realizing that no doctor or counsellor was going to fix me. I learned to quit running away from my negative moods, instead to be with them in the Present Moment, learned to love & accept myself, connect with others (love), and provide service to others. Nonetheless, too often, I've been in survival mode, dragging myself from professional appointment to professional appointment. That was the extent of my "life." I felt I had the emotional equivalent of the Ebola Virus i.e. incurable. My biggest fear was ending up in a psychiatric hospital — something my self-image wouldn't allow me to do. During this time I saw the Mel Gibson movie The Passion of Christ with a group of Monastic Priests. After the show, I told them that I would gladly exchange my years of suffering for the physical / psychic suffering of Christ. And what has been the response of the bulk of my family, friends, co workers and acquaintances? "Don't tell and don't ask." The psychiatrist I was seeing during this time was useless, utterly useless! Like many people with a mood disorder I didn't have the energy to find another doctor. To me there's no quick fix, it's a journey. I see mental illness as a 20-piece puzzle, yours being different from mine.

Posted Saturday, June 28

Jeff Kelland from St. John's writes: I wish to commend the Globe and Mail for devoting a full week to mental health. Rarely are such features as substantial, as comprehensive and compassionate, or as clearly devoted to helping advance the issues. I have been a public advocate for mental health here in St. John's, Newfoundland for eight years now, following my emergence from decades of disabling depression in 2000. I delivered a presentation to the command staff of the Royal Newfoundland Constabulary, gave testimony at the Reid/Power Inquiry, and since 2000 I have added to my BA (hons.) in philosophy with a Diploma in Applied Ethics (spec. in mental health ethics), and I am presently working on a Master's thesis in Community Health in the School of Medicine at Memorial University. I look to make further contributions in this area with mental health and illness research, and by putting my range of credentials to work to inform and improve the public understanding, and influence public policy in this area. Toward this end, my thesis is a critical analysis of the CIHR health research funding database; to ascertain Canada's health research priorities by determining the relative proportion of funding across all thirteen of the CIHR's 13 virtual institutes and, more specifically, to delve into the Institute of Neurosciences, Mental Health and Addiction funding database to provide a breakdown of its funding allocations. All findings will be graphically illustrated. It is my hope that the findings of my research will be used by the Mental Health Commission of Canada, the Canadian Mental Health Association, the public at large, and organizations working in all areas of health research; and the analysis of the database, both generally and specifically, may well be of value to the CIHR itself. May I take this opportunity to encourage any and all individuals and organizations who share these goals to stay the course, and to once again thank the Globe and Mail for such a timely and significant contribution to the cause.

Posted Saturday, June 28

Jill Campbell-Miller from Canada writes: I don't think I want to leave the name of the city because I'm still scared my brother will find me. Even though it is sort of ridiculous. I haven't seen him in nearly ten years. He has some form of schizophrenia, I think. He's never been properly diagnosed, because in Nova Scotia the mental health care for a rural person at that time was non-existent. He was the nicest person imaginable, so creative, so imaginative, so funny. But definitely odd. He couldn't write legibly, he had trouble with table manners. Then he started to act strangely. He couldn't get up for school in the morning. One night he said the clock was talking. Worst of all, he was violent, and my parents also had to make the difficult to choice to have him arrested to protect us. He went to a mental health centre (in Dartmouth, I believe it is closed now) but was released. I'm fuzzy on the details because I was only 8 or 9. Miraculously, he made it through university, but the disease started to affect him again. He came home when I was fifteen. Needless to say, things didn't go well. He was violent and delusional again, I left because I didn't feel safe, he left again. The hardest part about it is that my father died a few years later of leukemia without knowing where his son was, or even if he was alive. We don't have the money to hire someone to find him. My guess is he is on the street somewhere. I hope people give him money, and don't ignore him. I hope he's somewhere, stable on medication, living well, and just doesn't contact us because his delusional memory tells him we were awful people. My parents tried their best, but we didn't have a lot of money or knowledge. The best part about your article was that it showed that even people with a lot of resources who know the system have trouble getting help. What chance did we have?

Posted Saturday, June 28

Karen MacAdam from Toronto writes: I have been struggling with depression and anxiety disorders for three years now. I teach in the Toronto area and when struck down with these mental illnesses, I was at the top of my career. Now I'll be lucky if I can find a job teaching a subject I love dearly. My school board and administration have been so unsupportive and I would like to know how the largest board in North America can go on enabling the stigma and lose incredibly passionate teachers.

Posted Saturday, June 28

Lindapc Foothills Rocky Mountains from Canada writes: The mental health of all Canadians is at risk. As a society we try to sweep mental health under the carpet, keep it in the dark where it belongs. In my family when our mother had mental health issues, she was locked away in a prison-type setting, subjected to various wonder drugs, given electric shock treatment, and in the end her mental health only declined over the years. She had undiagnosed Diabetes. My step-daughter has mental illness and she gets a shot every two weeks to keep the voices at bay; does she actually ever get any help? Probably not. There are really no perfect settings for the multitude of individuals that suffer from severe depression, anxiety and/or any other mental condition. Places like Kingston Mental Hospital, where my mother resided for some period of time I believe are still operating. What good do they do?

Posted Saturday, June 28

Sensitive Sue from Canada writes: I have had Depression for 25 years but it took me 21 years to admit I had an illness. I saw my depressive episodes as weaknesses caused by situational circumstances. Each time I had a depressive episode, it would present itself differently. Eventually I came to accept that Depression is an illness that has physical causes and can be triggered by external events. Except for my medical practitioners, family and very close friends, nobody knew what a painful ordeal I went through. There was reason for such reticence, given the platitudes, erroneous perceptions and minimizations people say to someone suffering from the disease. I developed an amazing skill at hiding my pain from others. I had a job managing a not-for-profit organization whose mission was to provide compassion for those when they need it the most--when faced with a life-threatening illness. My creative juices were always flowing around the intent and mission of the organization, however there were unhealthy stresses and practices that put my mental health at risk. I tipped over the edge and went into another relapse that crushed my spirit and even my will to live. This time I made a suicide attempt. I have been really hurt and bothered by the lack of support I received from my colleagues. Here I was working for an organization that advertises its compassionate care to those living with a life threatening illness or with grief by offering information, support, hope, choice, dignity and meaning. However, I was isolated and experienced negative behaviours from others. No cards, e-mails, phone calls, flowers, meals, invitations for coffee -- nothing. My past performance at work has been discounted and my problem has not been put in context of my work history. In reality, it seems like they are casting me aside. The irony and disillusion of it all is mind boggling. If I had a physical illness, they would have supported me. We have a long way to go in erasing the stigma of mental illness.

Posted Friday, June 27

Sandra Klapstein from Canada writes: Thank you, G&M, for running this series of articles & comments. I have read through all the submissions, & find so many which could have been taken from 'my book'. First, though, I would like to make a comment.

Harold Maio from Florida is a man with a long string of 'qualifications' behind his name. He said he is 'far too educated' to stigmatize 'people with mental illness', 'people with physical illness' or 'people without illness'. Sorry, Harold, we are all just people with the only label attached: 'people of the world'. We all have our own cross to bear. I hate to judge, but could yours be lack of humility?

My cross? I was diagnosed almost 9 years ago with severe clinical depression & anxiety disorder with panic attacks, & all the lovely goodies to go with it (eg. short term memory loss, et al).

Fortunately, I have a wonderful family GP who had seen it coming & was watching for it. When I crashed, I crashed hard! With his help, & the usual amount of trial & error with psychologists, psychiatrists, & combinations of meds, I now have a psychiatrist with whom I have good rapport. We have found the right 'cocktail' of meds which have me functioning fairly well. I will never be the same as I was, but I have accepted it, & am no longer ashamed to talk about my illness.

My children have a hard time accepting me as I am, even though 2 of them have & are going through depressions of their own. My grandchildren love me anyway. I was also lucky enough to have a good benefit plan through work, & now, with that & CPP disability, I can almost make ends meet (until someone moves the ends!). I will never be able to return to work.

To Heather Lee from Toronto wanting a Psych. Service Dog - it is not necessary. I was adopted by a beautiful RottweilerxG. Shep. from my local SPCA. She gives me unconditional TLC & always senses my feelings & instinctively does the right thing. It's hard to contemplate suicide when you are doubled over in laughter!

Posted Friday, June 27

Ellen Richardson from Toronto Canada writes: I was delusional from Sept. 2000 to July 2001, having been diagnosed with major depression in my 20's. I am now 44.

During those 11 months, I went sometimes one day after the next to try to get treatment, perhaps over 60 times. There were two serious suicide attempts, the first one being an overdose. I complained at this time about hearing voices; still no proper treatment. With the other, I went to the hospital in the week prior to the attempt and stated that unless hospitalized, I intended to jump from the Bloor Street Viaduct. Instead of being hospitalized, I was sent to a psychiatric crisis centre that was in fact walking distance from the very bridge I threatened to jump from. I left the centre and went home. Two days later, I called 911 on myself, again expressing my fears that I would jump from the bridge. Again, I was sent to the crisis centre. Unbeknownst to me, I was part of a study that promoted in-community care of the mentally ill. I stayed at the centre for two days, and walked to the bridge and without hesitation, threw myself over, thinking it was 'God's will' for me to do it.

I am now paraplegic.

I have also written a book entitled, 'Hope for the Heavy Heart: For the War-Weary and the Heaven-bent' that is due out in the fall. It for anyone who has ever been low enough as to think of suicide and is an attempt to dissuade people from suicide.

Just three years prior to my developing delusions, I had graduated with a Master of Divinity in Counselling. I am in fact a trained individual, marriage and family therapist. My psychiatrist at the time of these two suicide attempts had pulled me off an antipsychotic medication, the very kind I required, stating that I did not need it. He also told me about three weeks prior to the jump that 'hospitalization was not an option'. I got the proper medication when a new psychiatrist diagnosed me correctly. I firmly believe that the newly diagnosed need mentors in stable psychiatric patients.

Posted Friday, June 27

Ashley Swalm from Ajax Canada writes: When I heard that the Globe and Mail was doing a whole story on mental health I was very happy because maybe the horrible mess that has happened at the Rouge Valley Health Ajax Pickering hospital would come to light.

At the start of April the residents consumer and their families have been living a real life nightmare that does not go away when you wake up. I am one of the consumers who has been living this nightmare and has been fighting for my voice and many other voices to be heard by Rouge Valley and Central East Local Health Integration network. Unfortunately the voices of those are not being heard and a whole mental health ward is being transferred to Rouge Valley Centary Hospital in Scarborough. This has caused an uproar in the community. There are has been public meetings and rallies where 1,000's people have shown up to protest them moving these beds. The cracks are getting larger instead of smaller and a lot of people will fall through before they can get the help they need.

1 in 5 people will be affected by mental illness in their life time , Will it be you or someone you love? I sure didn't think it would be me nor did my family. Please remember this when you are tearing mental health services apart because it might be you or your family or friend who needs these services maybe not now but one day you may. What will you do then?

Posted Friday, June 27

Joanne Curran from Ottawa Canada writes: How to begin. There is so much I can say about the professional and peer support that is required to help someone with a mental health problem reach the point where they accept their thoughts and feelings while allowing themselves to move towards a life they value.

This path to recovery demands much of the person with the mental health problem and of their family. I am the parent of a now young adult who, at the age of 11, became fixated on food so that she could redirect her focus away from her 'crazy' thoughts. Her severe anorexia caught everyone's attention and subsequently led to a diagnosis of Obsessive Compulsive Disorder.

I'm writing today because of my experiences as a mother of a child with mental health problems. I am blessed with a wonderful mother who has always been there when I needed advice on parenting our three children.

When our daughter became ill, my mom didn't know how to help me parent a child with mental illness. She had no life experiences to fall back on. As a parent, I desperately needed advice and a listening ear to guide and support me over the course of those four years when life was anything but stable or predictable. Mom and my siblings were unbelievably supportive to our family but they did not have the training to give us the sound advice that we needed to support our daughter through times that were frightening, confusing, and consuming.

As caregivers, we have to be included as active members of the mental health workforce and given the training, support and voice that is essential to the well being of our children and ourselves. Professional training, peer support and the opportunity to be engaged in the decision making process of the mental health system is critical to families who are invested to helping their child live the life they want for themselves. This is the change I envision and wish for.

Posted Friday, June 27

L B from Canada writes: I have struggled with social anxiety and panic attacks for too many years to remember. I have always felt it was my dirty little secret that I needed to keep hidden, but, after confiding in a friend, she convinced me to discuss it with my doctor because there were helpful treatments available, especially for the panic attacks as they take a very physical toll. My friend assured me that doctors deal with these things all the time, and that my doctor would be supportive and would help find me some relief.

Mustering all my courage, I hauled myself in to talk to my doctor about it (you can imagine the panic attack this brought on). Her response: take a hot bath, find more time for myself, and learn to live with it, because people think you should never experience any emotional discomfort these days.

I was humiliated, devastated, and have yet to find the courage to seek help from another doctor. So I live with it, and it rules me.

What I would consider a number one priority is the education of doctors on what anxiety disorders are about. My doctor thought it was a phobia that an exposure therapy style of living my life would cure, despite me telling her that I work in a profession that exposes me to social situations constantly.

Anxiety and panic attacks are different from phobias - mine can come on without warning and with no apparent trigger, even in the calm and quiet of my own home, and I do believe that medication would be an effective treatment for these. However, there is a very giant barrier - doctor ignorance and societal shame - to accessing that relief.

Posted Friday, June 27

Gilbert Michaud from Sarnia On Canada writes: Today friday june 27th you published that Australia has set up a good system and you have neglected to mention that the province of Alberta has set up and fashioned on Australia. They call it 'First aid for mental health' I am in the process of becoming part of their system... Look into this. Gilbert Michaud

Posted Friday, June 27

Jennifer Forbes from Ottawa, ON Canada writes: On behalf of the online resource eMentalHealth.ca, I commend The Globe and Mail for shining a light on mental health in Canada. No doubt there will be many individuals, who upon reading these articles and viewing the interactive web content, will look to get help for themselves or others.

In addition to the many excellent resources provided on the Globe and Mail website, I would like to bring your readers's attention the website known as www.eMentalHealth.ca, http://www.ementalhealth.ca/splash.php an online directory of mental health services and events in Eastern Ontario. The web resource eMentalHealth.ca makes it easy to find where to go for mental health help. We are an Ottawa-based, non-profit initiative of the Crossroads Children's Centre in Ottawa, with start-up grants from the City of Ottawa and Community Foundation of Ottawa. We invite all interested readers to visit our website. Our hope is to take this project national so that Canadians outside Eastern Ontario will have online access to mental health resources in their respective regions. Thank you! Jennifer Forbes, Advisory Panel Member, eMentalHealth.ca

Posted Friday, June 27

Katherine Adlam from Aulac Canada writes: My descent into depression began June 7, 1996 when I was struck from behind by a fast moving car in front of the school where I taught in Ontario. I suffered a head injury that was only diagnosed when a psychiatrist in Nova Scotia made the link between my accident and the depression.

I had complained to my doctor that I was experiencing cognitive problems. She thought these were related to my migraines which had increased many fold since the accident. A complete breakdown at the Toronto International Airport signalled the end to my career and the beginning of a long journey to attain some sense of well being.

I was fortunate in that a move to New Brunswick enabled me to access the services of a caring family doctor and a health care system that although cash strapped provided much need diagnosis and support. I attended the Stan Cassidy Rehabilitation Centre in Fredericton where the diagnosis of a head injury was confirmed and I received strategies to cope with the cognitive part of my injuries.

The depression and anxiety disorder incapacitated my day to day life. I struggled with parenting three teenagers and a preteen and the role of wife of an academic. My husband jeopardized his career with his support. He drove me to a multitude of medical appointments as I could no longer drive safely. My children seesawed between fury that I was no longer the strong parent and teacher they were used to but a weeping stranger who found it difficult to get out of bed.

If depression was a silent companion who followed me everywhere then suicide was a jealous lover who tantalized and monopolized my waking thoughts. I cried rivers of tears. I cried in the bank with the bank officer as I gave up all rights to banking as I could no longer handle money. I cried on my son's lap as the despair threatened to overwhelm me. My husband held me for hours as I would cry unceasingly.

I no longer live with this level of depression. But I struggle with sadness regularly.

Posted Friday, June 27

Karen from Canada writes: I wish that I were able to be comfortable enough to write with it there. Too many people would be ashamed of me in my family that I would write about 'their daughter with mental illness'.

I have read the articles and comments. So much of these resonate with me. I have been hospitalized twice (my choice). The third time they didn't have any beds. I have been off work full-time since Sept 11th 2003. A small stint back under the RTW program was unsuccessful for a variety of reasons. I have been off since February 14th and am to return now July 2nd on a graduated return to work.

I have been fortunate during the this last period that my insurance company and some people in my work didn't give up on me completely and brought in a Voc Rehab Counsellor. With working with Voc REhab, my psychiatrist, my manager and a very special lady (whom I am not supposed to contact any more).

I hope that this will be successful. That we all learned from the mistakes that were made in easing in my return to work. It hurt immensely that since February I didn't get a card from the office. I know that the group I am going back into want me back, but am unsure how many of the others will respond to me. I wish that everyone in my work and actually all managers in our Dept (DND) read the articles, took the time to understand the issues in dealing with those who have mental health disabilities. Treat us not as a staff relations issue waiting to happen, truly want us and truly support us.

I am hopeful that this attempt to return to the workplace will be successful. I have too much to offer and a sincere desire to be a contributing member of society again. I sucks big time when I have to tell my kids that because my disability didn't come in today that I will not have money for the long weekend. I have had other support during my time off from some very special people who know who they are.

Posted Friday, June 27

rev. lynn from Toronto Canada writes: My mother had a 'nervous breakdown' when I was 13. She was first diagnosed with 'chronic depression', then with 'manic depression' - neither of which seemed to explain why mom acted the way she did.

A few years later, the diagnosis was changed to paranoid schizophrenia - which made a lot more sense to everyone but my mom. She didn't believe there was anything wrong with her, and continues to hold that belief. When my father died 7 years ago, my sister still lived at home and tried to keep mom on her meds, but she wasn't always successful.

Mom's behaviour got both of them evicted from their apartment. Mom moved to a retirement home, but was again evicted a few months later. On the recommendation of her CMHA caseworker, we moved her to a Home for Special Care. These homes are licensed by the Province specifically to house those with chronic mental health issues, and have staff trained to deal with these unique issues. At least that's what I was told.

In fact they were a shocking disappointment. These homes were in a different catchment area - so mom gave up her GP, her psychiatrist and her caseworker. They were never replaced - so no health care, mental or otherwise, was available. She was evicted from one Home into another one. And from that one she was evicted onto the street, without notice and with the help of the region's mental health team (i.e the police drove her to a local motel and gave her the number for an emergency shelter). When I called the HSC Program, run from CAMH, they said they would no longer house her.

I've seen our mental health system in action for 30 years now, and I'm still capable of being disappointed by it. Now mom's in private housing, similar is appearance to the HSC- but they're actually working to keep her housed and trying to get her a GP (hard to come by) and get her meds reviewed (nearly impossible). The province and the HSC program should be ashamed.

Posted Friday, June 27

karen midwinter from southern ontario Canada writes: May I commend the globe for tacking this horrendous issue of the breakdown in the mental health system. I have been dealing with mental health issues for over 47 years. Name it I have had it done to me in the name of 'curing me' another word is controlling me.

My body is covered in scars from slashing it plus numerous suicide attempts

I have multiple personalities -bi-polar-years of being heavily medicated with variety of drugs plus suffering from some horrible side effects.

From day when I could I took responsibility for myself and later on for our system through reading phoning and non-stop journaling.

I will not go on into detail of the revolving door at the local hospital were they basically denied me treatment or help let alone respect. Finding someone who would work with me was hard as they said I was to difficult .

I had 4 wonderful years with a GP and now he is retired. I have been reaching out for help/support in a new area but I am not getting anywhere. I so much want to work with local agency's and help bridge the gap from the public /EMS to clients but it keeps hitting a brick wall. AS you see I am still here . I have been married for 22 years and now divorced my choice. I have been to college and half way through my social work degree. I have the most wonderful strong adult children who have been to hell and back plus seven grand children that are keeping me on my toes who at time as are suffering because of their parent's life.

I have wonderful jobs and not so wonderful jobs that I lost due to my mental issues -- lost my house and have very low funds at this point. I fall through the cracks for any assistance.

I have 4 wonderful girl friends I have known for over 30 years .. I am still here off all meds everything is not perfect there is still pain anger etc -what is next -- My motto -- WHY BE NORMAL?

Posted Friday, June 27

elly litvak from Vancouver Canada writes: BRAVO to the Globe and Mail for your series on mental illness.

I am one of the millions of Canadians who has been challenged with serious mental illness from the early age of 13. I am now 57 and consider myself 'recovered' from bi-polar disorder.

My journey of recovery has been a long, slow process of ups and downs (I lost custody of my two small children back in the early '80's).

I have been working in mental health for over 12 years and now it is my goal and passion to help others achieve the quality of life that is possible after being diagnosed and struggling with the inadequate services available.

It is the stigma that so profoundly affects most people. Stigma prevents many people from reaching out to get the help they need. It also acts as an invisible scar for many of us diagnosed. It is my goal, through my work with others and my one woman show 'Now Who's Crazy Now?' to help bust the stigma of mental illness.

The Globe and Mail's series this week is a humungous step forward to breaking down the stigma and developing quality mental health services. The Kirby Report was hopeful. The Globe and Mail series is that much closer to the light at the end of a long, dark tunnel.

Thank you. Thank you. Thank you. Elly Litvak www.whoscrazynow.com

Posted Friday, June 27

anthony from toronto Canada writes: As a brother of a bipolar sister, I have a constant concern when she relapses as to how the medical system treats her re admittance to the psych ward.

If we are unable to reach her psychiatrist in time she actually has to go through the emergency room process to get into the ward. There is no modus operandus for her to go directly to the ward even though they know her and have been treating her for years.

It's quite scary to imagine her being turned away at 2 am on a Saturday night or wandering around an emerg room full of gunshot victims and stab wounds while vulnerable and manic but that is the system as it stands today. (please withhold my last name for my sister's sake)

Posted Friday, June 27

Cindy Rose from Toronto Canada writes: My son was diagnosed with Schizophrenia 5 years ago. He was fairly stable on Resperidone for a number of years. On Resperidone he gained a lot of weight and fearing diabetes he was switched to another antipsychotic last summer.

The medication switch did not work for him and despite my warnings to his psychiatrist that his symptoms were increasing, He is considered an adult who can refuse his own admission to hospital unless he is a danger to self or others.

It was not long before he progressed to that point. During that time he lost all friends and social supports with the exception of me. Since last summer he has had four admissions and each time he has gotten a little better to the point that the doctor refuses to extend the involuntary status fearing that he would no longer meet the criteria for involuntary status.

Not wanting this cycle to continue the last time I pleaded with the doctor to renew the form but he wouldn't each time as soon as the form lapsed he left the hospital. Two of his recent admissions were as a result of my having to go to a JP and ask for a form 2. This has made him very angry at me and I am his SOLE support.

There is something wrong with a system that forces a wedge between a person and their only support in order to get them the help that they need.

He is currently missing and the last time I saw him he was sicker than ever before. It is as if my son no longer exists. As I listened to the slide show of Jesse's story I could so relate to the breakdown part. The behaviours seem so classic. And yes I have hidden the knives also.

The system has totally failed my son and myself. The onus needs to be taken off family members to have to get a form 2 and once admitted they need to be kept involuntary until insight returns and ability to understand why they need to take medication is proven. It is not fair to have to wonder if my child will still be alive the next day.

Posted Friday, June 27

Erin Schulthies from London Ontario Canada writes: I am twenty-three and have been suffering from major depression, anxiety, ptsd, and a number of other serious mental issues for seven years now. My life has been destroyed.

I have local friends suffering from similar mental issues and have lost a friend to suicide. We all suffer much more than we have to due to London Ontario's lack of mental health facilities and dedicated workers.

London has lost any hope with the mental health field. People come here to study at the University of Western Ontario but have no desire to work with the people in the community who desperately need their help.

London also has literally no services to help people outside of the hospital and outside of needing immediate crisis intervention. Even in the hospital help is limited - you get two weeks, maximum, and then they kick you out. Only those who can afford costly private therapy get a fraction of the help they need. Waiting lists for available psychiatrists in the community are incredibly long. London has no eating disorder treatment centre, either.

From the sounds of the recent articles about mental health stigma in Canada, there aren't many services in our country at all. It's no wonder so many of us are depressed.

Posted Friday, June 27

j s from Canada writes: I can speak from personal experience about the prejudice and the stigma people face when they are forced to deal with mental illness. (I still struggle to cope with depression and PTSD.)

Although I am one of the fortunate people who are covered by a good health plan through my job, when I was ready to return to work I could raise no complaints regarding the fact that the corporate culture in which I worked was a strong contributing factor to my becoming ill in the first place. I could not return to the same position I left.

I wish your series could have probed more deeply society's tolerance of how the mentally ill and the differently abled are treated, particularly when working in environments where the corporate culture is cutthroat, and there is no room for people like me, (I have Asperger's Syndrome) who seem eccentric and strange to those who work with us. Usually our medical problems have very little bearing on our ability to perform our jobs, yet we are treated as though we are totally incompetent.

A lot of corporations in today's world talk up diversity a good deal, but they fail miserably in enacting policies of diversity and tolerance in the workplace. Unfortunately, it seems that in today's workforce, your ability to come across as slick, socially competent, and likely to succeed trumps your ability to perform a decent job, your qualifications, your experience, and your integrity.

Having excperienced the psychological terrorism of workplace bullies, my congenital inability to present in a glib, socially savvy way hurts me terribly, and has contributed to much persecution, frustration and egregiously unfair treatment. I am now in the same entry level position I started in 25 years ago, despite the fact that I have qualified myself for much better jobs within the organization. I hope your series is a good starting point for real changes in attitute to occur towards not only mental illness, but also other disorders that are publicly misunderstood.

Posted Thursday, June 26

Barbara Bawlf from Vancouver Canada writes: I am writing to express the view that people with mental illness have the best outcomes for recovery when they are given something meaningful to do and are encouraged to be productive members of society. Too often mental health consumers have been told they are not capable of working or going to school and that belief becomes internalized. Over-medication can also result in impaired cognitive functioning which further interferes with the ability to concentrate and therefore tasks become increasingly difficult.

I am a manager of a non-profit organization which employs people with mental illness, recruits them as volunteers and includes them in activities. Many of my staff have progressed along the continuum from participant to volunteer to staff member. The pride I see in these people cannot be measured. I am also a mental health consumer in a very responsible position.

Hopefully the trend is swinging more towards recovery and stigma is being reduced as a result of your excellent coverage.

Posted Thursday, June 26

JJ from Toronto writes: In one sense, I am one of the lucky ones. I currently have a very caring and compassionate GP and, after an initial 3 month wait, bi-weekly appointments with a psychiatrist. But, I have been unfortunate at times too. When first seeking medical treatment, I was referred to an MD specializing in mood disorders. In a both contradictory and condescending fashion, this doctor gave me a prescription for Remeron and told me I wasn't troubled enough for further treatment. Since that time I have been on and off various anti-depressant / anti-anxiety medications to varying effects, although only rarely have I felt my best.

Weight gain or sexual side effects would often lead me to try alternative medications, even if my mood was in an acceptable range. I use the word 'acceptable' loosely, because it's hard to feel your best when you're taking a pill that makes you fat and prevents your orgasm for all but a Herculean effort.

Crass doctors and annoying side-effects aside, I view the biggest obstacle to my treatment as the lack of a precise diagnosis.

To this day I do not know whether I suffer from GAD, bi-polar II, dysthymia, cyclothymia, major depressive disorder or any other condition the American Psychiatric Association came up with in DSM-IV. As a result, my medication regimen over the last 8 years has largely been an exercise in trial and error.

Regardless, my battle wages on and I continue to do everything in my power to beat my illness. Some things come easy, like not smoking, not drinking and taking my supplements and medications. I know eating well and exercising will help, but they are a struggle.

In one sense, depression is like AIDS. Both diseases attack the one thing that can cure them. For AIDS, it's the immune system; for depression it's the drive and motivation you need to do the things that can make you feel good. Lithium is the latest weapon I've employed from arsenal and next week it's a trip to the Naturopath. Never give up.

Posted Thursday, June 26

Karyl Pope from Dundas, Ontario Canada writes: As a nurse for 20 years and a psychotherapist for 30 years, I have always been shocked and saddened by the lack of training or even concern in the police and prison system, for the mentally ill who use drugs. It seems to me that more and more, we copy the US with their overuse of prisons to treat anything that they find distasteful in their system, unless, of course, the family has the money for private clinics.

Posted Thursday, June 26

Sharon Fawcett from Moncton Canada writes: I was diagnosed with major clinical depression at the age of 26. My battle with mental illness lasted nine years and in that time I was prescribed approximately 20 antidepressant medications and combinations, received more than 100 electroconvulsive treatments, and spent 80 weeks as a patient in psychiatric wards. I participated in numerous forms of therapy and when not in hospital I made the bi-weekly 100 km trip to my psychiatrist's office.

I'm grateful to the Medicare system for making this treatment possible for me. It kept me alive, but it did not heal my depression. After nine years my diagnosis was changed to "refractory depression"—depression that does not respond to most forms of treatment. It was obvious that if a cure for my depression were to be found, it wouldn't come through medical treatment. I decided to seek spiritual counselling. Three months later, the depression was gone. That was nine years ago. I never relapsed, never returned to the psychiatric ward, never had another electroconvulsive treatment, and no longer need medication or psychiatric care.

Depression can have emotional roots, biological roots, or spiritual roots, yet the spirit's needs are virtually ignored in government-funded treatment. I can't help but wonder how many hundreds of thousands of dollars Medicare would have saved on my case alone had spiritual counselling not been my treatment of last resort.

The change in policy that would help most is for the treatment of depression to incorporate care for body, mind, and spirit. If counselling services were made accessible to all through Medicare coverage, the roots of mental illness (in those cases when they are spiritual and emotional) would be addressed and resolved, rather than having sufferers linger with medical treatments that are often inadequate or unnecessary. The government would save money in the long run and our citizens would be emotionally, spiritually, and physically healthier.

Posted Thursday, June 26

Claire Carle from Toronto Canada writes: The opposite of "stigmatize" is "normalize". How to normalize mental illness and addiction? Tell the truth. Stigma is borne ignorace and pride. The fine journalists and editors at the Globe and Mail have this week brought facts of mental illness and addiction to national light. Pride remains the internal work that we with severe mental illness and addiction must take on with courage. If we are to recover, we must first tell ourselves the truth. "Shame" is a term used by many to describe their relationship with mental illness. In my life I have made poor choices of which I've felt ashamed, but I am not ashamed of a process of disease over which I have no control. In being human, I have limitations. A hard lesson to learn, I believe that what plagues many of us with mental illness and addiction is less shame than damaged pride. Pride says "I'm better than this"; it says "This will not happen to me." Pride manifests as willfullness and defiance, and camouflages an internal level of denial. We are not unique in this. All with severe illness or disability struggle; even natural aging has it's stigma...enter Botox, and thank you 'Campaign for Real Beauty'! On what basis can we expect others to respect and accommodate our psychiatric illness when we ourselves are loath to do it? It seems reasonable that to the extent we shun our diagnoses and keep silent about our needs, others will do the same. The feminist writer Simone de Beauvoir said that "it is in the genuine conditions of our lives that we must find our strength and our reasons for living". There is no room in recovery for pride. Acknowledging illness is not the same as being dispirited; it's more about allowing for soul. In our own campaign for real beauty, as we learn to accept our limitations with grace, it follows naturally that we begin to heal. Those around us also begin to heal, and to learn. Authenticity emerges, we see the good reasons we live, and stigma dissipates

Posted Thursday, June 26

David Heath from Canada writes: I am a psychiatrist and congratulate the G&M on this series on mental health.… You ask what changes in the system would help. I suggest that programs be developed that enable people having break downs to avoid having to be admitted to hospital and be treated in their own homes instead. Hospitalization of mentally ill people — as the articles point out — takes up an enormous number of bed days and is very expensive. Most mentally ill people would prefer to be treated out of hospital — at home — as would their families. Being admitted to a psychiatric ward increases the stigma that the mentally ill experience. Research shows that 30 to 50 per cent of people destined for hospitalization can be diverted to treatment at home — at much less cost. This approach has been used extensively in Australia since the 1990s and became a major plank in Britain's mental-health policy in 2000; there are over 200 of these programs in the UK, with plans for more. I developed the first progam of this kind in Canada in 1989 — the Hazelglen Service at Grand River Hospital in Kitchener. There are similar programs in Edmonton, Victoria and Langley area of B.C.…—3 in all. I wrote a book on this topic called ' Home Treatment for Acute Mental Disorders: An Alternative to Hospitalization by David S Heath, published in New York by Routledge in 2005. I have been trying very hard to interest our Ontario Ministry of Health in developing these services, but without any success so far. Different names are used for these services: ' crisis resolution teams—CRT' in UK; ' Crisis assessment and treatment teams -CATT in Australia; I call them mobile crisis home treatment teams . [These services] can even be used to treat a portion of individuals who would otherwise have to be involuntarily admitted: Just be cause a person refuses to go to hospital does not mean that… — with the right approach — they cannot be persuaded to accept treatment at home.

Posted Thursday, June 26

Andrew Li from Canada writes: My son suffers from the shocks and conflicts between the Chinese culture and Canadian (West) culture, also the bully from his class-mates in his primary and middle schools (I think the Canadian education systems fail to protect the victims of bully) since my family immigrated to Canada in 1996. He was doing great in academic: he was the Top Student in his high-school, still he was often in sad and angry moods. He even got the title of "Prom King" somehow when he graduated from the high-school, yet he was lack of confidence and had negative feelings to himself. When my son became a first-year student in University of Toronto in 2002, we thought he would become more mature and forget about his pains in the past. However, his situate became worse: he kept thinking of his past bad experience and tasting negative feelings. He couldn't concentrate on his study and kept dropping courses. In a few times, he talked about killing himself. We were so worried about him and tried to contact University of Toronto's administration staff for help, but we didn't get meaningful helps from them (University of Toronto is Not good for undergraduate students, especially the ones with mental problems like my son, who really need tremendous supports from the caring teachers and administration staff). After three years struggles, my son ended up with a psychiatrist who diagnosed that my son was in severe depression and need to take medications. Now my son has taken the drug daily for more than three years. From our experience we know that a lot of people think the person with mental illness is "Week" and "Cycle". Now it's time to educate the general public: mental illness patients are suffering the same or even more pains than the patients with physical illness. Save our children!

Posted Thursday, June 26

ellen m from Ontario writes: I am very glad we have this series, but in all reality, what Is going to happen after. will everybody forget about it and go on with there everyday lives?

when I was in the hospital the nurses keep saying over and over to me that I have to look at what I am dealing with as if I had high blood pressure or something physical. that I need the medication in order to get better and to live hopefully a normal life.

Now, society sees the opposite. because of lack of knowledge of society, they are unable to connect the two together.

The people with metal health issues. often hearing that 24-7 from people around us. we end up embarrassed, so we internalizing
everything, we may go off our medication because there is a high standard of wanting to be Normal..... 'WHAT IS NORMAL'??

can anyone answer that.

as being a person, dealing with a number of mental health issue's, you know what, I don't want to take medication....the thought of giving up is always there. I want everything the way it was 2 yrs ago.

Now someone that has a stroke and cannot walk. people except them still and they are compassionate towards them and try to uplift them. the people that have mental health issue's need the exact same. we need society to start us as human, we have feelings, we need the acceptance, from our society.

Posted Wednesday, June 25

Tricia Kell from winnipeg Canada writes: My daughter was in an accident 20 years ago and was in a coma for 2 months. After she came out of the coma, she worked very hard to get herself back to a good quality of life, considering her injuries. Three years ago she started to have some problems and we were referred to a psychiatrist. The psychiatrist diagnosed her to be clinically depressed and prescribed her large doses of antidepressants. Within a couple of days, our daughter became manic and even with taking her off these medications, the mania didn't stop.

We walked through mental health system in this province for the past three years and watched them continually pull our daughter back into the small box of policy that only made her more ill. Then we were told she was beyond the system.

That lead me to sleeping on the legislature steps on a hunger strike for 4 nights with full media attention. The days were spent in meeting after meeting until finally the Minister of Health and Family Services seemed to realize the crisis we were in. For the past two years, it was so bad that keeping my daughter safe became a full time job for both my husband and I. This is now been taken on by the Ombudsman in Manitoba and our hope is the outcome will be a new policy in this province.

It is our understanding that Manitoba is now down 7 psychiatrists and there is no Neuropsychiatric doctor here at all. It has been a daily walk with the Minister of both Health and Family Services since April and we are now at the stage of our daughter being sent for a two week assessment at the University of British Columbia Neuropsychiatric Assessment Program for two weeks.

This is about my daughter and the hell that we have gone through as a family in the past three years but we have known for a long time that there is also a much bigger picture here. We are now walking through that bigger picture. As hard as it has been burning holes in the system, looking back and seeing a path for others to follow makes it worth every step.

Posted Wednesday, June 25

Norm Albert from Canada writes: Erasing the stigma may not be as easy as we are lead to beleive. How do you explain to your employer/employees, family and friends how you feel and why you feel that way when you don't know yourself. Ten years ago I was forced to leave my job because of physical illness brought on by a mental disorder I had been living with for more than a year. Life(for the most part) has been a down hill spiral ever since.

Unable to successfully compete in the job market, a less than empathic spouse, a less than benefical medical program and an enability to be fully truthful about my condition with those closest to me only exaserbated my condition. It is painful and demeaning to passively stand by and watch everthing you held dear just disappear. The Chineese torture results of mental illness. Why can't I do something to stop this.

I ran the gauntlet of medical treatments only to come out on the far side less optomistic of anything beyond meer survival. Attempting to survive on slightly more than $500. poses it's problems as well. Having been one of those people consumed by meeting my financial obligation added insult to injury. Having someone who earns more in one year than I was in 20 or 30 years telling me that I would have to lower my expectations and adjust my expectations did not ease my frustrations either.

Maybe that is a big part of the problem. Great expectation with limited resources combined with those frustating circumstances over which we have no control. Then expecting meds and talk theoropy to erase the damage. We all row to the beat of a different drummer or do we.

I really do have a lot of sympathy for health care workers who have to deal with this ghost we can not see.

Posted Wednesday, June 25

Emily Elder from Toronto Canada writes: The solution to erasing the stigma surrounding mental illness lies in education and awareness. The Globe and Mail should be applauded for bringing attention to a growing problem that is never going to disappear. With the stress of today's living it will only get worse. It seems that more and more people today, especially youth, are being diagnosed ADhD, bipolar, depressed, and have high levels of anxiety and stress. This is becoming the norm, and people are being over-medicated, or misdiagnosed.

My younger sister suffered a severe bout of depression as a teen and was put on high doses of anti-depressants. This made her high and she was overcome with extreme episodes of mania. For years she was given the wrong medication, constantly being passed on from doctor to doctor. Finally, at the age of 19 one pyschiatrist was clever enough to see she was bipolar and prescribed her lithium. Now her life has some order and control to it and she is finding a way to be happy again. My youngest sibling, a brother, is also taking lithium, but I really question whether he needs it as he's never had an episode of mania.

The point I'm trying to make is that doctors need to be educated as well. The best way is to listen to their patient, alerting themselves to the symptoms. An aspirin isn't going to take away the migraines this time. Neither is ritalin necessarlily. There are so many drugs out there, and so many different faces of mental illness. People need to be sensitive to a person as an individual and not as a statistic or guinnea pig for a new brand of meds.

Families affected by a loved one's struggle need to educate themselves by reading about the illness, and learning everything there is to know. I found Patty Duke's memoir 'A Brilliant Madness' extremely important in opening my eyes and answering my countless questions about bipolar.

The best solution to educating myself was listening to my sister and spending time with her. I have discovered great patience and love.

Posted Wednesday, June 25

Annamaria Jackson from Edmonton Canada writes: Mental Illness As a child, I grew up in an unstable family, where my dad was a violent man, and my mum suffered from undiagnosed OCD. Everything in our house was 'contaminated' and if we touched anything and then touched something else, we 'cross contaminated' things, and we might be guilty of making somebody ill or die. I fed on all this stuff and took it to heart. I suffered from great anxiety to the point of panic attacks, vomiting and lack of appetite. My mind was constantly worried about everything. Nobody could ever explain why I was like this, and it was put down to me being 'wierd' or 'weak', and resulted in poor self-esteem.

By the time I was an adult, I finally used alcohol to 'soothe my nerves'. Alcohol then became my friend, and I used it to cope with so many situations that I had failed at in the past - social gatherings, concert performances, interviews, eating in public and calming myself down. Of course I knew it wasn't normal to do this, but I knew I wasn't normal anyway, and anything to bridge that gap was a great relief.

Over the years, things didn't improve and I became an alcoholic. My OCD became worse when I had young children of my own, and I was finding I was passing on my obsessions, just like my mum had. I could see what was happening but was unable to stop. My husband saw me as weak and useless and he repeatedly told me to sort myself out. I felt so bad and so guilty that I could not do so, and fought this 'weakness'. I would look in the mirror and hit myself and scream at myself to try and make myself change. Eventually, I was taken into rehab where I was told I wasn't bad or weak, simply sick.

With these words, I started to get well. I was put on anti depressants to help me with the OCD and also went for professional help to understand this more. Once I knew I was sick, I had the self esteem to recover. I loathe the stigma attached to mental illness. It sends the already sick soul into isolation.

Posted Wednesday, June 25

Susie Q. from Canada writes: Many excellent posts! One that stood out for me right at the beginning is the one by Tom Muskett. A big yes to everything he says. To his comment 'tracking the number of staff absences due to depression and adding that criterion as a new factor in annual performance reviews of managers might encourage senior staff to treat subordinate staff more carefully, the way they would be treated themselves', I would add however that sometimes the problem IS that senior staff treat subordinates the way they treat themselves.

I remember well the time when a top bureaucrat, well known for her 24/7 dedication to government, called a subordinate in the middle of the night to say the big cheese needed something done by 8 a.m. that morning. So although the surbordinate was sick, she dragged herself to the office and tried to do as told: she was found the next morning lying on the floor from having fainted, too weak to get up. Subordinates often have to pay a heavy price for a higher-up's ambitions, as the latter will imlicitely put across the message that if they can sacrifice everything, including health, family and hobbies, so should everyone else. I believe in loyalty, but that kind of loyalty is slavery.

Posted Wednesday, June 25

Lupa Nare from Canada writes: I was 10 when I first thought about killing myself. My parents had just divorced and I was angry, confused and wanted to make everything stop spinning. It was my exit strategy.
I'm in my early thirties now, have a wondeful spouse and a baby daughter who is the centre of my world. My suicidal thoughts aren't frequent, maybe twice a year, but they still creep up and I'm haunted by the black dog.
I'm in family medicine and my career would be in tatters if I ever revealed these thoughts to any of my colleagues. I have never sought help as I manage to struggle on my own through these dark periods. And they very seldom happen to me. But I realize that deep in the recesses of my mind, I still see suicide as an escape, an exit from all of the bullshit.

Posted Wednesday, June 25

Pat Vanderkooy from Guelph, ON Canada writes: I congratulate The Globe and Mail on running this series about mental health and mental illness. You ask your readers to recommend best approach or solution. I recommend that we collectively, through our government, invest in poverty reduction and early childhood development. One of the biggest predictors for poor health - physical and mental - is poverty. It's no coincidence: if a baby is born into a household that is stressed to afford rent and not able to access/afford enough nutritious food, it's no surprise that this baby will grow up at greater risk for falling behind in early childhood brain development and having difficulty in school.

Check out the excellent work of the Council for Early Child Development (cecd_general@councilecd.ca). I had the privilege of hearing Dr Fraser Mustard speak this morning - he shared how much it costs to treat mental illness and deal with crime... and how little it would cost in comparison to fully fund supports for early childhood development. All the costs of human misery aside, how can we NOT afford to give all our children healthy starts, with most development happening in the brain before they get to school?... and why can't our provincial and federal governments 'just' get on with poverty reduction, with adequate income, supported housing, food and health care for all, early childhood supports and care for all our babies and tots? If we started now, we could make a real difference in the prevalence of mental illness within a generation's time. If you think that will cost too much, remember that it costs so much more to pay for treating illness and dealing with crime. As a health professional, I believe we've done most of what we can in our noble efforts of raising awareness, promoting health, running educational programs... the real barrier to making further progress is that we need to get rid of poverty.

Posted Wednesday, June 25

SPALFRAM from Canada writes: I had my first direct experience with mental illness last summer, when my husband's acute mania bridged into psychosis. My children lost their father for four months. His fear of help was so enormous he ran off in the middle of the night, even though he was convinced our home was surrounded by murderers, just before the police and ambulance arrived.

My biggest struggle in getting treatment was caused by the mental health act in Ontario, which was enacted to protect the mentally ill from the type of permanent involuntary incarceration that caused so much grief and horror. The right of someone who is seriously mentally ill to refuse treatment is not a right at all, but an additional hindrance. My husband's illness could have been treated, but was not, forcing him to climb slowly down from his mania and return to his family. He lost four months of his children's lives, months he feels terrible about. Yet during those months, he had no awareness of his illness and therefore any resulting need for treatment. The doctors did their best, but he wasn't violent and so couldn't be treated against his will.

When the brain is sick, decision making is impaired. We should have a capability test other than violence that lets physicians determine who can't decide on treatment for mental illness. I'm not saying the patient should be entirely removed from the process, but they should not be able to refuse treatments as long as those treatments are not experimental, represent the best standard of the day, and do not have intolerable side effects. The "right" to refuse treatment is meaningless and harmful for those unable to make rational choices.

Posted Wednesday, June 25

Bill Gibson from Vancouver Canada writes: Three university degrees and a professorship until misdiagnosed hypomania ended it.

Starting several years later, I sought psychiatric help for five years before getting it only after becoming suicidal. Then a series of contract jobs, some good and some awful. I usually function very well and think it's really no big deal, but at the same time, wouldn't wish it on anyone.

In my attempts to hide the illness, I haven't always been the kind of character I would like to be and the person I am.

The one thing most desired is: knowledge. If those succumbing to illnesses knew more, if general practitioners were better able to diagnose, if families understood, if employers accurately realized what was happening and if the person with the illness knew more about their illness, so much suffering could be avoided. I didn't understand what was happening to me and did not want to. My then employer wanted to be rid of me. My most recent, an institute purportedly dedicated to research into mental illness, demeaned my credentials and abilities.

Knowledge. Better diagnosis and medicines. Freedom of opportunity. Freedom of acquaintance. Freedom to be able to say, right now I'm not completely well. Freedom from being treated without individuality. No more quick prescriptions, demeaning jobs and segregation within our kind. No more fear of being uncovered. No more being used as political pawns.

Knowledge: the source of understanding, compassion, empathy, skill, patience and fun.

Some mentally ill have taught me deep lessons about life. Some well folks have saved mine. The differences between us all are not really so big.

I lost hostility some time ago and haven't been looking for it very hard. Ignorance causes fear and acts based on fear usually lead to regret. I have not given up on humans. Well or ill, it is time to embrace knowledge. It is time to lose the fear of just what we humans are.

Posted Wednesday, June 25

L Mitchell from Orangeville Canada writes: I am a flight attendant by profession and I began to have anxiety attacks while at work. This quickly moved into a fear of flying and I was off work for some time. The pain and the angst that I suffered from hiding the truth from so many people was probably the most difficult part. It is so stigmatized to this day. Until we can begin to talk with one another about mental illness just as we would if we had diabetes or an ulcer we will not have progressed enough in my mind. Mental illness is still seen as a weakness that the sufferers succumb to rather than something that is for the most part beyond their control.

Posted Wednesday, June 25

Mark Heber Brown from Calgary Canada writes: I have read the articles posted in the June 21, 2008 edition in Globe Focus on Canada's mental health crisis and want to applaud the courage of the contributors and writers in opening up a dialogue, that is sorely needed in this area. I also want to share with readers, even at the risk of creating disharmony within my extended family on this badly stigmatized subject.

My wife has suffered from mental illness most of her adult life, and has been misdiagnosed at least twice (schizophrenia, post traumatic stress disorder, anxiety disorder). A few years ago she recieved a diagnosis of bi-polar disorder and has been living with the prognosis and treatement options available to her, with marked improvement.

The years she has spent suffering with this disease, the impact on her, on the family and on our marriage has been horrific. That is to say, this disease does not define her, it is what she has to contend with and what we in the family have to deal with too. The key for me has been open dialogue and a willingness to look for solutions and coping strategies.

Our families have fallen into the stigma pit, and very little is discussed openly or honestly. It is a difficult topic as it affects everyone in the family. On my wife's side virtually everyone is touched in some way with the disease. Her dad has struggled with depression all his adult life and the therapies have focused almost entirely on medication. Her brother struggles with other manifestations of the disorder and so it also has touched the lives of her two sisters. Proper diagnosis, medication, and therapies have been the challenges for everyone. The single biggest barrier is a willingness to recognize this as any disease such as diabetes, thyroid disorder, high blood pressure or for that matter any disease that has a strong genetic link.

Both the maternal and paternal side of the family have been directly affected with depressive disorders and there is schizophrenia on the father's side too.

Posted Wednesday, June 25

Jane Adgett from Saskatoon writes: I am an ex-health care worker who suffered depression from chronic stress due to excessive workload. I was denied compensation by the workers compensation board and had to try to heal while going through financial crisis, losing my home, my pension and going bankrupt. I have not recovered even now, seven years later.

The single change I would like to see would be for the federal government to address the discriminatory policies that were put in place during the 1990s by provincial workers compensation boards that categorized workload as a labour relations issue and made chronic stress diseases due to workload non-compensable.

A recent study from Australia highlighted the substantial under-compensation of psychological injury by workers compensation boards in that country and stated: 'Job strain and associated depression risks represent a substantial, preventable, and inequitably distributed public health problem. . . job strain is an important contributor to mental health inequalities . . . there is substantial under-recognition and under-compensation of job strain-attributable depression'. The same thing is happening in Canada.

Posted Tuesday, June 24

Chrystal Ocean from Duncan writes: I feel compelled to express an alternative view, a partial warning about our acceptance of 'mental illness' as a disease and mental health labelling. It comes from my own experiences with people so labelled. I have been one of them and was hospitalized for 11 months at the tender age of 14.

Unfortunately, there's not enough room here for me to include all that needs to be said and so I refer The Globe and readers to my blog, where I've written a fairly extensive amount on this topic: http://challengingthecommonplace.blogspot.com/ - Search for the articles under the 'Mental health-illness' tag

Posted Tuesday, June 24

THancock from Toronto writes: Wages and benefits terminated....that was the news today...25 yrs at a public utility...fourth generation....2 billion dollar company...won't accommodate me to work closer to home...anxiety disorder with panic attacks and agoraphobia.

Not enough 'objective' medical information. Is there a blood test to show post partum depression? An MRI that shows schizophrenia? A 'test' for depression?

The 'walking wounded' is more than just those that are 'walking' but their family and friends that suffer along with them emotionally and financially. It's a disgrace.

Posted Tuesday, June 24

Tom Muskett, Lakefield writes: Passing workplace laws to force management to respect staff will never happen and would never work even if they did happen -- but tracking the number of staff absences due to depression and adding that criterion as a new factor in annual performance reviews of managers might encourage senior staff to treat subordinate staff more carefully, the way they would be treated themselves.

An end to quasi-military corporate cultures in which staff are regarded as foot soldiers who -- to keep their jobs -- must silently accept new lots in life imposed upon them by management without so much as a word of discussion, would go a very long way to preventing the causes of absenteeism and sick leave for depression.

For as those who have been there know, being manhandled unjustly by an indifferent management crew gives cause for feeling powerless, insecure, worried, anxious, panicked, sleepless, exhausted and outraged -- that deadly soul-deep anger that invariably ignites final collapse into clinical depression.

Then follows the hard part -- the use of short-term sick days, the label of disability, the dismissal into long-term disability, reduced income, and the need for courage to start over, to come to one's own rescue, to sell the house, to say goodbye to friends, family, and neighborhood -- to leave behind all the things one loved when times were good, to move on, and one day forgive and be free of what was done.

Posted Tuesday, June 24

Lauren M from Toronto writes: Mental Illness still carries with it a great stigma. I believe that this is partially because we cannot always see the damage it causes. It can be an almost invisible disease. People suffer in silence and there is often a very incorrect belief that just because someone can wake up, get dressed, and present themselves to society-smiling occasionally, that nothing is necessarily wrong.

People mistakenly associate mental illness with the most extreme cases. Unless it can be seen, it must not exist.

I work with the Mental Health Awareness Committee (MHAC) at Queen's University to provide information on mental health as well as to end the stigma surrounding it. It is not an easy task and there must be a willingness on behalf of everyone-those suffering from a mental illness or not-to change how we perceive these conditions and diseases.

We must learn how to talk about them, how to reach out and how to open up to one another. Schools and workplaces must learn how to accommodate those suffering with mental health issues in a way that they would with any other type of disability or disease.

I believe that more education and awareness is necessary if we want people to change how mental illness is viewed and handled. We cannot point fingers and remain frustrated that no one understands.

It has become well overdue for all of us to become aware of these types of illnesses and to become informed.

In a time where the internet is so easily accessible, obtaining this information is a simple task that does not require much difficulty. Learn, read, research, pass on the knowledge to others. TALK.

We can all do our part in ending the stigma surrounding mental illness if we try.

I commend The Globe and Mail for providing its readers with these valuable stories and educational articles. It is fantastic to see that this matter is gaining the attention it needs to become less stigmatized.

Posted Tuesday, June 24

John S from Toronto writes: Read Claire Weekes' books. She is an Austrailian Doctor and PhD, who devloped, pioneered and applied Cogntive and Behavioural techniques in the 60's - almost 50 years ago.

Science did not accept CBT for a long time until they could image and scan the brain and see that it works. Since science has no spiritual basis and does not believe in anything it cannot prove, CBT was rejected.

Sad that a pioneer like Weekes, was buried in science all this time.

The body wants to get back to normal. Attitude is key to everything.

We all have souls and spirits, science does not believe this because it cannot prove it.

Posted Tuesday, June 24

Rebekka Bondy from North York writes: Well, as a teen with mental health issues, I can say that it really is harder than it may look. Being diagnosed with a myraid of syndromes: Tourette's, ADHD, OCD, PTSD, and depression, I can feel the pain that Alyse goes through every day - the obsessive thoughts that haunt you, the rituals you can't stop, and the tics that you can't manage.

I also have spent time in hospital, and recently graduated from 1 year and 6 months of residential treatment. I've met a lot of people just like me, and just like a lot of mentally ill teens. One girl is almost exactly like Alyse, taking many years to complete high school, and although after 4 years of treatment she is not cured, there is hope. I've seen myself, and many other kids go above their illness and actually do what they want in life.

I know that to most, and to me, life can seem hopeless when you know you face such overwhelming challenges, but it's always a plus to have friends, family, and supports.

Posted Tuesday, June 24

asproull from Vancouver writes: While participating in a long distance fundraising ride for cancer research this past weekend, I was overwhelmed by the bravery and courage of the cancer survivors that were a part of it, and the love and support that people showed each other as the families and friends of those who were either battling this terrible disease, or had already lost the battle, or both.

It was a deeply emotional experience, and very positive. The day after returning home, however, I found myself crying without knowing why...until I realized that my social anxiety had been tripped hugely, yet again. I had been innocently asked to call into radio stations to report in on the progress of the ride, which is about an 80 on my scale of anxiety! I did it, of course, and am obviously still alive, but as I watched everyone supporting each other in the brave, open struggle that is cancer, I couldn't help but feel the harsh sting of the reality that mental illness is still a hidden and shameful struggle for millions of people and their families; amongst so much love and compassion, I felt utterly alone.

So reading this timely in-depth examination of mental illness by the G&M is beautiful, and hopeful: If even a tiny fraction of the love, understanding and compassion given to people with physical illness could be also given to people with mental illness - if people could just BE, WITHOUT SHAME, then healing for everyone - those afflicted and those who love them - would be so much closer.

Money for research and treatment is also absolutely essential, but erasing the stigma and fear within our society would go a long way towards erasing the fear and shame within ourselves. May we all, someday soon, be able to 'speak our minds' - openly and freely - into health and wholeness.

Posted Tuesday, June 24

Penelopelloyd from Canada writes:My policy recommendations:

1. Decrease the time that mentally ill people wait in emergency. Not only more beds, but less paperwork. A mentally ill person cannot wait 12-20 hours in an emergency room. Treat them as if they have an emergency wound!

2. More hospital beds and staff;

3. A coordinated database system shared by the police and hospitals. The police need to be working with the health professionals to assist the mentally ill;

4. Training for all police officers on mental illness;

5. New legislation that gives families, doctors and health care workers more power to treat people they think need it. The responsibility for admitting a mentally ill citizen should not rest solely on families. Our mental health laws should expand the grounds for hospitalizing people with mental health problems, particularly with manic depression. If someone is in a manic episode, he could be spending thousands of dollars and destroying his life, but his friends are not able to help him because of the Mental Health Act. Please expand the grounds for hospitalization. We need to re-examine the Provincial Mental Health Act, specifically "involuntary admission" section 22.

6. Bridging nurses, social workers and support for mentally ill people when they are discharged from the hospital;

7. Assistance for families during times of crisis;

8. Clear communication between doctors and families; and

9. Mandatory meetings with families and social workers prior to release. I can see that all mentally ill people will end up on the street under our present health care system, unless they have strong families with endless resources. Change is past due!

Posted Tuesday, June 24

Zararobinson from Vancouver writes: As someone who has been treated for depression and anxiety and who has been on anti-depressant medication for the last 2 years, mental health is an important subject for me.

I applaud The Globe and Mail for devoting time and space in its newspaper to this issue. I'm lucky because I have family, friends and an employer who are understanding and compassionate. They have supported me through very difficult times.

When you hit rock bottom, lying on the floor of a hotel room, in the fetal position, unable to make any decision, raked with anxiety, crying, during your most important work engagement of the year, you realize things can't get much worse (at least for me). And that's the point...you have to individually come to the conclusion ... 'I NEED HELP!'.

Doctors visits, time off from work, medication, and many other life changes have made daily living more bearable for me and those around me. I realize I'm fortunate to have this support system. I realize I'm fortunate to have said 'I need help' aloud to myself and to those around me. I realize that it's important to say these things publicly so people understand it's all right to admit you have a problem.

Just because people can't see a 'broken brain' like a broken bone doesn't mean you aren't sick and need help. How many lives have to be negatively affected by someone with depression? Why does society have to stigmatize this problem? Why can't we, as a society, be open enough to help those with mental health problems - mild to severe - so all of us, collectively, can enjoy life?

This isn't a problem just for the individual with a mental health crisis; everyone s/he interacts with is affected by the illness. We don't live in vacuum.

Congratulations to 'Canada's National Newspaper' for bringing the issue of mental health out of the closest. More organizations should be brave enough to follow your lead.

Posted Tuesday, June 24

Catherine Medernach from Winnipeg Canada writes: The problem with stigma is that it starts with many of the service providers. How can we begin to alter public perception when so many people know professionals who share their views of people with mental illness. Despite all efforts to alter this fact, stigma continues to be the largest hurdle for people with mental illness. It keeps those who function with illness hidden so that public perception is based mostly on those who are most visible - those who are ill and somehow end up on the streets and in the news. This does not foster public support for mental health services in the community it one fosters the demand to return people to being warehoused in institutions.

Posted Monday, June 23

Melissa Thomas from ontario Canada writes: from the time I was a teenager to now I have been struggling with in my mind. most of the time I acted how other people needed me to act. It is almost like I can detach myself from reality and not feel human. I have always felt that way. During my teenage years....I would take pills to numb the emotional pain I felt inside. Often, I feel I have a good voice and a bad voice, the bad voice telling me to die and kill myself, (is always there) the two fight inside myself. Is that normal to have a constant conflict in side. As you can see I am still struggling to get answers. I am struggling for someone to take the time and help me. I don't have a therapist now, due to cutbacks. I don't have a psychiatrist to manage my medication. The only reason, I know this is happening is I have been told that sometimes my thinking isn't reality. Which I doubt, because I believe it is true. I sometimes believe people are making judgments about me. I hate going into crowed places because I think everybody is looking at me. and there thinking what a loser I am. I have taken CBT classes. It doesn't help to get rid of those bad thoughts. At the moment I have many diagnoses and on 4 or 5 different medications. To date, I am dealing with, GAD, major depression, social and panic disorder, OCD, ED, now possibility Bipolar, which one who knows!!!!! I can switch on and off. I often feel like I am a prisoner within my own mind. and I am paralyzed within. Now to make friends and family understand what I think it seems like they can't relate. to what is going on. (I know my doctors are trying the best to help me) but I am suffering and struggling as I speak I wish my mind would just shut down. I wish there would be more focus on mental health. sometimes I feel so alone, it dealing with everything....because society doesn't want to go there. I understand so well why people with mental illness kill themselves. they just can't take it anymore.

Posted Monday, June 23

amelie asselin from Toronto Canada writes: Hello, I've struggled with depression since my youth. A few days ago, I started a website called Pure Reflections, in order to share my poetry, art, stories etc. and hopefully others will add on theirs as well. My friend Paula inspired me... She's written over 5-thousand poems since age 13. Unfortunately any poem I wrote before the age of 19 has vanished in my wild days. This is the link to my intro. http://purereflections1.wordpress.com/intro-welcome-am/
Thank you -Amelie A.

Posted Monday, June 23

Katherine Arthur from Toronto Canada writes: I have Bi-polar 1 disease, rapid cycling, with several co-morbities, meaning other simultaneous psychiatric disorders that may accompany bi-polar. My psychiatrist informed me that I have the most serious form of this treatable, but incurable disease. In retrospect, it is obvious that I had the disease all of my life. Regrettably, I was not diagnosed until my mid-years. Since then, I endured many years of largely unsuccessful treatment. All these factors further worsen prospects of lasting relief. At the present time though, I am now enjoying a period of remission. Before the full-blown illness I led a very fruitful and busy life, working, volunteering, publishing, speaking at Conferences, teaching at a University, socializing and raising a family. I became ill when I was mid-way through a Doctorate in Theology, at U of Toronto. Despite my early successes and high level of collegial involvement I have been consistently ignored by the school community and its Professors. This academic year I received one email from one advisor as my recompense for my $800+ tuition paid. I received no other contact whatever. They are well aware of my disease. Society is afraid of madness. The stigma of psychiatric illness is about the phantoms of old. It is about the wide-spread cultural denial of death, and the terror that attempted suicide or suicidal death represents. It is about unconscious social prejudices concerning perceived weakness when a patient seems unable to overcome the illness. "It's all in your head." This is true in a paradoxical way. The shame of Bipolar 1 disease is born out of ignorance that this particular psychiatric disease has numerous biological causes and somatic complications.

Posted Monday, June 23

Harold A. Maio from Ft Myers FL United States Outlying writes: We need to EDUCATE the public concerning mental illness ... If -We- need to educate the public, what are the people we educate to educate the public doing?

Posted Monday, June 23

Lynn-Marie Ramjass from Ajax Canada writes: Danish philosopher and theologian Soren Kierkgaard wisely said: 'Life is not a problem to be solved but a mystery to be lived.' Many years later I read a maxim by Oscar Wilde' The final mystery is oneself.' It is a mystery why I have been afflicted with this troubling disease (bipolar disorder) and not the other members of my family.

When I first became aware that I was ill, I felt what seemed an inner battle for both my soul and my mind. I felt, tasted and breathed a fear every minute of every hour of every day. It was a fear I had never known before. I felt such shame in accepting the fact that I was troubled in mind. I did not know where to go with that pain, the succession of wounds that I had sustained over a life time, and therefore I internalized it.

Mine was a generation where we did not discuss personal problems. I had the feeling that if others knew that I was different, they would love and respect me less. I could not talk about it. I would not talk about it. The only thing I knew for certain was that none of my family or friends, my husband or my children, as much as they loved and supported me, could possibly know nor understand what I was going through. They did not know how to help me and their immediate response seemed to be 'she's broken, fix her' None of them could feel my pain, share my shame, or touch my fear. Not unless they themselves had had the experience they could not possibly know how it feels.

The mentally ill are the walking wounded. We are like comrades in arms having been on the battle fields of our minds, our hearts often also broken, clinging to life, the burning hope that somebody, somewhere could believe in us, so that someday, somehow, we could find the courage to believe in ourselves. I learned to let go of my pain and completely trust in the Creator who has sustained and protected me all of these years. I have learned to let my suffering mold me into someone who no longer fears the future and is less inhibited by the past.

Posted Monday, June 23

Michelle Mainwaring from Lakeshore, Ontario Canada writes: I would love to share my thoughts and personal story on this matter. This is such an important issue and so grossly misunderstood. Just recently stories of a young, beautiful girl who committed suicide and a notable local lawyer who spent 7 weeks in the hospital from mental illness and the schizophrenic son of a well known doctor who killed his father shortly after a visit to the hospital have been the topic of conversation. It seems to be more prevalent than ever.

To have an intimate look at Bipolar disorder alone can be frightening and I am a witness to the depths of the 'dark place' in which it can delve. I had the challenge of playing a Stephen King character once. Her name was Annie Wilkes from 'Misery' and she was frightening, my partner playing Paul Sheldon in real life was and is bipolar (classified type 2 bipolar disorder). As the run of the show progressed and the shows stresses caught up with him and his cocktail of prescribed psych meds (which is crucial to coping with this crippling illness) was being adjusted I was able to see the 'dark place' up close and personal. It was very scary and I wasn't sure if I could maintain the friendship. It was very disturbing to watch him change into this strange, self loathing person who I couldn't recognize.

I'm grateful that I educated myself enough to be able to accept the illness and its symptoms. He has since just finished an original work entitled 'Type 2 - A Tragic Comedy' a one hour, minimalist play. It has such an important message and is so brutally honest that people will be able to relate and identify with each and every scene. I truly believe that if more people were educated about the many layers and severity of mental illness the general public, the employers and government would be more apt to want to resolve the growing problem of mental illness in the workplace and in everyday life.

Posted Monday, June 23

Jennifer Sandler from Markham Canada writes: As a holistic nutritionist with mental illness in the family, I would urge (beg?) anyone suffering from mental illness to include Naturopathic Medicine in their search for stability. Drugs can only do so much (sometimes nothing, with harsh side affects), whereas many people have benefited from thereaputic doses of naturally occuring substances like vitamins and herbs. As well, many mental disturbances are a result of undiagosed allergies and blood sugar imbalances. Drs. Abram Hoffer and Carl C. Pfeiffer are renowned in their work in this field, called 'Orthomoleculur Medicine', and for the many who have been left with no hope, please look into this.

Posted Monday, June 23

Mike Gamache from Montreal writes: When all this started for me in the early '90s, the odds were 1:10 for depression. The articles ring true for me, because I told no one, and just continued working. I still have memories of walking down a corridor, feeling the side effects that were new to me, and seeing the walls turn 90 degrees. Just trying to keep my balance or concentrate in the first week of medication was a challenge. While I think of myself as a person with an illness, and not AS an illness, forgetting one dose of medication is all the reminder I need of how fragile I can be. In the face of this, I finished graduate school, conducted a professional career in research, and built a home for my family. My goals in life changed, and I ultimately had to change jobs. After over ten years, I am finally building a new career.

The healthcare system can be a nightmare to navigate, however, all one needs is the careful attention of a competent diagnostician to receive the right medication, as the Ottawa resident in your story did. What would change the workplace is a workplace meeting by psychiatrists to frankly discuss how co-workers and superiors may support employees. What would change the medical system is admission of more MDs to the specialty of psychiatry. There will be fewer and fewer to go around.

Although it is not my situation, I am concerned for single-parent families who must have more support from our society if mental illness occurs, because children need care. The up-side is, with medication, counselling, group counselling, family support and great determination in any combination that is available and works for you, it is possible to overcome the challenge of such an illness. Helplessness is not hopelessness. I have found that if you persistently reach out, you can find the resources you need to get better, public or private. But diagnosis is essential. That's why I think this specialty should increase enrolment now, to be ready for 2020. Thanks for the opportunity to share.

Posted Monday, June 23

Tracy Bracy from Ottawa Canada writes: They never did and never will. No institution will accomodate a mental or cognitive problem. Patients need to find drug therapy and have it monitored by a doctor. They must have control over their illness. They need to stay away from hospitals and use the law properly against threats from the community. Mentally ill people are THE most despised people of all. They survive only because there is somekind of benefit to medical people. They have only one right and that is for medical treatment. They have no other rights.

Posted Monday, June 23

Kim Philby from Ottawa Canada writes: It's something of a generalization to say that mental illness is stigmatized but physical illness is not. Certainly we fear the mentally ill who are violent, or even those street people who, while not violent, rage and curse at invisible entities while ambling down the sidewalk. But, aren't those with AIDS shunned by many in society? Do we not turn away from people disfigured by illness? Do we not feel uncomfortable if we have to engage with a quadraplegic? Some who don't understand the nature of cancer are afraid of 'catching it.'

Although I prefer to keep my condition private, I'm not sure that I would be stigmatized if I told my fellow employees and others that I suffer from dysthymia (a form of depression). It seems that, unless you show overt signs of illness, whether physical or mental, it is not that difficult to remain an accepted member of society. Indeed, given the prevalence of diagnoses of various forms of depression, I wonder how abnormal it really is. This may be why some people, like me, are conflicted about taking medication; years ago I stopped taking SSRI's because, although they helped, I felt like I'd lost my identity to some degree - I was no longer who I was really supposed to be, even if the real me meant dealing with depression. (I'm currently back on medication - Effexor. It, too, is helping, but I'm not sure I'll continue to take it.)

When an illness like depression is so widespread in society, does it become more difficult to stigmatize it? We can probably never rid society of the stigma attached to certain manifestations of mental and physical illnesses; trying to do so may be fighting against deep-seated instincts of self-preservation. Perhaps we need to focus efforts on ensuring that those who are ill and can't function - the psychotic, the violent - are provided the necessary social safety net and medical care. For them, perhaps we need to re-think the idea of institutional care on a larger scale.

Posted Monday, June 23

TM from Lakefield Canada writes: T.M. , Toronto retiree, writes about the suicide rate in Japan still climbing (reported in a June 21 Medical News Today article by Catharine Paddock, PhD. She says new figures from Japanese authorities show the country's suicide rate still climbing with the fastest rise being among elderly Japanese-- a growing population sector that is also experiencing rising poverty. Nearly 100 Japanese killed themselves every day in 2007 (33,000 people in the year), a rise of 3 per cent on 2006 and the tenth year in a row the figure has exceeded 30,000. Depression was singled out as the main reason in about 20 per cent of cases, followed by physical illness and debt. The suicide rate of those aged over 60s in Japan rose 9 per cent from 2006 to 2007, to a record high of 36.6 per cent of all victims. Some reports have suggested that one contributor to the high suicide rate among pensioners is the breakdown of support that was once there from extended families; it has led to greater isolation and poverty among older Japanese. The Japanese government launched a 220m dollar campaign last year to cut the suicide rate by 2016. Dr. Paddock's piece says that 'critics of the government's campaign say they are targetting the wrong thing and should be doing more to remove the stigma of mental illness, and depression in particular.' She writes 'many elderly Japanese are not likely to talk to their GPs about mental illness' because they are of a mindset that believes one should not be open about mental problems.' Dr. Paddock writes that 'according to the World Health Organization, Japan's suicide rate is about 51 per 100,000 people, with men committing suicide at over twice the rate of women.' This, she says, 'is more than twice the rate in the United States (22 per 100,000), and three times that of the United Kingdom (15 per 100,000), but less than some Eastern European countries such as Lithuania (92 per 100,000) and Ukraine (62 per 100,000).'

Posted Monday, June 23

Paula Hudson-Lunn from Canada writes: Where I worked, anyone who went on 'stress leave' was stimatized. When/if they returned to work they were treated differently, often left out of social and team projects. Before even being accepted for stress leave, employees had to jump through so many hoops to prove their condition and there was always a rumour that these people were faking it to get a paid 'vacation'. You didn't dare admit your own suffering. Supervisors feigned concern while asking when you would get this under control and show up. When I succumbed to a depression in my early 50's my supervisor started to keep notes on me, finally asking me, not only for a doctor's note, but his explanation of my condition. Instead of sick leave to recover and return to that employer, I quit my job - no package, no pension - and found my own way back to health. I left a $50K corporate position to make $12/hour working at a travellers hostel. Many employers are not just unsympathetic to the mental health of their employees, but are major contributors to employee breakdowns. Your articles on the subject help. Thanks

Posted Monday, June 23

Nelson Alexander from Ottawa Canada writes: My greatest wish is that people will stop treating mental illness as taboo and realize that it is all around us, a part of our daily lives. I hope the discussions that CAMH and The Globe have started will continue. I'm 23 years old and will be starting my PhD in September. All my life I've struggled with symptoms of depression, anxiety, OCD and ADHD, and while my battles aren't always apparent to those around me, they take a huge toll on me. The happiness many people take for granted is something I constantly struggle to obtain. I dearly wish that there had been greater awareness of mental health issues while I was growing up. Early childhood treatment likely would have made my subsequent life much easier.

Posted Monday, June 23

D.E. Suta from Hamilton Canada writes: I have suffered from depression since I was a child but wasn't diagnosed until I was 40. And now after 9 years of therapy and anti-depressant drugs I am out of that horrible darkness that was swallowing my soul. I lost so much time. I would like to tell parents to find help for their children. If your child's behavior is symptomatic of mental disease, get them help. They will not 'snap out of it', it's not 'just a phase'. Mental illness is as serious as cancer and can be just as deadly for the sufferer. Letting your child suffer mental illness untreated is abusive and can lead to decades of suffering.

I am fortunate to have a wonderful employer. I have been able to be upfront about my illness and they have been extremely supportive. I believe the supportive environment has helped me to recover and stay healthy and, ultimately, be a productive worker. My suggestions to employers would be to treat mental illness as you would any physical illness, with honesty, forthrightness, and, above all, compassion. Remember, your employee can't just 'snap out of it'...any more that a worker with a broken leg can heal overnight. Thankyou for letting me use your forum.

Posted Monday, June 23

J Saffron from Canada writes: I am considered a classic bipolar. I went without treatment for many years, mostly because I refused to acknowledge that I had a problem; afterall, I received top grades, had many friends, held down several jobs and had many creative outlets. I was just seen by my friends to be 'flighty' and full of energy. I was careful to hide my depressive episodes from everyone, and I never mentioned the auditory hallucinations that plagued me when I was manic. I was a master illusion artist--no one clued in that I was on the brink of losing control completely, that I was an anxious wreck, that I was under constant attack from 'inner voices' and that I constantly thought about suicide, drawing up plans on a weekly basis.

Following a series of traumatic events, I was no longer able to maintain the illusion. I chose to go to a local ER and explain the suicidal ideation, the 'voices', the panic, the unbelievable manic highs that I was experiencing. I was spending money like water, sleeping less than 3 hours a night, running for miles and miles in the river valley, losing weight to the point of emaciation, drinking copious amounts of wine in an effort to 'slow down'...I was out of control. I was eventually seen by a psychiatrist who prescribed a few medications for me and arranged for follow-up the next week with a mental health professional. I was relieved. I immediately began the medication regime. Three days later, I woke up in another ER in restraints. The cocktail seemingly had an adverse effect and I overdosed, slashed my wrists and was found by my father. I have no recollection of the overdose. I am, however, thankful that it happened because it was evidently the alarm bell I wasn't able to consciously ring myself. I was placed in a psychiatric hospital for a couple of weeks and was put in an outpatient program. I finally recieved the treatment I needed. That was three years ago. I am now medication-free and in control of my life.

Posted Monday, June 23

Foamy the Squirrel from Canada writes: Thank you for a great series. This is so needed and should benefit so many. I have mental health issues that I keep hidden at work and with family. I think I have depression, coupled with a long-term eating disorder. I have tried a couple times to seek help, but our system has so many barriers: fees, physician attitudes, availability of services.

A couple years ago, afraid of my growing focus on suicide, I went to a physician to ask for an antidepressant that would not make me gain weight. She was dismissive, judgmental and lectured at length on how she wouldn't prescribe without knowing what my thyroid levels were...um, crisis here. Aren't they taught to stabilize first and then probe for other contributing causes? No questions, no compassion, no listening. I left without help, and found it so humiliating that I've not been able to try again.

On the outside, I seem pretty normal. Inside I'm a mess. I maintain an executive job, but have big tuition costs so can't afford the fees for a psychologist. I know so many people at work that need help. We never reach out though. One guy is on the edge of a meltdown, but he has intense anger symptoms so no one speaks up. I think that's such a sad reflection on our society. His suffering is obvious, but everyone looks in the other direction.

We need: 1) funded access to psychologists 2) faster, better access to psychiatrists 3) greatly increased availability of treatment programs 4) sensitivity training for GPs - GPs are the pathway to other levels of care and should be better trained for this 5) GPs with the time and funding to ask about emotional health at every appointment 5) a far stronger corporate awareness of and capacity (insurance, trained HR people) to deal with mental health 6) societal acceptance of mental wellness in all its forms 7) accountable government willing to REALLY cut wasteful spending (rather than just talk about it) in order to support what matters

Posted Monday, June 23

R.M. from Regina Canada writes: I am sharing a website that I came across a few years ago that is designed and run by those with mental illness. Perhaps there is a Canadian equivalent but I am not aware of it. We need to continue to build online communities with 'rooms' for all both to discuss/network and learn about the 'worlds' others live in and share with us and others. I would be willing to collaborate if others were like minded.

http://theicarusproject.net/

Posted Monday, June 23

Carol Anderson from Sudbury Canada writes: I read the article with interest, especially since there was a positive outcome. Unfortunately, my experiences with mental illness and attempting to get treatment for a family member have been frustrating. Proving that someone is a danger to themselves or to others is very difficult. A formerly jovial, athletic, working man turns into an angry, paranoid, delusional, unemployable person who alienates himself from everyone and everything. He can lose everything- relationships, job, possesions,....and that is OK, that is his right in our system. It is so sad to watch and be unable to do anything. He does not even have a reasonable chance for recovery or to decide on therapy or medication because the paranoia interferes with his judgement. When he can be convinced to go for therapy/see a psychiatrist, there is little help there. Appointments are scheduled perhaps once a month, perhaps every two weeks. Not enough time to build a relationship, not enough time to actually breakthrough his defenses. So, as a family, we struggle to maintain contact and struggle to not lose him.

Posted Monday, June 23

c.f. from unspec. Canada writes: Thank you Globe and Mail for tackling this issue. As many others have commented, this is a BIG topic that will take time for most people to absorb and bring into everyday awareness. The mentally ill encountered on the streets, and in crisis situations (in emergency rooms), etc. act 'differently' to the norm and that frightens people. In fact it frightens many health care staff too. As a result, the stigma is felt at a gut level by both sides of the equation, and not necessarily a thought stigma. This is hard to overcome.

There is a shortage of mental health nurses now and looming in the future as the older group retire, there is a lack of psychiatrists already keenly felt in Ontario. Why would students choose mental health as their specialty when they are stigmatized as ''weird'' for doing so? when there are other more glamourous choices? We need to incentivize these specialities becuase we have a crisis in our society. Also, we need to address the issue that to be mentally ill automatically ensures poverty - need to relook at the disability programs.

The other piece is the integration of mental health and addictions. While society feels addictions is often a moral issue, mental health isn't. The joining of them together for treatment makes sense medically (many mentally ill use substances to ease symptoms) but tainst mental health with moral issues. This needs addressing.

Finally, whilenot in favour of warehousing ANY portion of society, there are those mentally ill for whom supervised, controlled living is essential for them and the safety of the public. We need to fund those settings and not eschew them because of the old ''insane asylum'' model. Families can only take care of a certain number of the mentally ill because the needs and reluctance to take meds etc., can be overwhelming. Dumping them in group homes in parkdale didn't work in the 70s/80s, it won't work now.

Posted Monday, June 23

Ria Mistak from Halifax Canada writes: Hey there...My name is Rita and I am 22 years old. I was diagnosed with anxiety/panic disorder when I was 15, although, I've been feeling the pangs of this disorder as early as 8 years old. At first, I felt bizarre, unlike my peers, always worried that something bad was going to happen. It became debilitating when I reached adolescence and found help. Immediately, I was given a prescription for Prozac and Clonazipam, a heavy dose for such a young, fragile mind. After weeks of fighting with myself and my psychiatrist, who seemed ever ready to keep pumping me full of pills, I gave into a high dose of Paxil, a newer antidepressant. This helped my anxiety but I soon spun into a world of fatigue, weight-gain, missed school, self-mutilation, promiscuous behaviour, alcoholism, drug addiction and major depression.

The drugs were not working, in fact, the label that perpetuated my anxiety and depression was defined by the fact that I was, or so I thought, crazy. I hated not being able to control my own thoughts and behaviours. Everything was out of control. I went from Paxil, to Celexa, to Effexor, to Cipralex and back to Celexa. Although my teen years are well behind me, I've had to deal with the trail that anxiety disorder comes with. I have suffered from bouts of agoraphobia, social anxiety, delusional thoughts, manic depression, and obsession compulsion. All of which have been eased by talking to a councillor, not taking medication.

I am angry at doctors for writing me off as 'another case of depression and anxiety' and writing me away with a prescription. There needs to be more help to people who are not able to afford therapy, not able to find the right referrals and are too scared to ask for help. In order to be able to ask for help, there needs to be more awareness and support from people perpetuating the term 'crazy'. I know I'm not crazy; there is no such thing.

Posted Monday, June 23

Tom Drummond from Ottawa Canada writes: I'm pleased to see the Globe and Mail focussing on such an important issue. I was on 'stress medication' (read anti-depressants) for almost 10 years. A year ago, I ended up in the Ottawa Hospital and after being an in-patient, was priveledged to attent the Acute Day Hospital Program for a six week-period. I'm pleased to say I haven't had to take so much as an aspirin since, and although I still struggle with my emotions at times, my newfound awareness carries me through.

Previous commentors are correct, Self Awareness and Cognitive Behavioural Change should be part of the school ciricullum, beginning in early grades. Apparently there are some School Boards in The States and Canada that are doing this and every step like this forum in The Gobe is a step in the right direction.

Posted Monday, June 23

s p from Toronto Canada writes: For all the technological advancements we have witnessed, there is nothing that can challenge the power and complexity of the human brain. Within each of us is a three lb supercomputer dictating our every perception. To truly appreciate the brain is to marvel at the remarkable brilliance of its creator. With that being said, any science that aims to understand the function of the human brain is trying to tackle a subject beyond anything else in the known universe. It will be centuries before psychiatry is able to reliably and effectively deal with mental illness. Just like there were no antibiotics available during the Plague, this problem is is well beyond today's science.

Posted Monday, June 23

Judith Meyers from Stoney Creek Canada writes: During the last ten years Mental Illness has been the leading edge in our life. Our son has suffered with ADHD Bipolar and sever depression. In 2004 I lost a brother to suicide and have recently being diagnosed with Bipolr 11.

I can only wish that society could please understand the devistation of this terrible disease. I have heard quite frequently that someone that comes through cancer is considered a HERO...and yes they are however getting to the other side of Mental Illness is a journey and trying to conquer is a journey all on its own.

Posted Monday, June 23

Sandy McMurtry from London Canada writes: My only son age 19 took his life 10 years ago. My dad also took his life so did my dad's brother. My mom's mother, my grandmother took her life. A great-uncle, and a great-grandfather also took their lives.

Posted Monday, June 23

When will the cycle stop? I suffer from depression, but I have been very lucky to have an incredible psychiatrist or I to would have taken my life. Before my son died I was working. One day I went into work and just started crying. My son was eighteen then, and we were having a terrible time. We were so desperately trying to get him help as we knew he was ill. No one would llisten to us. Our son was a wonderful caring loving young man until the age of 17 1/2. It was like he changed overnight. He was very angry, smashed his hand right through walls, doors. One day he attacked his dad and I had to call 911. The Crown wanted to send him to jail. He could not live with us this was ordered by the court. Eventually he got a conditional discharge. He seemed to pull himself together with school. The court sent him for an assessment at Sunnybrook Hosp. to a Psychiatrist. They said he was ok. A week after the conditional discharge he hung himself at his house. He was revived, lived for 10 days, and we took him off life support. To make matters worse the lab made mistakes and they said they could not use his organs. There was nothing wrong with my Matthew. His organs could have been used. This still upsets me.

My mother was a Schizophrenic. Her mom had depression. My oldest nephew elder-abused my mom and is a very violent young man. We do not know what he is, but he is ill also. My youngest nephew would burn himself with cigarettes. He is 23. Their father almost killed himself with booze and drugs. My younger sister also has depression. My husband and I have been very lucky and have received extensive therapy over the past 11 yrs or we would not be here. At one time my hubby was suicidal and was admitted to hosp. Matts Mom

Posted Monday, June 23

lisa Netkin from toronto Canada writes: I'm just amazed that I found this series today. I just returned from the 'Mood Swings' Golf Tournament at Taboo Resort in Gravenhurst. This fundraiser is in it's 4th year for the Mood Disorders Association Of Ontario. Not only do I volunteer, but I have been struggling with bipolar disorder since my early teens yet not properly diagnosed until my late 30's ( I'm now 41). It is and always will be a struggle for myself and my family. This illness changes every time I think I have a grip, so the fight is won but the battle will always continue.

Without the support of family and the dedication of doctors I can truly say there would be no purpose for me. Patience is crucial! It's days like today when a group of people come out to support Mood Disorders Association of Ontario and watch Mike Weir hold his clinic for them that I know my battle will continue. Thanks Team!

Posted Monday, June 23

Paula Verlegh from Canada writes: Thanks for doing these series on Mental Health. Mental health should be an integral part of our health care. We need fast and easy access to mental health services. A few years ago my teenage daughter was depressed and had suicidal thoughts. Living with her dad (an alcoholic who may well be depressed himself) in a rural area; there simply was no timely access to the necessary services. Working together with her family physician we got her medication (with the possibility of negative side effects) because there was nothing else. I could not take time off work. I spend many a night on the phone with her, listening and helping her through another night. I don't know how I got through that time. She came through this episode, but I will always be on guard that it doesn't return. I believe that if my daughter had access to mental health services during that time, she would now be stronger and better equipped to deal with adversity.

Posted Monday, June 23

Lauri Nerman from Victoria Canada writes: Since 1988 I have struggled with depression that manifests itself in psychotic episodes, they have ranged from believing that everyone in the psychiatric hospital was there because of me, that my family was trying to kill me, the list goes on. Yet what is not really addressed so far is the linkage between addiction and mental health issues. It was not until 3 years ago when I suffered another acute depression that the psychiatrist connected the depression with my drug of choice which was marijuana.

My life now is probably the best it has ever been, but it was a struggle to get to the place that I am in now. One of the biggest issues was the lack of support for my family- I would be sent home from the hospital without any follow up or guidance. Imagine a cancer patient being told go home and we wont follow up at all. I am one of the lucky ones, I didn't succeed in killing myself, I did ECT treatments which left very minimal side effects and I have been symptom free for over three years and I have been clean for that amount of time.

I think the Conservative government while lauded for the mental health commission has done a real disservice to mental health patients by ignoring the component that Kirby initially addressed in his report: the connection between addiction and mental health issues. I applaud the courage of your participants and I hope that the public understands that having a mental illness should be no different than having a broken leg or something that is more visible and tangible. Ultimately stigmas are broken by the courageous acts of people who go public in a big way like The Globe and Mail as well as the day to day courage of letting the people around them know that they are suffering.

Posted Monday, June 23

Candace Allman from Toronto Canada writes: Thank you Globe and Mail for opening the door to begin to erode the stigma around mental illness. Did you know that post-stroke depression affects one in three people who have had a stroke, yet it is seldom talked about?

Approximately three months after a miraculous recovery from a debilitating stroke, I developed severe depression with psychosis. The blood clot on my brain altered my brain chemistry. I withdrew from family and friends, could not focus at work, imagined I had developed several other illnesses - including cancer and diabetes and could not function at home. I found it impossible to sleep and would anxiously pace up and down the stairs. I felt my life was hopeless, and when my husband became concerned that I was becoming suicidal, he had me admitted to the psychiatric ward at Sunnybrook hospital. For the first five weeks, I was on antidepressants and did not show any improvement. Luckily my psychiatrists recognized that electroconvulsive therapy would help me . After six treatments over the course of three weeks I completely recovered. That was three years ago, and I have not experienced any depression since.

It is time for post stroke depression to be talked about as a common result of stroke. Also, the stigma surrounding electroconvulsive therapy needs to be addressed. I am fortunate in having a very supportive work place, family and friends and excellent medical care. It is my prayer that all who suffer from mental illness will have access to the care and support they need, and that mental and physical health will one day soon be viewed as equal partners. I thank all of the people who have shared their stories. I applaud your courage. We can change nothing with our silence.

Posted Monday, June 23

Martha Morris from Toronto area Canada writes: Talking makes me uncomfortable. Of course, as the story goes, this wasn't always the case. As a child I bubbled over with the ecstasy of speaking and singing and shouting, much to the irritation of older brothers and the exasperation of parents. Every thought was deserving of an airing, dead air being anathema, at very best a waste. I commented on the sun on the water (didn't it look like it was coming from the bottom of the lake?) and questioned why spaghetti didn't get tangled in knots and announced that I was going to be a farmer when I grew up (and weren't these strawberries delicious?). Sleep didn't deter me altogether because I would wake in the middle of the night and tell God He had made a "damned fine moon". Sometime in the middle of being ten years old, I stopped. The words wouldn't come out, they refused. Running conversations continued in my head but they were determined to race on an endless track inside instead of flying into the air. It became clear that I didn't want anyone to catch what I was thinking. This shutdown marked the beginning of a long and lonely journey through a minefield. Hospitalization for anorexia, a psychiatrist who considered sexual interaction with an adolescent "treatment", medication and counselling for depression. Once struck, there ain't no cure, just ways of dealing. Coping with the chronic pain that crushes and then, when it eases, rushing to catch a breath and move ahead a little further towards feeling like it might be okay to be who I am, before the next blow is delivered. Reading the stories in Saturday's Globe was a knife through the heart. I don't want anyone else to feel the way I have and do; there is no comfort in knowing that others experience pain in living with the shame and struggle. Can something good come from cutting away the scars and exposing the raw hurt? I hope so. Hope is what brought me this far, forty years down the road. Maybe the time has come to talk.

Anonymous writes: I was not surprised to see that 86% percent of readers said that they knew of someone who had a mental health issue. In my own circle I know at least four individuals who have been afflicted with this, so I will certainly be following this very closely. I commend you on tackling a very difficult subject. The individuals who are dealing with this do not want others to know, including other family members. It makes it very hard to be a support person, when you are not able to get support for yourself. Suicide watch is a very lonely place when you can't tell anyone else about it.

Harry Zeit from Toronto Canada writes: I hope that, as this series goes on, the articles will become more clear and up-to-date on the current understanding of causes and effective treatments of mental illness. There is no illness that is specifically a mental illness and a brain disease; it's now well understood that all illnesses exist along a continuum but involve the body and mind. Also, most newer advances in 'mental illness' are pointing to early attachment and other trauma rather than to genes as primary causes of diseases like depression, anxiety, autism, schizophrenia and PTSD. We also know that the therapies which aim at rapid resolution like CBT and medications just don't really work wel, and invariably fail to address causal factors. Also, many of our emotional traumas underlie chronic illnesses that we consider physical, or lead to addiction, violence and broken lives. So far, I only see the articles I'm reading relieving the stigma of mood disorders, but at the same time, they are much more deeply stigmatizing the traumas that create these so-called Axis 1 disorders. Perhaps the Americans are moving much more quickly in the direction of adopting effective therapies because of their need to treat the epidemic of psychiatric disorders in Iraq War Veterans. At any rate, as a physician and a psychotherapist, I find it frustrating that these articles are not addressing the deeper issues that create physical & mental illness and discussing the treatments that really work. I fear that these articles will only lead to more money going in all the wrong places; that it will lead to millions of dollars chanelled into pharmaceuticals and cookbook formulas while the scope of suffering, the sense of futility for mental health patients and the terrible cost of mental illness, denial and human alieniation continues to dramatically increase.

Lynn-Marie Ramjass from Ajax Canada writes: I think the motto at the head of the issue says is best, FACE IT, FUND IT, FIX IT. We need to EDUCATE the public concerning mental illness and the many myths attached to it. We need a forum like this one, in which to let the patients have their say. We need to stop equating all persons with a mental illness in the same category as the likes of Paul Bernardo and other violent offenders. It hurts, angers and appals me that I must forever be equated with someone like him, purely because I have a mental disorder. I am tired of watching television and seeing those with mental illness forever portrayed as violent and someone to be feared. When in fact, most mentally ill patients are not violent whatsoever. There are so many different forms of mental illness, many of which can and are treatable. People need to know that even when we seek professional help, the health system does not provide enough doctors. We have a shortage of family doctors as it is. To see a psychiatrist or any other specialist takes months and you need a referal. Many people end up on the streets because they have no one to advocate for them, they lost trust in the system years ago and they just plain gave up. I know that my disorder cannot be cured, but it can be controlled. If some people want to call compassion a bleeding heart, than let them. If we shared a lot more love and understanding, if we do unto others as we would have them do unto us than we would not be having these social problems. We live in a society that often judges first and asks questions later. I think the one single thing I would like to tell anyone living with or knowing someone with a mental illness is this 'Be not afraid.' I would like the general public to know that it is courage personfied to face and overcome our fears. Having bipolar depression for nineteen years, I discovered a strength, courage, wisdom and compassion I never knew existed prior to developing this disease.

Aethne Hinchliffe from Ottawa Canada writes: Almost 10 years ago now, my father killed himself. It wasn't for a long time that I stopped feeling ashamed when telling people how he died - due to the stigma that surrounds mental illness. (Perhaps even I was a little ashamed of him.) Now that I've accepted that he was ill and needed help, I can tell people how he died without feeling as though others are going to judge me or him.

This series in the Globe & Mail is a step in the right direction in helping to create awareness and erase the stigma. Thank you.

Hog More from Guelph,ON Canada writes: Hi Moderator, It is good to know that there are good citizens out there who care about sickness of the mind and related maladies. The cost of mental illness to the patient, his family, and to the society is very large. For example, the patient misses earned income during the course of progression of the illness. Even if he manages to secure a job, it will be a low paying mundane job. Let me briefly narrate the progress of my brother Clement who had been on medication for schizophrenia 25 years. Clement did well in school. He chose to do research in Chemistry in India.Clement struggled to live up to the expectations of the members of the elite class. He withdrew from friends and stayed in the room in the hostel for long periods. He became an easy target for the smart guys. There he was given Thorazine and Haloperidol because he voluntarily consulted a doctor with the complaint that a bird is singing in his head. Noise from other rooms nearly drove him to deeper levels of craziness. He missed many doses due to the drowsiness associated with the meds. He had not been shaving or bathing for a while. He wore shabby cloths. Then he stayed home listening to radio and dreaming about a better life. We had an issue and we realized that something must be done about Clement. Later, he was prescribed Zyprexa and Tegritol. This combination worked wonders on Clement. He started looking for jobs. He updated his skills with few evening classes. The meds made him tired for any big tasks. Even if he managed to earn $28,000 per year, over 12 years, it would add up to nearly $300,000. I blame the sickness for the lost wealth.So, what could you do about it? The psychotics do not have a good role model to emulate. They walk in darkness, absorbed in the background noises and dreams of the brain. Some psychotics try to find meaning to their life at the wrong places. I mean, in movies and music. They slowly lose the touch with reality as the sickness progress.

Susan Baxter from Canada writes: Hi. Thanks for bringing mental health into the open. Following the sudden death of my youngest child I became clinically depressed. With reluctance I began Effexor 2 years later. I remained on the medication for 2 years and slowly withdrew after my son told me I was neither happy or sad. I had a flat affect. After reading about exercise helping to decrease the symptoms of depression, I joined a gym and began a fitness routine while slowly withdrawing the medication. Six years have passed since that child died and I live medication free, accepting my loss and incorporating exercise into my daily routine. Despite my strong faith, I was living a hopeless life all the while trying to convince myself to 'snap out of it'. In the midst of my depression, in the Spring of 2005 my son was diagnosed with his first psychotic episode as he completed his 3rd year of an undergrad degree. He was abusing alcohol and marijuana in order to cover up his grief and other feelings of loss. Unable to cope with exams he called home at 4:30 in the morning. This call had followed a few weeks of weird e-mails and other phone conversations. I never clued in to his substance abuse or his distraught. As I set out for the 4 hour drive to bring him home, I knew he was in a crisis. He received an abrupt and uncourteous evaluation by the psychiatrist in our general hospital. He took only one pill of the prescription he was given because it made him so physically ill. Two weeks later at Whitby Psych. Hospital he received excellent care by the staff as an outpatient. He was told that he could never use marijuana as with some people it could lead to psychosis. Apparently the incidence of psychotic episodes has risen sharply in the past few years among the young. This window of opportunity in calling for help, was very small for my son. Three years later he is working on a masters' degree, living independently and facing his grief and other losses medication and marijuana free!

Harold A. Maio from Ft. Myers, Florida writes: 'People with mental illnesses --face a stigma-- that can prevent them from getting care' is poorly edited. Some of us do, some of us don't, some of us are far too educated to 'stigmatize,' and others of us are far too educated to accept the proffered prejudice, to paste it on ourselves or others, or on a page. Editors err to generalize. 'People with mental illnesses' is as definitive an address as 'people with physical illnesses,' about whom we do not generalize, we know both that people vary in vast degree and illnesses vary in vast degree. We are trained to stereotype one, not trained to stereotype the other. We largely conform to both trainings, as a survey of journalism shows. 'People with mental illnesses,' 'people with physical illnesses,' 'people without illnesses' win the Nobel and Pulitzer are elected to major offices, including heads of state, earn doctorates and judgeships, succeed- and fail- at every level of society. And 'people with mental illnesses,' 'people with physical illnesses,' 'people without illnesses' face prejudices in one form or another from other people. Sometimes in the press. Harold A. Maio, Advisory Board, American Journal of Psychiatric Rehabilitation, Board Member - Partners in Crisis, Former Consulting Editor - Psychiatric Rehabilitation Journal, Boston University Language Consultant UPENN Collaborative on Community Integration of Individuals with Psychiatric Disabilities

Andrew Toth from Oliver, B.C. writes: I suffer from Major Depressive Disorder. Brought on by a marriage separation in 2003; I lost the ability to carry on my career, which was an AACI, a Professional Real Estate Appraiser. Prior to going in 'depression: I never knew it existed; in fact I had some pre-wired stereo typical ideas of it all, the types of mental illnesses; medication if any, etc. I went from a high energy business person to having sleep, resulting from fatigue, take up about 80 per cent of my days. I have lost the ability to sense outside temperature, because of my body sensing hypothalamus has somehow been disordered, I am more cold blooded then warm blooded, so to speak. My short term memory is, how shall I say, none existent. When very fatigued I need to lay down and when I walk into my apartment place the keys down; fall asleep for several hours for an needed afternoon nap; I will not remember where I place the keys. An hour later of searching I may find them. I could not listen to music of any kind for the first 10 months, after entry; into the world of severe depression. My spelling went from very good to very bad as I had forgotten how to spell words. I was not able to use a computer, which was a major tool in my business, for at least two years, post onset. I am on anti-depressant medication which I regard as a necessity to my minimal function. My typical day now is awake at between 10:30 am and 1 pm. I function doing what ever I can achieve, dishes, laundry until I require a nap of several hours. When I go to sleep in the evening I require sleeping medication, and have been on sleeping medication for the past 5 years. I deal with the fact that I cannot work. I also deal with the fact I have to manage stress. All stress, right down to shutting off the phone when I go to sleep. Depression, untreated take lives in the form of suicide; which I can understand, because the loneliness it creates is almost unbearable. I can only read say 15 pages of text, while laying down, then I need rest.

Victoria Arsenualt from Halifax writes: I think the hardest part about living with someone with a mental illness is talking to your friends or family about it, or sharing a difficult day, or a good one. Our son has schizophrenia, and other than our immediate family, and the fabulous team at the hospital, no one knows that he is ill. It isn't something people understand, or even sympathize with, so it's easier not talking about it. Mental illness makes people afraid, like anything that they don't understand. Our son is a wonderful man. He is quite, stays within our home most of the time as he has severe anxiety issues. People don't understand that a person with mental illness is more afraid than any of us will ever be. They have to battle things within themselves that we can only imagine. They are afraid, and they depend on those closest to them to help, and understand. If they are abandoned, they are lost. Our son use to play the guitar, taught himself, and played beautifully. Now it bothers him, his memory is not so great, so he doesn't play. If he can't be perfect, he won't do it. He gets agitated, but has a quiet, peaceful room that is easy on his mind. We love him, and I could fill a book about how I feel, and what we deal with, but I just wanted to add a comment on this great topic.

Sharon R from Canada writes: I was diagnosed with a mood disorder called 'cyclothymia' when I was 38. Most recently, I have found out that I am now Bipolar Two with underlying cyclothymia. Prior to my diagnosis, I self medicated with alcohol and various types of illegal substances to try and dull the pain and emptiness that I constantly fought inside. Needless to say my condition has affected every part of my life. The worst of all is knowing that I am different. When you meet me, you see this attractive, articulate, intelligent, posed, confident lady. Once people get to know me, it's a different story. People that I have deeply loved have turned away from me primarily because of the lack of understanding and the 'stigma' associated with mental illness. I am very pleased to see this editorial. I am hoping that people who read these articles will view mental illness from a different perspective and that those who suffer silently will not be afraid to speak out.

Jada Roche from Moncton writes: After years of struggles and misdiagnosis, after a post partum depression/psychosis that nearly killed me and my child, I got a bipolar diagnosis. And a doctor who said I wasn't 'sick enough' for her to see me. At every turn have been doctors either unwilling or incapable of seeing beyond the surface or easy answers. Imagine a manic person on Ritalin. It's truly a joy. Things could have been so much better if someone had every stopped to really listen, if someone on that maternity ward had paid attention to how I turned away from my child, if someone had seen past what they wanted to see. I wasted years of my life because no one would help me. Even still, I have to be grateful that I even have a doctor, even when I'm chastised like a child because I'm annoyed at her 40 minute delay for my appointment during my workday. We have no options-we have to take what we get and be happy for it. I would think we deserve a little better than that.

Doris Wrench Eisler from St. Albert, Alta. writes: It's great to see this subject demythologized and discussed like any other but while new and effective drugs are helping, we might keep in mind that that is not the only approach. Context is important. Not so long ago, for instance, women could be and were sometimes put away in asylums because of perceived 'sexual dysfunction', or having sexual proclivities seen as normal only in males. There is a famous case of this type on record involving a prominent American political family. Experiments in Korea seemed to show that actually, almost anyone (99% of the general population) can be driven 'crazy', have visual and aural hallucinations, become extremely depressed etc. People diagnosed with schizophrenia have said that the worst aspect of their affliction has been societal attitudes and the depression induced by it. It should be pointed out to all sufferers that there exists a far worse form of mental illness from the moral and societal point of view in people who seem to function quite adequately but are capable of rationalizing the most immoral (deadly) policies and behaviour. Factors such as self-empowerment seem to be all-important as fewer women are having problems these days, having attained a measure of real autonomy.

Charles Macphee from Toronto writes: It is nice to see a national newspaper tackling this major medical issue. I know all about the stigma that mental illness has since I am one of those diagnosed with depression. At times it is a struggle to get out of bed each morning. One thing that I have done is started a blog about my illness to tell one persons tale and trying to remove the shadows and can be found at http://dragons-sphere.spaces.live.com/default.aspx The one thing that a lot people in Ontario may not know is that the Ontario Disability Support Program cages those into a cycle of extreme poverty which does not help the recovery process

Michael Bryson from Toronto writes: I would have liked to have seen something included in this feature series about children under the age of 10. Specifically, something about learning disabilities and how the school system attempts to address them. There is a child in my life who was diagnosed with a learning disability last year, and we have had a heck of a time understanding 'the system.' There are supposedly many support systems and procedures in place. However, once one tries to access them -- there are waiting lists, excuses, and huge skepticism from the people on the front line of the solution. I mean: teachers! One can only imagine how much better off 'the mentally ill' would be, if the school system weren't so content on promoting a cookie cutter approach. (Yes, governments need to fund these supports better, but my experience has been that the attitude of the teacher can be the primary 'disabler.' If the teacher doesn't 'see' the problem, no supports will be put in place!) Perhaps the next series for the G&M? Special Education Reform?

John Smith from Canada writes: In my opinion one of the most important issues is that of the destigmatization of mental illness. As in everything else, what we learn at a young age stays with us for quite a while. I think that workshops in middle and high schools would be quite effective in helping children better understand mental illness, both in their families and in the larger world around them. Similar workshops could be arranged for companies and work places. Understanding is the key to acceptance.

John Chuckman from Canada writes: I do wish that we could wave a magic wand to eliminate the plague of mental illness, but I know perfectly well that we cannot. We have no good answers for most of the severe forms. All the various non-drug treatments are ineffective on the severe mental illnesses, which are all the result of glitches in the body's most complex organ, the brain. Actually, we still suffer a lot of mumbo-jumbo myths around various psychotherapies, the practices of the same people who forty years ago told families that schizophrenia was due to overbearing mothers, sending already-victim families into waves of ignorant guilt. Schizophrenia is in many ways more tragic than brain cancer. It destroys whole families. It is what sends all the most pitiful street people out onto the streets. But the medications we have for schizophrenia have major problems. First, many schizophrenics have intense paranoid fears. They actually fear efforts to help them. That is why many refuse to go to shelters. Second, the drugs themselves are partly ineffective and can be quite dangerous in some cases. In other cases, they turn some schizophrenics into pathetic foggy zombies. How do you control a paranoid person taking his/her medication? You cannot without imprisoning them in institutions as we did forty years ago, something which is unacceptable in a free society. Despite our pride and arrogance about our science, the truth is our abilities with mental illness remain fairly primitive. We just do not know enough. So I find it difficult to see any immediate light at the end of this very dark tunnel.

Matthew Spears from Vancouver Canada writes: It's wonderful that you're creating this series. Awareness helps.

The main problem I see that will be very difficult to change is our prediliction to immediately assume different behavior is bad and needs to be punished. Before someone is diagnosed, they usually will alienate friends, be fired from a job, have their family distance from them, and even sometimes be on the wrong side of the law. There is an immediate assumption that negative behavior should be punished. It is only afterwards that there is the thought that it could be a symptom or a subtle cry for help. I've seen this many times.

We need to learn to recognize cries for help without having the label of mental illness, because we rarely will be given it. It's called coming together as a community.

della baird from vancouver Canada writes: where does a person start. there are so many beginnings and too many endings. i, at first did not view my particular disorder as mental illness. i fooled no-one but myself. the names used before the current name(post traumatic stress disorder)were words i had heard my mother use to aquaintances about my behavior ie: high strung, flighty,etc. as a teenager in the 50's, 60's it was squirrely, spaced out, wired etc. these comments usually within earshot. the worst of all was knowing that somehow you were different, even within your own family. that's the part that hurts the most. my trauma stemmed from a father cursed with the same disorder. he was injured at vimy, married a 17 year old girl when he was 45. he was a wreck and alchoholic, his brutality to my mother was feasted on us. i still hear my mothers screams today. and those of two other family members. one is because of my actions. knowing i could not protect my mother added guilt along with my shaking, jumping at every little sound. at times even crying because the sound would not only hit my ears, it would reverberate thru my body. my feet can literally leave the floor at a clap of thunder. two bouts of rheumatic fever which affects the central nervous system as well as other physical disabilities just added to the mix. i was shy. i was (mixed up),i was a mess. yet i always had hope. today i have none. i want it back. i am now 67 and still find it hard to function. i am a fun loving person until a sound, a scream, a fight, gives me flash backs. i immediatley react by running to the scene to help without a thought to the consequences or running around like a chicken with no head. everyday, almost is a struggle. i used to feel hurt ,now i mostly feel anger and ask why. we do not in this world know everyones story. is it not time to step out out of the cozy niches' and look at others lives? you may be surprised, and you just may also learn that we all have our own degree of normalcy. you just may be able to identify. try it.

i had no room to speak about the lack of mental health facilities. there are very good people who work in the system. there are as everywhere, those uncaring, there for the paycheque. people who land in jail because of their mental problems are not always given help. some police persons recognise there is a mental problem, the person is taken to hospital and they are usually out the next day or a while later. the system is overloaded. i have been in a pysche ward 3 times, of my own volition. treated very well. sad to say, others not. mainly because there is ,hard to believe, stigma, even in the system. the one place that should be a haven is often a worse hell for some. verbal and physical abuse happens quite frequently. i have seen a lot in my lifetime, probably too much. most people have families. some do not. if your family can identify, then know this. support is the most important tool you have. stop thinking of them as DIFFERENT. just love them and show it. it usually rubs off.

Jennifer Jilks from Muskoka Canada writes: This is an excellent series. It will really help to raise the awareness of mental health issues previously swept under the carpet. I fought depression, having dealt with the death of my mother, moving, changing jobs, homes, and caring for an ailing father (brain tumour). Caregivers at at huge risk for depression and most of us (80%) are women with other family responsibilities.

The health care industry and health practitioners do not accommodate for those of us with mental health issues. They write a Rx and do not advocate for psychotherapeutic treatments.

Bosses do not understand the impact of mental health issues. They anger as they view your illness as interfering with job productivity. They fear mental health issues, demonstrate ignorance and show little understanding. Education is the only answer, as we share our stories and reflect on our situations.

harry warner from salt spring island Canada writes: If we see someone lying at the side if the road with a broken limb we rush them to medical care. Yet when we see someone with a 'broken mind' we tend to avoid them; judge them or just plain ignore them.
Until our society can speak of mental illness with the same candour with which we now speak of cancer (not too long ago referred to in hushed tones as 'The Big C') our mentally ill will be marginalised.
Thank you for your series of articles on this issue.

G. A. from Brampton Canada writes: I suffer from mental illness, but not schizophrenia. I have suffered for 14 years, 12 of those years, causing problems in my day-to-day, week-to-week functioning.

People will have different ideas on what your problem is, but only the sufferer truly knows what his or her problem is. They just may not be able to put it into words.

People will also have different ideas on how to solve your problem. The sufferer can consider these, but must keep following his or her own 'gut', in what she thinks will get her out.

God Bless.

al goguen from Victoria Canada writes: When my brother and his wife began to notice that their oldest daughter was acting differently from the other three daughters, they had her examined by their family DR. and after several tests, it was shown that she was a schizophrenic. They were devastated like any other parents, but they wanted the best for their daughter. Of course the first reason was to keep her at home and try to change her or cope with her. The parents had a business and had to work. So their Dr. suggested to place her in a group home. In San Diego where they lived has that service. We don`t in Canada. She has been in a group home for over 20 years, and she is very happy to be with her new family of women who have the same problems as she has: helping each other. They can interact with each other. They care for each other. They live in a certain way a normal life. She is always invited with her family at home for certain holidays, but at the end of the day, she looks forward to go back to her real home. I wish we had that system here in Canada. Instead many schizophrenic are left on their own roaming the street. We see them here in Victoria. They have no home for them, and the VIHA and the others responsible to help our sick people keep a closed eyes. There is a stupid human right law which says that you cannot remove a sick person from the street and put him in rehab if he or she doesn`t want to go. But aren't we the guardians of our our sick people. When they can`t think for themsleves and do not undertand what is best for them, why is it wrong to offer a hand. But if we hear that a bady had been abandoned in a garbage can we all rush to retrieve this child and fine him a home which is exacly what we should do. But some schizophrenics, some drug addicts, some alcoholics, are like small infants; they can`t thing for themselves; they can even remember their own name. What is so wrong for us to help them. Put them in a group home, a detox center and help them, giving them a normal life.

Melanie McCallum from Ottawa, Canada writes: Our son was diagnosed with Generalized Anxiety Disorder just before his 5th birthday. He is a kind, intelligent, and funny little boy who can go into an aggressive rage when he feels overwhelmed with worry that he cannot express. For a long time people said that he had 'behaviours'. Rarely did anyone outside of our house see our little boy literally sick to his stomach with worry about anything you could possibly think of right down to what he should wear to school the next day. All they saw was a five year old who could flip over a table full of paperwork and boxes in the daycare office when they told him that he could not 'time himself out' in the hallway when he felt overwhelmed with anxiety - a coping mechanism he regularly engaged in at home that the 'system' has efficiently trained out of him. We are slowly trying to re-teach him to step out when he feels that he can't hack it anymore even though his school and daycare has made it clear that he is not allowed to do this for 'safety reasons'. It seems odd that they would prefer him to have an outburst and potentially injure his classmates than sit in the hallway alone for 5 minutes until he is ready to come back and face the challenges of the classroom. As he gets older (he is 6) he gets better and better at using words like I am scared or I don't know what to do. He has been on medication for his anxiety for a while now and we have finally found a med (Celexa) that helps with the anxiety and still allows him to be himself, emotions and all. He has made friends with the children who used to be afraid to go near him and he enjoys spending time playing and learning at school and daycare. All of this he has achieved on his own with little to no support and understanding from the systems he has to function in daily. We came very close to losing daycare when we learned that he has no 'right' to be cared for in a safe and loving environment, only a 'privilege' to fit into the box. The system needs to change...now.

Laurie Petch from Regina, Canada writes: The last commentor's remarks show the importance of developing school-based mental health services. This is an innovation that is badly needed in Canada as elsewhere in the developed world.

Yvonne Parti from Toronto, Canada writes: I lost my mother to madness over 50 years ago: it was a very painful and dark period for Mother and her children. Today, treatment is better, but the progress made isn't nearly enough. There is more understanding and more useful medication - outcomes are generally more successful - but still there is no cure and recovery is partial at best. Much more money and effort needs to go into researching the causes and potential cures for mental illness.

Heather Lee from Toronto, Canada writes: I have been depressed since my teens. I was lucky enough to find a medication that helped me for 15 years but then it stopped working for me. I have been off work for over 2 years now and I have been through so many different medications and combinations. It is exhausting when it takes so long to try and find something that works. I have even been through Electro Convulsive Therapy or ECT and it did not work for me either. Matter of fact, it took away a lot of my memory and I find that there are many times when I start a sentance and can't find the words to finish it. That is very frustrating!! I have been doing a lot of research online, looking for help to my problems.I came across a surgery called Deep Brain Stimulation. I am in the study and I hope to have the operation done this summer or fall if all goes well. I have also been looking for a Psychiatric Service Dog but the only place that seems to have them is in the US. I only know of one woman in Guelph that trainss these dogs and she only does it for Guelph and area. There is a great demand for these service dogs and I would help me get out of the house every day. As it stands now, I am mostly in my bed every day. I would love to have my old self back and be able to create a non-profit organization with some help from others interested in the same. Build this organization to teach dogs to help us with this illness. I wish the best for others in my situation and I hope some day I will be able to go back to work and be a part of society again. Thanks

M. MacDonald from Halifax, Canada writes: I just want to thank the Globe and Mail for running this feature on mental illness. My wife is a mental health nurse and a good friend of mine suffers from bipolar disorder. It sickens me the way society treats many of those with mental illness and the lack of services for victims of mental illness is deplorable. Unfortunately, it seems often times those who suffer from mental illness do not have the same ability to advocate for themselves or organize major fundraising initiatives, like cancer sufferers (I don't know of any Canadian bank that has sponsored a nationwide run for mental illness, for instance, but someone can correct me if I'm wrong). This type of advocacy and awareness-raising is very important. Thank you!

Rose Simpson from Ottawa Canada writes: My life swirls with mental health and addiction issues. Both of my parents were alcoholics and I suffered the fallout in my youth. My father died when I was eight months old in a car rollover; a six pack of beer was found beside him in the front seat. My mother suffered serious depression, so much so she had to be institutionalized to undergo shock treatments -- which still seems utterly barbaric to me. For years, as a teenager, I served as my mother's therapist over boozy evenings, as she offloaded her problems and anger on to me. I listened to her tirades, wiped her tears and put her to bed many nights. I now realize that she stole my innocence; I became the parent, she the child. I also realize she passed the terrible torch of mental illness on to me and my children. For years I have suffered from general anxiety disorder and agoraphobia. My condition has made finding full time employment impossible and has in effect ruined my career. Fortunately, I can eek out a living as a freelance writer, working from home. But I realize that my isolation contributes significantly to my condition. As a sandwich generation mom, I got it from both ends. First caring for my mother in my youth, and now struggling to help two of my own children who have suffered with their own drug and alcohol problems. I've warned them that substance abuse runs in the family and they are cognizant of that fact. Still, I am pained to see history repeating itself. But through investigation, I found hope. I have come to realize the importance of talking about your problems. I joined a therapy group, which taught me the unique tools of cognitive behavior therapy, tools I have been able to use to tame my panic attacks and live and participate in the real world again. By speaking its name, and facing fears, I believe we can make the impact of mental illness a little smaller in our lives. And by sharing our stories, we can help each other.

James T from Toronto Canada writes: It's been a long time that I read a feature article from beginning to end. Thank you for your series. Coincidentally, this week, I told my employer that I've been battling depression to explain recent absences. I think promoting awareness in the workplace is so important. I've been fortunate enough to have great bosses who understood and were flexible to allow me to get better. I really look forward to Monday's instalment. The reluctance for people to talk about it is incredible - I find even my own psyche blocking out memories and thoughts and feelings. My partner commited suicide 6 years ago - It took me about two years to mourn the loss and just when I thought I was better, I had my first anxiety attack since I was a kid. That was the beginning of a slippery slope which left me debilitated on and off for the next few years. Within that time, I've sought medical and psychological treatment and with time and effort, I'm dealing with my depression. The frustrating thing is while I'm used to controlling every aspect of my life, I am completely powerless to predict how I will feel. I feel depressed that I'm depressed. It's a horrible feeling to think that life has no meaning and to question whether happiness will once again be a part of my life. Yes, I can function and make jokes and laugh... but I really can't remember the last time I was happy. And I wonder whether 'normal' people even question this. I have a very close friend who is also affected. And whenever I tell someone about my problem, I'm amazed at how they already know someone with the same issues. I'm thrilled that the Globe is doing this series and I know it will make a difference for a lot of people.

janna m from Toronto Canada writes: One of my family members had a serious psychotic episode just over a year ago. I looked for help but every road led back to CAMH. The family doctor faxed referrals for an assessment to CAMH. After numerous phone calls to CAMH their response was there was at least a 9 mth wait list. All services in the city had waiting lists or were expensive. Over a year had passed without any response from CAMH. Last mth I faxed a letter to CAMH saying they had this great advertising campaign 'transforming lives' but after waiting for more than a year my family member hadn't been acknowledged never mind had her life transformed. That day CAMH finally made contact to set up an appointment. Its frustrating what a person in crisis with no money, someone to advocate or connection to resources has to go through to get help.

Mary-Jane Kingsley from Toronto Canada writes: I read the article in this mornings paper about mental health in particular, anxiety. As much as I appreciate that this article was written and the topic about CBT was discussed and of course, the importance of CBT for those of us who have GAD, there is so much more that people should know about this disorder. One thing that I think is important to mention is that just because a person may have GAD, that doesn't necessarily mean that they also have depression. This is a misconception that I would really like to clear up. Yes, a person can have both and often it can be the case but certainly not always. This leads to the issue of the appropriate therapy and treatment. It is my opinion that it is very important to recognize if the patient has GAD as the primary problem or depression as the primary problem. I say this because in my opinion it is very important to get the correct medication especially if the GAD or panic is primary. Some people have anxiety and then become depressed because they have anxiety and possibly can't leave their homes. If the anxiety is treated, then often the depression will go away. I feel that CBT is an extremely important treatment for those with anxiety disorder but often it is necessary to combine CBT with medication to having as full a life as possible. CBT will help many people and that is all they will need to get by, but others will definitely need the added help of medication if their anxiety/panic is very sever. A long term benzo is often a good choice rather than an antidepressant for those who just have anxiety/panic disorder. Some doctors don't agree with this and prescribe an SSRI. In my opinion, if your primary issue is anxiety then a long acting benzo is the appropriate medication. There are countless numbers of people who can't leave their homes because of their debilitating fear. They are the hidden suffers. How do we reach them? How can we get them the help they deserve?

L Pady from Toronto Canada writes: The single change in policy that would make an enormous difference to the welfare of many Canadians who struggle with mental illness, is to have Psychologists fees covered by OHIP (or other provincial insurance plans). The high fees prohibit the majority of people from accessing vital therapy. Once someone with mental illness is ready to confront their issues, they need to be able to get the very best possible help. Often, a psychologist can provide just that, but only a very few can afford this service, and turn instead to those with far less training, and continue to struggle as a result.

Congratulations on your fine series. As a survivor of a serious depression many years ago, and an ongoing anxiety disorder, I applaud you for helping to bring this issue to the forefront, and lessen the stigma attached to it. Some day perhaps, we won't need to hide behind a 'designed life'.

Gizella Oehm from Toronto, Canada writes: One of my close friends suffers from 'social anxiety disorder', and has suffered from this, I think, since she was 6 years old. For years I've been helping to support her as I could, and watching her struggle with the sense of humiliation she feels at the condition of her life, which continues to deteroriate. She now sees no way out. While I was excited to read the article by Carolyn Abraham, 'A very designed life', and will show it to her, I know what her response will be: distrust of the medical establishment (ie CAMH), and distrust of the professionals who would need to work with her. Since she feels socially anxioius, she is horrified at the thought that people will find out about her, where she lives (subsidized housing), that she receives the federal disability pension, etc. She feels that once people find this out about her, they will treat her differently. She feels that the public institutions deal with people like her (or any of the poor) with contempt and indifference, just going through the motions. She cannot subsist on the meagre amount of money provided by the disability pension (maximum about $900/mo if you live in Toronto. Think about that: it is almost impossible to get even a basement apartment in Toronto for under $700. This amount of money has not changed in over 20 years). She cannot work right now until she gets a handle on this problem. She is filled with rage and resentment. So, at the end of the day, as I've rather helplessly listened to these litany of concerns, I am honestly at my wits end as to what to do. And so is she. This so sad, because she is such an intelligent, charming, funny woman, who has the potential to be so much more than she is.

G G from Calgary Canada writes: Many of the commentators suggest that mental illness is an illness just like a physical illness. However they are not the same thing at all. Having a cancer or high blood pressure does not prevent you from freely participating in your own treatment however such is not always the case with mental illness. Often the patient is not the best person to assess their own needs. The very nature of a mental illness often prevents the patient from knowing what is best for them. I am not saying that locking people away or treating them in a demoralizing is the answer but the case of the bi-polar man illustrates my point. He was 'homesick' and decided to leave the Ottawa hospital that was providing him the necessary care that he needed. Non compliance on the part of the mentally ill is a big issue perhaps as big an issue as society's attitude toward the mentally ill. Both need to be addressed.

Susi Lessing from Mississauga Canada writes: I praise The Globe and Mail for bringing to the attention of the general public the plight of so many mentally ill people. Society has come a long way, but the stigma of psychological struggles persists; even friends seem to judge, distance themselves or just misunderstand. They feel that these struggles can be overcome by willpower or self-control, long baths ore exercise, without comprehending really.

My mother lived in terrible anguish, depression and despair due to what was then called manic-depression. Electroshocks, insulin shocks, hospitalization and institutionalization did not soothe her despair. My brother and I grew up with this loving, guilt-ridden person who suffered terribly for 50 years.

My brother later had to deal with his own rages and depression and I have had two major clinical depression bouts myself. I have learned to accept my anxiety, which interferes in my ability to be more effective; I have learned to recognize that the moments of deep despair will subside and the sun will shine again at some point ...

I am thankful to Canada for recognizing mental health as an integral part of the health system, yet feel there is a lot to do.

First and foremost, the long waiting time that exists for people to receive help for their agony needs to be improved with more and better services. Another equally urgent concern is the quality of the doctors who offer service. I have met many uninterested, self-absorbed individuals who don't really connect or listen to these suffering patients.

These health officials are very dangerous since they have a big effect on the sick who are desperate and vulnerable. They need to have support and be controlled as well.

Once again, thank you Canada and thank you Globe and Mail for your effort in making mental health understood and the mentally ill accepted.


Read more!

Safety plan proposed to protect doctors -Melbourne (Australia) Age

By Jill Stark

A NATIONAL register of violence to monitor a growing number of assaults against doctors will be considered in the wake of the killing of a Melbourne GP.

The plan to record violent incidents on a country-wide database comes after Dr Khulod Maarouf-Hassan was stabbed to death by a mentally ill patient in her Noble Park surgery two years ago.

Her close friend and fellow GP Leanne Rowe proposed the register after interviewing hundreds of doctors about their experiences of violence, harassment and intimidation.

The Australian Medical Association has backed the submission — to be considered at a meeting of the Royal Australian College of General Practitioners next week — and wants the Federal Government to help pay for the scheme. Health Minister Nicola Roxon agreed to look at the proposal.

Dr Rowe said that at least seven doctors had been murdered at work in Australia in the past decade and more deaths were inevitable without better protection.

A national register would allow doctors to share information and learn from tragedies such as the killing of Dr Maarouf-Hassan, a 51-year-old mother-of-three.

Dr Rowe told The Age she was shocked by GPs' experiences, including one doctor who nearly died after being shot six times in the chest and abdomen by a patient who was angry about an insurance claim. Some doctors were forced to leave their practices because of repeated threats and harassment by patients and many suffered assaults.

Most doctors she spoke to experienced some level of violence and felt the problem had grown over time.

"No one in the profession on a national level is counting those deaths or incidents of grievous bodily harm, so we don't know if they were drug-related or related to a patient's untreated psychosis," Dr Rowe said. "Unless you analyse what the pattern is, you can't work out what went wrong and look at the systemic factors that might have contributed to the incident."

The submission comes as the late doctor's family and friends recount the story of her life and violent death in tonight's episode of the ABC series, Australian Story.

In the documentary, Dr Maarouf-Hassan's husband and eldest daughter discuss their mother's dedication to her patients, many of whom were refugees. They also speak compassionately about the man who killed her.

In March this year, Sudanese-born Samuel Benjamin was found not guilty of murder by reason of mental impairment and is serving a 25-year sentence in a psychiatric facility.

Dr Maarouf-Hassan's daughter, Nawaar, said the verdict was the best result possible. "Obviously it's tragic for us and the community, but it's also tragic in that we have this person who is very ill and needs treatment," Ms Hassan said. "The verdict is the best way not only to protect the community but to make sure that he gets the treatment he needs."

Mr Benjamin suffered from a major psychotic disorder at the time of the killing and believed people in the medical profession were trying to murder him.

Despite pleading for help from a number of organisations, including the Victorian Health Services Commissioner, the threat he posed was not detected.

Dr Rowe said the case showed how mentally ill patients often fell through the gaps in the health system.

"There is so much to learn from this case and we know it's the tip of the iceberg because 10% of people who commit murders and 10% of people who perpetrate major violence are psychotic at the time they do so," she said.

"Doctors need more information on what to do if they're threatened with violence, how to take out an intervention order or how to respond to stalking … because there's a growing concern among GPs on the ground and we really need national leadership on this issue."

The college of GPs will next week launch a detailed handbook for doctors on how to deal with aggressive patients and make their practices safer. It comes after the Australian Medical Association mailed an anti-violence kit to all its GP members.

AMA president Rosanna Capolingua backed the national register and called for greater funding to treat the mentally ill. "We had a case in Western Australia a few years ago where a GP went to do a house call on a patient who had a mental illness and the guy chased him with a shotgun. The doctor was pleading for his life but he was shot several times in the head," Dr Capolingua said.

"The problem with mental illness is that someone who goes around telling people they're going to kill a doctor may not qualify for a hospital admission. They may not be sick enough for that but what other resources are there for us to help them?"

*The AMA urges the Government to help fund the plan.

*More money is needed to treat mentally ill patients. Read more!

Twin Valley to close doors Monday -DAyton Daily News

By Anthony Gottschlich - June 29, 2008

DAYTON — Its beds empty and its staff packed up, the Dayton area's only public psychiatric hospital closes Monday, June 30, after 153 years in business.

"It's just very depressing," said Deborah Dietz, volunteer program administrator and 35-year veteran of Twin Valley Behavioral Healthcare on Wayne Avenue, formerly Dayton State Hospital.

Dietz is one of 25 Twin Valley employees retiring with the closing. Of the remaining 175 staffers, 43 were laid off, 30 resigned and some are taking jobs at other state hospitals and agencies, said Trudy Sharp, spokeswoman for the Ohio Department of Mental Health.

Sharp said 32 of the hospital's 51 long-term patients have moved to Summit Behavioral Healthcare in Cincinnati, the rest to state hospitals in Columbus and Toledo.

"None of them went kicking and screaming," said Jim Chase, a social worker and patient advocate at Twin Valley who is retiring after 32 years. "Most of the patients are pretty resilient. They'll do anything they think is required of them, generally speaking."

The closing follows months of protests and pleas from community leaders, patients' family members and other Twin Valley advocates who tried to convince Gov. Ted Strickland to reverse his January decision to close the 110-bed hospital. But Strickland, a Democrat, would not relent, saying the closing, as well as that of a similar hospital in Cambridge, was needed to help the state avoid a $733 million budget deficit in fiscal 2009, which begins Tuesday.

Twin Valley opened in 1855 as the Southern Ohio Lunatic Asylum with 59 patients and a budget of $4,900. It grew over the years, adding hundreds of acres and changing names several times along the way, to around 1,600 patients in 1969 before the deinstitutionalization movement of the 1970s. The main building later became 10 Wilmington Place, a retirement community.

Looking back on his career at the hospital, Chase said what he liked most about his job "was just being able to talk to patients like they were human beings and knowing they appreciated that."

For Dietz, whose mother worked for 18 years as a beautician at the hospital, it was the employees and volunteers, the "wonderful, caring people that really had the patient's interests at heart."

"That's all they really cared about," Dietz said. "It took a special kind of person to take care of these people and we had the best there was."

Contact this reporter at (937) 225-7408 or agottschlich@DaytonDailyNews.com. Read more!

Real solution, real home for homeless - Charlotte (NC) Obserer

For the first time in 23 years, 50-year-old William has a place to call home.

“This is the best I've been living in a long, long time,” he said.

William is a participant in Charlotte's Homeless to Homes, a program developed by Kathy Izard of the Urban Ministry Center. For safety reasons, the Observer is not using his last name.

Homeless to Homes is Charlotte's version of Housing First, a program that takes chronically homeless individuals off the streets and places them in permanent housing. A case manager also helps the participants with long-term problems such as substance abuse or mental illness.

Housing First has celebrated success in cities such as New York and San Francisco. Charlotte's program is one month into its two-year pilot.

A grant from a private donor covers most of the funding. Izard hopes the program will save taxpayers thousands.

Jail and Justice Director Tom Eberly of the Mecklenburg County Sheriff's Office said he wishes the city had more programs like Homeless to Homes.

For the chronically homeless, jail is “a way of life,” Eberly said. These individuals should “seek out other alternatives that are possibly life-changing.”

The program

Homeless to Homes currently has nine participants, ranging in age from 39 to 64. They average about 10 years of homelessness each. Its long-term goal is a 100-unit building with on-site support services.

Just as its name promises, Housing First places homeless individuals in stable housing and then focuses on getting them the help they need.

This necessary stability is almost impossible to secure when the homeless operate in what Izard calls “survival mode.”

“‘What am I gonna eat? How am I gonna shower? There's no room in the shelter, what do I do?'” she said.

There are 5,000 homeless men and women in Charlotte on average, and other programs also help fight the problem.

But Homeless to Homes concentrates specifically on single, chronically homeless men and women – those homeless for more than a year.

They make up only 10 to 20 percent of Charlotte's homeless. But they use 50 percent of resources dedicated to those who are only temporarily homeless.

On any given night in Charlotte, about 20 percent of the jail population is homeless. With jail cells costing $114 a night, Mecklenburg County residents could be spending as much as $53,000 per day on the population of chronically homeless.

The cost of one night in a Homeless to Homes apartment? $28.72.

“We're saving city tax dollars and getting positive outcomes,” Izard said.

Homeless to Homes' rent – $475 per month, plus water and electricity at about $20 to $25 and $88 per month, respectively – is covered mostly by the private grant.

Participants who work or receive disability checks each contribute 30 percent of their income to the rent.

A place to call home

William has been arrested 10 times in Mecklenburg County for misdemeanors such as possession of drug paraphernalia and larceny.

He's also been to N.C. prison twice – once in 2007 for drug possession and once in 1996 for forgery.

He spent 135 days in prison.

William knew he had a problem. But he couldn't find his way out. He was addicted to crack cocaine and alcohol, something he calls “vicious” and “insane.”

He also contracted HIV and hepatitis C through his drug use.

No matter how hard William tried to clean up, he fell back to his addiction.

Izard and other Urban Ministry Center employees had watched William visit the center since its doors opened in 1994.

He fit the criteria: chronically homeless, disabled, able to do well in a community setting. Izard and Markley decided to make William one of Homeless to Homes' pioneer participants.

One month later, William is sober and thrilled to have an apartment of his own. He can't keep a smile off his face.

William spends his time volunteering at the Uptown Men's Shelter or at the Urban Ministry Center.

After 23 years of homelessness, drug addiction and jail time, William finally has a place to call home.

“I know I got a new life,” he said. Read more!

Southeastern board cuts building plans to stave off service cuts - Wilmington (NC) Star-News

By Vicky Eckenrode - June 27, 2008

Southeastern Center for Mental Health will ask New Hanover County to give back $5 million slated for a new building but now is needed to stave off drastic cuts in client services.

Southeastern put the money up as its part of a nearly $23 million project to house the center’s offices as well as the new home of the New Hanover County Health Department.

As part of the project, Southeastern also had given the 13 acres off Physicians Drive. Members of Southeastern’s governing board, which met Thursday night, decided to keep the land in trust but unanimously approved trying to use the $5 million.

Southeastern officials have fielded angry and frustrated calls from families of disabled people who receive services. In recent weeks, they were warned by their service providers that therapy and community help hours would be scaled back or cut altogether because there was not as much funding for reimbursements from Southeastern.

Some providers were told to expect half or less of what the companies received last year because of what Southeastern thinks it will be getting in state money.

Southeastern administrators estimate they will face $12 million in needed services during their new budget year, which starts July 1. But they do not expect to get more than $8.3 million in state funds, the same level they received for this year.

To make up the difference this year, Southeastern dipped into its reserves but cannot tap its remaining $2.3 million because the state requires it to keep 8 percent of its budget protected in savings.

In turning to the $5 million building fund, Southeastern officials said they will start the year without people having their services dropped, but warned that it was only a temporary solution.

“What it does is buy us time,” center Director Art Costantini told the board while presenting the proposal. “Next July, if we do nothing, we’ll still be faced with the same $12 million budget program and an $8 million” state allocation.

He said the center needs to spend the coming months working with providers and families to evaluate services and payments to figure out how to rein in growth.

Several authority members expressed concerns about what will happen next, particularly since Southeastern will not have the extra money available next time like the $5 million being targeted now.

“If we accept the administration’s proposal tonight, we’ve got one year,” authority member Richard Nubel said. “We’re going to be right back here next year unless something fundamental changes in the way we allocate funds.”

Nancy Pritchett, an authority member and New Hanover County Commissioner, pointed out the organization has essentially six months to try to lobby for more state funding next year.

Pritchett also had sharp words for the center’s administration in reporting its finances to the board.

She said she was unhappy with the depth of budget projections board members were receiving and called for the hiring of an outside consulting firm to go over the finances – a proposal the board decided to debate next month.

“I have no choice but to go along with this, but we’re just digging a deeper hole,” Pritchett said about the $5 million shift. “We don’t have planning for long-term eventualities, and that bothers me.”

Board members asked for detailed monthly reports and also decided to form an advocacy group to help appeal to state lawmakers.

In other business, the board also decided to reopen the center’s detoxification center now that state regulators have lifted a suspension on the facility.

The state closed it last month, saying that a number of policies needed to be addressed following an investigation into the death of woman who sought treatment for heroin addiction and died of pneumonia while at the facility.

Although the new proposed policies will require spending more money on staff for supervision, board members said the service was still needed in the community.

Costantini said the facility would reopen once the rest of the changes the state called for, such as staff training, were complete.

The board on Thursday night did not decide the fate of the center’s crisis station, which also was suspended along with the detox center.

Costantini said he is still talking with New Hanover Regional Medical Center about whether the hospital would assume some of those functions for handling people being voluntarily or involuntarily committed.

Board members asked Costantini to get memos of understanding from New Hanover Regional, Brunswick Community Hospital and Pender Memorial Hospital about how they would handle the mental health crisis services if the station does not reopen.

Vicky Eckenrode: 343-2339

vicky.eckenrode@starnewsonline.com
Read more!

Boseman seeks audit of Southeastern Mental Health - Wilmington (NC) Star-News

By Vicky Eckenrode- June 27, 2008

The state auditor’s office may launch a review into Southeastern Center for Mental Health’s finances after receiving a request Friday from Sen. Julia Boseman for an investigation.

“Mental health and substance abuse services in Brunswick, New Hanover, and Pender Counties are in crisis due to the abrupt and significant decrease in funding for mental health providers of developmental therapies,” Boseman, a New Hanover County Democrat, wrote in the letter to State Auditor Leslie Merritt Jr. “I am concerned that Southeastern Center’s financial practices may have led to this crisis. In addition, it appears that they may not be in compliance with financial reporting requirements to their board and the three counties they service.”

Chris Mears, a spokesman for the state auditor, said the agency is reviewing the request. He said it was typical to take a precursory look to decide whether an issue merits a full audit. Mears also said that audit requests from legislators are given high priority in scheduling reviews.

Southeastern’s area director Art Costantini said Friday he was shocked by the request.

“We worked closely with her on a number of projects. I’m surprised she didn’t call and collect more information before she did that, but that’s certainly within her jurisdiction,” Costantini said. “I’m not at all opposed to it. I welcome it in the sense that we didn’t do anything wrong.”

Costantini said he had not met with Boseman this year about the funding issues.

Southeastern has been struggling in recentmonths with having enough money for services such as developmental disabilities therapy. The center functions as a pass-through agency, allocating state funds to private service providers.

Covering reimbursements became a problem after Southeastern realized it would be receiving $8.3 million from the state, less than its appropriation in previous years. It expected there would be more to give out to providers.

Southeastern administrators expect to receive the same $8.3 million from the state in its upcoming budget year, which starts Tuesday, despite estimating about $12 million in need and warned providers that the reimbursements would drop off sharply.

Providers, clients with disabilities and family members reacted angrily to the cuts, prompting Southeastern to shift $5 million from a building project to make up the difference and avoid cutting off services for many clients.

Whatever the source of the money issues, a full review is needed into how Southeastern handles its funding and what has caused the situation, Boseman said in a phone interview.

“Hopefully, we can figure out what the problem is,” said Boseman, adding that she has fielded dozens of calls from constituents upset they might lose services. “There’s something not right going on at Southeastern.”

Boseman said it was possible that Southeastern needs additional state funding, but she said she was unwilling to push for throwing in more money without knowing things are in order at the local office.

“We need an audit to figure out what’s going on so that they can get a better handle on what they’re doing,” she said.

In her letter, Boseman also questioned whether some of Southeastern’s 16-member governing board have overstayed their term limits.

“I don’t mean to be critical of what they (board members) are trying to do, but we need to fix this system,” Boseman said.

Board Chairman Fred Blankenhorn said Friday he did not think any of the sitting members have been on longer than the six-year maximum limit.

The Star-News has requested information on board members’ terms, but the document was unavailable late Friday afternoon.

After getting board approval Thursday night to tap the $5 million building fund, Southeastern administrators spent Friday meeting with providers to make sure no clients are dropped.

Those meetings are expected to continue Monday and Tuesday.

“If there’s a silver lining,” Costantini said about a potential state audit, “hopefully, it draws attention to the issue, that there is not enough funding in the system to meet the needs of the clients. You either restrict the services so much, or you overspend your budget.”

Boseman has faced her own questions recently about personal finances, including delinquent property tax bills. Friday she said she was not concerned that requesting the audit would raise eyebrows.

“I have continued throughout any difficulties in my personal life to do my job and fight for these people that I represent,” she said. “If someone wants to protest me doing my job, I have absolutely no problem with that. I’m going to keep continuing to do my job.”

Vicky Eckenrode: 343-2339

vicky.eckenrode@starnewsonline.com
Read more!

ChristieCare scraps mental health plan -Roseburg (OR) News Review

Marissa Harshman

After more than a year of trying to bring mental health services to the children of Douglas County, ChristieCare has withdrawn plans for its two most recent projects.

ChristieCare’s halting of a planned treatment foster care program and a transition home for young adults in Douglas County are the latest in a string of canceled project plans, largely due to funding shortfalls.

When Mercy Medical Center announced the looming closure of its Behavioral Health Center in February 2007, officials at the Portland-based nonprofit company started to discuss the possibility of bringing services to the area.

Last June, Mercy approved a joint venture between ChristieCare and Telecare Corporation, which is based in Alameda, Calif., to bring children and adult mental health care to Douglas County. ChristieCare announced in November — less than one month after the BHU officially closed — that it could not acquire the needed funding to move forward with the BHU project.

Telecare officials are still working to finalize contracts with the state so the company can provide adult mental health services in the area, Director of Communications Shea McGuier said in an e-mail May 30.

ChristieCare had plans to bring an array of services to Douglas County. Original plans included using part of the BHU building to provide nine beds for children who needed short term care and offer a 30-day intensive psychiatric services program.

The company also hoped to provide behavior rehabilitation programs, the home for transition-aged young adults ranging from 18 to 24 years old and the treatment foster care program.

But as contract after contract fell through, and funding became further stretched, ChristieCare officials realized the project as a whole wouldn’t work, Executive Director Lynne Saxton said Friday.

“Children and families need an array of services and they need to experience those services with consistency,” Saxton said. “That’s what we were trying to build, and as each piece of the array fell through it became harder and harder for us to accomplish what we wanted to do.”

The state awarded ChristieCare with a contract to provide five treatment foster care beds, but with the lack of funding for the other projects, ChristieCare officials realized the project wasn’t realistic, Saxton said.

Staffing a Douglas County office for only one program — treatment foster care — was not realistic with the nonprofit company’s budget, Saxton said. The low state reimbursement rate for services results in climbing costs and additional financial strain for the company, she said.

“It’s a very tough time in mental health anyway because the system is underfunded,” Saxton said.

All hope for children’s mental health services may not be lost yet, though, said Janet Holland, Douglas County mental health director.

The mental health department, partnering with the local office of the Department of Human Services, is trying to encourage the state to reissue a request for bids for the treatment foster care beds, Holland said.

“We’re hoping the state will go back out for bids and will issue the contract to another company who can bring (the beds) to Douglas County,” she said.

• You can reach reporter Marissa Harshman at 957-4202 or by e-mail at mharshman@nrtoday.com. Read more!

UW-Madison dropout charged in Joel Marino's death - Associated Press

A University of Wisconsin-Madison dropout was charged Friday in the murder of a 31-year-old man, potentially solving one of several murders that had frightened city residents.

Adam C. Peterson's DNA matched a sample taken from a knife used to kill Joel Marino in his lakeshore home Jan. 28, according to a complaint charging him with first-degree intentional homicide.

Mayor Dave Cieslewicz said the charge was a relief to residents worried about their safety after three high-profile murders went unsolved for months. He praised detectives for good police work.

Police said they have not established a link between Peterson and the April death of UW-Madison student Brittany Zimmermann or last summer's murder of 22-year-old Kelly Nolan, who disappeared after a night of barhopping. Police Chief Noble Wray said the investigation continues.

"There is a great sense of relief in reaching some closure with this particular homicide investigation," Wray said at a news conference. But he added later: "There's still a lengthy road ahead for the Madison Police Department with this investigation and other unsolved homicides."

An intruder stabbed Marino twice in the abdomen and chest in his home in the middle of the day, police said. He was found dying in a nearby alley, after apparently trying to get to a hospital for help.

Police Capt. Jim Wheeler said detectives have not been able to establish any relationship between Marino and Peterson, 20, or a motive. Wray described the case as a stranger killing.

The murder of the popular environmentalist and musician who worked for a medical device company shocked the city. As months dragged on, police faced criticism for failing to catch his killer and fear swept the city after Zimmermann was killed.

Wheeler said detectives became interested in Peterson after the department had several interactions with him. Peterson reported his laptop stolen days before the murder and again a month later, saying he needed a police case number to get a replacement at a discount.

At some point after the murder, Peterson's roommates called police because they had concerns "and we had to check his welfare," Wheeler said. He declined to elaborate on that incident, which police spokesman Mike Hanson said was being reviewed.

Peterson was then included on a department bulletin as someone potentially having mental health problems, Wheeler said. He also looked similar to a police sketch developed after a witness saw someone running from Marino's house the day of the murder.

"Things just kept coming together," Wheeler said.

Peterson was arrested Thursday at his mother's home in Grant, Minn., where detectives served a search warrant seeking a DNA swab. A DNA test at the state crime lab on Thursday evening matched it with DNA taken from a paring knife with a 4-inch blade that was recovered from Marino's residence, the complaint said.

The DNA also matched samples taken from a Wisconsin stocking cap and a backpack that were recovered in a residential recycling bin, the complaint said.

Adam Peterson declined to challenge his extradition during a court hearing in Stillwater, Minn., on Friday afternoon and was expected to be transported to Madison. An initial court appearance has not been scheduled.

Peterson attended UW-La Crosse before transferring to UW-Madison last fall as a junior, UW-Madison spokesman John Lucas said. He said Peterson dropped his classes in October and officially withdrew from the university in November. He declined comment on whether the university noted any concerns about his behavior.

Peterson continued to live in Madison for several months and had several addresses, which detectives were still trying to trace, before he moved back to Minnesota, Wray said.

One address, according to the criminal complaint, was in an apartment complex about a block from the residence where Zimmermann was killed in April in a neighborhood populated with students. Marino's house was about one mile from there.

Peterson's father, Melvin Peterson, told the Wisconsin State Journal that his son returned home to Minnesota in March after a week-long stay in the psychiatric ward of a Madison hospital because he became so unstable that his brother called 911.

The elder Peterson told the newspaper Adam Peterson experienced a "psychotic episode" that "involved extreme verbal violence that his brother had not seen before."

Melvin Peterson said that since his return home, his son has been in intensive psychiatric care.

Steve Purdue, 41, said he was shocked to learn a suspected killer used to live next door but relieved Peterson was caught. Purdue said he started keeping a baseball bat by his door and wouldn't let his girlfriend walk in his neighborhood by herself after Zimmermann was killed.

"I was scared to death all the time," said Purdue, who moved to Madison from rural North Carolina. "I'm not used to stuff like that. I'm from the country."

SIGNIFICANT EVENTS IN THE INVESTIGATION OF JOEL MARINO'S DEATH


January 28: Joel Marino is killed

January 29: Police report witnesses saw a man wearing a stocking hat and backpack and a tan Carhart-type jacket in the neighborhood at the time of Marino's death.
February 26: Police release a sketch of a "person of interest."

March 10: Investigators say the backpack found near the crime scene was purchased at a business on State Street.
May 8: Joel Marino's parents meet with the state Department of Justice. They are frustrated with the way the Madison Police Department is handling the murder investigation.

May 20: Lou and Debbie Marino, Joel's parents, meet with Madison police to discuss the investigation.

June 26: Madison police announce that a suspect in the murder has been arrested in Minnesota a suspect in the slaying has been arrested in Minnesota.

June 27: Adam Peterson, a former UW-Madison student, is charged with Marino's death Read more!

Inpatient mental-health treatment needs a second look - Canton (OH) Repository

Commentary: CHARITA GOSHAY

The basic, bare-bones definition of news is this: It's the same stuff, happening over and over again, to different people.

Last Christmas Eve, a woman suffering from schizophrenia walked into St. Peter's Catholic Church in downtown Canton and tried to take a baby.

Earlier in the day, police had taken the woman to a crisis center, but she was released in accordance with the law.

The St. Peter's incident wasn't her first brush with police. She is what newsrooms call a "frequent flier," someone with a long sheet of arrests for public disturbances.

On June 22, almost six months to the day, a Canton police officer was attacked and nearly killed in a Wal-Mart by David J. Carter, a bat-wielding drifter who suffers from mental illness.

It's time to stop being politically correct. There are cases in which some people with severe mental illness cannot function as outpatients.

David J. Carter had no business being out on the street.

NO PANACEA

According to Canton Prosecutor Frank Forchione, Carter, who was convicted of threatening a park ranger with a knife last December in Washington, D.C., was supposed to be under supervision and on medication.

Instead, Carter, who is homeless, blindsided officer John Clark with a baseball bat.

We know that in an overwhelmed and underfunded mental-health care system, people drop through the cracks like rain. But prison is not a panacea. Our jails have become de facto warehouses for the estimated 500,000 people who need treatment much more than they need to be incarcerated.

The American Psychiatric Association estimates that 700,000 people with mental illnesses pass through the criminal justice system every year.

Though 5 percent of Americans suffers from some form of mental illness, people with mental illnesses make up more than 20 percent of the state-prison populations — 5 percent of whom qualify as psychotic.

In comparison, 55,000 people are hospitalized for mental illness, according to a 2005 PBS "Frontline" documentary that featured the Ohio Department of Corrections.

THIS TIME

No one wants mental-health treatment to return to the throwaway days of the "snake pit" insane asylum. Improvements in psychotropic drugs have enabled most people with mental illness to function perfectly fine. But we must re-evaluate our dwindling access to inpatient treatment for those who don't have a good outpatient support system, or those whose families simply are overwhelmed.

As states continue to shrink funding for hospitalization, legislators need to realize that any money saved vanishes when someone with a mental illness is repeatedly churned through the criminal justice system.

This time, an armed and experienced police officer was the victim. The next time — and there will be one — the unsuspecting person being blindsided might be you.

Reach Repository Writer Charita M. Goshay at (330) 580-8313 or e-mail: charita.goshay@cantonrep.com Read more!

Man dies after scuffle with police -Providence (RI) Journal

Mother says son suffered from schizophrenia.

By Maria Armental

WEST WARWICK — A 47-year-old man died in police custody Friday night shortly after he was placed in a cruiser, the police said yesterday.

The police say they responded to a report of suspects damaging a sign outside Joyal’s Liquor Store at 90 West Warwick Ave.

The police said they found Mark Jackson standing behind the store. According to the police, Jackson became combative when officers approached him.

They said that officers were knocked to the ground while they attempted to subdue Jackson with pepper spray. When that didn’t work, the officers used their batons to hit Jackson in the legs, and called for backup, the police said.

The police said that when additional officers arrived, the police were able to handcuff Jackson and put him into the cruiser.

On the way to the police station, which is about two minutes away, Jackson stopped breathing and officers called for rescue workers, the police said.

According to the police, officers tried to revive him and the rescue workers took over while they transported him to Kent Hospital. Jackson was pronounced dead at the hospital.

An autopsy will be conducted this week, the police said.

The incident is being investigated by the state police, the attorney general’s office, and West Warwick police.

Nicole Frank, a clerk at Joyal’s Liquor, lives in a house behind the store; she said she was lying in bed watching television when she heard the commotion outside the store.

Frank said she looked out the window and saw “five police officers on top of [Jackson].”

“They did jab him,” Frank said, adding she didn’t see the officers using pepper spray or batons.

“He was trying to resist,” Frank said, adding, “I think he was more scared than anything.”

As the struggle continued, Jackson kept screaming, “I love you. I love you.” She said she thought he might have been referring to his mother who lives in an apartment next to the parking lot of the store.

Eventually, she said, two officers picked Jackson up from the ground and “shoved him in” the cruiser while another officer pulled him in from the other side.

“His shoes were all across the parking lot,” she said.

Jackson’s mother, Juanita “Anita” Jackson, said her son, the youngest of five, suffered from schizophrenia.

The 87-year-old woman said her son was very quiet. Neighbors who knew Jackson said they couldn’t believe he would have done anything that prompted police to hurt him.

“He was like the most harmless guy there was,” said Colin Dawson, who lives in Anita Jackson’s apartment complex.

“Of all the people … I can’t picture him doing anything,” Dawson said.

“They [officers] don’t know people, though,” Anita Jackson replied.

Mark visited his mother on a daily basis. At nearly 6 feet and more than 200 pounds, with long hair, Jackson was easily discernible, friends said. He would usually walk to Dunkin’ Donuts, Kingston Village, and the liquor store, where he would buy cigarettes and occasionally a lighter or a soda.

Mark would sometimes sit by the liquor store loading dock smoking, Dennis Joyal, who owns the liquor store said.

Anita Jackson said officers arrived at her house around 3 a.m. to tell her that her son had died while scuffling with the police; she was still awake, her door unlocked, as she waited for him to return.

Colin Dawson said that he saw the police search through Anita Jackson’s car. Jackson said later that morning the police went to her son’s Warwick apartment and she watched them search through piles of documents for medical records.

The police would not comment citing the ongoing investigation.

Yesterday afternoon, Jackson and a friend were still calling relatives.

“I just don’t know how I’m going to live because I counted on him for everything,” Anita Jackson said.

marmenta@projo.com Read more!

Manor patients need home -South Bend (IN) Tribune

JEFF PARROTT

SOUTH BEND -- Madison Center plans to close its money-losing downtown residential facility and move its 55 mental health patients into another institution across town, but that facility also appears to be on shaky financial ground, a Tribune investigation has found.

If West Park Health Care Facilities, with 45 of its own patients, were to close down after receiving the Madison Center transfers, 100 people with chronic mental illness and few resources could hit South Bend's streets seeking food and shelter.

Madison Center on June 18 announced it will close The Manor, its residential care facility at 118 S. William St., because it is losing too much money. The county's only other two facilities that accept patients who are poor and lack private insurance are West Park and the county-owned Portage Manor, but Portage Manor is nearly full.

West Park, however, is licensed to care for 230 patients, meaning it is less than 20 percent full.

West Park's owner, Thomas Hein, declined to comment for this story, but his Indianapolis attorney, Janet McSharar, acknowledged that West Park has had financial problems.

In recent months, she confirmed, the facility has had its natural gas, telephone service and parking lot lights disconnected for nonpayment of bills. Employee payroll checks also have bounced several times, although employees ultimately received their pay, she said.

In July, South Bend-based Approved Safety and Security Inc. sued Hein and West Park in St. Joseph Superior Court, alleging the defendants defaulted on their contractual obligation to pay $190 a month for a security system, along with bouncing a $3,000 check to the company.

In October, a New Jersey-based real estate investor bought the West Park property in a property tax delinquency sale, after Hein fell about $54,000 behind in property tax payments, according to county assessor records. Hein has until October to pay off the back taxes or lose the property.

And in a federal court order filed last week, Hein and his creditors agreed that Indianapolis-based CIB Bank has the right to foreclose on the West Park property and seize ownership of every item inside of it. McSharar said she "wouldn't hazard a guess" as to whether the bank will exercise that right.

McSharar said CIB Bank has told Hein that it has since paid the back taxes, but that assertion was not corroborated by county assessor records.

An Indianapolis attorney representing the bank in the case did not return The Tribune's calls seeking comment.

State finds kitchen issues

During a routine state licensure inspection of West Park's kitchen last month, a team of four registered nurses found many deficiencies, according to state health department records. Among the findings:

-The kitchen and equipment were not clean or free of litter. More specifically, a ceiling vent was completely covered with dark brown soot or dust; a wall outlet was covered with a "thick, brown tacky substance"; the large refrigerator doors were streaked with a "dried white/red substance" and the handles had a build-up of sticky crumbs at their base; and the bottom vents were "soiled with a dried white substance and dust."

A dietary manager told inspectors that she assigns employees to a rotating cleaning schedule, but she did not recall when the kitchen was last deep-cleaned, according to the inspection report.

-The inspectors also found shredded cabbage that had expired a week earlier; a bag of frozen chicken -- with no marked expiration date -- with freezer burns; oranges and margarine sitting on the floor, under the bottom shelf of a cooler; and 13 packages of moldy bagels.

The facility's staff corrected all of the deficiencies and vowed to make changes to prevent their recurrence, the report said.

McSharar declined to comment in detail on each of the deficiencies but replied, "If (inspectors) honestly thought that the residents were in danger, they would have taken stronger action."

'A bit of a Band-Aid'

Madison Center's vice president of operations, Wendy Chapman, said West Park has been open about sharing the kitchen report with Madison Center and feels confident that the facility is fixing the problems: "They showed us they have been working on that."

Chapman said she feels assured that West Park will remain open.

She said Madison Center officials have been talking with West Park's owner about the financial crisis. And Madison Center has been providing casework for West Park residents for several years.

She said that if most of The Manor's residents move into the West Park, that would generate a lot more income and put West Park "in a different situation."

Madison Center officials know what the income and expenses would be, she said, adding, "We know what their break-even point is and we know they will exceed that."

"We've spoken with them about it, and they've provided enough information that we don't doubt that," she said.

Despite the problems, McSharar said Hein is "very confident" that he will be able to keep the facility open "for the long term." A 25 percent jump in state funding effective Tuesday, after several years without an increase, will help considerably, McSharar said.

"It's going to create a positive cash flow," she said. "It's a bit of a Band-Aid. In the long run we're hoping the state is going to honor its obligation to pay more in (residential care assistance program funding)."

She said it's the state, rather than her client, who is to blame for West Park's troubles.

"When the state doesn't live up to its obligation to its most needy and vulnerable citizens, Mr. Hein must step in ... reaching into his own pocket."

McSharar said Hein interprets state law and regulations as requiring the RCAP funding to be determined by a facility's costs, but the Indiana Family and Social Services Administration, which administers the money, has instead paid facilities a fixed rate.

McSharar added that there was a time, within the past six to eight months, when the state completely cut off West Park's funding for three months. She said she did not know why that happened, but she figures it must have been related to the facility's license coming up for renewal.

A troubled history

West Park's financial woes are nothing new. A day after Hein opened it in November 2001, in a building formerly occupied by a nursing home, the FSSA announced a freeze on new admissions to the RCAP program because of projected funding shortfalls.

The freeze meant that the state would no longer be paying for new admissions to Indiana's 19 county homes and 52 privately owned residential care facilities. Three months later, FSSA slashed funding for current RCAP recipients by 17 percent.

For a time, Hein tried to pay operating expenses from patients' federal disability benefits and his own pocket. Lee Alan Bryant Health Care, a facility Hein operates in Rockville, Ind., near Terre Haute, sued FSSA, alleging the agency was violating state law by refusing to process new RCAP applications.

A Parke County judge ruled in FSSA's favor, finding that state law does not require the agency to finance all RCAP applicants -- only those it can afford to finance with money appropriated by the General Assembly.

Lee Alan Bryant Health Care appealed to the Indiana Court of Appeals, which affirmed FSSA's right to place new applicants on a waiting list but ruled the agency must at least process applications.

Saying it could no longer stay afloat, West Park closed in March 2003. Some of its residents were moved to Portage Manor, and they still live there, according to Portage Manor administrator Louann Becker-Pruett.

West Park reopened in July 2004.

More help from state?

It appears West Park and Madison Center are not alone in their struggles to operate residential facilities for the mentally ill. Bob Dunbar, executive director of the Adult and Child Center, a community mental health center in Indianapolis, said its 15-bed "Branigin" residential facility also is hurting.

The organization has discussed closing Branigin but hopes it can survive the rest of the year, Dunbar said.

"Many of these people would be in acute in-patient care or state mental hospitals, so it's an alternative to more costly services," Dunbar said.

McSharar said it's the FSSA, rather than Hein, who is to blame for West Park's financial troubles.

Megan Ornellas, director of FSSA's Division of Aging, which oversees the RCAP, said the agency under Gov. Joe Kernan's administration cut funding because of budget constraints. For the past several years, the General Assembly has held the program's annual appropriation constant at about $11 million.

Ornellas said she agreed to meet with Hein in May and examine his facilities' costs. She then reviewed cost reports filed by other providers, and decided the rate increase was overdue.

A state revenue forecast expected in December will give legislators a feel for how soon another increase might come, Ornellas said.

"We realize our work is not done," Ornellas said, "but we feel we have made a step in the right direction."

Tribune staff writer Joseph Dits contributed to this story.

Staff writer Jeff Parrott:
jparrott@sbtinfo.com
(574) 235-6320 Read more!

Help for suicidal prisoners -The Baltimore Sun

By Justin Fenton

In an effort to reduce the number of self-inflicted deaths in Maryland prisons, inmates placed on suicide watch are being monitored by unlikely aides: their fellow criminals.

Officials with the state Department of Public Safety and Correctional Services say the practice, launched last year after a spike in suicides, enlists only the most trustworthy of inmates. But some critics say it's a shortcut for staff-strapped institutions, and a report last fall recommended that one area jail discontinue the practice after finding that prisoners can agitate their suicidal peers.

Inmate observation aides in both men's and women's facilities in Maryland sit on chairs outside of cells, and work four-hour, paid shifts with a pen and logbook taking notes on the prisoner's condition. They must alert a nearby corrections officer if the inmate attempts to hurt himself.

'We leave it up to the individual institutions to pick the inmate, but they're people who demonstrate the right attitude and skill level,' said Rick Binetti, a spokesman for the Department of Public Safety and Correctional Services. 'It's sort of the cream of the crop of the inmates.'

The program hasn't been widely adopted across the country, but the federal prison system and institutions such as New York's Rikers Island jail use prisoners to supplement observation of suicidal inmates requiring round-the-clock supervision.

Federal researchers found that suicide watches performed by other inmates reduce the frequency and length of watches, reduce costs and may even improve socialization. A 2005 study showed that the increased attention was partly responsible for a drop in the suicide rate, and boasted that the system saved $300,000 in overtime pay one year.

The study released in 2005 by researchers at Federal Medical Center in Butner, N.C., found that increased prevention awareness, including the observation aide program, had helped lower the rate of suicides among inmates in federal custody to below that of adult men overall.

The aides were empowered by 'joining with an 'adversarial' system to 'do good,'' according to the report. Suicidal inmates, meanwhile, found themselves safely able to converse with peers who were coping more effectively.

But last fall, a report prepared for the Department of Justice described the use of the practice at the Baltimore City Detention Center as 'very problematic.' The jail has continued to enlist prisoners as aides, Binetti said.

Critics say that the program poses liability concerns as uncertified inmates are placed in a position of responsibility.

'When it comes down to it, they are still inmates, and they became inmates and were convicted of crimes because they were not reliable members of the community,' said Lindsay M. Hayes, a consultant with the National Center on Institutions and Alternatives who has studied prison suicides and prevention programs. 'Now suddenly they are put in positions where prison officials are desiring their reliability. It's a little bit bizarre when you conceptualize the whole thing.'

While suicide remains one of the leading causes of death in many local jails, the suicide rate in corrections facilities has declined over the past two decades, according to federal statistics. It is the third-leading cause of death in state and federal prisons, behind natural causes and AIDS, and corrections officials say it has received more attention in recent years.

According to a review of data from 2001 and 2002 by the Bureau of Justice Statistics, Maryland had the fifth-highest total suicides in the country among state prison systems and the 13th-highest suicide rate.

About 23,000 people are serving time in Maryland prisons, said Mark Vernarelli, a spokesman for the Department of Public Safety and Correctional Services. His department is also responsible for the Baltimore City Detention Center, where about 4,000 defendants are awaiting trial.

Hayes said that there is a budget crisis in every jail and prison system in the country, which has led to spiraling overtime costs. He said that while corrections systems that use the observation system might report lower suicide rates, effective prevention includes many more factors, including mental health assessments and clinical staff training.

Rhode Island, for example, had an observation program from 1992 to 2000 in which trained inmate aides worked as peer counselors and 'befrienders' of potentially suicidal inmates, but it was discontinued in 2000 after staffing was beefed up, spokeswoman Tracey Poole said.

'It's not that we disliked the program, but we now have staff who are trained to do more formal clinical assessments and whenever there is a report of an inmate who is thought to be suicidal ... these trained staff respond rapidly,' Poole said. 'We believe we have a good system in place and we don't need [the inmates'] services in the same way we did years ago.'

Gary D. Maynard, state secretary of public safety and correctional services, who previously led Iowa's corrections system, adopted the observation aide program there after a spike in suicides, Binetti, the Maryland system's spokesman, said. In the four years that followed, the system recorded no suicides.

Maryland began training inmate watchers late last summer after a similar spike in 2007, with seven suicides in the second half of last year.

"The secretary found the numbers unacceptable," Binetti said.

He said there has not been a suicide since the program went into effect in December.

Wendy Hess, an attorney for the Public Justice Center in Baltimore, applauded the efforts to reduce the number of suicides, but said she found it "worrisome if the system is relying on basically untrained persons and, in particular, other inmates to monitor the safety, welfare and mental status of other inmates."

"In light of the [Baltimore detention center] report ... it does not appear that there's uniform agreement that this system achieves the goal of preventing suicides," Hess said.

justin.fenton@baltsun.com Read more!

Madness’ author recalls mental struggle -Associated Press

JEFF BAENEN

MINNEAPOLIS – Marya Hornbacher remembers her “endless nights” as a child as young as 4, when she says she first began to show symptoms of bipolar disorder.

“Bam! At 5, 6 o’clock I’m off, I’m ready to roll. And the world is shutting down around me and I’m getting more and more frantic because nobody wants to talk,” Hornbacher recalls with a laugh, “and nobody else wants to go to the moon that afternoon and nobody else wants to go ice skating in the woods, you know, at 4 a.m.”

She would spin out of control, racing around the house until her mother discovered that a late-night bath would calm her. Finally, she says, her parents told her she could do anything she wanted at night, “but you cannot come out of your room and talk to us, because we’re going to bed.”

Hornbacher, now 34, says those early episodes were the start of a lifelong cycle of mania that culminated in repeated hospitalizations, electroshock treatments and eventually daily medication that stabilizes her mood.

After chronicling her battle with eating disorders in her 1998 memoir “Wasted,” Hornbacher tackles her alternating bouts of euphoria and depression in a new book, “Madness: A Bipolar Life.” Reviews have been positive, with USA Today saying that as Hornbacher “whips around this roller-coaster ride, her unflinching style keeps us seated firmly beside her.”

Writing in a straightforward narrative, Hornbacher fills “Madness” with grim details, such as the time in 1994 she slashed open her left arm while cutting herself as a 20-year-old. She recounts spending sprees, failed romances and her haziness after electroconvulsive therapy. But she also writes with humor about stuffing a brocade bedspread into a too-small washer during a cleaning frenzy.

Dressed stylishly with her hair dyed red and cut short, Hornbacher appeared upbeat during an interview at the comfortable house she shares with her second husband, Jeff Miller. Thanks to her medication – she takes around 26 pills a day – and basic daily tasks, Hornbacher is at equilibrium “much of the time.”

But her impulses – such as to suddenly travel a great distance or go shopping – can trigger a manic episode.

Bipolar disorder, formerly known as manic depression, affects as many as 5.8 million American adults each year, or 2.6 percent of the U.S. population age 18 and older, with 25 the median age of onset, according to the National Institute of Mental Health. Hornbacher writes that she was diagnosed with bipolar in 1997 and is bipolar I, spending more of her time manic before going into an occasional “vicious” depression, than the milder bipolar II.

A recovering alcoholic who has been sober for years, Hornbacher writes that despite her bipolar diagnosis, she would continue to drink, which negated the effects of her medication.

Patients with bipolar have a high rate of substance abuse and may turn to alcohol or drugs for self-medication, according to Dr. Husseini Manji, head of the Mood and Anxiety Disorders program at the NIMH.

Hornbacher says she has about four episodes a year and was last hospitalized last summer. She says she occasionally has grandiose delusions – “I did think I was a Supreme Court justice at one time” – and that reminding herself of her accomplishments doesn’t help.

“Telling myself what I’ve done, how well I’ve done, when I’m manic, and saying, ‘Well, it is enough to just be a best-selling author, you don’t need to be queen.’ It’s not that I feel a desire to be queen. It’s that one day, I think I’m queen,” Hornbacher said.

Hornbacher accepts that she eventually will be hospitalized again and says there is no stigma to it.

“Were I to put myself on … one of those online dating things, I would not include in my profile that I’m regularly hospitalized for psychosis,” she said. “But I do know that when I get really bad, there is a place for me to go where I will feel better.” Madness: A Bipolar Life

By Marya Hornbacher

Houghton Mifflin, 320 pages, $25 Read more!

Confront mental illness with courage, candor - and care - New York Daily News

Errol Louis, columnist - June 28th 2008

A great many of the worst ills afflicting inner-city communities - crime, violence, despair - are rooted in mental and emotional illness that hasn't been recognized or treated.

Yet nearly a decade into the 21st century, tragically, there's still a stigma in many communities about acknowledging the need for medication or counseling. Too many people refuse to seek help - for themselves or for loved ones - for fear of being written off as "crazy."

But silence can be deadly. Last November, I wrote about the tragic case of Khiel Coppin, a mentally troubled 18-year-old from Bedford-Stuyvesant who died in a hail of bullets fired by cops who thought - mistakenly - that the agitated teenager was armed.

And a series of Daily News editorials has documented the fact that New York City sees five or six cases like Coppin's every year: instances in which unstable people lash out at others or wind up in violent confrontations with the police.

A panel created by Mayor Bloomberg and ex-Gov. Eliot Spitzer has issued a report calling for common-sense measures to handle extreme cases. It's clear, for instance, that 911 operators need a better way to convey accurate information about emotionally troubled people to police before they respond to a disturbance.

But government can only do so much. The real change has to happen within neighborhoods and families, where even easily treated problems too often get hushed up.

In a remarkable act of personal and professional bravery, my friend Terrie Williams - a high-flying publicist whose blue-chip client list includes Fortune 500 corporations and A-list celebrities like Chris Rock - recently published a book, "Black Pain," that details her battle with depression.

"As far as my colleagues and clients were concerned, the work got done and got done well," she writes, recounting the days she criss-crossed the country representing the likes of Miles Davis and Eddie Murphy - only to come home and lapse into fear, apathy and food binges.

Friends saved Williams - she'd become numb and paralyzed by depression, huddling in a dark room for three days - and got her to a psychiatrist who prescribed medication to get her body chemistry back in order.

A magazine article she wrote about the ordeal drew 10,000 responses, mostly from people who'd been silently struggling with their own issues, terrified of revealing the secret.

Williams writes: "I am fully engaged, day by day, in the fight to feel, to have fear and sadness rather than anxiety, and to become reacquainted with calm, vibrancy and joy. And I will not rest until you join me in that fight."

We need many more evangelists for straight talk about depression to join her. By one conservative estimate, America loses up to $33 billion in work days lost by employees battling the disease.

In many cases, untreated depression leads to "self-medicating," in which people use alcohol, drugs, food or sex to stabilize their moods, when what's really needed is a combination of counseling, education and prescription meds.

The fact there are more mentally ill Americans in prison than in all our psych wards is a scandal and a tragedy - and a sign we need to rethink the connections between right and wrong and health and illness.

It's up to all of us to begin imagining a smarter and more compassionate system. Cops and jails should not be the first and primary response in communities where illness runs rampant.

elouis@nydailynews.com

Read more!

A little pet therapy goes a long way -Federal Way (WA) Mirror

MARGO HOFFMAN, mhoffman@fedwaymirror.com
June 28, 2008

The mental health ward in a hospital can be an unfamiliar and scary place.

But patients at St. Francis Hospital in Federal Way often forget their misfortunes when they see Casper, the 2-year-old Cardigan Welsh Corgi who serves as a therapy dog there.

Casper visits the mental health patients at St. Francis each Monday evening in the television and recreation room.

“He’ll wrestle with the guys that want to wrestle with him, and the girls, he’ll usually lay at their feet and be petted,” said Kim Kiefer, Casper’s owner.

Kiefer became interested in pet therapy after taking a litter of kittens to a nursing home with her Future Farmers of America group in high school. She also recalled that when a close family member died of leukemia, she was denied the opportunity to bring her pets into the hospital to visit.

“That’s something that I know I would want if I was at the end of my life is to see my animals,” she said.

Kiefer realized that animals could make almost any patient’s day a little brighter, and she wanted to help. She and Casper went through six weeks of training with the Delta Society before Casper became certified as a therapy dog. She chose St. Francis Hospital for her volunteer work because St. Francis is the patron saint of animals.

Casper is one of three dogs who participate in the pet partner therapy program at St. Francis.

“I do know that a lot of the patients truly do benefit from the pet partner program,” said Toni Myhre, the volunteer coordinator at St. Francis.

Volunteers in the program are required to go through training and be registered with the Delta Society, a nonprofit organization that trains pets as therapy animals.

Just about any dog with good manners and a love for people can be a pet therapist, Kiefer said.

“They want a more laid-back animal that doesn’t react to things like crutches and canes and children grabbing their ears,” she said.

Part of the test in order to receive certification includes bringing the dog around crowds of people and other dogs to be certain they don’t react. The dog must also demonstrate that it can sit, come and stay on command.

Kiefer thinks that bringing Casper in to visit allows the patients to forget, momentarily, that they are in a hospital. She hopes that they are encouraged to work toward recovery.

“If they have animals at home, maybe it makes them want to get home faster,” she said. “A lot of them tell me they miss their animals.”

For Casper, the work is pretty easy.

“He basically goes in and gets pets for an hour,” Kiefer said. “He’s allowed on the furniture, and people lay on the floor with him... Basically he thinks it’s a one-hour massage.”

Although there are different patients each week, there’s always someone there who benefits from Casper’s visit, Kiefer said.

“Even the quiet people want to come tell you stories about their animals,” she said. “Dogs always bring out the good.”

Contact Margo Hoffman: mhoffman@fedwaymirror.com or (253) 925-5565.

For more information about training an animal to become a pet partner, visit www.deltasociety.org/.

Federal Way Mirror Reporter Margo Hoffman can be reached at mhoffman@fedwaymirror.com or (253) 925-5565. Read more!

Struggling on the streets -Peoria (IL) Journal-Star

Mental illness takes heavy toll on life of Peoria man left homeless

By FRANK RADOSEVICH II

At Peoria's Richwoods High School, Tom Iaun was a strapping athlete and an average student. A member of the school's wrestling team, he garnered medals while building a trim, muscular physique.

After graduating in 1974, he left for Carthage College in Kenosha, Wis., where he continued swimming and began lifting weights, constantly honing his strength and thick biceps.

Three years later, he joined the U.S. Navy, serving as a sailor monitoring the ship's radar screens. He even considered applying for the demanding Navy SEALs unit, but was disqualified for poor eyesight.

But as Iaun's health improved and his muscles strengthened, his mind began to unravel.

A self-described shy child, Iaun slowly became more introverted and withdrawn. He turned self-conscious about his acne - solitary, guarded and leery of crowds. His time in college was spent mostly on parties and drinking. Relationships frayed. Confidence waned. Prospects dimmed.

His once-firm grip on reality loosened and crumbled.

Then, one summer at a local fairground, he got into a fight with a man, swung and hit him, starting what would be the first of several brushes with the law. At the age of 24, after his parents had divorced, Iaun had an argument with his father and left home, hitching a ride from a trucker on Interstate 474, headed for California.

Now, at the age of 51, Iaun sleeps in homeless shelters and lives on the city's streets, all the while hoping one day to land a job and a home of his own. Diagnosed with paranoid schizophrenia, he has spent the last 20-plus years cycling through shelters, nursing homes, jails and ramshackle apartments. He shuns drugs, seldom drinks alcohol and smokes heavily. He is a snapshot of the chronic homeless, supported by a safety net of family and charities but somehow unable or unwilling to wriggle free of the streets.

"He's one of the crack dwellers. He just falls into the crack, and that's where he lives," said Wendy Kooken, a professor of nursing at Bradley University who's worked with the mentally ill and homeless - including Iaun - in Peoria. "And there's no roof over the crack."

Seated on the second floor of the Peoria Public Library's Downtown branch, Iaun, dressed in cut-off jean shorts and a bright green T-shirt, summed up his story in a deep, gravelly voice with a wry smile.

"Life hasn't turned out the way I thought it would," he said last week. "I'm starting to realize I need to get ahold of the reins."

On any given day there are roughly 745,000 people homeless in America, according to the National Alliance to End Homelessness. They range from down-on-their-luck families to single adults suffering crippling addictions or disabilities. And their reasons for ending up homeless are as varied as their own personal histories.

An estimated 45 percent of the nation's homeless population reports indicators of mental illness during the past year, while 25 percent are believed to suffer from a serious mental disorder, including bipolar disorder, depression or schizophrenia.

Iaun's story, just one of several hundred in central Illinois, reveals the toll a mental illness can inflict on someone and how it can make a bad situation worse.

With a mental illness, basic tasks like arriving at an appointment on time or carrying on a conversation can become challenges.

"He's just not even the same kid anymore," said his elderly mother, who spoke on the condition that she not be named or photographed.

"He's on that thin line between reality and non-reality."

His mother recalls Iaun as a bright, happy, if a bit fussy child. Although he occasionally talks to himself or bursts into laughter, she notes his resourceful side and improving ability to care for himself.

At a recent doctor's visit, he filled out all of his forms by himself, and when his mother worries about him, Iaun looks her in the eyes and states, "Mom, I'll take care of it." Still, she is pained by his current lot in life and wishes he could find a permanent place to reside.

Iaun's symptoms first began in earnest while he was in the Navy.

Watching a radar screen for hours at a time made him feel crazy, he said, his thoughts drifting and often shrouded in a haze.

"I remember him saying he was losing his mind looking at all these things," his mother recalled at her North Peoria home.

"I couldn't handle it. I got kinda cagey," he said. "That's when the trouble started in my life. . . . I got wild."

After leaving home, Iaun disappeared for about eight years and wandered from state to state. Unable to find continual treatment for his schizophrenia, he shifted from nursing homes in Indiana to jails in Florida and many points in between, each time released back onto the streets.

He eventually returned to Peoria in 1994 to Sharon Woods, a nursing home and assisted living center, but his stay there, like the time spent in other nursing facilities, was brief.

Never comfortable around groups of people, Iaun would inevitably call his mother to ask her to pick him up, or he simply walked out on his own. Sometimes he left after fighting with residents; other times after he grew tired of, depressed by and trapped in his surroundings. He also felt neglected by staff.

"Unless you got good money, you don't get good care," he said.

A generous and friendly person, Iaun usually shares what little he has with others. Occasionally it makes him an easy target, leading some to take advantage of his charity. During a short stint in a Downtown Peoria apartment, his mother said roommates and freeloaders would borrow money and never pay him back. Now she budgets his monthly payments from the Supplemental Security Income program and rations out money on a weekly basis.

"I keep saying, 'Tom, tell them no,' " his mother said. "He doesn't budget well."

A few times, Iaun would clash with those who repeatedly harassed him for cigarettes, food or cash. Since the 1980s, he has been arrested in Peoria County for battery, assault and once for attempted murder for choking his roommate at the Sharon Woods care facility, though the charge was later changed to aggravated battery. Most of his charges stem from the inability to control his schizophrenic outbursts.

Sometimes his offenses were born out of necessity, like the time he stole an orange from a Florida motel.

He is still dealing with the fallout over a 2004 charge for resisting and obstructing a peace officer, and he recently missed a court appearance while on probation, leading to a warrant issued for his arrest, which only compounded the situation. A letter was sent to a homeless shelter alerting him of the appearance, but bounced back after he could not be found.

"Once you have a felony on your record, a million doors close," Kooken said. "You become sort of a persona non grata."

Iaun now takes daily medication, Haloperidol and olanzapine, which is packaged and doled out to him by his mother, to help control his symptoms of schizophrenia. Even with the medication, though, he still notices the effect of his disorder.

His conversations wander or spiral off on tangents. At times he seems distracted. Iaun complains about waking up and feeling like he is on the verge of a nervous breakdown. Poor sleep also leaves him agitated and beleaguered.

"I used to get up in the morning and just be shaking," he said. "I can't seem to sit still. I really don't know what it's from. I have all this energy to do stuff but no strength to do it."

Despite his situation, Iaun remains surprisingly upbeat and hopeful for the future. He has applied for permanent support housing at the newly renovated New Hope Apartments, but so far he has not heard back from the building's administrators.

He has looked into renting several apartments but is usually overcome with anxiety before meeting the Realtor or landlord, and Iaun seizes up, souring the deal. He also applied to work as an attendant at a Downtown parking garage, but again froze when asked to solve some math problems. His criminal record and stigma of schizophrenia have not helped.

"He would love to get an apartment of his own where he could lock the door and feel safe. But his background doesn't allow that," Iaun's mother said. "There's just no place for him."



Frank Radosevich II can be reached at 686-3142 or fradosevich@pjstar.com.
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Stigma and shame go hand in glove -Toronto (Canada) Globe & Mail

Opinion - June 27, 2008

Shame is inseparable from stigma, stigma the glove and shame the hand inside. A centuries-old sense of shame still attaches to mental illness in Canada, out of place though it is in our advanced, diverse society. Weakening its hold is a public-health imperative.

People with mental illness are no longer “counted among the dead,” as a Globe story put it in 1890, but the stigma implied by that phrase lives on, making it harder for individuals and families to ask for help.And because these patients and their families tend not to shout, scream and demand the help they need, governments have not developed a full range of supports for them. Unless effective services are available, there is not much point in asking for help. It's a self-defeating cycle.

The persistence of shame is eloquently expressed in today's Focus section by Aethne Hinchliffe of Ottawa, whose father committed suicide a decade ago. “It wasn't for a long time that I stopped feeling ashamed when telling people how he died – due to the stigma that surrounds mental illness. (Perhaps even I was a little ashamed of him.) Now that I've accepted that he was ill and needed help, I can tell people how he died without feeling as though others are going to judge me or him.”

Stigma's seemingly unshakable grip is strange in a country where one in five people will suffer a mental illness. One in five means nearly every family has some incidence of mental illness. Yet as documented in Breakdown, The Globe and Mail's series on mental illness, Canadians hide this fact of their lives. They hide it even though people with mental illnesses are not tucked away in institutions any more; even though many public personalities have spoken about their experiences with mental illness; and even though every large workplace has employees who struggle with it.

Why do they hide it? In part because of the natural tendency to conceal one's personal or family pain. In part because they do not feel “safe” to open themselves up to employers, colleagues and neighbours. And in part because, though Canadians praise diversity, they wish, by and large, to be like everyone else. They wish to be seen as successful and happy. Success is seen to include self-sufficiency, career accomplishment, family and stability. A 40-year-old living in her mother's or father's basement because she is anxious among people does not fit that image.

No, people with mental illness are not counted any more among the dead, but they and their families often feel set apart, or adrift. Well-meaning anti-stigma campaigns will not by themselves end that feeling; what is also needed is a concerted effort from employers and the health and education systems to accommodate and meet the needs of the mentally ill.
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Poet was an inspiration to his niece, many others - Corpus-Christi (TX) Caller Times

By Adriana Garza - June 27, 2008

There were quiet times when Tío Luis fell silent, deep in thought beyond what most would understand, including his only niece, Lamar Saenz.

The thoughts racing through Luis Omar Salinas' mind were constant and profound, haunted by the specter of a lifelong loneliness and a longing for the most fundamental love of all, Saenz said.

It was from this dark place and from the memories of his childhood growing up in Robstown and Mexico that Salinas drew the inspiration to put words to his sadness. It was a gift that would make him a pioneer in Chicano poetry.

Salinas, 70, died last month in California after a lengthy illness, but it was his hope and now the mission of his family to promote the poetry that became his outlet for grief.

"He never wanted to be rich," Saenz said. "He just wanted his poetry to be known."

Reading through the pages of Salinas' poetry is a trip through the surreal yet familiar. Solitude, death and an unmistakable sense of Chicano culture pervade his words.

Saenz, 40, said her uncle lived his life in grief over the death of his own mother when he was 5. Soon after his mother died his family moved back to Robstown after spending a short time in Mexico.

Death was something he didn't understand at such a young age, Saenz said, and he spent the rest of life trying to figure it out.

With a young, single dad with two children to raise, Salinas soon was adopted by relatives in California and separated from his sister.

The pain of losing his mother and being separated from his family was something Salinas never got over. As an adult, his pain became a battle with bipolar disorder.

He put his pain to paper and became a widely lauded poet, recognized with several national awards. His works are found in volumes of American literature and taught in universities from Texas to California to Wisconsin to Puerto Rico.

Though he lived most of his life in California, Saenz never forgot his South Texas roots, even penning a poem titled "Robstown" and speaking twice to students at Texas A&M University-Kingsville, most recently in 2002.

For many, Salinas was the "Crazy Gypsy" he wrote of in one of his most popular poems. But for Saenz, he was the quiet tío -- a smoker with a contagious laugh that at times would give way to sudden melancholy.

The work he did to promote Chicano culture, civil rights and education in the 1970s wasn't something Salinas discussed, but it was something Saenz came to appreciate as an adult.

Saenz attended poetry readings as a young teenager with Salinas in Fresno. The passion with which her uncle read his poems and the passion with which they were received struck the seventh-grader.

"There was something major going on, but I just didn't get it yet," she said.

As an adult, Saenz said she now understands and is committed to spreading Salinas' works.

"He was a great man, an amazing human being," she said. "He was a great example of sometimes you have no idea the depth of a person."

Former staff reporter and Corpus Christi native Adriana Garza is pursuing a master's degree in political science at Texas A&M University-Kingsville. Contact her at adriana.garza@tamuk.edu.
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Formerly homeless mothers help each other rebuild lives - Contra Costa (CA) Times

By Sara Steffens - 06/28/2008 Garden Park

"You need to wake up. C'mon bud."

Morning arrives early in Apartment 213, as Wyvona Smythe prods her kids to climb from their beds and get ready for school.

Usually the first up, DJ, 16, is already dressed. He pulls a can of Coke from the fridge and begins slugging it.

Rochelle, 11, finishes her art project on the kitchen table, daubing bits of construction paper with Elmer's glue.

Anthony, 10, hovers to watch, holding a milk-free bowl of cereal and catching his mother's eye.

"Anthony: Hair. Comb it. And brush your teeth," Wyvona orders. "Does everybody have your backpack? DJ, where's your coat?"

She makes a last frenzied search.

"What are you looking for?" Rochelle asks.

"The keys." Wyvona answers. "C'mon Kemo Sabe. Are you brushed, combed, haired? ... Anthony, I found your music folder. It's 7:23. We're about to do this. OK, light off, computer off ..."

They troop downstairs to Apartment 113, where Wyvona's friend Jami Tussing completes a similar dance, preparing her four kids for the day.

It once felt nearly impossible to find their things, four pairs of matching shoes, everyone's backpacks and homework. Now Jami has a routine. And when she needs it, help from a fellow mom.

The families sort themselves in two clumps and head off in different directions.

Jami walks the youngest to Fair Oaks Elementary; the others go with Wyvona, who will drop them off at preschool, middle school and
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high school in Jami's truck.

"That's what we do," Jami says. "We all roll together."

To the casual visitor, Pleasant Hill's Garden Park looks no different than a lot of other modest apartment buildings.

What sets the 27-unit complex apart is its mission — to help homeless parents rebuild their lives and create stability for their children.

The program is part of a movement called "permanent supportive housing," which many advocates call the best long-term solution to ending homelessness.

The idea is simple: Give homeless families a place to live, then offer help with the things that caused them to lose housing in the first place.

Parents arrive via shelters, treatment centers or hospitals. A few come directly from cars or outdoor encampments.

Many have histories of domestic violence, substance abuse, and mental illnesses such as anixety, bipolar disorder or major depression.

Friendships began slowly, as Garden Park mothers chatted about their kids over coffee and cigarettes.

Now, a handful of the women help each other through life's ups and downs, supporting one another's efforts to stay sober, gain and retain custody of their children, redefine their lives and their potential.

No longer do they feel defined by society's labels: crazy, homeless, addict, AIDS patient.

In helping one another, they find hope.

"We're home now," says Wyvona. "I feel so comforted that my kids have somebody that doesn't judge them for the things that happened."

# n n

With the kids off at school, Wyvona checks in with her fellow mothers.

Though several women drift in and out of her circle, she's particularly tight with Jami, 27, and Lisa Van Gerrevink, 32.

Each of the three women have four children. Each has struggled with mental illness. All know how it feels to be homeless and alone.

"Wyvona's been through a lot, and she holds a lot of inspiration and hope for the rest of us," Lisa says. "As long as Wyvona and I stay clean, we'll be friends. I have a feeling we'll be clean for a long time."

Staying sober is especially important to Wyvona, who has twice lost custody of her kids.

"I'm a raging alcholic," she says. "That's where it begins for me."

Wyvona spent 15 years with the father of her younger children. After leaving him, she bounced between shelters and treatment programs for five years. She moved into Garden Park three years ago with all four of her kids, including her oldest son, Eric, now 19.

"They have great friendships here; they all look out for each other," said Wyvona. "My children can talk to other people about what they went through and get support."

That support became especially important 21 months ago, when Wyvona relapsed, again losing her kids to foster care. Being at Garden Park helped her navigate the hurdles set by Child Protective Services, she says, and other residents celebrated too when her kids moved back in.

"I owe a lot to everybody here," she says.

When it's nice, the mothers of Garden Park sit together in the courtyard. When it rains, they pool their resources to cook a group breakfast.

As Wyvona fries eggs and bacon, Jami sits on the couch, dividing Abbigail's hair into two neat pigtails. The 3-year-old is home from preschool with a nagging cough.

"You're all uneven, young lady," Jami tells her.

Jami and Wyvona became friends last fall, when Wyvona asked for a ride and Jami handed over her keys instead.

For a time, the women saw each other every morning and night, sometimes tapping on the floor or ceiling to say hello. In November, they got matching tattoos, a yin-yang symbol dripping water and fire, designed to represent their friendship.

"She's more subtle, and I'm more brass," Wyvona explains. "She's more quiet, and I'm more loud."

"And then when we get together, it's one big goofball," Jami adds.

"She's definitely going to be in my life for the rest of my life," Wyvona says. "We'll be old biddies together. Like Thelma and Louise. She's my Louise."

After breakfast, they have an hour to kill.

"Is it time to smoke yet?" someone asks.

They line up along the railing, trading jokes and surveying the courtyard as they blow plumes of smoke into the cold morning air.

"I do like it up here. I do. It's got a great view," says Wyvona.

The catwalk looks onto a contractor's storage lot. But beyond that, she can see a slice of hills, and the gray morning sky stretched above it. Somewhere, a bird warbles.

# n n

Throughout the Bay Area, demand for subsidized housing far outstrips supply.

"There's always a waiting list, and it's often long," says Sara Marsh, social services coordinator for Garden Park.

Until three and a half years ago, Garden Park was an ordinary market-rate building.

Contra Costa Interfaith Housing, a nonprofit formed to address homelessness, spent years raising the money to buy and refurnish the complex; it now operates the program with Mercy Housing.

Garden Park residents pay 30 percent of their income as rent. Rent subsidies are funded by HUD, but Contra Costa Interfaith Housing raises $30,000 a month to continue on-site services.

Garden Park follows a harm-reduction model: residents aren't required to seek services, and lose their units only if they repeatedly violate the lease.

Only two to three apartments turn over each year.

Most tenants do opt for help, and work with Marsh to write a family goal plan, outlining their ambitions for themselves and their children. In turn, she helps them navigate the bureaucracy inherent in social service programs.

"A lot of people who live here have had very bad experiences with systems and the society," said Marsh. "I do everything from attend parent-teacher conferences to take people to visit the psychiatrist."

Several families have made huge gains since moving in, regaining legal custody of their children, maintaining sobriety and improving their parenting skills, Marsh said.

Just as important, she says, residents have made friends.

"Knitting community together really is such a huge thing," Marsh says. "For all people who become homeless, one thing they have in common is that their support network had fallen apart.

"In the context of these few apartments, this community, we create another support network, so wherever they go, they won't be at risk for that again."

# n n

Midspring, Jami and Wyvona have a falling out. Neither will say exactly what the argument is about, but both seem sad about it.

Jami begins keeping to herself, in her apartment. Other residents worry, invite her for cigarettes or breakfasts.

But Jami insists she's fine, just taking a break to focus on her kids, adjust to new medications and recover from a cold.

"Around here, when you get sick, people (talk about you), so you stay inside,'" she says.

It frustrates her, how little society understands mental illness. She raises money for the National Alliance on Mental Illness, and she wrote a children's book, "Mommy Doesn't Feel Good."

"My kids understand what's going on with me," Jami says. "They know that mommy's cookie wasn't put together quite right. To the point where my son asked me, 'Is my cookie going to be put together right?' And I had to say, 'You know, I don't know.'"

Because of her illness, Jami rarely left the house in the nine years with her children's father, whom she moved in with at 15 and married at 17.

At 24, she mustered up the courage to leave, moving into a women's shelter.

"I knew that it was my job as a parent to do what was necessary, so my kids could have the best life possible," she says.

Jami had a high school diploma, but no work experience or resume. She left the kids with her mother, and she began couch-surfing and sleeping in her car.

It took a year for her name to come up at Garden Park.

Though the close quarters sometimes feel suffocating, she's grateful to have her children together, with a roof over their heads.

"My kids are doing better. I'm doing better," Jami says. "I don't feel alone anymore. I don't feel like I have to do it by myself. That's a big difference."

# n n

One quiet spring afternoon, Lisa wanders into the courtyard wearing full-size Tigger sleepers, wrapped in a blanket. She hasn't been feeling well, and fears her T-cell counts have dropped. Soon she'll have to start antiviral medications, her doctor warns.

Changing medications can be rough, the women of Garden Park know.

Wyvona offers to care for Lisa, watch her kids, during the worst of it. Lisa, grateful, says she can pay.

"You were there for me when I was sick," says Wyvona, whose Hepatitis C is now in remission. "You don't have to pay me."

Lisa, who has four children, was diagnosed HIV positive three years ago, while pregnant with her youngest.

Miraculously, she says, all four of her children are negative.

Known on the streets as Precious, Lisa lived for a time in a car in Brentwood. She went to jail, then treatment, before landing at Garden Park.

Having HIV can be isolating, but Lisa leans on others at Garden Park who have dealt with serious illness.

"Wyvona, she's my security blanket right now," Lisa says.

Jami wanders out to the courtyard to join the women.

"I haven't seen you in a minute," Lisa says, surprised and pleased.

She's reorganizing her apartment, Jami explains. She tucks her hands into the front pocket of her hoodie, nodding and smiling, slipping back into her circle of friends.

"Are we going for a walk today?" Lisa asks. "I figure if there are enough of us, I can stand in the middle and make it."

# n n

As Wyvona stands in front of the Contra Costa family courthouse, her two youngest run up and down the steps, burning nervous energy.

Up since 6 a.m., dressed in neatly ironed outfits, they must endure a few last minutes before a long-awaited milestone, the closing of the family's child protective services case.

Their dad, Anthony Montis, has come from San Francisco for the hearing, wanting to ensure the documents record his visitation rights.

The family gathers on benches in the courthouse lobby. DJ hunches over his phone, texting friends. Rochelle critiques the fashion of the attorneys and caseworkers as they hokey-pokey through the security check or rush past, clutching paperwork.

"Look, there's the lady that came to the house," Wyvona points out.

"Lady, hi!" calls Anthony. "Hi, social worker!"

Minutes stretch into hours, testing the kids patience.

"How do we know we're going to get called?" Rochelle adds.

"The bailiff will come," Wyvona assures them.

Anthony leans in. She rubs his head, promising, "there is no reason to be nervous."

A passing social worker recognizes Wyvona, stops to congratulate her. The children's attorney arrives, pulls them aside one by one.

"She said, 'Your mom seems really good,'" Rochelle reports.

Rochelle delights in ripping into tiny squares the attorney's business card, offered "in case she ever wants to talk." DJ follows suit and they begin throwing pieces back and forth.

Anthony refuses to talk to the attorney at all. "I'm doing great," he tells her. "I think you should close the case."

By 9:20 a.m. they are leaning forward, waiting for the door to open.

Finally, they hear their name.

The kids emerge a few minutes later beaming, toting stuffed animals.

# n n

Arriving home, Wyvona finds the door of Apartment 213 decorated with wrapping paper and garland.

Lisa and Jami give her a big hug, then attack her with whipped cream, ruining her careful hairdo.

She and Wyvona are still on the outs, but Jami couldn't stay away.

"She was there when my case was closed, so it meant a lot to me," she said. "I'm real proud of her. She did good."

Still, it wasn't easy. "I started to cry when I hugged her, so I kind of pulled it back."

Mylar balloons have been tied to the railings around the pool, and fliers passed out to every apartment.

"She did it!! Come and Celebrate. Wyvona and family CPS case is finally closed. Today at 5 p.m. Clean and sober party."

A mom who recently moved in grills hamburgers. A dozen adults and kids crowd the community center, filling their plates with potluck.

Lisa's feeling good. With her T-cell count on the rise, she avoided starting antiviral medications after all, and she awaits a visit from her two older children.

"I'm a lot peppier now," Lisa says. "I have a lot to look forward to. "

Days like this make Wyvona so lucky to live where she does, to have come so far, to get a second chance to be a good mother to her children.

Closing the family's CPS case means more than an end to drug-testing and social worker visits, Wyvona says.

It's the end of an old chapter of her life, and the chance to open a new one.

"I'm not afraid of succeeding any more," she says. "I am 40 years old and I'm ready to start my life."

# n n

Epilogue: In June, Wyvona bought a car and got engaged to Wayne, a man she met in recovery.

"He's really good to me and the kids," she reports. "Everyone here is really excited for me."

Sara Steffens covers poverty and social services. Reach her at 925-943-8048 or ssteffens@bayareanewsgroup.com. Read more!

Community meets challenge -Hendersonville (NC) Times-News

By Jessica Goodman

With the memories of her daughter, Kathie Cramer, Rosalie Hurst spoke of her early support of the Sixth Avenue West Clubhouse.

Hurst responded to an article in the newspaper wanting to start a place for the mentally and physically ill. Hurst went because of her daughter. That was about 25 years ago.

"Generally, people feel there's something wrong with the mentally ill," said Hurst. "The Clubhouse doesn't treat them as if there's something wrong with them."span class="fullpost">

"Our philosophy as an agency is one of participation and engagement," said Jacque Combs, the executive director of the Clubhouse.

The Clubhouse was a place for Cramer, who suffered with mental illness, to go and be a part of a community, her mother said. They had training and outreach programs. Clients were involved with the community by holding jobs or doing service. She could be a part of society and feel useful. Nancy Clark, Hurst's niece, added it gave Cramer "a sense of significance," and helped build self confidence.

"Kathie had such a heart for needy individuals," said Clark. "She had her mother's heart for sure."

"She was a people person," Hurst said of her daughter. "And she was a talker."

Years later, when the Clubhouse's existence was in jeopardy after the closure of New Vistas/Mountain Laurel in October 2006, Cramer and Hurst wanted to help. They wanted to see the Clubhouse as its own entity.

The pair offered $75,000 as a challenge grant for the Clubhouse in November 2006. They wanted to help make the Clubhouse independent, but also wanted the community to be involved. The Clubhouse gained its independence and its non-profit status and is now known as Sixth Avenue Psychiatric and Rehabilitation Partners.

"When Kathie heard the news it was now an independent entity," said Clark, "tears came to her eyes. She was so happy."

The challenge grant has now been met, and funds totalling $150,000 will be donated to the support of the Clubhouses's programs and administrative needs.

"I'm delighted," said Hurst of the match. "It's wonderful to have the community back it up, realizing the importance of (the Clubhouse)."

"Our gratitude for what they did is really hard to articulate," Combs said. "And our gratitude to the community because they really responded."

Cramer passed away last year suddenly at the age of 64, but her memory rests in those who knew her. Her mother continues, at the age of 93, to support the Clubhouse, though she says she wishes she could do more. She suffers from macular degeneration, which she said has given her a new perspective on what it means to be disabled.

"I'd probably not know the need of (the Clubhouse) if I hadn't had a mentally ill daughter," Hurst said. "She was a wonderful girl... wonderful young lady."

The Clubhouse is not just a place for people to be. The agency is able to provide a whole range of services to the community.

"Each client can go to one place and get all their needs met," said Janet Slack, a member of the Clubhouse's board.

"We're the only agency doing what we're doing," Combs said.

The Community Foundation of Henderson County helped the Clubhouse during its transition to nonprofit status. They collected the funds donated to the Clubhouse and will continue a fund to collect donations.

"Rosalie wanted to thank all the people that contributed," Clark said. Read more!

State backs off new mental health rules – for now - Asheville (NC) Citizen-Times

Leslie Boyd • LBoyd@CITIZEN-TIMES.com

RALEIGH – The N.C. Department of Health and Human Services has backed off fully implementing its new rules 0n limiting the oversight of professionals with provisional licenses.

The rules, which were to take effect July 1, would have left many mental health consumers without counselors, therapists and social workers.

When mental health practitioners finish graduate school, they must serve one to two years with a provisional license after graduation. During that time, they must be overseen by a doctorate-level professional in their specific fields.

The state had proposed limiting the oversight to physicians, which most agencies do not employ. The move would have limited the number of people available to provide outpatient services, and it would have left many patients without care, especially in rural areas.

“The department still plans to go ahead with this in a year, but we’ll take this for now,” said Raymond Turpin, Ph.D., whose agency employs several provisionally licensed professionals.

Turpin and others were concerned that the shortage of physicians with mental health experience, especially in rural areas, would mean people with provisional licenses would have to leave the state to get the training and oversight they require.

The state countered that agencies could contract with physicians and provisional licensees could bill under the physicians’ Medicaid billing numbers.

“That would leave the docs open to all kinds of liability, and if I were a doctor, I wouldn’t do it,” Turpin said last week.

Medicaid will not reimburse for services unless the bill comes in with a valid billing number. Most providers guard those numbers closely because they are responsible for all cases billed under that number. If someone overbills using that number, the person who holds it is responsible.

The state relented and will allow people with provisional licenses to bill through the local management agencies so they can continue providing services, the state said. Read more!

Mental-health parity: Are we ready? -Wala Wala (WA) Union Bulleting

By SHEILA HAGAR of the Walla Walla Union-Bulletin

Washington state has a mental health parity law that is the envy of the nation, according to Randy Revelle, senior vice president of the Washington State Hospital Association and chair of the Washington Coalition for Insurance Parity.

Unfortunately, those standing to benefit the most are often the least informed such a law exists at all, he said.

To have mental-health parity is to balance the health needs of humankind, health advocates believe. While insurance companies have historically covered most physical-health situations, mental health has often been the redheaded stepchild.

Insurers could discriminate by imposing limits on numbers of visits and demanding higher co-pays for mental-health care, or refuse to cover such care at all.

That changed in 2005 when the Legislature passed a mental-health parity law, with planned implementation in three phases.

Phase 1 came in 2006, No. 2 became effective the beginning of this year.

The third piece, the one with the greatest impact, is due to come on line in January 2010. It requires insurance companies to cover mental-health issues the same as physical-health issues, using identical standards and criteria.
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The rules will affect an estimated 2 million residents.

Is Washington ready?

Despite a law that's seen its third birthday, it remains a mystery to many people, Revelle said.

While the state's Office of the Insurance Commissioner supports and monitors the law, insurers have not embraced it, he said.

"In terms of the companies educating their people about it, they fight it tooth and nail. They oppose it and continue to try to do anything they can to stop it ... they would say 'we don't have the money.'"

Consumers understand discrimination, but most haven't absorbed the concept of parity or what mental-health benefits include, Revelle said. "But once they understand it, they want it."

It would be tempting to view glitches in implementing the parity law to be as simple as insurance companies reluctant to pay out for mental-health services, said Mark Stuart of Premera Blue Cross.

That would be the wrong picture, he said.

"As the bill was being discussed, the only point we brought to Olympia was 'if you have a mandate, there is a cost attached.'"

There is no question that employees need to take care of their mental health as well as their physical health. Research has shown stress and depression can manifest into physical ailments, causing lost time at work and even more money spent on medical care," Stuart said. "When you're dealing with stress better, then you are not costing the system in the big picture."

However, Premera and other insurance companies are in the business of business ¬--- creating benefit packages for employers, he pointed out.

Those employers base insurance-purchase decisions on three basic factors: staying competitive for good employees; what the company can afford; and what employees need and can afford, Stuart emphasized. "It is a decision based on their ability to provide for their employees."

Insurance premiums are driven by health-care costs and affect everyone who helps pick up the cost of coverage. "What we want for our members is to understand the impact of changes."

The same goes for staff at the Premera office, Stuart said. Every person involved with the public or health-care providers is brought up to speed about issues and changes, "that they are as well informed as possible and can speak to it as well as possible."

While Washington's law offers a "very broad scope" of mental health coverage and the coalition members are set to "ride off into the sunset," there's more work to be done, Revelle pointed out. "Dealing with the stigma is the next long-term project. We're a long ways from where we ought to be."

Sheila Hagar can be reached at sheilahagar@wwub.com or 525-3300, ext. 285.

WIDESPREAD PROBLEM

Mental illness directly touches more than 50 million adults and 10 million children in America; fewer than 20 percent of kids and 33 percent of adults get professional treatment, according to the Washington Coalition for Insurance Parity. Most mental illnesses improve with treatment and early intervention is most effective and appropriate treatment reduces medical costs overall, the coalition states.

The coalition doesn't have the funding to do a large-scale promotional campaign to educate the public about mental illness or parity laws, according to coalition chair Randy Revelle. The group did recently start a newspaper ad campaign aimed at reaching minorities. Other than that, information must be spread in other ways, he said.

Still, people are beginning to ask questions, said Stephanie Marquis of the Office of the Insurance Commissioner. "Since the law took effect in January, we've had 36 phone calls and have opened seven complaints."

Read more!

Disability benefit denials, delays ravage lives of claimants - Asheville (NC) Citizen-Times

By Leslie Boyd

The horror stories roll off their tongues like a litany: claimants who die while they wait, families falling apart, bankruptcies, homelessness, even suicides.

Disability attorneys and advocates say these are the fates of an increasing number of people who become ill or injured and apply for federal Social Security Disability benefits.

From first application, people who cannot work because of illness or disability wait an average of three years for benefits. Many wait longer, and a large percentage of people simply give up.

In cases where benefits have been denied, the average time taken to process a claim after the first two rounds of rejections in 2000 reached 274 days, according to U.S. Senate testimony from Nancy G. Shor, executive director of the National Organization of Social Security Claimants' Representatives.

That average today has climbed to 541 days, "and it is important to remember this is just an average," the report states.

Loss of home, children

Rebecca Bell became homeless while she waited. She spent two years in homeless shelters, lost custody of her two children and became addicted to drugs.

Bell injured her back and became unable to work. She then was diagnosed with bipolar disorder. She first applied for disability in December 2003, was rejected, appealed, was rejected again in May 2004. She applied for reconsideration in August 2004 and lost that appeal and then lost a second appeal in November 2004.

She went to attorney Leah Broker in Asheville, after she was denied again in February 2005. Her reconsideration was denied again in July 2005, so Broker filed for another hearing, which happened in August 2007. Bell finally was approved in September.

"How do they expect a person to live?" Bell asked. "You go from your own place to staying with family and then where?"

Bell's addiction started with the pain pills she was prescribed for her injury. The pills helped her emotional pain, too, she said. She felt as though no one in the Social Security Administration believed she was telling the truth about being unable to work.

"As long as you stayed numb, it didn't hurt so much," she said. "You don't know how hard it is until you have no money, not even for personal items or food. You have to eat what the soup kitchen is serving, and you have no place to go during the day because the shelter doesn't want you there."

Bell used the lump-sum payment of back benefit, about $20,ooo, to buy a used mobile home. She pays a modest rent on the lot.

Wait time

Broker said Bell's case is typical. The office in Greenville, S.C., where most Western North Carolina cases are sent, is under court order to deal first with cases that are more than 900 days old. A survey last fall showed that the Greenville office is among the most backlogged in the country, with cases taking an average of 624 days to process.

The House Ways and Means Committee has been holding hearings on the backlog as the number of people waiting for a decision continues to climb.

"Today, more than 1.3 million disabled Americans are waiting for Congress to do the obvious: find a solution," Income Security and Family Support Chairman Jim McDermott (D-Wash.) said in April. "We're taking steps to fix this, because these disabled Americans deserve nothing less. The backlog in processing disability claims is a burden and barrier for disabled individuals who are waiting for critical cash assistance and health care coverage."

Health care access

Even after a person is approved for disability, they have to wait two years to be eligible for Medicare, Strom said.

"If it's a two-income family and one spouse is working, they're not eligible for Medicaid either," Strom said. "This lack of accessibility to the health care system makes people sicker, and it's financially motivated. It is driven by money, and that's not right."

Some people lose their homes while they wait. Relatives go into debt trying to care for the person who can't work.

A few cases are approved quickly - when people are elderly or clearly dying, said Cynthia Strom, a disability attorney in east Asheville.

"But for most people, it's a waiting game," she said. "I've had clients commit suicide while they wait because they just can't do it anymore."

Strom has been a disability attorney since 1990. When she came into the field, it was unusual for someone to die while waiting for approval. Now it's fairly common, she said.

Broker, who also said she has had clients commit suicide while waiting, has become alarmed at the types of cases being denied.

"Even people who are disabled according to all the rules and definitions are being denied," Broker said.

One client has a developmental disability. She received disability payments until she married. When her marriage broke up, she applied again and was denied.

"She has no income," Broker said. "We've been waiting for a hearing since last July."

Savings by attrition

Broker said she believes the government counts on a certain percentage of eligible people giving up or dying during the process.

"I would estimate that only about half the people who should be getting disability are actually getting it," she said.

Curtis Venable, an attorney with Pisgah Legal Services, said he has clients who have waited more than four years for approval. Getting approval in less than 2 years is rare.

"I'll bet one-third of the people living in homeless shelters are people waiting for disability," he said.

Bruce Peterson, district director for U.S. Rep. Heath Shuler, said the office gets hundreds of calls a month asking for help with disability.

"By the time they call us, they've applied and been rejected at least once," Peterson said. "One of the things that bothers us the most is that people apply and wait a year, get rejected, wait a year, ask for a hearing and wait another year."

Frozen staffing levels

The biggest cause of all the delays is staffing, said disability attorney David Gantt.

"The Social Security Administration has the same number of people working for it now as it did when Gerald Ford was president," he said. "It's no wonder Greenville had a backlog of 12,000 cases."

But not all offices are as backed up as Greenville. Since October, cases from Buncombe County have been sent to the office at Kingsport, Tenn., where the average wait, according to the study, is 346 days - still a long time to wait when a person has no income.

Strom says she also has seen a change in attitude at the Social Security Administration.

"It used to be people were believed for the most part," she said. "It was assumed that the medical records were accurate. Today, it's assumed everybody's cheating. The smallest discrepancy is viewed as a deliberate attempt to deceive. ... This is beyond acceptable. This is beyond bureaucracy." Read more!

Mental-health court will have a plateful -Deleware County (PA) Daily Times

By: GIL SPENCER, gspencer@delcotimes.com, 06/27/2008
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(First of Two Parts)

She was taken into custody Aug. 27, 2007. The arrest report says she was in Chester "kissing and touching" children and when she was confronted by several adult females, "she pulled up her skirt to show (them) her bare butt numerous times."

The charge against her was indecent exposure. But as of Thursday, she was still in jail, awaiting a trial that might never come.

Her name is Emily. She's black and she is 47 years old.

"I've been in jail for a year," she says, sitting across from me at a table in the visitors' room at the county prison. "The mental-health people, they're not right. They took money from me ... It's like they want me to stay here."

Nothing could be further from the truth. It's just that the mental-health people don't have any place else to put her.

She's been judged incompetent to stand trial by a court psychiatrist. She has a history of arrests dating back decades. Everything from assault to disorderly conduct. She's been in and out of jail and mental institutions for years. Mostly in.

She is handcuffed and wearing a dark brown jumpsuit. Her hair is short and her two front teeth are missing.

She tells me a story with an allegation about a mental-health worker who was supposed to take her out to get something to eat.

"He waited until we left. Then he went around the corner and went back to my house and ate my food."

I ask her how long she's been having these mental issues.

"I was pregnant and my sister had these pills. I took an orange sunshine ... They've been using me for a guinea pig ever since.

"There is nothing crazy about me. I've been on some kind of medicine and it don't work. I just want to be myself."

As for the charges against her?

"They said I was running down the street with no clothes on. I had clothes on. People make up stuff and then lock me up. I never kissed that kid. Them kids was up on that tree. They was pushing each other and I went and told them not to do that because they were gonna' hurts themselves."

She said all she wanted to do was help those kids, but nobody seemed to understand.
"That little boy's mother was smoking drugs on the porch. That's why she said all that stuff.

But the police didn't believe her because of her past problems.

"The cops said, 'She's crazy. Put her in a mental hospital.'"

There were other misunderstandings.

"Like I got maced in Darby because a grown boy told his mother that I was messing with him. She maced me. They always messin' with me. Like kids chasing me down the street with big boards. So I be running home. They followed me home. They robbed me, robbed my house and took all my money. It's hard out here."

But she's not out there. She's in here. Before this stay, she said, she was in from 2001-2007.

"When I did get out, mental health never found me no place to live. So they're not good. They kicked me out of the program."

She didn't say why. It might have had something to do with her cocaine use. There are two giant and ugly scars on her arms.

"This is Alex," she says looking down at one and then the other. "This is James."
She says the scars are from shooting cocaine. But she's been straight for months.
I ask her how she spends her time in jail.

"I clean the showers. But I don't feel good sometimes. I'm asking them to let me go to medical because I think I'm pregnant."

She says she has four sons and two daughters.

"One of them works here," she says. "I don't talk to her much because this is her job. I'm proud of her. I knew I had a daughter, but I didn't know what she looked like."

She lost custody of all her kids years ago. She says two of her sons live with their father in Lancaster. But she still has family in Chester. A son and a "God-sister."

"She told me as long as I take my medications, it will be all right. But she don't like coming up here seeing me like this. She don't come. Nobody come."

I ask her what she's been diagnosed as.

"Bipolar," she replies.

"Not schizophrenia?" I ask.

"They said that before, but the doctor said they made a mistake. Sometimes, though, I get mixed up."

She shakes her head a little and looks me in the eyes.

"So do you know where they are going to take me yet?"

I don't, and neither does her lawyer, Mike Harper.

As a 16-year veteran of the county Public Defender's Office, Harper has seen more than his share of cases like Emily's.

One thing he makes clear at the get-go, the new Mental Health Treatment Court being set up by county council won't be appropriate for people in Emily's condition.
More about all that Sunday.

Gil Spencer's column appears Sunday, Wednesday and Friday. E-mail him at gspencer@delcotimes.com.


Read more!

Departments told to expect trims -Milwaukee Journal-Sentinel

By STEVE SCHULTZE - June 27, 2008
sschultze@journalsentinel.com

Milwaukee County would shed scores of parks, maintenance and human service workers. Two community centers would shut down. A local jail alternative would cease. And the farm and fish hatchery at the House of Correction would close.

Those were some of the belt-tightening measures included in 2009 county departmental budget requests submitted this week.

While not dictated specifically, the trims in the requests were the result of guidelines imposed by County Executive Scott Walker. Walker told most departments they’d get no more money next year than they did this year; in a few cases, he ordered reductions.

Walker applied the pressure as part of his insistence on issuing a budget that freezes next year’s tax levy at this year’s $249 million level. Critics say six years of minimal increases under Walker in the face of rising costs of salaries, benefits and supplies have pared county services to unacceptably low levels.

Unlike last year, no fare increases or route trims for local bus service are proposed. And the parks department says it won’t close swimming pools unless funding cuts are imposed.

Walker said Friday in an e-mail that he had not yet reviewed the budget requests. A tax levy freeze for 2009 remains essential, he said.

Not all departments complied with Walker’s budget freeze directive. Sheriff David A. Clarke Jr. is seeking an extra $8.4 million. The courts budget request is up $2 million and District Attorney John Chisholm is asking for an extra $1 million. Clarke, Chisholm and Chief Judge Kitty Brennan — all independently elected — said they can’t provide required services without the increases.

Clarke said an arbitration award on deputy pay accounted for more than half of his increased 2009 costs. If Walker or the County Board wants to cut some of the work his department does to trim his budget, he’ll find a way to make that work, Clarke said.

In response to a call from Walker for privatization, the Behavioral Health Division suggests outsourcing food service workers, housekeepers and others who work at the Mental Health Complex, eliminating 177 county jobs.

Those jobs don’t relate to the division’s core mission, said John Chianelli, behavioral health administrator.

Richard Abelson, president of District Council 48 of the American Federation of State, County and Municipal Employees, predicted the privatization push would fail. “It’s bad public policy to create layers of bureaucracy that are not accountable,” he said.

Other departments proposed hiring private firms to operate the O’Donnell Park parking ramp, concession stands in parks and the county fleet vehicle parts department.

Walker has extolled outsourcing as a way to avoid service cuts or tax increases.

“It’s our annual ‘drag our employees through the mud’ (time) again,” said Kurt Zunker, who heads AFSCME Local 882. If the cuts go through, the quality of services would decline and longtime county employees and their families would suffer, Zunker said.

The departmental requests are the first of many steps toward shaping the 2009 budget, and give a glimpse into controversies likely to flare up. The next move comes in September when Walker formally issues his budget plan.

The O’Donnell ramp privatization idea evolved last year, after a trial balloon on selling it went nowhere. The outsourcing move would generate an estimated $200,000 next year. Adding more concessions to unspecified parks would bring in $20,000. And vendors at the Schulz Aquatic Center under construction at Lincoln Park would provide an estimated $30,000.

Operation of the county’s public assistance call center, with its sluggish response time, would be turned over to IMPACT, an agency that already handles the 211 social service hotline.
Dogs could help parks

Parks Director Sue Black says dog parks could bring in $100,000 for the county next year. Ten county parks would have dog parks — areas set aside where dogs run free for a $20 annual fee.

Black has again proposed swapping dozens of parks maintenance workers for seasonal help, an idea strongly endorsed by Walker but rejected in the past two years by the County Board. For 2009, Black is proposing cutting 48 maintenance workers. She can hire seasonal workers who put in more hours and still save $1.8 million, according to her department’s budget request.

Shutting down the King Community Center, at 1531 W. Vliet St., and the Kosciuszko Community Center, at 2201 S. 7th St., would save the county $617,000. Both were also tabbed for closing last year but Walker decided to retain them after an outpouring of local support.

A community justice program that serves as an alternative to jail would be halted, saving nearly $1 million for the House of Correction’s budget next year. The House’s farm and fish hatchery also is proposed for elimination, a trim repeatedly rejected by the County Board. Read more!

Disabled protest proposed cuts to services -Inland Valley Daily Bulletin (CA)

By Robert Roger

RIVERSIDE - Some stood and many sat in wheelchairs on the downtown sidewalk, protesting what they regard as an assault on their rights.

And the father of modern civil disobedience looked on.

More than 100 protesters gathered in front of the 9-foot bronze statue of Indian independence leader Mahatma Gandhi in downtown Riverside.

Disabled men and women, many representatives for local disability advocacy groups, toted signs and shouted slogans in protest of Gov. Arnold Schwarzenegger's proposed budget, which includes cuts to Medi-Cal and in-home support services as part of the effort to close a $17 billion state budget shortfall.

"The governor's budget is simply a big threat to my ability to live independently," said protester Christie Rudder, 46, who lost use of her legs in a 2002 car wreck and now works at a disabled advocacy center. "The only thing between living free and working at my job and living in a nursing home is my in-home care, which the governor wants to cut."

Organizers claimed the governor's budget would increase long-term costs by imperiling the health of the state's disabled population, whose care is generally covered by Medi-Cal, the state's federally subsidized Medicaid program.

Julie Williams, a coordinator for San Bernardino-based disabled advocacy group Rolling Start, said the governor's proposed cuts would reduce in-house aid services for 84,000 people, making it more likely they would require full- time, costly care in a facility.

"The governor is looking to balance the budget on the backs of the most vulnerable," Williams said.

Schwarzenegger's press secretary, Aaron McLear, said the in-house care programs have more than doubled in the past decade and that the governor's plan would merely reduce the average hours for in-house care providers to 52 from 74 for the "highest-functioning recipients."

"The governor doesn't want to have to make these cuts," McLear said. "But we can only spend the money we have, and we have a $17 billion shortfall in our budget. The governor does not believe raising taxes is the prudent thing to do in a tough economy."

Williams said the budget proposal would reduce wages for in-house care providers, driving people from that labor force. Other medical, dental and mental treatments would also be put out of reach by tightening eligibility requirements for Medi-Cal, she said.

Cars honked and people shouted as they drove by, generally in approval of the protesters' message.

Riverside resident Eugene Harris, 75, watched the protest from a nearby coffee shop. A former community organizer in his native Chicago, Harris compared the protesters' to the civil-rights movement.

"I think they got some help coming to them," Harris said. "It's about rights. Obviously they need our help, and they have a right to basic health."

robert.rogers@inlandnewspapers.com

(909) 386-3855 Read more!

Behavioral health loses 45 positions -Chico (CA) Enterprise-Record

By ROGER H. AYLWORTH - 06/26/2008

OROVILLE -- While county-run clinics in Paradise and Gridley have been spared the ax, the proposed Butte County Department of Behavioral Health budget remains a bitter pill for many.

Tuesday, the Butte County Board of Supervisors accepted a tentative budget for the Department of Behavioral Health that lops roughly 10 percent off the current year's budget and will eliminate 45 positions.

Edward Walker, interim director of behavioral health, told the board the 2007-2008 budget was about $48 million and the proposed 2008-2009 budget will drop to $43 million.

Meegan Condon, principal management analyst for the county's administrative office, explained the proposal calls for the elimination of 45 positions, 19 of which are currently vacant. On top of that, the budget includes money for four new positions.

The department is funded almost exclusively with state and federal money.

In the coming year funding from both those sources will shrink. Also the budget is taking another hit because of what amounted to an unscheduled loan from the Butte County General Fund.

The state has been slow to make its required payments to the department for Medi-Cal funded mental health services. In order to keep the department afloat, the county fronted $1.7 million over the past two fiscal years to cover the delayed payments, Edwards said.

Also, according to Walker, the department suffers from a "structural deficit," in that it costs the county $2.71 per minute to provide
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out-patient services. He explained the federal rules require by-the-minute billing.

However, the maximum allowable billing is $2.61-per-minute, so each billed hour costs a dime more than comes in.

Walker said the staff cuts, as well as increased emphasis on improved productivity, will allow paying back the General Fund, getting through the current sag in state and federal funding, and ultimately building a reserve that will allow the department to weather future dips income and problems with cash flow.

In an earlier incarnation, the proposed budget had included plans to close county clinics in Gridley and Paradise, and replace the services with private, contracted providers.

During at least two public hearings before the Behavioral Health Advisory Board, clients and staff begged the department administration to maintain the clinics. Subsequently, the department issued a memo saying closing the clinics would be a violation of both state law and the county charter, and the proposal was dropped from the budget.

Some of the department's staff have offered to cut back to a 36-hour week in order to avoid seeing colleagues lose their jobs.

Condon and county Chief Financial Officer Greg Iturria both told the board that while such offers are sincere, they ultimately don't save as much money as it would appear.

The supervisors voted unanimously to accept the preliminary budget.

Staff writer Roger H. Aylworth can be reached at 896-7762 or raylworth@chicoer.com. Read more!

Mending a broken mind -Toronto (Canada) Globe & Mail

Interesting videos, links contained on story site, accessible by clicking title post.

By CAROLYN ABRAHAM

The first time I met Sean Miller, we were strangers waiting in a corridor at the outpatient psychiatry unit of Toronto General Hospital. He was the redhead, wearing a grey sweatshirt, jeans and a 100-watt smile. “Popular place,” he said.

He looked rosy and energized, as if he had been for a run. “Pretty warm out there today,” he added. He mentioned rain in the forecast and cracked a joke about the “nice weather” we had been having. Then a door opened down the hall and he waved goodbye – “See ya!”

A few minutes later, Peter Giaccobe, a 33-year-old psychiatrist, beckoned me to his office. “It's fine,” he said. “You can come in.”

I had been waiting to observe Dr. Giaccobe's 4 o'clock emergency appointment. Emergencies are routine in psychiatry. Patients turn up worried about a medication, feeling manic or fighting off suicidal thoughts.

But that May afternoon was something different: A 41-year-old patient had placed an urgent call to have his battery checked. His depression had been so severe that last year he allowed doctors to drill a hole in his head and thread two battery-powered electrodes down into his brain. The operation made him the 21st subject in one of the more radical mood-altering experiments on the medical books – a world-first, Canadian-led trial to treat depression with a procedure called deep brain stimulation.

The man had visited a lawyer friend at a courthouse, passed through a security check and later felt a downswing in his mood. Had the metal detector somehow short-circuited the electrodes in his head?

Dr. Giaccobe opened his office door and that was the second time I met Sean Miller.

He laughed and tapped the top of his head. “Yeah, well, I was depressed – before this went in,” Mr. Miller said. “This thing saved my life.”

At a spitfire clip, he described the way he now bounds of out bed in the mornings, impatient for the day. “Before the operation, I wasn't myself. … I love life, seriously love it, but I couldn't think straight. I couldn't work. I hardly left my apartment for four and a half years.”

“You're the happiest person I've met all day,” I told him, and meant it.

“I know,” he beamed. “Isn't that crazy?”

From the home front to the workplace, from the schools to the streets, mental illness presents one of the great challenges to modern society, a leading cause of disability, absenteeism and deaths due to suicide. Not only does it strike one in five Canadians, usually in their prime, but too often it defies the ability of modern medicine to treat it.

Depression, which affects one in 12 people in this country, is one of the trickiest disorders to cure. While 80 per cent of patients find effective relief with standard drug or psychotherapies, the latest numbers suggest that only 40 per cent truly feel well. Worse, experts estimate that, for 10 to 20 per cent of sufferers, nothing works.

To the shock of many, and the horror of some, the most promising treatment for intractable depression on the horizon is not a designer drug, a new form of talk or even genetic therapy. It's electricity. The same force that powers our TVs and microwave ovens can lift the human spirit.

With deep brain stimulation (DBS), surgeons implant metal rods that aim steady pulses of electrical current at the faulty neural circuits believed to underlie mental illness. Spaghetti-thin, the rods connect to a cable that snakes invisibly down the neck to a cookie-sized, battery-operated regulator embedded just south of the collarbone.

DBS itself is not new. Doctors have used it to treat physical ailments for nearly 60 years, first to counter chronic pain and since the 1990s as a therapy for movement disorders. But society has long separated neurological diseases from psychiatric ones, as though physical conditions can stem from concrete malfunctions of the brain but maladies of the mind cannot.

Then in 2003, working with just six patients, University of Toronto researchers tested DBS on depression. It not only proved safe, it also made four of them better. Since then, 50 patients in Toronto, Vancouver and Montreal, as well as at least 30 in the United States, Europe and South America, have undergone the procedure in a bid to see whether electrical implants can indeed mend a broken mind.

The Toronto trial, open only to people whose depression has proved impervious to all other treatments, so far suggests that DBS is safe and offers lasting relief in more than half of all cases. The early results are encouraging enough that one manufacturer of the DBS device has already started down the road to have the U.S. Food and Drug Administration officially approve it for treating depression.

“The emerging picture seems to be that, if you can get better [with this], you can stay better,” says neurologist Helen Mayberg, whose work at the Baycrest Centre's Rotman Research Institute in Toronto laid the groundwork for the DBS trial. Ivy League researchers in the U.S. are now investigating DBS as a treatment for obsessive compulsive disorder and, at Emory University in Atlanta, where Dr. Mayberg is now based, the target is type 2 bipolar disorder.

Shocking the brain to behave is hardly a revolutionary concept. Doctors first tried it in the 19th century, and in 1937, Italian researchers launched electroconvulsive therapy, zapping patients' heads to induce seizures that sometimes improved symptoms, but also damaged memories and muscles. Even now, a gentler version of ECT remains an established, if controversial, treatment for a narrow range of severe mental disorders, depression in particular.

But the Toronto researchers point out that it's not the use of electricity that makes their treatment a major advance – it's where they put it. “With brain surgery, it's like real estate – it's location, location, location,” says Andres Lozano, the neurosurgeon and senior scientist who has led the trials at Toronto Western Hospital.

DBS offers a fresh opportunity to “de-stigmatize” mental illness, he says. If a mechanical device can regulate mood, then “behaviour is modulated by the same kind of circuitry. … People have no control over it. … They can't just ‘pull up their socks.'

“There has been this distinction between neurology and psychiatry that's artificial and arbitrary.”

But brain surgery for psychiatric conditions has a long, unhappy history – from head bashings in the Bronze Age to the 20th century's infamous frontal lobotomy. After psychopharmaceuticals hit the market in the 1950s, cutting as a treatment for mental conditions became as unfashionable as Brylcreem. Which makes it all the more unlikely that any depression treatment involving drills and electrodes is making such an auspicious comeback.

“Some people say this is barbaric – One Flew Over the Cuckoo's Nest kind of stuff,” Dr. Lozano adds, but more than 40,000 Parkinson's patients have already had DBS ease their tremors by targeting parts of the brain where motor neurons misbehave.

“People have no problem operating for Parkinson's, but they have a problem operating for psychiatric conditions,” he says, adding that “we can go anywhere in the brain now. We can turn it up, we can turn it down …. regulating it, just like a thermostat.”

The only difference in using DBS for depression is that the electrodes target the brain area where sadness lives.

‘I LITERALLY FELL APART'

A few weeks after we met at Toronto General, Sean Miller sits in a Yorkville café. He downs a bottle of water and shrugs – nothing from his childhood predicted his long spiral into despair, he say.

He had grown up happy in Toronto's tony Rosedale, the second of three children in a warm, supportive family. His father ran an import-export business. His mother, a former social worker, stayed home to raise the kids. He had close friends, attended good schools, flitted off to camp every summer, skied, played tennis and flirted with serious hockey.

He faced his only obstacle at 14, when he developed Guillain-Barré Syndrome, an autoimmune disorder that temporarily paralyzed him. He spent a year in rehab centres. When he returned to school, with a dropped foot and an awkward gait, he could no longer play hockey. Even so, he says, “I felt frustration and anger, but not depression.”

He did his last year of high school in the south of France, graduated from university to an exciting film industry job and landed a serious girlfriend. Life was grand.

But at 24 he had his first bout of depression. It was mild, but left behind a sense of “joylessness … purposelessness.” A psychiatrist prescribed an antidepressant but he found the libido-killing side effects too much to bear. He quit the medication after a year.

The next episode, at 27, was tougher to beat. He left his girlfriend and his job and flew to Thailand for an indefinite stretch of travel. While there, he started smoking dope, which he suspects “changed the depression from feeling low to something based on fear and anxiety.”

He returned home, resumed medication and, eventually, went back to work.

In a bid to avoid a relapse, he regularly attended 10-day meditation retreats, trying to train his mind “to stop the stream of negative thoughts.” He even volunteered to help others stay positive, answering the phones at a distress centre.

He remained well into his early 30s, climbed corporate ladders in sales and marketing and became involved in another serious relationship. Then, once again, he stopped taking the medication.

“I know, it was crazy,” he says, laughing now at what he did. “The side effects bothered me – but also, I was kind of a health-conscious guy and I didn't want to take drugs.”

But at 36 his depression returned and this time, the third time, the drugs proved powerless. “I literally fell apart. The next four years were the worst of my life.”

Most friends stood by him. His girlfriend at the time rarely left his side. “But there were a few, who would be like, ‘Sean, get a job …. get a life … get your ass out of bed.' I didn't even feel like I was a part of life,” he says. “It felt like being buried alive.”

WELCOME TO AREA 25

Sadness lives behind the eyeballs, four centimetres back in from the forehead. That's where Dr. Mayberg found it after 20 years of brain-imaging studies, in Boston, Texas and then Toronto in the late 1990s.

The pictures showed that a patch of the prefrontal cortex known as Brodmann Area 25 flicked into high gear when healthy subjects were made to feel sad, for example, by reading a personal essay about losing a loved one. At the same time, significant swatches of the subjects' frontal cortex, the brain's chief executive officer – its motivator and decision-maker – powered down. When their minds moved away from sad thoughts, the cycle reversed. Activity shut down in Area 25 and shot up in the frontal lobes.

But in patients with depression, the cycle never shifted. The lights at Area 25 were always on, stuck in a constantly active mode, compromising cognition in the frontal cortex.

Sitting in the ancient limbic lobe passed down from our slithering ancestors, Area 25 connects to the brain structures involved in human function – emotion, memory, stress, sleep, libido, appetite, energy levels and learning. “It's linked into all the core areas involved in depression,” Dr. Mayberg says.

The images led to a hypothesis: If they had found one of the sites where a feeling runs amok, could they find a way to fix it? Would the type of DBS used for Parkinson's charge the cells in Area 25 out of their “on” position?

In 2001, in a moment of serendipity, Dr. Mayberg met Dr. Lozano at a conference of neurosurgeons.

Dr. Lozano was world renowned for his brain-stimulation operations. He had performed DBS for Parkinson's and other neurological disorders since 1992 – about six times a month. When Dr. Mayberg suggested that they try it for depression, he thought it was “a long shot” – but right up his alley. “I don't want to do the ordinary, the routine, the established,” he says. “I'm not a fan of incrementalism. I just want to take big steps.”

A HOLE IN THE HEAD

In the spring of 2006, in the grip of depression in his downtown apartment, Mr. Miller watched a television segment on the DBS procedure. His mother had called to tell him to tune in.

By that point, he had burned through 20 types of antidepressants, five months of cognitive therapy and four rounds of ECT. He had been admitted to hospital three times for two-week stretches. He had tried meditation, acupuncture, vitamin regimens and a shop's worth of naturopathic remedies. He had changed his diet and stopped eating dairy. His parents had even spent $4,000 so he could undergo transcranial magnetic stimulation, an experimental treatment that uses rapidly changing magnetic fields to alter the brain's circuitry. None of it helped.

“I was suicidal every single day,” he recalls, “but I was scared shitless to die too.”

On the Internet, he researched painless ways to kill himself and wrote a suicide note in the event he could ever bring himself to do it. It told family and friends there was nothing anyone could have done, that he loved them and that he was sorry.

Until he saw the DBS segment, he did not hold out a glimmer of hope that he could ever recover. The patient featured was just like him. She had tried everything and everything had failed. Then, after doctors turned on those electrodes, she finally emerged from her long black fog.

As radical as brain surgery seemed, Mr. Miller knew instantly that he wanted to be a test subject. Having been paralyzed as a teen, he had often thought of tradeoffs he would be willing to make to be free of the anguish. “I used to lie there and think, ‘I'd give up an arm, or a leg, or both my legs … I would take paralysis over depression any day of the week.' ”

Fear, he says, drove him to seek DBS. “It wasn't having the guts to do it – it was what would happen if I didn't do it.”

Having a hole drilled in his head seemed a small sacrifice.

‘MY LEGS ARE ON FIRE'

On a May morning in operating room No. 6, Dr. Lozano peers down at a patch of scalp, shaved and stained rusty red with iodine. He picks up a blade, cuts a square and tugs back the flap of flesh.

“Okay, John, you're going to hear some noise now. It sounds like an air gun at Canadian Tire, the type they use to take the nuts off your tires,” he says, powering up the drill.

It takes two minutes to pierce a stubborn centimetre of cranium and bore a hole the size of a nickel. A nurse asks if the patient feels okay. He gives her a thumbs up.

Patient John McCutcheon, 38, doesn't have a mental disorder, but he is still a pioneer – just the second person with multiple sclerosis ever to undergo DBS in a bid to ease the phantom-like pain in legs he can hardly feel.

“I've woken up dreaming my legs are on fire,” he told Dr. Lozano before the surgery began.

“What is it on a scale of 1 to 10?” Dr. Lozano asked.

“10-plus.”

Mr. McCutcheon's head has been immobilized by a thorny titanium crown screwed into his skull. A chrome cradle grips his neck like a pipe in a vice. The probe that will slide through the hole in his skull sits locked in an arced frame that stretches over his head like a steel rainbow. The entire contraption makes him look part person, part metal, and wide awake – as he must be, to tell the surgeon what he feels as the probe plunges 8.5 centimetres into his brain.

First, it will journey to Mr. McCutcheon's thalamus, to explore the rebel neurons scorching his lifeless legs. The sensory circuits near the midbrain will be the second destination, as the probe confirms exactly where the electrodes should go.

But for Dr. Lozano, every DBS procedure is about more than implanting electrodes – it's an opportunity. Every dive beneath the brain's glistening folds is a chance to glean its secrets, and often he has.

He discovered how neurons that once governed limbs that are now gone can misbehave to cause phantom pain, or take up new jobs to control other body parts. He found mirror neurons, the cells responsible for empathic pain, which can make you close your eyes or turn away when someone gets a needle. In January, while operating on an obese patient, he stimulated part of the brain that controls appetite and came across a crucial new area involved in memory. Expected to talk about food urges, the man instead vividly recalled a date he had had in a park more than 20 years ago … right down to what he and she were wearing.

As a result, Dr. Lozano has launched a pilot study to see whether DBS can improve the memory of early Alzheimer's patients. In the process, the Spanish-born neurosurgeon – whose fit, six-foot-plus frame seems to tower over everything – has become a celebrity scientist at 49 (the hospital's public-relations director calls him the resident rock star), featured in The New York Times, The Independent and 60 Minutes. Patients come from as far away as the Philippines to have him operate, and doctors move to Toronto for year-long stretches to watch him work. This particular morning, it's a surgeon from Singapore and another from Manhattan.

Up in his office, with his bookcases and antique surgical devices that have the feel of old mariners' instruments, Dr. Lozano likens himself to an explorer – to Christopher Columbus, he says, “describing the frontiers of the brain.”

“I want to go where no one else has gone before,” he says, without irony.

THE SOUND OF SADNESS

The hands of a surgeon usually steal the show in an operating theatre. But with DBS, the ears play the starring role. The micro-electrode probe that descends into the brain one micron (a millionth of a metre) at a time detects the electrical signals in the tissue it penetrates.

Electrophysiologist William Hutchinson operates the probe, which is wired to a bank of audio-visual tracking equipment that lines the rear wall of the operating room like components in a stereo shop. There are oscilloscopes that display volts in visual spikes, amplifiers that translate the firing pattern of a single neuron into sound, suddenly filling the room with rhythmic pings and rat-tat-tats like eerie signals from a distant planet. Everyone falls silent, eavesdropping on the alien within.

They begin to sample the sounds of Mr. McCutcheon's neurons 10 millimetres above the target in the thalamus. The neurons talk and the probe talks back, emitting a low-voltage current to elicit a response, and the cells can do one of two things: cease or fire.

“John, we're going to put some electricity into your brain now,” Dr. Lozano announces. “You'll hear a beep. Tell us if you feel something.”

After a zap several millimetres north of the target in the thalamus, Mr. McCutcheon reports sensation in his cheek, then his jaw, then somewhere around his ear.

“Okay, onward,” the doctor says, and the probe heads farther south to the cells that once moved his legs.

Periodically, Dr. Lozano puts his hands on Mr. McCutcheon, scratching his chest, poking his hip, patting his leg as he listens for the neural response his touch might trigger.

“Cells make different sounds in different regions. They're like a guide; they tell you where you are in the brain,” he says. “It's like driving through Europe. … You know where you are by the language they speak.”

Neurons that control vision fire at different rates than those that control movement. Some cells are idlers. Others burst and pop like the backbeat on a jazz track.

And how does sadness sound? “Cells firing five to 30 times per second,” he replies.

In DBS operations for depression, Dr. Lozano runs a show-and-tell. Instead of touching patients, he vies for emotion. He has them read moving stories or shows them pictures, scenes of splendour, or violence, images of despair or a sexual nature. He asks how it makes them feel, focusing on their words as well as the noise their neurons make.

But motion or emotion, the method is the same, he explains. When he tells Mr. McCutcheon to try to move his right foot, for example, a cell fires fast in the millisecond before the attempt. “Okay,” he says, “so that's involved in planning the movement.”

The erratic sound of the misbehaving neurons ring clear – like static from a radio in need of tuning. “His neurons are firing abnormally, and we want to turn them down,” Dr. Lozano says. “It's causing a brainstorm in the pain pathway.”

A few moments later, he reaches the target deep in the thalamus and signals Dr. Hutchinson to charge the probe. Mr. McCutcheon says it makes his legs tingle from hip to toe. “This might be a good spot” to place the first electrode, Dr. Lozano says.

They move next to strike the second target in the midbrain, the periaqueduct, where sensory circuits control the emotional response to pain – involved when a soldier fights on, oblivious to an injury, say, or when an athlete keeps playing despite a broken bone.

As the probe slides down, it passes cells that seem strangely quiet. “Silent neurons,” Dr. Lozano says, “terra incognita” – no one knows what they do, and electricity seems to have no effect on them.

A moment later, he steps away from the patient to whisper a prediction: “When we reach this target, he's going to tell us he feels good. … Some people say, ‘Oh, I feel calm, mellow, like I had a double scotch.'

“Go,” Dr. Lozano says, directing Dr. Hutchinson to charge the probe.

“How does that feel, John?”

Suddenly, Mr. McCutcheon's face relaxes: “Oh, what did you do? That feels good.”

Dr. Lozano asks if the feeling reminds him of anything.

“Like when the kids were born” is the reply.

Bingo. This will be the site for electrode No. 2.

The sensory circuits in the periaqueduct happen to be directly connected to Area 25 and the instant well-being Mr. McCutcheon felt when they charged it, Dr. Lozano says, was the same response from the first patient who underwent DBS for depression in May of 2003. “She suddenly said, ‘What have you done? The room is in colour.' ”

REGROWING THE BRAIN

With depression, the electrodes seem to quiet the hyperactivity of Area 25 like a muzzle on a barking dog. Yet scientists suspect that the story is more complex.

Dr. Lozano, who grew up in Ottawa and holds the Canada research chair in neuroscience, estimates that the currents directly affect up to 20,000 neurons, but flow outward “like dropping a pebble in a pond.” Research suggests it may have an impact on the very structure of the brain.

In the mid-nineties, University of Calgary cell biologist Samuel Weiss discovered that the adult brain can actually produce new cells. Since then, some researchers have come to believe the steady growth of new brain cells may be crucial to mental health.

For example, imaging studies show that people with depression have a smaller hippocampus in their brains than healthy people do. Psychiatrist Glenda MacQueen, head of the mood disorders program at McMaster University in Hamilton, recently reviewed the brain images of more than 1,000 people with depression and 1,000 healthy control subjects, and found the hippocampus to be especially small in those who had suffered several episodes of depression.

Housed in the limbic lobe along with Area 25, the hippocampus is best known as a mansion of memory – the great neural archive that records the context of our lives. But it has also become a hot property in mood studies.

People with depression have long reported problems with memory. As well, half of people with depression have high levels of stress hormones circulating in their blood and it is the hippocampus that controls the chemical cascade that stress triggers. (When the brain mistakes a ruffling curtain for a tiger ready to pounce, it's the hippocampus that says, “Relax, it's only a cat,” Dr. MacQueen explains.)

Stress hormones, meanwhile, are particularly toxic to cells of the hippocampus, which may explain why the structure shrinks with depression. In animal studies, Dr. Lozano and colleagues have discovered that DBS can boost new brain-cell growth – particularly in the hippocampus. Neuroscientist Scellig Stone, who works with Dr. Lozano, has found that one hour of deep brain stimulation in a rat doubles its production of new cells.

Dr. Weiss speculated that depression that responds to therapy or medication may be the result of chemical imbalances built up over the short term. But deeply rooted depression may be more responsive to DBS if the procedure really does boost brain-cell growth.

Although Dr. MacQueen has tried to study the hippocampus size of depression patients before and after DBS, images taken so far have not allowed accurate measurements. For now, researchers must base their results on what the patients tell them.

PROS AND CONS

Through 2006, Mr. Miller imagined his electric moment – lying on the operating table, doctors flicking a switch and saving him. He had called his psychiatrist for a referral to the trial as soon as he saw the TV segment. Then he lobbied, pleading his case to the doctors running the trial, phoning and writing letters.

But he wasn't alone. Results from the initial experiment made headlines around the world in 2005, and nearly 700 requests for DBS poured in. Even now, the waiting list has more than 30 patients.

Deciding who makes the cut is in part the job of Sidney Kennedy, the health network's head of psychiatry. Deeply involved in planning the DBS trial, he describes the procedure as a “major paradigm shift” in the treatment of a mood disorder. “It has been an interesting role for the psychiatrist: He's evolved from psychotherapies, to pharmacotherapy … to adjustments with stimulators. … It's one of the best examples where psychiatry meets neuroscience.”

Dr. Kennedy, 57, had no great expectations when the trial began. Even after the initial heady results, he tried to wear “the hat of the skeptic.” But “I thoroughly believe now there are no five-year placebos,” he says (referring to how long the first patient has had relief of symptoms). “I do think a cycle of depression continues for these people, but it's not as severe.”

Not that DBS is without its critics. For example, Jeffrey Schwartz, a renowned research psychiatrist at the University of California at Los Angeles, a leading proponent of cognitive behavioural therapy and co-author of The Mind and the Brain: Neuroplasticity and the Power of Mental Force has called DBS “essentially nothing more than an electrical prefrontal lobotomy.”

He told a U.S. newspaper that its pioneers have been careful, but that he worries its widespread use could lead to abuse by companies or amateurs offering it to anyone who wants to tune up his mental state.

In response, Dr. Lozano stresses that, unlike other psychosurgeries, DBS can be reversed, the electrodes removed, and five years since their first patient, none has suffered serious side effects.

Dr. Kennedy says he suspects that it does not work for all patients because, like faces, no two brains are exactly alike. Different brain regions could be involved in depression in different people, he explains. “Maybe in 30 years, people will look back and say, ‘How primitive – they stuck electrodes in their brains and turned the batteries on.' ”

Still, all surgeries carry a risk, Dr. Lozano notes. The experience with DBS for Parkinson's suggests that one in every 500 patients will suffer a hemorrhage during the surgery. Four in a thousand will suffer a serious complication, such as a permanent neural deficit or even death. If the numbers of patients being treated rise appreciably, “it will happen” for depression as well, he says flatly. “It is just a matter of time.”

Even the positive affects rarely appear right away. A few patients report relief as soon as the electrodes have powered up. But for most, it takes weeks, even months, to find the right voltage and frequency – “the sweet spot,” as they call it.

After the operation, Dr. Kennedy and Dr. Giaccobe, their offices mere steps apart, see each patient once a week to track their progress and tweak their settings. As time passes, the appointments are less frequent, but they still require adjustments.

Unlike patients with pain, those with depression are not able, or allowed, to adjust their own voltage. For one thing, researchers say the electrodes should be on all the time. Adjusting them haphazardly could have negative effects.

“We're managing this ever-growing cohort,” Dr. Kennedy says, which at the moment includes 30 men and women from their late 20s to their 60s. “We haven't had people very often who couldn't tolerate the stimulation. … If it's up too high, they feel an inner restlessness, you know, ‘wired,' and turning it back down relieves that.”

Even when they do find their sweet spot, Dr. Giaccobe says, it can be difficult for people who have been profoundly depressed for so long suddenly to reclaim their lives. “They still have ups and downs,” and even their relationships change. One patient grew frustrated with a partner who missed the needy and vulnerable homebody he had been when he was sick.

“In a way, this is like learning to walk on a new hip,” Dr. Giaccobe explains. “I help them adjust and I adjust them.”

AT LONG LAST RELIEF

After nearly a year of lobbying, doctors eventually decided that Mr. Miller fit the criteria of treatment-resistant depression. In February, 2007, a metal crown bolted to his temples, he at last found himself on the operating table.

But he did not have his electric moment then and there. He awoke from the procedure, groggy, sore and “deeply depressed.” A technician arrived at his bedside to switch on the stimulator, and he felt ... nothing. “I was so upset. I went home devastated.”

He began to suspect that the treatment had failed, but Dr. Giaccobe gave him regular “pep talks” and, over several weeks, slowly increased the voltage. At month five, and nearly seven volts – about enough to power a smoke detector – the black fog finally lifted.

“I just woke up one morning and I felt good. I actually wanted to get out of bed. Ah, and I was hungry, I was so hungry – I couldn't wait to eat.” He popped out to a deli had a Reuben sandwich for breakfast.

“I called my friends. I called my mom. I was, I don't know, excited. I felt the joy of being alive.”

In the past year, Mr. Miller has rebuilt his life, visiting friends, playing sports and launching a business. But he has had his low points too. His father died of cancer last spring before he could see his son free of depression. Somehow the grief didn't knock Mr. Miller back into the darkness. But certain symptoms return – sudden flashes of anxiety, trouble sleeping.

Dr. Giaccobe says patients can have their moods improve, but still have a lazy libido or erratic appetite. Sometimes such symptoms seem like warning signs that the treatment is failing – which is what happened to Mr. Miller after he went through the metal detector at the courthouse.

It seemed a reasonable concern – doctors give DBS patients exemption letters to use at airport security – but at the emergency appointment, Dr. Giaccobe reminds him that it can be tricky to distinguish depression from a mere mood swing.

“It's hard when you've been sick for so long,” Mr. Miller says. “You have to remember that every bump in the road is not a return of the depression.”

“Okay, so let's take a look,” Dr. Giaccobe says.

Mr. Miller pulls up his sweatshirt, exposing his chest, and looks down to the slight bump of his battery pack. He says he had joked with his fitness trainer that he would have to work out the “pecs” on the opposite side a little harder “to make it even.”

Dr. Giaccobe aims a remote control at the power-pack buried in Mr. Miller's chest and flicks through settings like he's changing TV channels.

“You're at 6.75 volts,” he says. “I'm keeping it there.”

“Am I the highest patient you have?” Mr. Miller asks.

“No, there's another patient around seven.”

“You don't want to turn me up?” Mr. Miller asks, laughing.

“No,” Dr. Giaccobe says. “You're good.” Read more!

Texas high court rules that exorcism is protected by federal law - Associated Press

June 27, 2008

FORT WORTH, Texas - The Texas Supreme Court on Friday threw out a jury award over injuries a 17-year-old girl suffered in an exorcism conducted by members of her old church, ruling that the case unconstitutionally entangled the court in religious matters.

In a 6-3 decision, the justices found that a lower court erred when it said the Pleasant Glade Assembly of God's First Amendment rights regarding freedom of religion did not prevent the church from being held liable for mental distress triggered by a "hyper-spiritualistic environment."

Laura Schubert testified in 2002 that she was cut and bruised and later experienced hallucinations after the church members' actions in 1996, when she was 17.

She also said the incident led her to mutilate herself and attempt suicide. She eventually sought psychiatric help.

But the church's attorneys had told jurors that her psychological problems were caused by traumatic events she witnessed with her missionary parents in Africa.

The church contended she "freaked out" about following her father's life as a missionary and was acting out to gain attention.

The 2002 trial of the case never touched on the religious aspects, and a Tarrant County jury found the Colleyville church and its members liable for abusing and falsely imprisoning the girl.

The jury awarded her $300,000, though the 2nd Court of Appeals in Fort Worth later reduced the verdict.

Justice David Medina wrote that finding the church liable "would have an unconstitutional 'chilling effect' by compelling the church to abandon core principles of its religious beliefs."

Chief Justice Wallace Jefferson, in a dissenting opinion, stated that the "sweeping immunity" is inconsistent with U.S. Supreme Court precedent and extends far beyond the Constitution's protections for religious conduct.

"The First Amendment guards religious liberty; it does not sanction intentional abuse in religion's name," Jefferson wrote.

After the 2002 verdict, Pleasant Glade merged with another congregation in Colleyville, a Fort Worth suburb.

A message left for the church's attorney Friday evening was not immediately returned, and calls to two numbers listed in Schubert's name went unanswered. Read more!

Vegas jury finds mother guilty of killing daughter, slashing son - Associated Press

LAS VEGAS (AP) — )June 27) A Las Vegas mother faces life in prison after she was convicted of stabbing her 7-year-old daughter to death and slashing her 8-year-old son in February 2003.

Lawyers for 47-year-old Sherri Love pleaded insanity, telling a Clark County District Court jury that Love suffered from bipolar disorder and alcoholism.

But jurors deliberated less than an hour Thursday before convicting Love of killing Arabella Moreno and wounding Brian Moreno. The jury also found Love guilty of child abuse or neglect.

Clark County District Court Judge Stewart Bell is due to sentence Love on Aug. 14.

Prosecutors say Love wasn’t legally insane when she killed her daughter and attacked her son after an argument with her teenage son, who left the house before the attacks.

Love’s mother, Marjorie Bull, blames Las Vegas police for not doing more when they responded to the house after that argument.

Following the attack, Love spent several days unconscious at a hospital after what authorities characterized as an overdose of prescription medication. Read more!

Vegas jury finds mother guilty of killing daughter, slashing son - Associated Press

LAS VEGAS (AP) — )June 27) A Las Vegas mother faces life in prison after she was convicted of stabbing her 7-year-old daughter to death and slashing her 8-year-old son in February 2003.

Lawyers for 47-year-old Sherri Love pleaded insanity, telling a Clark County District Court jury that Love suffered from bipolar disorder and alcoholism.

But jurors deliberated less than an hour Thursday before convicting Love of killing Arabella Moreno and wounding Brian Moreno. The jury also found Love guilty of child abuse or neglect.

Clark County District Court Judge Stewart Bell is due to sentence Love on Aug. 14.

Prosecutors say Love wasn’t legally insane when she killed her daughter and attacked her son after an argument with her teenage son, who left the house before the attacks.

Love’s mother, Marjorie Bull, blames Las Vegas police for not doing more when they responded to the house after that argument.

Following the attack, Love spent several days unconscious at a hospital after what authorities characterized as an overdose of prescription medication. Read more!

Connections - KPLC-TV Lake Charles (LA)

Click on the post title to connect to what looks like numerous video reports, links and information on mental illness. Read more!

Count on report to help kids -South Bend (IN)

Opinion:

The latest Kids Count Data Book provides ample reason for concern for Hoosiers and Michiganders alike.

The report ranks Indiana 34th among the 50 states in child well-being based on 10 measures involving health, education and economics. That's a drop from the state's rank of 31st just last year. And the percentage of Indiana children living in poverty in 2006 rose a percentage point to 18 percent, or nearly one in five.

A closer look at Indiana's numbers in this state-by-state study on the status of America's children is even more troubling. The infant mortality rate puts the state at 39th and the child death rate at 38th.

In Michigan, which ranks 27th overall in child well-being, more than a third of children are living without a full-time working parent, a key measure of child poverty. The state ranks 37th in this category and earns the same ranking for its infant mortality rate.

Perhaps the biggest attention-grabber is the grim statistic that Indiana places youths ages 10 to 15 behind bars at a rate that's nearly 1 1/2 times the national average.

These figures highlight a concern that other groups and studies have expressed about Indiana's high rate of incarcerating young people. Simply incarcerating these kids does not serve them -- or society -- very well, and typically results in them learning to become better criminals. A report by the Annie E. Casey Foundation says that children in the juvenile justice system don't go as far in school, work and earn less, have less stable families, have more health problems and are more likely to be imprisoned again.

Rather than be overwhelmed by these and other statistics, however, the focus should be on using this report as it is intended: as a resource tool to help authorities and those who work with children to come up with ways to improve the status of the youngest and most vulnerable among us.

Bill Stanczykiewicz, president and CEO of the Indiana Youth Institute (part of the Kids Count network), says the "power" of this data is in "helping states compare against each other."

Because crime is handled on a local level, there's "not one solution for Indiana ... actually, there are 92 solutions for Indiana."

Several of the state's 92 counties have begun experimenting with alternative sentencing for nonviolent juvenile crimes, he says. In Clinton County, for example, Big Brothers, Big Sisters and religious congregations have partnered to mentor juveniles.

Alongside punishment and restitution, the pilot programs include such elements as mental health counseling and life and job skills.

Stanczykiewicz emphasizes that these initiatives are for non-violent offenses, such as fighting, petty theft and graffiti. "We are not talking about murderers, rapists ...."

Already the counties that have piloted these programs are seeing a reduction in repeat crimes, he says. Another payoff is that the programs don't put a greater strain on the budget; rather, they use existing money, spending it in different ways.

Given this limited but encouraging sign of success, Stanczykiewicz thinks there's every reason to believe that there will even more pilot programs throughout the state as judges "compare notes with each other."

But Stanczykiewicz says the responsibility for improving the status of children in this state doesn't end with state officials. "It takes local leadership, local law enforcement, community organizations ..."

And it takes an understanding by the public that programs that help troubled children instead of warehousing them isn't giving them a free ride. It's giving them a chance at a future. Read more!

Better juvenile treatment cited - Crescent City (CA) Daily Triplicate

June 27, 2008 - By Nicholas Grube

Juveniles in Del Norte County receive more drug and alcohol treatment than in previous years, according to a recent report from a county agency.

In its second annual public report, the Juvenile Justice and Delinquency Prevention Commission lauds local governments and agencies for their efforts in providing these services.

The findings are in stark contrast to the commission's 2007 analysis that found drug and alcohol treatment for youth severely lacking or non-existent.

"We ID'd a problem. There was not much drug or alcohol counseling available," Commission Chairperson Paul Dillard said. "This year's report is the recap of a year of phenomenal growth and awareness."

In the Juvenile Justice and Delinquency Prevention Commission's 2007 report, it noted a significant lack of drug and alcohol rehabilitation services for youth in Del Norte County. One of the only places kids could receive treatment was at Juvenile Hall, but once they were released on probation it became hard for them to find services.

"There wasn't anything outside of being confined," Dillard said.

Today, there are 24 Del Norte County youth who are in substance abuse counseling outside of Juvenile Hall.

Many of these youths are on probation, but according to Del Norte County Director of Health and Human Services Gary Blatnick, there are some juveniles who get counseling who are not.

"We have some group and individual services for youth who also have mental health-related problems along with alcohol and drug problems," Blatnick said. "We were able to find meager, but at least some, sources of funds to help those youth in the community."

These services are provided through a series of partnerships between the county and other outside agencies, Blatnick said.

"It's a limited resource but it's something," he said. "It's more than we had a year ago."

There's also some uncertainty regarding this year's state budget—an estimated $17.2 billion shortfall—and how it might affect these programs. Blatnick said it's unlikely the funds for these juvenile programs will be cut, but until Gov. Schwarzenegger signs it there will be uncertainty.

"I don't foresee any cuts to these particular programs ... but nothing is safe," Blatnick said. "If there's cuts in other areas, they may still have some impacts to these services."

The Juvenile Justice and Delinquency and Prevention Commission's report also differs from last year's in that it moves toward a mantra of prevention rather than treatment.

County Supervisor Martha McClure is on the commission and is also a teacher at the McCarthy Education Center, which serves youth who are court-ordered to attend.

"I see hands-on the kids who are struggling with drug and alcohol choices that are affecting them in a negative way," McClure said, noting that some are included in the 24 that currently receive substance abuse treatment. "I see some of those kids actually turn the corner and (they) are able to combat their drug and alcohol issues and win."

It's important to catch kids before they start to dabble in drugs and alcohol, she said, because it will save money.

"It's money well spent. Any time we can keep a child from going down the road of drugs and alcohol, in the long run it's going to cost us less as a community," McClure said. "It's an investment in our most precious resource."

To help in its goal of prevention, the Juvenile Justice and Delinquency Prevention Commission is in the process of finding grants to hire two interventionists who will work with the school district to turn at-risk kids away from drugs and alcohol.

"We don't have anything at the schools before they get to the courts, (or) to probation," Dillard said. "This interventionist is out there on the cutting edge trying to grab (the kids) before they get into trouble."

Dillard called this a "high priority" project, and the Commission already has someone working to find grants that would provide for two interventionists.

In the coming year, the Juvenile Justice and Delinquency Prevention Commission will look at foster care and investigate the systems that serve youth who have been subjected to neglect or abuse.

The Commission is designed like the county's Grand Jury. It oversees the Juvenile Court system and conducts yearly inspections of Juvenile Hall, the Bar-O Boys Ranch and the McCarthy Education Center.

In only its second year of providing public reports, Dillard said he hopes the positive trends that came out of this year's report will continue.

"If we can do this in a year, what can we do if we get all the stakeholders pulling together, and the community, and the residents?" he said. "I'm not sure if we were the catalyst or not. (But) somebody motivated people to do the right thing because it got done."

Reach Nicholas Grube at ngrube@triplicate.com. Read more!

City to vacate block of street for mental health complex - Muskegon (M) Chronicle

By Robert C. Burns - Friday, June 27, 2008
bburns@muskegonchronicle.com

MUSKEGON -- A one-block section of Emerald Street, north of Apple Avenue, will be vacated to establish a campus setting for Muskegon County's planned expansion of Community Mental Health Services.

Muskegon city commissioners on Tuesday voted to vacate that portion of the street between Apple and Allen avenues, at the request of county officials.

The county has embarked on a plan to centralize its CMH functions in a single location. A new building just west of the John Halmond Center at 376 Apple will combine the agency's mental-health outpatient clinic on Southern Avenue near Hackley Hospital; its Assertive Community Treatment Program and client clubhouse on Peck Street; and the CMH youth services center now on the county's south campus.
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Those programs serve an estimated 5,000 people a year.

The city's action follows a series of steps already taken by the county, starting with purchase of more than two acres of land between Emerald and Fork streets, for $240,000.

The county plans to issue bonds to cover the $6 million to $7 million the new building will cost, and an architectural firm has been retained to complete a building design and bid specifications.

Vacating Emerald Street will allow for a campuslike environment between the newly consolidated services and the Halmond center, which houses CMH administration and treatment programs for developmentally disabled individuals.

The street vacating had previously won unanimous approval from the Muskegon Planning Commission. The city's only condition is that it retain all easement rights.

A similar vacating of Larch Street by the city led to the expanded campus of Hackley Hospital, now known as Mercy Health Partners' Hackley campus since the merger of Mercy General and Hackley hospitals early this year.
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Psychiatrists agree Williams faking -Burlington (VT) Free Press

By Adam Silverman, Free Press Staff Writer • June 27, 200

Dueling psychiatrists, prosecutors and defense lawyers agreed Thursday that murder suspect Christopher Williams is faking psychosis — his own attorney described his actions as “a fairly transparent attempt” — but disagreed about whether underlying mental illnesses mean his trial should be postponed.

During a three-hour competency hearing, the government’s expert witness said Williams suffers from several diseases, including personality disorder and post-traumatic stress disorder brought on by an alleged shooting rampage through Essex, but nonetheless is mentally fit for a stressful, involved trial scheduled to begin July 7.

“When have you found him to be the most stable?” prosecutor Mary Morrissey asked the psychiatrist, Dr. Robert Linder, who has interviewed Williams, 29, of Essex six times since the August 2006 shooting spree, most recently last week.

“Now,” Linder replied without hesitation.

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Under questioning from the defense, Linder said the trial could exacerbate Williams’ legitimate mental problems, and the suspect might require special accommodations to ensure he can understand court hearings — a key element of competency. Later, defense psychiatrist Dr. Jonathan Weker said despite the fakery, Williams appeared to be experiencing mental and intellectual disorders that would make a trial difficult.

“Malingering is not the purview exclusively of people who don’t have mental conditions or do have mental capacities,” Weker said.

The expert said he lacked enough information to pronounce Williams incompetent for trial, but he wouldn’t rule that conclusion out, either.

“He was malingering some things, but at the same time I felt that there was enough of an indication of a possibility of a clinical condition or conditions that might detract from his ability to meet the competency standard,” said Weker, who the defense hired two weeks ago and who evaluated Williams for four hours June 13.

Competency means suspects are able to understand proceedings and assist in their defense. Williams, who Linder pronounced competent in fall 2006, January 2008 and today, raised fresh doubts about his mental status this month by sending letters to Judge Geoffrey Crawford in which he claimed to be experiencing tormenting visions and fantasies of bestiality.

Defense attorneys say Williams also has long-term problems, such as cognitive disabilities and a low IQ, and has wrestled previously with having visions and hearing voices. Prosecutors claim Williams wants to delay his trial and is manipulating the legal system by feigning instability.

Authorities say Williams reacted to the ending of a romantic relationship by killing two people and wounding two others at an apartment building, town house and elementary school where teachers were preparing for the start of classes. He has been jailed without bail since his arrest the day of the shootings and has pleaded not guilty by reason of insanity to two counts each of first-degree murder and attempted first-degree murder. Each charge carries a possible prison sentence of 35 years to life.

The shootings killed Linda Lambesis, 57, of Essex, the mother of Williams’ ex-girlfriend Andrea Lambesis, at her town house; and Alicia Shanks, 56, of Essex in her second-grade classroom at Essex Elementary School two miles away, where the younger Lambesis worked.

Corrections Department mental-health professionals have believed Williams was pretending to be mad since an evaluation less than a month after the rampage in which the suspect reported symptoms from myriad disorders that typically do not overlap, according to records the prosecution disclosed during Thursday’s hearing in Vermont District Court in Burlington.

“If this defendant spent as much time working on the case rather than faking mental illness, he might actually be able to work with his attorneys to present a better defense,” Morrissey said while questioning Weker.

Crawford said he would issue a ruling by early next week about whether Williams is competent and whether the trial should proceed.

Contact Adam Silverman at 660-1854 or asilverm@bfp.burlingtonfreepress.com
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Judge weighs death for man who killed partygoers - Miami Herald

Fri, Jun. 27, 2008 - BY LAURA ISENSEE
lisensee@MiamiHerald.com

When Kevin Evers shot and killed three revelers at a Miami Beach birthday party in 2003, people here and abroad were shocked: Two young fathers from Argentina and a Brazilian woman died because Evers thought the music was too loud, sending him into a rage.

Now five years later, Evers awaits his fate: Life in prison or the death penalty.

The penalty phase of his case ended with closing arguments Thursday. Judge Stanford Blake will weigh Evers' actions that night and his criminal history against his mental health and childhood.

Evers pleaded guilty to three murders and two counts of attempted murder. His attorneys tried without success to persuade prosecutors to accept a plea deal for five consecutive life sentences, one for each victim and survivor.

PASSED ON JURY TRIAL

Evers gave up his right to a jury trial and instead asked Blake alone to hear the sentencing phase. In most death-penalty cases, a jury decides guilt, then has another hearing to recommend a sentence. The judge then issues the final sentence.

Prosecutor Reid Rubin on Thursday argued that two factors aggravated Evers' crime, justifying the death penalty: his previous violent criminal history, and the fact that his actions that night put many people at great risk.

Evers was charged with kidnapping with a weapon in Nevada in the 1990s, and served a three-year sentence after pleading guilty to lesser charges.

''We're not talking about rehabilitation here -- we're talking about punishment,'' Rubin said.

Rubin stressed that as many as 20 people could have been killed at the 2003 party, when Evers confronted the revelers with a loaded gun. He was carrying extra ammunition. ''He opened fire on them like they were animals,'' Rubin said.

Defense attorney Steven Yermish argued that other factors mitigated Evers' crime, warranting a life sentence: a bipolar disorder, psychotic episodes, neurological brain damage that impairs his ability to restrain his impulses, and a childhood scarred by abuse and neglect by alcoholic parents.

Yermish said Evers knows he will die in prison. ''The only question is when and by whose hand: the state of Florida or God,'' he said.

ILLNESS AND STRESS

Yermish recounted defense testimony by three medical experts that Evers suffers from mental illness, which influenced him the night he opened fire on the revelers.

''He was in need of hospitalization to prevent harm to others,'' Yermish said.

The defense argued that traumatic events in Evers' life triggered a downward spiral: the death of his wife in childbirth and giving up their daughter for adoption a few months before the shooting.

During the final arguments, Evers sat quietly, flanked by his team of defense attorneys. After the court appearance, he changed from a collared shirt and thick gray sweater into a bright orange prison uniform.

Blake is expected to sentence Evers later this summer.

Since taking the bench in 1995, Blake has given the death sentence once: He followed a jury's recommendation in 2003 and sentenced Michael Seibert to death for murdering an 18-year-old high school student and then butchering her body.

Read more!

VA launches expansion in veterans health facilities - Assicuated Press

WASHINGTON, D.C. - June 27 -Secretary of Veterans Affairs Dr. James B. Peake has announced plans to create 44 new community-based outpatient clinics to bring the world-class health care of the Department of Veterans Affairs closer to home for veterans in 21 states, according to a news release.

There are five planned for Louisiana -- Lake Charles, Leesville, Natchitoches, St. Mary Parish and Washington Parish.

"VA continues to make access to care easier through an expanding outpatient system focused not only on primary treatment but also prevention of disease, early detection, and health promotion," Peake said.

The new clinics, scheduled to be activated over the next 15 months, will increase VA's network of independent and community-based clinics to 782, an increase of more than 100 in five years.

In addition to on-site primary care staff, clinics offer telehealth systems permitting veterans to maintain regular contact with doctors in specialties from cardiac care to mental health at regional VA hospitals linked for video consultations, coupled with telemetry of health data or images.
VA's planned sites for new outpatient clinics

Alabama (2) -- Marshall County, Wiregrass

Alaska -- Matanuska-Susitna Borough area

Arkansas (2) -- Ozark, White County

California -- East Bay-Alameda County area

Florida -- Summerfield

Georgia (4) -- Baldwin County, Coweta County, Glynn County, Liberty County

Indiana (2) -- Miami County, Morgan County

Iowa -- Wapello County

Louisiana (5) -- Lake Charles, Leesville, Natchitoches, St. Mary Parish, Washington Parish

Maine -- Lewiston-Auburn area

Minnesota (2) -- Douglas County, Northwest Metro

Missouri -- Franklin County

New Mexico -- Rio Rancho

North Carolina (2) -- Robeson County, Rutherford County

North Dakota -- Grand Forks County

Ohio -- Gallia County

Oklahoma (4) -- Altus, Craig County, Enid, Jay

Tennessee (3) -- Giles County, Maury County, McMinn County

Texas (5) -- Katy, Lake Jackson, Richmond, Tomball, El Paso County

Virginia (3) -- Augusta County, Emporia, Wytheville

West Virginia -- Greenbrier County
Read more!