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Konstantine Zakzanis

ANTI-STIGMA CAMPAIGNS: reduction of the stigma of schizophrenia is the focus of a worldwide campaign by the World Psychiatric Association o Preventive intervention aimed at reducing stigma in high school students involved a video based active learning program that chronicled the challenges of actual people with schizophrenia CANADIAN PERSPECTIVE 1.4: Canadian National Committee for Mental Hygiene (CNCMH) precursor to the CMHA - Hincks suffered from major depression in uni - The objectives of the CNCMH 1. Psychiatric examination and care of 3. Adequate facilities for diagnosis and those who were in the war treatment of mental disease 2. Post-war psychiatric screening of 4. Adequate care of the mentally deficient immigrants 5. Prevention CANADA’S MENTAL HEALTH CARE SYSTEM - Mental health services are tied closely to the health care system. In the developing world more than 75% suffer from mental disorders and receive no treatment  less than 2% of limited health funds are spent on mental health. Canadians are better off than Americans in all major health indicators MEDICARE: taxes are employed for universal health care, including care for people with psychological disorders o The Canadian Medicare system in effect since 1970. The Canadian health act was passed in 1984 and is the legislative cornerstone of our national health care system. US health care is determines by individual income MENTAL HEALTH OF CANADIANS FIRST VIEW: o FACTORS WITH MENTAL HEALTH IN CANADA: Stephens, Dulberg and Joubert (1999) analyzed data from the National Population Health Survey (NPHS):  Current stress, social support, life events and education were strongly and independently associated with multiple indicators of both positive and negative mental health status  Amount of stress was a strong correlation of mental health status -> positively associated with all positive indicators and negatively associated with all negative measures  Second Only to current stress in importance, social support  Number of childhood traumas is associated with negative indicators, including depression  Amount of formal education related to positive indicators of mental health  Stephens et al. Found that mental health improves with age o EXTENT OF MENTAL HEALTH PROBLEMS: 20% of Ontarians have one or more mental disorders. Many of these people have problems performing their main activity, conducting typical activities of daily life and have troubled relationships  2% of Ontarians can be considered severely mentally ill. Majority of the people 72% fall in the range age of 25-44 o REGIONAL DIFFERENCES: few consistent differences  The good mental health in both Newfoundland and Labrador and PEI, people reported the most happiness and the least distress  Quebec is noteworthy because it reported very high levels of self-esteem but the least happiness and most distress TREATMENT AND PREVENTION: there is a need to place greater emphasis on community psychology and prevention o In Ontario in addition to the Ministry of Health and Long-Term Care, 13 other ministries have some involvement with mental health o DEINSTITUTIONALIZATION AND CHALLENGES: consequences of deinstitutionalization are multiple and include homelessness and a lack of supported housing, the jailing of the mentally ill, the failure to achieve and ideal of community-focused care for people with mental disorders  370 general-hospital psychiatric units in Canada  The preferred mental health service model is one that emphasizes intensive local community support and services  CIHI 2008 reported  Average length of stay dropped by more than half  Patients in Manitoba and New Brunswick have the longest general hospital stays and Nunavut had the shortest  Majority of admissions were men between ages 25-44  Mood disorders were the most common psychiatric disorders leading to hospital treatment followed by schizophrenia , substance abuse, dementia, anxiety and personality disorders  Shorter general hospital stays pressure to free up hospital beds  Hospitalization is not as common as it is in urban areas except for serious conditions i.e. psychosis  1999 Yukon’s Whitehorse General Hospital launched a native “healing” building, program is staffed by first nations, Aboriginals make up half of patients in 49 bed hospital  Consistent with the recommendation of Kirmayer community development and local control of the health care system be extended to Canada’s Aboriginal people in order to 1. Make services responsive to the needs of aboriginals and 2. Promote the sense of individual and collective efficiency and pride  Universal health care system will face many challenges, consequences to the system of an aging baby boom population  Meeting the mental health needs of elderly people will require multidisciplinary teams  Emphasis on evidence-based treatment there is also a focus on best practice models of service delivery, two e.g. 1. First ensuring that newer antipsychotic and other medications are available to those who need it, 2. Ensuring that new and effective rehabilitation approaches such as community treatment teams  Another challenge is how best to use pharmacotherapy, treatment used in Canada  Physicians need to be more aware of the level and burden on benzodiazepine use in older people  Ontario has over 300 community mental health and addiction programs. A majority of these organizations are small and rarely have annual budgets over $1 mill  Latimer argues that if evidence-based practices are to be implemented with any real success, they require people from all different agencies  08 report by the Fraser institute, the national median wait time for those seeking psychiatric treatment in 08 was 18.6 weeks  Shortest wait times ->Manitoba, B.C and ON  Longest wait times ->PEI, Newfoundland and Alberta  Time spent waiting for treatment after an appointment was longer than the wait to see a GP  Median wait time to see a psychiatrist on an urgent basis was 1.8 weeks o DELIVERY OF PSYCHOTHERAPY: psychotherapists are being asked to restrict themselves to the most effective and efficient treatments  Canadian Psychological Association (CPA)  Waller  common errors in clinical practice that can impede
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