 What is clozapine’s role in treatment of schizophrenia?Although the antipsychotic drug clozapine was released in the early 1970s for the treatment of schizophrenia, there is still debate on when the drug should be used.
Clozapine remains the treatment of choice for schizophrenia when other drugs have only an incomplete response; however, in Canada, clozapine can only be prescribed when two other drugs have failed. In part, this is because of a low risk of adverse effects on white blood cell production that requires mandatory blood testing in patients receiving the drug.
CAMH’s Gary Remington and colleagues recently reviewed the research literature on clozapine, with the aim of advising clinicians whether the drug should be the first-, second- or third-line treatment of first-episode schizophrenia. Since early and effective treatment in schizophrenia is known to improve outcomes, the group felt that early use of clozapine – proven more effective when other drugs fail – might enhance and maintain response sooner, improving the illness’s outcome.
In the results, published in the American Journal of Psychiatry, Dr. Remington concluded that there are still “simply not enough data” in the clinical literature to answer this important question. The authors strongly argue for new clinical drug trials to provide the answer, as “many individuals with schizophrenia continue to do poorly.”
The review findings will probably disappoint most readers who might well assume that evidence-based clinical guidelines would already have been established for a 40-year old antipsychotic drug. The publication also illustrates the continuing need for rigorous clinical trial studies to determine whether clinical impressions of drug effectiveness are based on sound evidence.
 SAPACCY Reaches out to LGBTQ YouthCAMH therapist Leo Edwards knows the work he’s doing in the Substance Abuse Program for African Canadian and Caribbean Youth (SAPACCY) is important. Treating African Canadian and Caribbean youth who have substance use and mental health challenges is significant and now they have also taken on the task of treating black youth who identify as LGBTQ.
“We saw that LGBTQ youth were falling through the cracks,” Leo says. “We felt there was an opportunity for SAPACCY to focus on this group and provide them with care and support.”
The first program of its kind in Canada, SAPACCY provides clinical care for clients who have substance abuse and mental health challenges as well as issues around identity and sexual orientation. Clients can refer themselves or be referred by family members, schools or other LGBTQ organizations like the 519 Church Street Community Centre or the Black Coalition for AIDS Prevention.
At times work with LGBTQ black youth precedes traditional addiction and mental health treatment. Including elements of the Nugzo Saba, seven principles of African heritage that include unity, self determination and faith to create a sense of community, makes the SAPACCY program unique. Using these principles in collaboration with mainstream theoretical framework such as cognitive behavioural therapy and motivational interviewing give clients a well rounded experience.
“As black people we are a community. Our experiences are community based. Because we are wrapped in the same skin, though our individual experiences may be different, we share a common community based on our racial identity,” Leo says that this makes clients feel comfortable. “When the youth come in, you can see a sense of relief, a sense of familiarity. This person might get my story.”
In addition to therapy, community engagements and advocacy for clients, the program works with youth to create a treatment plan, set goals, help to integrate them back in to a school system and improve family dynamics. It works to provide a safe place for youth to express themselves and feel empowered in a society that they constantly feel rejected in.
For youth in this community, stigma is a serious problem
“There’s a lot of stigma in our community around being LGBTQ,” Leo explained, “LGBTQ black youth that misuse substances or have mental health issues have a multi-layered and intersecting experience of oppression of not just being black but being a minority based on their sexual orientation.” The work to change attitudes begins in the black community at large, “There needs to be a shift in our own communities. In the dominant black community there’s still a lot of stigma and homophobia within. Once those attitudes start to shift, it will open up doors for our youth that are LGBTQ to get the help they need."
Parents of youth in this program are also offered support. “Many times parents of LGBTQ clients have issues accepting that their child is LGBTQ. On top of an addiction or substance misuse there’s a lot of stigma for parents.” Parents are invited to participate in therapy sessions where their feelings can be addressed and can begin to do the work to accept their child for who they are and work with the child to make the right choices in their life. Working with family members has proven to be successful.
Upcoming SAPACCY ProgramsGoing forward, SAPACCY hopes to create workshops for black LGBTQ youth in areas like relationships, career assistance and school. From May 15 until July 17 between 4:30 p.m. and 6 p.m. SAPACCY is running a support group to understand substance abuse triggers at 80 Workman Way. They are also running a family support group in June.
 Mental illness and the law: a revealing look at the NCR processThis past weekend I found myself in a sold-out theatre taking in John Kastner’s film NCR: Not Criminally Responsible at the Hot Docs Film fest. The documentary tells the story of a man, Sean Clifton, who is found NCR after stabbing a woman in a mall parking lot. The timing of its release is perfect. We couldn’t be at a more critical time in history given the federal government’s proposed changes to the NCR defense.
The film was an unprecedented look into the lives of the patient, the victim and the staff of the Brockville Mental Health Centre where Sean Clifton was treated. In my view, the development of the film came with great risk. During a time of sensationalized stories and emotional debate, revealing such intimate details and personal stories can serve to further drive a wedge between opposite sides of the issue.
As we strive to eliminate the criminalization of mental illness, are we courting more controversy by showing the dimensions of these complex illnesses and revealing the vulnerabilities of the patients, victims and the mental health care system?
I don’t think so.
I was personally overwhelmed with the extraordinary courage shown by the patient, the victim and her family, and the health care professionals. The human face that Kastner portrays is compelling, and as someone who advocates on behalf of the mentally ill, it is exactly what is missing in our day-to-day efforts to break down prejudice and discrimination and advocate for better treatment and supports in the mental health care system.
<iframe src="http://www.nfb.ca/film/ncr_not_criminally_responsible/trailer/ncr_not_criminally_responsible_trailer/embed/player" width="516" height="320" ></iframe>
As any good documentary does, it left me with lots of questions to ponder. During one of my favourite moments, a local resident strikes up a “normal” conversation with Clifton in a coffee shop where he reveals to her that he struggles with mental illness and there is a film being made about him. She asks him for his autograph and wishes him well. It made me wonder if the small size of the community of Brockville and the visibility of the mental health centre helps to close the gap in the understanding of these illnesses. Is the visibility and proximity to serious mental illness the antidote to discrimination and stigma? If that is true, how can we close the gap in understanding within large and diverse communities right across the country?
There was one important issue that Kastner glosses over – the fact that Clifton tried to get help right before committing the offense and was turned away from the health care system. While it’s difficult to know what happened in this situation without the details, it certainly hints at the great challenges we have to overcome in providing timely care and supports right across the health care system.
For a sector that needs more personal stories, this film lends a powerful narrative at a critical point in time. In the discussion after the film, Kastner encouraged people to write to their political representatives about the NCR legislation. With Clifton himself sitting in the audience, isn’t that a great way to honour his road to recovery and his courage to tell his story?
 Taking a human rights look at mental healthLast fall, the Ontario Human Rights Commission released Minds that Matter, a report on our consultation on human rights, mental health and addictions. This was the biggest consultation in our history; we heard from more than 1,500 people across Ontario, who told us their stories of discrimination, harassment and inequality.
We heard how stereotypes and negative societal attitudes are found in legislation, institutional policies and practices. And we heard how these attitudes cause widespread discrimination in housing, employment and services.
We learned that many people don’t know they have the right to be free from discrimination because of mental illness, and, if they do, they’re not sure what to do when their rights are violated. In workplaces, many employers don’t know they have a legal duty to accommodate workers with mental illness or addictions.
People told us about the lack of children’s mental health services, about problems getting help in the years between childhood and adulthood, and problems in schools, colleges and universities.
So what can we do? Our report has 54 recommendations for government, employers, housing providers, service providers and other organizations. For example, municipalities need to look at their zoning and licensing bylaws to make sure they treat housing for people with mental health issues or addictions the same as other housing, and work to get rid of NIMBYism.
Many people talked about not getting jobs or volunteer positions because police record checks included health issues. That’s why we recommend that the Ontario Association of Chiefs of Police (OACP) actively promote their new police record check guidelines across police services, vulnerable sector agencies and other employers including the Government of Ontario.
OHRC's commitment to eliminate discrimination:
We also made 26 commitments for ourselves. Our forthcoming Mental Health policy will provide concrete steps for people and organizations to eliminate the barriers and discrimination that are so common today. We need more education on human rights for employers, employees and unions. We will provide it and focus on human rights, mental health and addictions. We’ll take legal steps when people are being discriminated against because of mental illness, in workplaces, schools and healthcare.
Getting rid of barriers faced by people with mental health issues or addictions is a big job – changing attitudes and behaviour that have existed for a long, long time. Many people are working on it. The consumer/survivor movement and people with addictions advocate for equality. They too are drivers for change – and must be active partners in making real systemic change.
The OHRC brings a human rights perspective to how to bring down the walls. We all have responsibility for making things better for tomorrow. Minds that Matter sets the stage for us to do that … one step at a time.
You can follow the OHRC on:
Facebook
Twitter: @OntHumanRights
 The time for youth leaders is now“I have the right to Mini-Wheats instead of Shreddies for breakfast”, that was my first complaint to Ontario’s Office of the Provincial Advocate for Children & Advocate a decade ago. A lot has changed since I was a teenager but what hasn’t changed is my passion for the rights of children and youth with mental illness or advocating as a former Crown Ward.
To give you some background, I was born to a single mother with mental illness, witnessed the toll my grandmother’s Alzheimer’s diagnosis took on our family, and when I was 13 I was diagnosed as having clinical depression and severe anxiety. I became a Crown Ward of Children’s Aid at the age of 9 and lived in 16 different group homes and foster homes until being discharged when I was 18.
Throughout my time as a client of the mental health system my style of advocacy has been described as outspoken, progressive, and a small minority has even called me aggressive. The fact of the matter is that I am fed up with the lack of youth leadership when it comes to mental health advocacy.
Youth are the ultimate stakeholders when it comes to the care they receive and could be life changing. I’ve been involved in a lot of initiatives when it comes to giving feedback on implementing much needed changes to the youth mental health system. Few organizations have taken the steps to creating change, except one.
Last September I was offered the chance to sit on CAMH’s Service User Expert Panel which will collectively be making recommendations on how to improve the youth mental health and addiction’s system in Ontario. I made it clear that a panel about youth needed to have one leading the panel. After all, young people have life experiences that are just as valuable as professional experience.
I am proud to have been appointed the co-Chairman of this Panel. CAMH has always been a leader when it comes to mental health and addictions. This is just the beginning and I encourage all mental health executives to take the chance on youth leadership. CAMH has, and you too could be pleasantly surprised!
 Explore Mental Health with CAMH and TVOTo mark Mental Health Week, CAMH and TVO have partnered for the second Mental Health Matters series. From May 3 to 12, tune in to TVO’s The Agenda for a week of programming dedicated to mental health issues and featuring CAMH clients and experts. The Agenda airs weeknights at 8pm.
Join the discussion on social media:
You can also participate in the discussion on social media by using the Twitter hashtag #MHmatters and through the CAMH and The Agenda’s Facebook pages.
Friday, May 3: Innovations in Mental Health
A look at some of the innovations driving the future of mental health. Viewers and attendees will get the chance to learn about some of the cutting-edge research being conducted at CAMH and to see its practical and clinical applications with patients and clients.
CAMH innovators include:
- Dr. George Foussias, co-inventor of a virtual reality tool used by CAMH scientists to gage motivational factors in clients with schizophrenia to help patients live better in the community.
- Dr. Jim Kennedy positioning CAMH as a leader in delivering personalized medicine for people with mental illness.
- Dr. Jeff Daskalakis, whose work in experimental brain stimulation therapies is poised to bring non-invasive, non-pharmaceutical treatments for severe depression and bipolar disorder to the mainstream.
- Dr. Sean Kidd and Narinder Dhami, whose efforts in micro financing are helping put meaningful employment – and its related psychosocial benefits – within reach of entrepreneurs with mental health and addictions challenges.
Monday May 6: The Risk of Immigration
Is immigration good for your mental health? How do immigrants cope with the emotional pressures of leaving home? How resilient does one have to be to be able to create a new life for oneself in a foreign country? How does a country like Canada, which depends on the ongoing inflow of immigrants, deal with immigration-induced mental illness?
CAMH expert:
Dr. Kwame McKenzie, Senior Scientist with the Health Services and Health Equity Research.
Tuesday May 7: Resilience in Children
Why do some children seem to constantly worry while others seem to breeze through life? Do those traits follow people into adulthood? We will look at why some individuals are more resilient than others and look at the importance of developing resiliency in the efforts to attain good mental health.
CAMH expert:
David Wolfe, RBC Chair in Children’s Mental Health and CAMH Centre for Prevention Science in London, Ontario .
Wednesday May 8: Aboriginal Mental Health
Last month, the Neskantaga First Nation in northern Ontario declared a state of emergency following two suicides in one week, the fourth suicide in a year, not counting 20 other attempts. Neskantaga, and some of the other remote First Nations in Nishnawbe Aski Nation face a much higher suicide rate than the rest of Canada. Yet, other First Nations saw a decline in the number of suicides and some, no suicides at all. Why are some communities overwhelmed with suicides and others suicide-free? How can communities in crisis cope and prevent further suicides? Can traditional mental health approaches treat the hopeless and despair in these First Nations communities?
CAMH expert:
Dr. Cornelia Wieman, psychiatrist, Indigenous Health Research.
Thursday May 9: When Anxiety Attacks
Anxiety disorders may be as pervasive a condition as depression and yet, still not publically discussed as widely as depression has been in the past few years. We’ll examine the research around anxiety disorders, the best treatments for it and talk to people who have learned to live with and manage it.
CAMH experts:
Dr. Judith Laposa, psychologist, Anxiety Disorders Clinic.
Dr. Zindel Segal, head of the Cognitive Behaviour Therapy Clinic.
Friday May 10: More Anxious Than Ever?
Are we collectively more stressed and anxious than ever before? Is it because of the rapid pace of technological change, economic pessimism, stories of ecological doom, or just a feeling of being individually disconnected? Join us as we analyze our collective angst and discuss what our cities and communities need to help people cope.
 Children’s Mental Health Week 2013: Our Kids Deserve MoreMay 5-11 is Children’s Mental Health Week in Ontario. Dr. Peter Szatmari, Chief of the Child and Youth Mental Health Collaborative, describes how we are moving forward to improve mental health care for young people.
It’s hard to read the newspapers these days and not be struck by the way in which mental health challenges faced by children and youth pervade all aspects of modern life. The names of Ashley Smith, Amanda Todd and Rehtaeh Parsons provide obvious examples of events with incredibly tragic outcomes. The suffering of these young people and the way in which the mental health system failed them is painful to read. But there are other stories in the papers in which mental health challenges are an important undercurrent. Stories about traffic accidents caused by “reckless” youth, reports about the epidemic of obesity in young people “addicted to the internet” or the rates of unemployment in those who leave high school early, all force us to realize that the only way to tackle these issues is to address the mental health challenges of children and adolescents in the21st century in Canada.
We often hear that 1 in 5 children and youth suffer from a mental health challenge. This is true but it is based on data which are more than 30 years old. We have no idea whether these rates have gone up or down with the increasing fragmentation of families, the recession, and the challenges that families face to find good housing and a safe environment. Only a small minority of children and youth with mental disorders are able to access services for mental health (20%) but again this is based on old data. It is possible that this figure is even lower today, as the mental health system for children and youth becomes even more overloaded, fractured, and characterized by intolerable wait lists.
It is ironic that along with these challenges in the system, the evidence base in child and adolescent mental health has exploded in recent years. We now have a range of effective treatments for disorders that were considered “intractable” a few years ago. Our knowledge of the social determinants of mental health and the developmental neuroscience of mental illness in children and youth has grown at a pace comparable to any other field in health over the last few years. The contrast between what we know and what we need to do is a chasm that is hard to view without increasing frustration.
The role of the Child and Youth Mental Health Collaborative supported by CAMH, SickKids and the University of Toronto, of which I am Chief, is to address this chasm in partnership with the community. This is a problem that we as a community need to address. The role of the Collaborative is to be a model of an efficient, evidence based service, to provide mental health expertise that cannot be accessed elsewhere in the city, and to be a knowledge translation broker bringing a critical, but constructive, view of the empirical evidence so that the newspapers are no longer filled with the stories of the failure of our system. Our children and youth and their parents deserve more than opinions, they deserve a new determination among all of us to make our communities a safe and nurturing, and “kid friendly” place to grow up.
 Spring HopeBy: Dr. Catherine Zahn, CAMH President and CEO Tuesday April 16, 2013
Yesterday, CAMH and MaRS Discovery District partnered with TVO for our second of three “Innovations in Mental Health” events. We’re proud to bring you catalytic conversations about the health issue of our century – mental health.
When thinking about innovation, our minds usually go straight to technology – to machines and computers. But innovation also lives in ideas and approaches. When it comes to the complexities of mental illness, there’s been a dramatic innovation in the last decade – and it’s not all about equipment.
The “what” of the new thinking is that mental illness resides in the processes we develop to adapt to our environment. It includes an acknowledgement of the way society identifies, labels and deals with our reactions to a life situation. It’s the interface between the brain and its environment.
The past decade has yielded major advances in our understanding of brain structure and function. Of course, there’s a long tradition of inquiry into the impact of environment and social factors – of life experiences and human interaction – on mental health. Now, we appreciate that the approaches are not mutually exclusive!
What’s really exciting is the “how.” In the past, we talked about a particular region of the brain or brain chemicals. Now, we talk about the way the brain develops, forms and actually changes in response to an environmental challenge.
We used to talk about genetic traits or the order of base pairs in our DNA. Now, we talk about phenotype (the way we present to the world) and epigenetics (the way genes become active or inactive – the way stem cells are stimulated to differentiate and brain circuits motivated to reorganize).
New approaches will produce targets for intervention in mental illness from health promotion and prevention to rehabilitation and recovery. Those approaches will be based on a solid understanding of the causes of mental illness. We showcased a few of these at our CAMH-MaRS Innovation event yesterday: virtual reality, personalized medicine, magnetic brain stimulation, social enterprise and patient entrepreneurship – exciting, inspiring, hopeful.
Hope is essential in creating a movement. In the spring of 2013, there’s every reason to be hopeful.  Mental Health Matters to Canadians Last year, CAMH collaborated with TVO to create Mental Health Matters – an award-winning series devoted to the in-depth exploration of mental health in our society right across the network, including children’s and documentary programming. We are proud to share the news that CAMH is again working closely with TVO and The Agenda with Steve Paikin on the second Mental Health Matters series to be broadcast every evening at 8pm and again at 11 pm during Canada’s National Mental Health Week (May 6 – 12, 2013).
Throughout the week, CAMH clients and experts will discuss the impact of mental health issues including anxiety disorders, suicide among Aboriginal youth, building resilience in young people, and the emotional pressures of immigration to Canada. Addiction and mental health issues will also be explored through exclusive online content to be featured on the Mental Health Matters website beginning April 22.
TVO’s live webcast on April 15 of the CAMH/MaRS/TVO event “Innovations in Mental Health: Igniting Discovery, Delivering on Hope” featuring some of the most innovative developments in mental health care kicks off Mental Health Matters 2013.
Join the discussion on social media:
You can also participate in the discussion on social media by using the Twitter hashtag #MHmatters and through the CAMH and The Agenda’s Facebook pages.
 Igniting Discovery at MaRSMaRS, CAMH, and TVO's The Agenda with Steve Paikin are pleased to present Innovations in Mental Health: Igniting Discovery, delivering on hope on April 15 at 6pm. From personalized medicine to social enterprise, an expert panel will present some of the most innovative developments in care, and their exciting implications for our world today and tomorrow.
Dr. Catherine Zahn, President and CEO of CAMH, and Dr. Ilse Treurnicht, CEO, MaRS Discovery District, will be joined by panelists:
- Dr. George Foussias, co-inventor of the virtual reality tool used by CAMH scientists to help patients live better in the community.
- Dr. Jim Kennedy, who leads Canada’s most promising foray into delivering personalized medicine for people with mental illness.
- Dr. Jeff Daskalakis, whose work in experimental brain stimulation therapies is poised to bring non-invasive, non-pharmaceutical treatments for severe depression and bipolar disorder to the mainstream.
- Dr. Sean Kidd and Narinder Dhami, whose efforts are helping put meaningful employment – and its related psychosocial benefits – within reach of entrepreneurs with mental health and addictions challenges.
Update:
All
available seating for this MaRS/CAMH/TVO event has now been SOLD OUT.
Online access to the live event will be available on TVOs Mental Health Matters website starting at 6:00 pm on April 15, along with a live web chat, and on Twitter #marscamh.
 Can web-based therapy help college students who are perfectionists?
When I attended college it was a rare student who worried whether a “B” grade on a test indicated “failure.”
Today, many university st udents now set such impossibly high standards and overly critical self-evaluations that they suffer from stress, anxiety, other psychiatric illnesses, and lack of success, because of this often disabling “maladaptive” perfectionism.
CAMH scientists Natasha Radhu, Jeff Daskalakis, and York University professor Dr. Paul Ritvo screened nearly 1,000 students at an urban Canadian university finding that, surprisingly, about 25 per cent qualified as perfectionists.
Then they measured maladaptive perfectionism among students who had received an internet web-based cognitive-behavioural therapy (CBT) lasting 12 weeks. They were compared to a control group who were on a “wait-list” (see the American Journal of College Health for more details). At the end of the therapy, the CBT group showed decreases in anxiety and negative thoughts versus the control group.
This study suggests that a web-based CBT intervention might help some students who are overly perfectionist—especially those who find it difficult to interact in person with a health professional. The study does need to be replicated in a larger number of participants, but web-based interventions have the advantage of being low cost and easily accessible.
It seems to me, however, that although such behavioural therapy may well be helpful, there should be just as much emphasis on trying to change the external factors responsible for the belief that anything "less than perfect is unacceptable." These include parents and college teachers having unreasonable expectations, peer pressure and competition, and the economic recession with limited employment.
 CAMH marks 15 years!
What started as a merger 15 years ago has become a movement in mental health and addictions health care.
When the Queen Street Mental Health Centre, the Clarke Institute of Psychiatry, the Donwood Institute, and the Addiction Research Foundation joined forces on March 9, 1998, it was a pioneering move to integrate mental illness and addiction, and clinical care with research, education and policy development. Since then, CAMH has experienced remarkable growth and earned a global reputation for transforming lives.
In some ways, CAMH is very much like any other 15-year-old — young, passionate, full of potential, and on the brink of fully becoming our best self. CAMH’s first 15 years set the pace for the next several years of transformation mapped out in our Vision 20:20 Strategic Plan. Research discoveries, new therapies and new buildings to help our clients recover have created a momentum which promises that the best is yet to come.
Here are some key highlights of the last 15 years that helped put CAMH on the map:
1998
Dr. Paul Garfinkel becomes the first President and CEO of the newly merged organization that becomes CAMH.
1999
CAMH helps launch Canada’s first Drug Treatment Court in collaboration with the federal Department of Justice, the Toronto Police Service, Toronto Public Health and various community agencies.
2000
CAMH is named a Centre of Excellence in Addictions and Mental Health by the World Health Organization.
2001
CAMH develops an award-winning master plan for the redevelopment of its antiquated and stigmatized Queen Street site into a multi-use “urban village,” an integrated health care centre unlike any other in the world.
2002
CAMH introduces revolutionary medication doses for depression and schizophrenia as a result of positron emission tomography (PET) technology.
2003
CAMH introduces Mindfulness-Based Cognitive Therapy, combining the practice and clinical application of mindfulness meditation with the tools of cognitive therapy, as a new therapy at CAMH.
<iframe width="560" height="315" src="http://www.youtube.com/embed/t4glFhlLEkU" frameborder="0" allowfullscreen></iframe>
2004
CAMH scientists discover more than 70 novel human receptor genes, many of which help mediate unique functions in the brain and are targets for drug design.
CAMH passes the Bill of Client Rights. It was adopted to promote the worth and dignity of all clients and is intended to enhance the care provided to our clients.
2005
CAMH launches the “Transforming Lives” public awareness campaign.
CAMH opens the Transcranial Magnetic Stimulation Clinic, offering a pioneering treatment that stimulates a region of the brain with a magnetic pulse to treat symptoms of schizophrenia and depression.
2006
CAMH PET studies reveal that most antidepressants miss the key target—serotonin receptors—for treating clinical depression. The discovery establishes a standard that anti-depressants being developed for the market be 80 per cent effective in hitting this target.
2007
CAMH opens the Women’s Medium Secure Forensic Unit, the only gender-specific unit of its kind in Ontario specially designed and staffed to treat women with serious mental illness who require specialized care and rehabilitation.
2008
CAMH researchers discover the first concrete genetic linkage to schizophrenia via a subtype of the disease called Deletion Syndrome.
Four new buildings on a new street called White Squirrel Way open their doors on April 7, completing Phase 1A of CAMH’s bold Queen Street Redevelopment Project.
2009
CAMH welcomes its new President and CEO, Dr. Catherine Zahn, on December 1.
Peer support workers bring their own lived experiences to round out the care team of the Schizophrenia Program, enhancing recovery, promoting client-centred practice and a holistic view of health.
2010
CAMH scientists discover higher levels of the brain protein called monoamine oxidase A (MAO-A) in women after childbirth may be a possible explanation why post-partum blues and clinical depression occur, and begin developing supplements to target this loss of nutrients, and lower the risk of post-partum depression.
2011
Using brain imaging and genetics, CAMH scientists identify a variation of a gene that may play a role in late-onset Alzheimer's disease. CAMH’s Research Imaging Centre opens its doors--the only imaging centre in Canada dedicated to the study of mental illness and addiction.
2012
CAMH transforms our Queen Street site into a new kind of hospital for the 21st century with the opening of the three new buildings of Phase 1B of the Queen Street Redevelopment Project, along with new through streets linking CAMH with the surrounding neighbourhood. The first non-CAMH building, affordable housing for the community, opens its doors as well.
The Campbell Family Mental Health Research Institute opens at CAMH with a focus on brain science. It was made possible by the Campbell family’s historic $30 million gift to accelerate research, Canada’s largest ever donation to mental health.   CAMH opens the new Temerty Centre for Therapeutic Brain Intervention (above) Canada’s first clinic to investigate using Magnetic Seizure Therapy (MST) and other promising new treatments for persistent and severe mental illness.
2013
Personalized medicine has arrived in the community. Mental health patients at a local medical clinic are offered genetic testing to predict how they will respond to psychiatric medication treatment. The tests, which will prevent trial-and-error prescribing and reduce associated health-care costs, will be analyzed in the Tanenbaum Centre for Pharmacogenetics at the Campbell Family Mental Health Research Institute.
Where do you see CAMH in the next 15 years? Leave us a comment to let us know!  Genes, the environment and brain development in mental illness On March 5, CAMH and Jarvis Collegiate Institute will present a Café Scientifique that focuses on teen and youth mental health. Hosted and moderated by CTV’s Pauline Chan, this talk will feature three CAMH scientists as well as a performance by spoken word artist Mustafa Ahmed.
As one of the presenting experts, Dr. Robert Levitan will explore how the interaction of genes and the environment affects both normal and abnormal brain development and behaviours:
<iframe width="560" height="315" src="http://www.youtube.com/embed/k1B26EZXGvo" frameborder="0" allowfullscreen></iframe>
Fellow CAMH experts include:
- Dr. Joanna Henderson – Scientist with CAMH’s Child, Youth & Family Program and principal investigator on a CIHR Emerging Team grant to develop approaches to understanding child and adolescent mental health and substance use concerns.
- Dr. David Wolfe – Director of CAMH’s Centre for Prevention Science and author, specializes in issues affecting children and youth, including abnormal child and adolescent psychology, with a special focus on child abuse, domestic violence, and developmental psychopathology.
Join the discussion!
Registration for this event is open but space is limited. You can also follow the discussion on Twitter using the hashtag #camhcafe
 Why we need to keep the conversation goingMental health is a hard topic for many to discuss out in the open. Having a day to speak about mental health openly is an amazing thing. When I was growing up, mental health was only talked about after a prominent suicide or horrible event (like a school shooting), and usually not in a positive light. This approach has made too many people, including myself, fight their illnesses in silence; in fear of being associated with countless negative images. Bell Let’s Talk is on its way to changing that conversation, by talking about stigma, about hope and about how most of us will one day recover.
What stigma feels like
When I was first trying to understand my struggle with mental illness, the images that came to mind weren’t positive ones. They were usually characters in movies or TV episodes that showed "crazy people" as serial killers, stalkers, overdramatic "emo kids" or old ladies that throw cats at people. When starting this journey, most people don't have any other image of people with mental health issues. This can make us scared and hopeless, thinking that's what we will become. Or some people disregard a diagnosis completely, because the common images don’t represent their experience.
Once we have learned a little about what it really means to be mentally ill and that recovery is possible, we are still in silence. We live in fear of the reaction of others. People think that mentally ill = crazy, or scary. So even though we are just learning to accept what is happening to us, we hear people saying things like they would never hire someone with a gap in their employment because " gasp" they might have been in the psych ward.
When people react in ways that make us feel bad about what we are going through, it creates a fear of talking about it to others. I have been told I would not have been hired if my mental illness was known. I have had friends insist that I am just lying. It is only because I have met amazing people and found support from my friends and my community that I can keep pressing on through these stigmatizing comments.
Change is happening
Campaigns like Let’s Talk Day help us recognize and appreciate those people who are awesome at continuing these conversations. But we need to do this work every day because people experience mental illness and stigma every day. We need to educate and show people what mental illness really looks like. We need to continue fighting stigma and educating Canadians about mental health and the resources available to them.
I can see people changing. The conversation is opening slowly, but in order to continue this powerful dialogue, we need to continue advocating for good mental health care at all times. Fighting mental health stigma is not easy, but by allowing us to be open about our journey to recovery we are making it just a little easier for others. And that, my friends, can be the difference between life or death.
NCR Bill: Searching for BalanceThe Federal Government has announced the Not Criminally Responsible Reform Act that proposes changes to the ‘Not Criminally Responsible
on Account of Mental Disorder (NCR)’ process.
If passed, this Act will represent a shift in how Canada views and treats a vulnerable
minority of people with mental illness.
NCR is a historical and important legal defense. It recognizes that in some situations mental
illness results in a criminal act. The
bar is high for using this defense. In Ontario, only .001% of
people charged with a Criminal Code violation are judged NCR. When the defense is used though, media
coverage can be prominent and emotional responses are common.
The Bill has three major elements:
- Victim rights to
information and involvement in the process are increased.
- A ‘high risk’
patient group is created. This group is
subject to more controls and less frequent review of their condition by the
Review Board.
- The issues that Review
Boards must balance in evaluating those accused and NCR are changed and public
safety is deemed paramount.
Here are some facts. Public safety is already a critical part of decision making in this
situation. As well, high-risk patients are
already detained in high secure forensic units until a clinical assessment and
a Review Board decision deem them fit for a medium secure unit. Currently, NCR
individuals already receive treatment and rehabilitation for their mental
illness, and rates of recidivism are very low.
Three high profile cases have driven these reforms. These
tragic examples have caused terrible suffering to the victims. However, none of these instances involved a decision
that resulted in a compromise of public safety.
So, has the new legislation even addressed the right
questions?
Does an NCR system that de-emphasizes treatment and
rehabilitation in favor of punishment help anyone? More restrictive processes will detain
individuals longer and in higher secure units than is necessary. Considering
that these individuals have been found NCR because of a mental illness, is this
approach effective, necessary or fair?
Forensic mental health should not be punitive - keeping
people in hospital for three years without review shifts the focus from
recovery to incarceration. At CAMH, we want
forensic patients to be active in their treatment and rehabilitation. We want them to take responsibility for
recovery and have the comprehensive and coordinated care that enables them to be
faithful to their treatment plans after discharge.
Many of the changes in the Act were understandably driven by
the experiences of victims of mentally ill offenders. I’m deeply respectful of the impact of their
suffering and agree that their needs must be given careful consideration. I also recognize the importance of public
safety. What’s missing is a robust
discussion of the need to balance the rights of all parties involved.
We need to do all we can to make sure that this takes place
in the coming weeks.
|
|
|
View in Web Browser /blog/_layouts/VisioWebAccess/VisioWebAccess.aspx?listguid={ListId}&itemid={ItemId}&DefaultItemOpen=1 0x0 0x1 FileType vdw 255 Manage Subscriptions /_layouts/images/ReportServer/Manage_Subscription.gif /blog/_layouts/ReportServer/ManageSubscriptions.aspx?list={ListId}&ID={ItemId} 0x80 0x0 FileType rdl 350 Manage Data Sources /blog/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId} 0x0 0x20 FileType rdl 351 Manage Shared Datasets /blog/_layouts/ReportServer/DatasetList.aspx?list={ListId}&ID={ItemId} 0x0 0x20 FileType rdl 352 Manage Parameters /blog/_layouts/ReportServer/ParameterList.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rdl 353 Manage Processing Options /blog/_layouts/ReportServer/ReportExecution.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rdl 354 Manage Cache Refresh Plans /blog/_layouts/ReportServer/CacheRefreshPlanList.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rdl 355 View Report History /blog/_layouts/ReportServer/ReportHistory.aspx?list={ListId}&ID={ItemId} 0x0 0x40 FileType rdl 356 View Dependent Items /blog/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rsds 350 Edit Data Source Definition /blog/_layouts/ReportServer/SharedDataSource.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rsds 351 View Dependent Items /blog/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType smdl 350 Manage Clickthrough Reports /blog/_layouts/ReportServer/ModelClickThrough.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType smdl 352 Manage Model Item Security /blog/_layouts/ReportServer/ModelItemSecurity.aspx?list={ListId}&ID={ItemId} 0x0 0x2000000 FileType smdl 353 Regenerate Model /blog/_layouts/ReportServer/GenerateModel.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType smdl 354 Manage Data Sources /blog/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId} 0x0 0x20 FileType smdl 351 Load in Report Builder /blog/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderModelContext&list={ListId}&ID={ItemId} 0x0 0x2 FileType smdl 250 Edit in Report Builder /_layouts/images/ReportServer/EditReport.gif /blog/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderReportContext&list={ListId}&ID={ItemId} 0x0 0x4 FileType rdl 250 Edit in Report Builder /blog/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderDatasetContext&list={ListId}&ID={ItemId} 0x0 0x4 FileType rsd 250 Manage Caching Options /blog/_layouts/ReportServer/DatasetCachingOptions.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rsd 350 Manage Cache Refresh Plans /blog/_layouts/ReportServer/CacheRefreshPlanList.aspx?list={ListId}&ID={ItemId}&IsDataset=true 0x0 0x4 FileType rsd 351 Manage Data Sources /blog/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId} 0x0 0x20 FileType rsd 352 View Dependent Items /blog/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId} 0x0 0x4 FileType rsd 353 Compliance Details javascript:commonShowModalDialog('{SiteUrl}/_layouts/itemexpiration.aspx?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/hold.aspx?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/Reporting.aspx?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/expirationconfig.aspx?ID={ItemId}&List={ListId}'); return false;}}, null); return false; 0x0 0x1 ContentType 0x01 898 Edit in Browser /_layouts/images/icxddoc.gif /blog/_layouts/formserver.aspx?XsnLocation={ItemUrl}&OpenIn=Browser&Source={Source} 0x0 0x1 FileType xsn 255 Edit in Browser /_layouts/images/icxddoc.gif /blog/_layouts/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source} 0x0 0x1 ProgId InfoPath.Document 255 Edit in Browser /_layouts/images/icxddoc.gif /blog/_layouts/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source} 0x0 0x1 ProgId InfoPath.Document.2 255 Edit in Browser /_layouts/images/icxddoc.gif /blog/_layouts/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source} 0x0 0x1 ProgId InfoPath.Document.3 255 Edit in Browser /_layouts/images/icxddoc.gif /blog/_layouts/formserver.aspx?XmlLocation={ItemUrl}&OpenIn=Browser&Source={Source} 0x0 0x1 ProgId InfoPath.Document.4 255 View in Browser /blog/_layouts/xlviewer.aspx?id={ItemUrl}&DefaultItemOpen=1 0x0 0x1 FileType xlsx 255 View in Browser /blog/_layouts/xlviewer.aspx?id={ItemUrl}&DefaultItemOpen=1 0x0 0x1 FileType xlsm 255 View in Browser /blog/_layouts/xlviewer.aspx?id={ItemUrl}&DefaultItemOpen=1 0x0 0x1 FileType xlsb 255 View in Browser /blog/_layouts/xlviewer.aspx?id={ItemUrl}&DefaultItemOpen=1 0x0 0x1 FileType ods 255 Convert to PDF /_layouts/images/Muhimbi.PDFConverter/pdf16.gif javascript:window.location='{SiteUrl}/_layouts/Muhimbi.PDFConverter/Convert.aspx?ListId={ListId}&ItemId={ItemId}&Source=' + escape(window.location) 0x0 0x0 ContentType 0x0101 305 Convert to PDF /_layouts/images/Muhimbi.PDFConverter/pdf16.gif javascript:window.location='{SiteUrl}/_layouts/Muhimbi.PDFConverter/Convert.aspx?ListId={ListId}&ItemId={ItemId}&Source=' + escape(window.location) 0x0 0x0 ContentType 0x0120 305 |
|
|
|
|