Category Archives: Mental Health

BCCLA takes a Mental Health position!

My heartfelt congratulations to the BC Civil Liberties Association for finally updating their mental health policy after 30 years!

I’ve criticized them publicly in the past for their lack of activism on the civil rights of patients, and I want to be the first one to congratulate them now. Here’s the position, written by member of the BCCLA board Dr. Muriel Groves and apparently adopted by BCCLA February, 2011, though not posted on their website until this week:
http://www.bccla.org/positions/patients/12BC-Mental-Health-System.pdf

I wish they’d reviewed the Yukon’s mental health legislation as a comparison instead of Ontario’s, because the Yukon’s is even better, but this position strikes at most of the key issues: BC needs laws that more clearly articulate when you can and cannot be stripped of your rights, and allow you to refuse psychosurgery (like lobotomies), write an Advance Directive, designate a substitute decision maker, and accept incarceration without forced drugging if you so desire.

Kathleen’s Demise: a cautionary tale

There’s much to learn about BC’s laws and eldercare system from the last years of Kathleen Palamarek’s life in a local nursing home—especially from the battles that were fought in her name between her children, care providers and the Vancouver Island Health Authority.

 

It was a small but important epitaph for a much-loved woman. NDP West Kootenay MLA Katrine Conroy spoke in the provincial legislature in June in support of a public inquiry into the recent “suspicious death” of Kathleen Palamarek, an 88-year-old resident of Broadmead Lodge in Saanich.

During Lois Sampson née Palamarek’s five-year struggle to help get her mother out of the nursing home, Kathleen became an icon to local seniors advocates. That’s why the Saanich Peninsula Health Association, Vancouver Island Association of Family Councils, Old Age Pensioners Organization local, and others have been blitzing politicians, media and public agencies with requests for an inquiry.

“[T]he suspected abuse was due to overmedication, and the family needs answers,” said Conroy.

Yet the story involves much more than possible improper medicating; I’ve been following it since 2006. Kathleen’s life, and now death, is a tragic example of how our outdated guardianship laws summarily declare seniors “incapable” and thereby turn them into battle zones over which families, health professionals and others fight for control amidst an increasingly troubled eldercare system.

Read more.

Robert Whitaker on the Dangers of Psychiatric Drugs

The author of Anatomy of an Epidemic speaks in Victoria, Canada on May 17, 2011. Whitaker overviews the past 30 years of scientific research into psychiatric medications, showing how the drugs seem to be creating the very chemical imbalances they’re supposed to cure, and why they’re so dangerous in long-term use. For more info, see here. If you’d like to join a group of people based in Victoria, BC working on these issues, email rob (at) robwipond (dot) com .

Crisis Behind Closed Doors

Data obtained through a Freedom of Information request shows nearly half of all seniors in long-term care in BC are being given antipsychotics like Risperdal, Zyprexa and Seroquel. That’s almost twice the average for the rest of Canada and amongst the highest rates found anywhere in the world. And even though Health Canada warns these drugs cause a doubling of death rates in the elderly, care workers admit they’re mainly being used as chemical restraints in the absence of adequate staffing and proper oversight.

“IT WILL RELAX YOU.” That’s the only explanation hospital staff gave when administering the antipsychotic medication to Carl. At least, that’s the only reason he recalls—soon he began experiencing “very strange cognitive feelings.”

“I’m a reasonably logical person,” he says, but suddenly he was in a “swimmy universe that didn’t make any sense.”

Carl (not his real name) became indifferent to his normal interests; inexplicably disengaged when friends visited: “like I was talking to them through a tunnel.” He felt as if he was in a “mind meld” with the Alzheimer’s patient next to him, losing his memory and connection to the world. Though he reportedly looked more docile, inwardly he was intensely disturbed. “I wasn’t relaxed at all.”

Carl didn’t understand what was happening and assumed the serious physical illness for which he was receiving treatment was the cause. Yet his experiences come straight out of the clinical drug literature.

A 2009 study of people’s subjective experiences with taking antipsychotics found many complained about “cognitive impairment” and “emotional flattening,” while few mentioned calmness or relaxation.

Antipsychotics are a class of tranquillizing drugs routinely used to help rein in the minds of people diagnosed with intense schizophrenia. In recent years, they’ve been used increasingly (albeit usually in smaller doses) to “calm” elderly people with dementia in hospitals and long-term care facilities.

Yet they’re hardly benign. Now widely described in medical literature as “chemical restraints,” common effects include foggy somnolence and disorientation, cognitive impairment, akathisia or “inner agitation,” extreme weight gain, diabetes, loss of muscle control, and muscle rigidity. Within a year of use, fully one-third of seniors will have Parkinson’s-like tremors from drug-induced brain damage. Within several months of use, death rates of seniors double—mainly from heart attacks.

Fortuitously for Carl, one long-time friend visiting him daily happened to be a nurse. She knew his illness could’ve precipitated some temporary psychological slippage, but nothing like what she was seeing.

“His personality was changing,” she says. “His cognitive level was changing in a downward spiral.”

But hospital staff barely knew Carl except in this irrational, helpless state, so they told her she should prepare for her 65-year-old, recently retired friend to spend the rest of his days in a nursing home.

After hearing of Carl’s story, I wondered: How many more like him are there?

 

Half of all residents are given antipsychotics

For two years, I tried to find out how many seniors in BC long-term care facilities were being given antipsychotics. Freedom of Information deadlines came and went. Not a single report, document, or email appeared.

It seemed unbelievable that this number wasn’t known. Since 2002, Health Canada has been repeatedly warning doctors against using antipsychotics in seniors with dementia because of the doubling of death rates. Nevertheless, antipsychotic use in Canadian nursing homes has continued rising inexorably, and alarm has been spreading through the medical literature and media. In 2006, BC spent $76 million on antipsychotics, making them our fifth most expensive class of drugs (for comparison, that’s double the arts and sports funding in our provincial budget). Yet no one in BC’s health ministry had the slightest interest?

Even my contact at the Office of the Information and Privacy Commissioner became frustrated with my persistence. “I can’t keep going back just telling them to search again,” he said. Repeatedly.

And then in March of this year, it magically appeared (see downloadable document below). A provincial-wide analysis using PharmaNet data had been completed months before I’d first asked to see one in 2009.

So now we know: Nearly half (47.3 percent) of seniors in long term care facilities in BC are taking antipsychotics. That’s close to double the US and Canadian average of 26 percent, and four times the rate of Hong Kong, which is at the low end of the spectrum.

“Do we have any answers…as to why BC has a higher use of antipsychotics in LTC [long-term care]?” wrote Darlene Therrien, a health ministry research and policy director who was wondering if a methodological error could be producing such huge BC numbers.

“I can’t see any issues in the data that would explain it,” emailed analyst Brett Wilmer. “I’m pretty sure it’s a health system phenomena…”

When I received these documents, I requested interviews. Ministry of Health spokesperson Ryan Jabs emailed back, “I can’t find a person from the program area who is comfortable speaking with media on this topic.”

So we’re left on our own to figure out what those BC health system “phenomena” are—and how dangerous they might be.

Read more.

It’s Justice, Not Charity that’s Wanting

A public inquiry is revealing how BC’s Attorney General is letting BC’s legal system plunge into disarray and widespread injustice.

Let’s throw judges, Crown prosecutors and stenographers off the taxpayer gravy-train. Victims of crimes can pay the thousands of dollars per hour necessary to take criminals to court.

Sound like an unfair, unjust and, well, hugely stupid suggestion? Then is it really conversely acceptable to stop funding criminal defence lawyers?

This question was asked repeatedly during the Public Commission on Legal Aid in Victoria in October. The province-wide Commission was launched by the Canadian Bar Association, Law Society, and other legal organizations after years of growing public concern. By day’s end, it was clear BC’s justice system is in alarming trouble.

Read more.