Refugees and PTSD

According to AllPsych Online, the DSM lists the symptoms of PTSD as including "re-experiencing the trauma through nightmares, obsessive thoughts, and flashbacks (feeling as if you are actually in the traumatic situation again).　 There is an avoidance component as well, where the individual avoids situations, people, and/or objects which remind him or her about the traumatic event (e.g., a person experiencing PTSD after a serious car accident might avoid driving or being a passenger in a car).　 Finally, there is increased anxiety in general, possibly with a heightened startle response (e.g., very jumpy, startle easy by noises)."
 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision (DSMIV-TR). (May 15, 2004). In Allpsych Online. Retrieved from http://allpsych.com/disorders/anxiety/ptsd.html
While looking for resources for refugees in Canada with Post Traumatic Stress Disorder, I found there wasn’t much out there. Most of the resources relating to PTSD were for people in the military coming back from war. I find it kind of odd that there is so much help for the people fighting the wars, but not much for the victims fleeing it.

When refugees arrive in this country, there is so much to deal with: a new culture, and setting up new lives. Dealing with what they have been through can be pushed to the side. Even up to 14 years later, there is still an important association between trauma and the risk of mental illness. (Steel et al., 2002)

In my opinion, there is a significant lack of long term mental health support for refugees coming to Canada. This deficiency needs to be remedied by creating more programs and services to help refugees with long term mental health issues like PTSD.

Steel, Z., Silove, D., Phan, T., and Bauman, A. (2002). Long-term effect of psychological
trauma on the mental health of Vietnamese refugees resettled in
Australia: A population-based study. The Lancet, 360(October 5), 1056–1062.


　Stacey T.

The mental health challenges older immigrants face in Winnipeg.

     The Downtown, Winnipeg, Summer 2008/ D.Hayward

      If you look around Winnipeg any given day you can see that the face of Winnipeg is changing. Winnipeg is becoming more diverse and welcomes many new immigrants every year. The immigrant experience can be very different depending on many personal factors, but what about persons that immigrate later in life. What are some of the local mental health issues?

      The population of immigrants in Winnipeg that is age 65 and older is primarily living with extended family, which feeds into a natural assumption that they are well cared for. In Winnipeg there are 6,850 immigrants age 65 and over who are living alone (“Recent Immigrants,” 2001). Another 240 immigrants age 65 and older live with non-relatives only, whereas a large number, 16,740, live with relatives (“Recent Immigrants,” 2001).

      A study in 2005 by Taylor, Taylor-Henley, and Doan, investigated some of the challenges faced by older immigrants to Winnipeg. Professors Laura Taylor and Sharon Taylor-Henley from the University of Manitoba's social work department were two of the main researchers on this project (Taylor et al., 2005, p. 23). They collected stories from older persons who were involved in an ESL program at Age and Opportunity Inc. (Taylor et al., 2005, p.23).

      Older immigrants can face many challenges when it comes to settling into a new country (Taylor et al., 2005, p. 24). Older immigrants leave a lifetime of experiences behind and must adjust to many losses (Taylor et al., 2005, p. 24). Immigrants may lose friends, family, personal property, and may have to adjust to a loss of status (Taylor et al., 2005, p. 24). After a lifetime of socialization into one culture, older immigrants may have to learn a whole new culture and ways of being (Taylor et al., 2005, p. 24.). This culture shock can be compounded by a language barrier (Taylor et al., 2005, p. 24). This can put older immigrants at risk for depression, anxiety, and psychosomatic symptoms (Taylor et al., 2005, p.24). These factors can be compounded by factors that may further serve to marginalize older immigrants, such as poverty, racism, or discrimination (Taylor et al., 2005, p.24.).

      A part of the stress an immigrant goes through is homesickness, which is seen as a form of grief

(Taylor et al., 2005, p.24). It can influence immigrants throughout their lifetimes (Taylor et al., 2005, p.24). It can cause emotional disturbances and effect relationships with others, possibly causing domestic abuse or abuse of older persons (Taylor et al., 2005, p.24).

      Not much research has been done on elder abuse involving immigrants who are older persons (Taylor et al., 2005, p.24). However some researchers have highlighted factors that make older persons who are immigrants more vulnerable, including inability to communicate, no access to services, and geographic isolation (Taylor et al., 2005, p.24-25). The possibility of abuse increases if an older person who is a immigrant is living with someone and if they are non-white (Taylor et al., 2005, p.24-25). It has also been found that having family around does not always help older immigrants (Taylor et al., 2005, p.25). Having family around can mean that older immigrants merely adopt a self-sacrificing attitude and give everything for younger family members (Taylor et al., 2005, p.25).

      In collecting the stories of older immigrants, the study identified homesickness, abusive situations, isolation during long Canadian winters, lack of English skills, and little knowledge of Canadian customs as sources of mental stress for older immigrants (Taylor et al., 2005, p.29-31).

      Homesickness was described by an older immigrant as feeling lonely and crying, thinking about wanting to go home (Taylor et al., 2005, p.29). One older immigrant described his coming to Canada and working hard to give his family money and doing chores at home (Taylor et al., 2005, p.30). He mentioned that despite this, they did not treat him favorably, ignoring him and verbally abusing him (Taylor et al., 2005, p.30). Fortunately this individual was able to move into a complex for older persons and described his life as getting better with taking ESL classes (Taylor et al., 2005, p.30). He did mention that he was fortunate to not have done anything stupid during his difficult times with his family, which illustrates how vulnerable an older immigrant is without support (Taylor et al., 2005, p.30). Several immigrants described how isolating they found the Winnipeg winters, and how it was just too cold to leave the house (Taylor et al., 2005, p.30). Many of the older immigrants described feeling helpless and dependent on family because of language or cultural barriers (Taylor et al., 2005, p.30).

      The study also found that ESL classes specifically for persons who are older immigrants helped combat some of the negative effects of settling in a new land (Taylor et al., 2005, p.30-32). A model for best practices is presented which describes the importance of ESL classes amidst other social services to better protect the mental health of older immigrants (Taylor et al., 2005, p.26).

      In my opinion, mental health issues among older immigrants is a very neglected field. I think that because of a general stereotype about other cultures being almost more respectful of their “elders” than in Canada, elder abuse may be overlooked. It is pleasing to see that some services are being geared to older immigrants in town. I often wonder when it comes to immigrant settlement, and mental stress issues, are problems being compounded by our Canadian belief in multiculturalism. Is it possible we are too timid to believe immigrants should be taught how to be Canadian? I think it is possible that we are too timid and cultural respect can be maintained while at the same time we can empower new immigrants by helping them integrate and welcoming them into the larger Canadian family, while maintaining their cultural heritage. 

D. Hayward. 

References

       Citizenship and Immigration Canada, (2001).  Recent Immigrants in Metropolitan Areas: Winnipeg; A Comparative Profile Based on the 2001 Census. Retrieved from http://www.ci.gc.ca/english/resources/research/census2001/winnipeg/partc.asp#c1a

        Taylor, L., Taylor-Henley, S., & Doan, L. (2005) Older Immigrants: Language competencies and mental health. Canadian Journal of Community Mental Health, 24(2), 23-34. Retrieved from http://www.metapress.com.proxy1.lib.umanitoba.ca/content/865086437r212250/fulltext.pdf

Comorbidity of Mental and Physical Disorders

As if it isn’t bad enough suffering from a mental disorder, image also suffering from a physical disorder. Such comorbidity exists between mental and physical disorders and it is more common than you may realize. Think of the war veteran suffering from the amputation of his limb, as well as battling post-traumatic stress disorder. Think of the teen born with cystic fibrous and who is now contemplating suicide after a major depression episode. Lastly, think of the Grandma with Alzheimer’s disease whose arthritis is so severe she is stuck in a wheel chair. There are an infinite number of faces of such comorbidity and more cases can strike at any given time. I think the majority of us take for granted our physical and mental health and it isn’t until one (or more) area is compromised that recognition is given to healthy functioning.

Sartorius (2007) has noted publications which document the frequency of physical illness in people suffering from schizophrenia as well as the frequency and types of physical illnesses in people with other mental disorders. Such publications have highlighted the alarming number of comorbidity cases of mental and physical disorders, as well as many implications of such a relation. The relationships between physical and mental disorders are indeed substantial, and give rise to the mind and body connection. Sartorius (2007) states that people with schizophrenia not only have higher rates of physical illnesses than those without, they also experience more difficulty getting adequate health care. This is in part due to the fact that psychiatrists are reluctant to treat physical illnesses in mentally ill patients. In addition to schizophrenic patients, depressive disorders are also associated with physical illnesses such as cardiovascular disease or diabetes (Sartorius, 2007). Specifically, people with dementia often have physical diseases as well as other individuals who suffer from other forms of mental disorders.

Sartorius (2007) states his frustration that little is known about the relationship between a mental disorder and a physical one. I believe that if you are mentally ill and weak that you are going to be physically weak and more susceptible to chronic and acute disease and vice versa. Sartorius (2007) takes a different approach by suggesting that mentally ill people do not pay sufficient attention to their bodies, nor do they follow rules of hygiene. In addition he states that people with mental illness are also often forced to live in conditions of poverty, are exposed to violence and abuse, and they may be abusing alcohol or drugs (Sartorius, 2007).

The Psychology Campus (2008) states that psychological stress and physical disorders are thought to be a mind-body problem. They propose that new research has demonstrated that the state of mind influences the body and such diseases as; the common cold and cancer, may result from suffering from a mental disorder. The relationship between stress and physical disorders is extremely noteworthy as the majority of people today experience high levels of stress related to work and family and this can result in a number of psychological problems. Stress has been found to be related to an infinite number of physical disorders including cancer and coronary heart disease. The Psychology Campus (2008) illustrates that psychological stress is characterized by the activity that causes the stress, the person’s reaction to the stress and how someone physically and mentally responds.

In conclusion, the world in which we live has countless environmental elements that may result in mental and physical disorders. The research shows that the connection between both mental and physical disorders is more evident than ever. This gives rise to the current trend of a healthy mind, body, and soul. If we can strive to keep individuals physically and mentally healthy such comorbidity can be reduced and a more contented live can be lived.

                                                                                                                                    Tara P.

References

Sartorius, N. (2007). Physical illness in people with mental disorders. World Psychiatry, 6(1), 3-4. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805725/

Psychological Stress & Physical Disorders. (2008). Retrieved November 28, 2010 from psychologycampus.com

Poverty related to Social Democracy

According to Mullaly social democracy occupies a wide area on the political spectrum, bordering on liberalism at one end and Marxism at the other end. (p.119) For this blog I want to look at the affects of poverty on persons with mental disabilities which is a social issue that ties into social democracy beliefs. Social democrats stress three central values which are equality, freedom, and fellowship. (Mullaly, p.122) But the primary value is equality, which rests on four interrelated grounds which are social integration, economic efficiency, natural rights, and individual self-realization. (Mullaly, p.122) 

I think that everything I have read on poverty is pretty much summed up in a quote from Dr. Dennis Raphael. “Poverty directly harms the health of those with low-incomes while income inequality affects the health of all Canadians through the weakening of social infrastructure and the destruction of social cohesion.” (Let’s Do Something About Poverty, 2010) Poverty not only affects the persons  going through poverty, it affects the rest of society. I truly believe that as a society if we have person’s living on the streets and living through these awful conditions as a community and society as a whole we are not doing our jobs. So often I have heard people complain about their tax money going to undeserving people who just need to get a job. But the reality is we don’t know how or why person’s get into the situations that they do. I think before I started writing this article, the definition of poverty was something that I struggled with a little bit. The best definition I could find was that “poverty is often defined as the lack of sufficient income to provide for the basic necessities of life, consistent with the norms of the society which one lives.” 

I found a short research review which evaluates the significant association between poverty and the prevalence of intellectual disabilities. (Wiley-Liss, 2007) This review split up the evidence in two ways. The first being that “poverty causes intellectual disabilities, an effects mediated through the association between poverty and exposure to a range of environmental and psychosocial hazards”. (Wiley-Liss, 2007) “The second distinct process is families supporting a child with intellectual disabilities and adults  with intellectual disabilities are at increased risk of experiencing poverty due to the financial and social impact of caring and the exclusion of people with intellectual disabilities from the workforce.” (Wiley-Liss, 2007) The article also goes on to talk about the importance of discussing preventative approaches that look at the health and social inequalities experienced by person’s with intellectual disabilities. 

I think that we need to be a more proactive society in a lot of our social issues, we need to make Canada a better place to live for everyone!

Alyssa V

References

Mullaly, B. (2007). The Social Democratic Paradigm. In B. Mullaly, The New Structural

               Social Work: Third Edition (pp. 119-122). Oxford University Press.

Let’s Do Something About Poverty, 2010

http://www.policyalternatives.ca/newsroom/news-releases/poverty-free-saskatchewan-launches-lets-do-something-about-poverty-campaign

www.ontario.cmha.ca/backgrounders.asp?cID=25341

 2007 Wiley-Liss, Inc. MRDD Research Reviews 2007;13:107–113.

http://onlinelibrary.wiley.com/doi/10.1002/mrdd.20144/abstract

The Immigrant Baby Blues

You just moved to Canada, and a new home! However you are several thousand miles from where you were born; from where you mother, father, and siblings reside. Although Canada has 2 official languages, you speak neither language. You have 1.1 million neighbors, but you know not one of them. Did I forget to mention… you are pregnant, and now live in Manitoba… it may as well be the moon.

           

Next week you will give birth. 

After many excruciating hours of labour, you are blessed with… the responsibility of another life to tend to, to cook, clean, nurture and love in a country where you feel lost. In your birth country, many family and friends would be there to help share your joy and offer any support you needed, emotionally and physically. You hoped your husband could take time off to help you with the first few months of raising your child so you would not be alone, but he won’t. He is afraid that he will lose his job. Not to mention, EI payments would not be sufficient to support new parents finding their way. So you continue on life’s merry way, but it hasn’t been merry in a long time, you feel the added pressure of child rearing and you begin to fall. Not physically, but psychologically into a pit. However, you really are not alone.  This pit is called postpartum depression…

            According to Statistic Canada (2006), between the years 2001 and 2006, 31,190 people immigrated to Manitoba and the experiences of moving to a new country will inevitability cause feeling of fear and anxiety. According to “Canadian Social Policy: Issues and Perspectives,” Canada requires immigrants and refugees to prosper; “immigration will become essential for this country’s healthy growth and even, perhaps, for its survival” (George, 2003, p. 146). In my opinion, immigrants and refugees suffer through a torrent of psychological and emotional shock, dealing and adapting to a new culture. Imagine during this confusion changing everything that is stable in your life during pregnancy and after child birth, when that in itself is a huge change to deal with.

Postpartum depression (PPD) is a serious condition in which women suffer depression at a time that most women typically considered it one of the best times in their life. This condition effectively renders you, as a care giver, to a state of carelessness. You realize and acknowledge your parental duties, but are void of feelings and any desire to complete even the simplest of tasks (CMHA, 2010). Clearly this is not ideal when dealing with the vulnerability of a new born. At least in Canada this condition is considered a “disease”. According to one immigrant mother, “I didn’t think like that ... that I had a problem. I didn’t think that this thing was a disease. I thought I was anxious because it was very hot in India and because I was in an enclosed house, with no light. This is what I thought was causing my anxiety. I didn’t think it was a disease, but here [in Canada] the doctors are saying it is a disease” (Morrow, Smith, Lai, & Jaswal, 2008, p. 602). With the acknowledgement of postpartum depression in Canada, at least resources, supports, and medications are available to women suffering from PPD.

“Many women also found the prospect of having to care for a baby without the help and advice of their mothers or other family members, to be daunting and even frightening. This was exacerbated by being in a new country where they were unfamiliar with the culture and practices” (Ahmed, Stewart, Teng, Wahoush, & Gagnon, 2008, p. 297-298). Compounding these challenges with hormonal changes and culture shock it is no wonder immigrant and refugee women have an increased risk of depression and postpartum depression when immigrating to a new country. For example, according to one Canadian study, it was “found that postpartum depression was five times more likely amongst immigrant women” (Morrow et al., 2008, p. 600). Additionally, “a recent study reported that newcomer women had a three-to five-fold increase in depressive symptoms” (Ahmed et al., 2008, p. 295). 

However, I believe there are other issues that new immigrants face including housing issues, increased support needs, and employment barriers. Immigrants to Canada “have higher levels of education on average than Canadian-born citizens, yet the newcomers find it more difficult to find jobs” (George, 2003, p 160). Does this make sense? Sometimes the obvious is not clear until it is stated.  These women are carrying the children of Canada’s next generation; the children that will grow to be doctors, politicians, police officers and every imaginable occupation in our country. The mental health effect on immigrants is clearly a subject that needs to be addressed especially considering the fact the immigrant women are in a group that is higher risk for developing depression during pregnancy and after the birth (Zelkowitz et al., 2004). It is our responsibility to provide support and resources to our new neighbours and friends.

-Darcie B.

Reference List:

Ahmed, A., Stewart, D. E., Teng, L., Wahoush, O., & Gagnon, A. J. (2008). Experiences of immigrant new mothers with symptoms of depression. Arch Womens Ment Health, 11, p. 295-303.

Canadian Mental Health Association. (2010). Post partum depression. Retrieved from:http://www.cmha.ca/bins/content_page.asp?cid=3-86-87-88

George, U. (2003). Immigration and refugee policy in Canada: Past, present, and future. In A.Westhues (Ed.), Canadian social policy: Issues and perspectives (pp. 145-163). Waterloo,ON: Wilfrid Laurier University Press.

Morrow, M., Smith, J. S., Lai, Y., & Jaswal, S. (2008). Shifting landscapes: Immigrant womenand postpartum depression. Health Care for Women International, 29, p. 593-617.

Statistic Canada. (2006). Population by immigrant status and period of immigration, 2006 counts, for Canada, provinces and territories - 20% sample data. Retrieved from: http://www12.statcan.ca/census-recensement/2006/dp-pd/hlt/97-557/T403-eng.cfm?Lang=E&T=403&GH=4&SC=1&S=99&O=A

Zelkowitz, P., Schinazi, J., Katofsky, L., Saucier, J. F., Valenzuela, M., Westreich, R., & Dayan, J. (2004). Factors associated with depression in pregnant immigrant women. Transcultural Psychiatry, 41, p. 445-464.

What Women Go Through

When trying to decide which direction to take for this post on feminism I came across a lot of different material about women with mentally disabilities, and the chances they will be physically or sexually abused, and some of the rights that are taken from them.

In Mullaly one of his points is that women are disproportionately the victims of male violence. (p.161) In the paper that I read from Karin L. Raye called Mental Disability Rights International, Women’s Rights Advocacy Initiative, Violence, Women and Mental Disability she wrote about how “women are a result of both gender-related bias and disability related stigma, so women with mental disabilities experience dual discrimination.”(1999, p.2) "This discrimination compounded by the geographical and social isolation of institutional living, renders women with mental disabilities especially vulnerable to a broad range of human rights violations, including sexual and physical violence and the denial of and restrictions of their reproductive rights." (Women’s Rights Advocacy Initiative, Violence, Women and Mental Disability, 1999;p.2)

The big thing that this paper looks at is the vulnerability for women living in institutions. According to Women’s Rights Advocacy Initiative, Violence, Women and Mental Disability, sixty to eighty percent of women living in psychiatric care experience violence.(1999) You would think that with this high percentage their could be more the state could do to stop, or at least try and bring this number down. 

This summer I had the opportunity to work in group homes which are homes for persons with  mental disabilities. I think the most challenging home I worked at was a home that belonged to two women who had recently been transferred from an institution. You could see the neglect and abuse that they had gone through just to make it, and the fact that neither of them could not talk only scares me more. To see them explore and realize that this was their house and that the staff were there to help them was really something to see. They learned to bond with the staff, and began trusting us almost in a way.

I think one of the things that did surprise me about my job was that the women were uneducated about their bodies, and often didn’t know what was going on. In the Women’s Rights Advocacy Initiative, Violence, Women and Mental Disability it talks about how many communities perceive women with mental disabilities as asexual, unmarriageable, ill-equipped to parent and undeserving of motherhood.(p.8) To me this seems like a touchy issue because yes some women who have mental disabilities are not capable of raising a child, but then again some women who are labelled as fit to raise a child don’t do such a great job either. It’s a hard topic to tip toe around because according to Mullaly, “women have the greatest responsibility for the family, including child care and elder care.(p.161) If a women is not capable of fulfilling these tasks it seem they are looked down upon. 

In some ways not letting a person know what is going on with their body is a better option because they don’t know what they are missing. But the more you think about this statement the worse it starts to sound. My professor made a comment that she thought that women with mental disabilities would still have sexual feelings, which I know is true because it was evident in some of my clients. My thinking is that by the lack of knowledge these feelings could be confusing. But then on the other had these sexual feeling are confusing to anyone if they are educated or not. The thing that I struggled with this summer is how you let women with mental disabilities wonder and be confused about her own self. I don’t think there is ever really going to be a “right” decision, but like I was taught this summer a woman with mental disabilities is still a woman and she should be treated with the same respect and class that she deserves.

Alyssa V

References

Mullaly, B. (2007). The Social Democratic Paradigm. In B. Mullaly, The New Structural
               Social Work: Third Edition (pp. 160-168). Oxford University Press.

Karin L. Raye, Esq. (1999)  Women’s Rights Advocacy Initiative, Mental Disability Rights International

Mental illness in older adults: Caring for those who can no longer care from themselves

Mental disorders in older adults are sometimes overlooked or dismissed as “old age” But there are many circumstances where the problem goes beyond “getting older” and requires attention, but not everyone receives the help they need. In the CJP (Canadian Journal of Psychiatry) an article I discovered had a lot of insightful information on the aging population and their involvement with home care or personal care homes. The study found (from a sample population of 1000) that those who were in a care home, over 87% accounted for those living with mental disorder such as anxiety or schizophrenia and  69% were diagnosed with dementia (Martens, Fransoo, Burland, Burchill, Prior, & Ekuma, 2007).

In the CJP (Martens, Fransoo, Burland, Burchill, Prior, & Ekuma, 2007) spoke about how people with dementia received homecare three times as much as those who do not have a mental disorder and lived in personal care homes eight times as much those without mental disorder. This really demonstrates the need for both forms of personal care. As the baby boomers are aging, the amount of mental illness including dementia and Alzheimer’s is going to increase.

One of my grandmothers had Alzheimer’s before I was born and my other grandma has had Alzheimer’s for nearly ten years. I’ve seen my only living grandma go from the woman who would ask me how school was going, buy me clothes  and cook the most amazing Caribbean food you’ve ever had, to a little girl who cannot dress herself, feed herself and as of late can no longer talk. As painful a journey as it has been my family would not have been able to manage everything unless we put my grandma in a personal care home. This decision is very hard for some people. They don’t want to feel as though they are giving up, but at the same it can become too much. The disease can make a person aggressive, passive, or somewhere in between all which vary day to day. Fighting with my grandma on a daily basis to do simple tasks and scheduling people to be with her all the time was starting to take a toll on the entire family and was making my grandpa very sick.

I look around the home she is at and see the majority of the residents have dementia to some extent, schizophrenia, anxiety, depression and other forms if mental illness. These people were doctors, pilots and teachers, they are someone’s mother, father, sister or friend and here they are refusing to eat their lunch for the fourth day in a row because they swear they just ate.

My family is fortunate enough to be able to afford care for my grandmother, but for a lot of families it is not an option. The CJNR (Canadian Journal of Nursing Research) posted an article about family members taking on most of the responsibilities of home care even though many of them are struggling to keep peace in the home. The article touches on many points about the health of caregivers. Many of them end up with health complications due to the stress and high demand of caring for someone ever day, all day. My grandfather is a prime example: We put my grandma in a home once his blood pressure started to give him problems. We really wanted to see if we could manage her care but it was becoming too much to handle.

Many care givers, whether looking after someone who is physically, or mentally disabled can reach a point where they don’t know where to turn and feel as though there is nothing they can do for their loved one. Not being able to afford services may be a problem, but so is not being aware of the services that are available (which are sometimes free) is another problem people can come across, making life more difficult than it has to be (Hawranik & Strain, 2007). From the CBC website I found an article about caregivers who say they want help but don’t know how to ask. This drives home the point mentioned in the article from the CJNR about how families don’t always know what kind of help is out there and aren’t sure how to get it.

I’ve watched many documentaries, read articles and interviews over the last couple years and there are two films that stand out in my mind. The films are about people with Alzheimer’s and profiles their families and caregivers. “The Alzheimer’s project” is a five part series that aired on HBO. (click on HBO USA) The second film is a documentary called “The Forgetting” from PBS. If you do not have much experience with what it’s like to care for someone who is disabled, you may not be aware of the need for services to help them and the people who care for them. These films will hopefully continue to create awareness and encourage others to get involved. People with mental illness are not always born with it. Some illnesses such as Alzheimer’s may not be the most obvious disease in the beginning stages. But no matter how advanced the disease is, those diagnosed with it are still human and deserve fair treatment, even if they don’t understand the difference between frozen peas or cooked ones.

Jennilee M.

Hawranik, P. G., & Strain, L. A. (2007). Giving voice to informal caregivers of
                Older Adults: Canadian Journal of Nursing Research, 156-172.

Martens, P. J., Fransoo, R., Burland, E., Burchill, C., Prior, H. J., & Ekuma, O.
                (2007). Prevalence of Mental Illness and Its Impact on the Use of Home
                Care and Nursing Homes: A Population-Based Study of Older Adults in
                Manitoba. Canadian Journal of Psychiatry, 581-590.

Social Work and Social Democracy

From the Canadian Journal of Psychiatry:
Child and Adolescent Mental Health Policy and Plans in Canada: An Analytical Review.

            The journal article I read was a review paper about services and policies in Canada, and which provinces in Canada have effective systems already in place. This article stated that the majority of those who have mental disabilities, specifically Major Depression, have a greater chance of committing suicide. One of the main points I took away from this article was that due to mental disorders being very expensive to treat and research, the policies and services in place are not enough or accessible to everyone. True to social democratic value, one of the results of this study was making people aware there is even an issue.  This ensures  people will be aware of problems in society and take action if they want to (Mullaly, 2007).

           The problem argued in this article is that we need to help people who are struggling to get help.  Although there are services that are very effective and helpful not everyone has equal access to these services due to wait times and lack of planning (Kutcher, Hampton, & Wilson, 2010).Some of the facts given in the article were surprising to me and I had to read it a few time before I could believe it. For example; over one million young Canadians are affected by mental disorders with around half developing by age fourteen and the remainder usually surfacing at age twenty four. (Kutcher, Hampton, & Wilson, 2010). I can't even imagine how many people out of the one million are on waiting lists.

            I can appreciate how frustrating it can be to be denied services because there is a wait time or absolutely no room. Many of us can relate to this in some way. It may be as simple as not getting a table at your favourite restaurant, or waiting over a year to get surgery that may better your quality of life. Whether waiting or being turned away due to lack of space is fair or unfair is something society can debate. There are multiple factors affecting who gets services and when. But when it comes to a person’s basic quality of life and they have to wait many months to get the most basic services, the anger and disappointment is understandable.

             I recently came across an article from the CBC news website about a man who committed suicide after bringing himself to emergency because he claimed to be suicidal. According to the article the man had been telling staff he felt as though we would harm himself and wanted to talk to a counsellor. Without any attention after many hours he hung himself. This terrible incident is under much review but the mother of Shayne Hay is left to wonder what happened or didn’t happen to get help for her son.  As mentioned in Kutcher, Hampton and Wilson’s article from the journal of psychiatry, suicide is one of the major causes of death among people with mental illness. This man had brought himself in quite possibly at his breaking point or maybe as a last resort to gain something positive in his life. Regardless of why he went to the hospital requesting help the system still did not manage to help him.  Studies such as the one mentioned earlier from the Canadian Journal of Psychiatry are important because without the research and data no one would be aware there was an issue (unless they were caught up in the struggle themselves).

            In my own experience witnessing some of the struggles my family has gone through, I have seen firsthand how frustrating it is to fight for services when you need it most. At times it seems as though the system has failed you. Social Democrats find equality very important and think that government should be very involved to help prevent the feeling that the system let you down (Mullaly, 2007).  I’ve seen the results of people not getting the help they need due to undiagnosed or untreated mental illness. They’ve ended up in jail, commit suicide, lost their children and have died from complications that are not only mental but become physical as well. Society is quick to judge the mother with the screaming child in the grocery store but they don’t stop and think. "What if the young child has autism?"  If anyone knows anything about autism you’d understand how difficult it can be to communicate with someone when they have a meltdown. It’s quite possible that the mother is unable to get her child the help to control their behaviour or learn skills she can use to aid her screaming child. Problems like these tend to lack a solution but many people will continue to get by clinging on to the hope that one day their name will be next on the list and it will finally be their turn.

Jennilee M.

Kutcher, S., Hampton, M. J., & Wilson, J. (2010). Child and adolescent mental health
              policy plans in Canada:An analytical review. The Canadian Journal   
              of Psychiatry, 100-107.
                                                      

Mullaly, B. (2007). The Social Democratic Paradigm. In B. Mullaly, The New Structural
               Social Work: Third Edition (pp. 114-137). Oxford University Press.

Bipolar Disorder & Institutionalization

As we know the social democratic ideology very much takes an institutional approach in responding to the needs of society members. I would like to use a personal example of this approach to social welfare. A friend of mine suffered from a psychotic manic episode a short time ago. He was experiencing a sense of grandiosity and believed that the devil was going to make him do something terrible if he removed the bible away from his face. He believed that he had a certain mission that he was to complete by the end of the week and that if he didn’t succeed there would be major repercussions. As a result, he ran all over town and spent hours speaking in a tone and language that was very uncharacteristic of him. Psychologists say that often an environmental cue or situation can set a person off and it is my belief that his loss of his dream job and failure at being a business owner, acted as a trigger to his mania and caused him to turn into a state of chaos.

His family and close friends were at a loss as to what they could do for him and eventually the police were called. After much struggle, he was admitted involuntarily to the Center for Adult Psychiatry (CAP). I think that such institutionalization is a prime example of the government helping a citizen who could not be helped by his family, his church, or by himself.  With institutionalization, he was diagnosed with bipolar disease, he received medication, and most importantly; he realized he had a problem and he needed help. His involuntary admittance was up after 48 hours and he agreed to stay for another 14 days to restore his mentality. Throughout his treatment it was found that depression and manic episodes were prevalent in his family history.

He has since been released from the hospital and from what I hear, he is doing much better. I believe that without being involuntarily admitted to CAP he could have been a threat to himself, to those close to him, and to society as a whole. His treatment gave him a sense of realization that this was abnormal behavior and gave him an opportunity to step back and form a plan of action to regain his mental health. The medical treatment and counselling gave rise to biological underpinnings and I think that this is critical because without such services they would have gone undiagnosed. Upon being released, he is now a healthier functioning member of our society.

We know that members of a society must be physically, socially, psychologically, financially, and materially healthy to strive (Chappell, 2010). In the case of my friend, many areas of his health were compromised and thus his social welfare was inhibited. At one point he was an aspiring and credible professional. He decided to open his own business with a partner and in the end, failed. I believe that his failures and poor decisions made him feel trapped in his current position. He looked at his old job and saw its success and thus he felt there was an unequal distribution of wealth and power in the profession within Brandon. His resulting debt and minimum income from a job he hated drove him into a state of disarray because of the frustration and hopelessness he felt.

I think that the prevalence of psychiatric institutions hold much stigma attached to them, and it wasn’t until an issue hit home with me; that I recognized the significance of such institutes. Psychiatric centres and practices have come a long way since lobotomies and inhumane treatment. Mental illness is a prevalent social problem and as a response to meet human needs. Such centers must exist to help at the individual and collective level to address special needs related to mental disorders (Chappell, 2010). This will give individuals with mental disorders an equality of condition by means of social democracy.
    ~ Tara

References

Chappell, R. (2010). The nature of Canadian social welfare (Chapter 1). Social welfare in Canadian Society (4^th Ed,: pp. 1-29). Toronto: Pearson Prentice Hall.

Suicides among LGBTQ* Youth

In my blog post I am going to examine the recent increased media attention around the suicides in the LGBTQ* community. “As late as the 1970’s the psychiatric profession regarded homosexuality as an illness” (Harrison, 2003, p. 107). Startling as it may be, in the year 2010, we still have adolescent suicides occurring regardless of the advancements, awareness, and programs in place to support those in need and to educate uninformed people. Furthermore, suicides are occurring at an alarming rate. As discussed in our Social Welfare Policy course, in terms of Human Rights Legislation, in 1996 Canada recognized sexual orientation in the Canadian Charter (Straka, October 20, 2010). This advancement by the government will hopefully influence views at the personal level. Throughout high school, many LGBTQ* youth suffer under the domain of their ever-present overseer…the bully. Negative behaviour and bullying have caused psychological trauma that leaves these young adults with a sense of hopelessness. Still, the LGBTQ* community is oppressed in our society.  Recently the media has excessively reported the events that took place in New Brunswick, NJ, where a 18 year old male named, Tyler Clementi, took his own life after a video exposed him being intimate with a man was posted online (CBSNewsOnline, 2010). Many talk shows also covered this occurrence, as did several hourly news shows. In time, this story disappeared, and more sensational news took its place. But, where does this leave these LGBTQ* adolescents?

In my opinion the adolescent age is a vulnerable time, full of conflicting feelings, uncertainty, and experimentation. Hormonal changes intensely influence these feelings. Experiencing an identity crisis or having to share an issue such as LGBTQ* leave many with confusion and self-doubt. Many fear rejection and judgment from their peers. It doesn’t help that LGBTQ* youth are labelled and overlooked as people; they become their sexual identity. At a time when the youth are trying to fit in and conform to peer expectations, many LGBTQ* feel they have no options and turn to suicide. The tragic suicide of the NJ youth was actually classified a “hate crime” (CBSNewsOnline, 2010).

SUPPORTING AUTHORITY REFERENCES & STATISTICS

“The gendered nature of suicidal behaviour is well documented, with men more likely than women to kill themselves and women more likely to self-harm” (Smalley, N., Scourfield, J., & Greenland, K., 2005, p. 133).

“Lesbian, gay and bisexual young people in general are more vulnerable to suicide, and young men especially. This is clearly a gender issue insofar as the pressure relates to the constraints of traditional gender roles and compulsory heterosexuality Boergers et al.’s (1998) study of adolescents who had attempted suicide suggests that half of the sample had wished to die, escape, or obtain relief from their emotional distress” (Smalley, N., Scourfield, J., & Greenland, K., 2005, p. 149).

“Coming out is associated with an increased risk of suicide. For both those who come out at an early age and those who do not come out at all, high levels of isolation are experienced. For example, a young person who is out is at risk of harassment or assault and so may experience psychological isolation. Also, a young person who is not ‘out’ may experience isolation associated with being unable to share their identity with those around them” (Smalley, N., Scourfield, J., & Greenland, K., 2005, p. 144).

“Distressed individuals may try to keep their sexual identities a secret because society encourages heterosexuality. They also may feel guilt and shame, and denial may become a powerful coping mechanism” (Harrison, 2003, p. 107).  

“The decision to hide or disclose homosexuality creates multiple concerns for developing adolescents, including placing them at risk for social stigmatization, isolation, depression, suicide, abuse, and rejection by their families” (Harrison, 2003, p. 112).

“54% of suicide attempts occurred before parents knew of the youths’ sexual orientation” (Canadian Mental Health Association, 2003).

“Youth who were gay, lesbian, bisexual, or unsure of their sexual orientation were 3.4 times more likely to report a suicide attempt in the previous 12-month period” (Canadian Mental Health Association, 2003).

“Gay, lesbian, and bisexual (GLB) youth are at an increased risk for suicide” (Canadian Mental Health Association, 2003).

“Nine out of ten gay, lesbian, and bisexual students are bullied in school. And they are four times more likely than straight kids to attempt suicide” (CBSNewsOnline, 2010).

After reviewing the consequences of bullying, it is evident that LGBTQ* youth have an increased risk of psychological problems, including suicide. I am going to view this social issue from the perspective of technology, which intensifies the effects of oppression. According to the YouTube video, live images were posted online of the victim being intimate with a man. This coupled with posting on social networks strengthen the negative influences affecting LGBTQ*. The entire situation that led to the tragic death of a young man revolved around poor decisions, the internet, and public outings. The roommate revealed the identity of the victim on a social network and then the victim attempted to cope through the same outlet; an online gay community message board. Sadly, the unfortunate “last words” of Tyler Clementi, were typed on Facebook and not spoken. Even now, a memorial for the victim is available on Facebook, the same social network that held his suicide note (CBSNewsOnline, 2010). Unfortunately the internet has allowed bullying and harassment to swell into a global problem and the penalties in having such a popular system has increased cases of cyber bullying and public humiliation.

            In high school, my best friend revealed to me he was gay. I was the first person he told and he was virtually the first person to be openly gay within our community. I was certainly open minded and receptive to his secret. I had actually suspected for many years and I was enthusiastic about offering my emotional support with his unfamiliar transition. Our peers however, were intolerable stemming from their uneducated way of thinking regarding sexuality issues. He was treated inhuman and was taunted every minute of high school. At one point, it went beyond emotional abuse and actually became physical because our male peers feared attempted sexual advancements. My friend revealing his sexuality was essentially the gateway to many males and females exposing their sexuality within our small town. Luckily he had a strong enough sense of identity and was able to endure and triumph over the bullying.  He did not turn to suicide as some feel they must.

            In conclusion, the recent media attention of suicides among adolescents has amplified the attention level to this heterosexism and the prevalence of this social issue. There still needs to be continuous attention through the government and media to encourage acceptance. Advancements around gay marriage, gay spouse benefits, and adoption by gay couples are improving, but improvement is not enough, a breakthrough has to happen. As per the YouTube video posted by CBS News, as a result of the Tyler Clementi story, 2 people are being charged with invasion of privacy. Prosecution needs to be followed through to send the message that harassment is not acceptable and people need to be held accountable. Even after Rutgers University kicked off a civility campaign, with respect to encouraging kids to use technology the right way, tragedies like this case still happen. (CBSNewsOnline, 2010). Tyler Clementi was exposed publically and he ended it publically.

-Darcie B.

 

Canadian Mental Health Association. (December 2003). Suicide among gay, lesbian, bisexual or transgendered youth. The Center for Suicide Prevention.

CBSNewsOnline. (2010, September 30). Rutgers suicide after gay tryst webcast [Video file]. Retrieved from http://www.youtube.com/watch?v=1sLDyq0VAPc

Harrison, T. W. (2003). Adolescent homosexuality and concerns regarding disclosure. Journal of School Health, 73(3), 107-112.

Smalley N., Scourfield J., & Greenland K. (2005). Young people, gender and suicide. Journal of Social Work, 5(2), 133-154.

Straka, S. (2010, October 20). Queer theory: Concepts and definitions (PowerPoint slides). University of Manitoba, Winnipeg, Manitoba.

Mental health from a queer perspective

                When it came time to start my research for this blog, it took me a while to finally decide on a topic.  This is because viewing mental health from a queer perspective isn’t just something I am doing for class, because I am someone on the queer spectrum with a mental disability.  These aren’t just theoretical for me; they affect me, my friends and my community.   There are so many issues, that I decided to discuss the overall issue of self-disclosure in the mental health system.

            Queers have had a long and somewhat confrontational relationship with mental health.  Since the birth of psychiatry in the late nineteenth century, until 1973 for the American Psychological Association, and 1991 for the World Health Organization, homosexuality was considered a mental disorder. (Murphy, 1997)  I have long thought of myself as crazy, but not for being attracted to women.  It is easy for me to understand how this could make people reluctant to seek help from institutions.

            As Daley (2010) says, “…Stein and Bonuck’s (2001) comparative study of disclosure between lesbian and heterosexual women indicate that the assumption of heterosexuality often means that women are required to initiate discussions about sexual identity/orientation and the disclosure process during their interactions with service providers.”  I have run into this myself.  The questions go through your head of “How do I bring this up?”, “Do I have to bring it up?”, “What if they (the service provider) have a problem with this?”, “Will I have to start all over again with someone new?”  It seems to me that all these extra doubts can exacerbate already serious mental health issues.  It is very important, as students going into social work, we remember that not everyone is heterosexual, and try to make help with mental illnesses as accessible as possible.

References

Daley, Andrea (2010) ‘Being Recognized, Accepted, and Affirmed: Self-Disclosure of

Lesbian/Queer Sexuality Within Psychiatric and Mental Health Service Settings’, Social

Work in Mental Health, 8: 4, 336 - 355

Murphy, T.F. (1997). Gay science: The ethics of sexual orientation research. New York:

Columbia University Press

Simkin, R. (1992, Spring/Summer). Lesbians face unique health care problems. Health Sharing,

40-42

Stein, G.L., & Bonuck, K.A.  (2001). Physician-patient relationships among the lesbian and gay

            Community.   Journal of the Gay and Lesbian Medical Association, 5, 87 - 93


Stacey T.

Alcohol Addictions and Residential Schools

In my blog post I am going to reflect on the current social issue around mental disabilities through an indigenous perspective in connection with residential schools and substance abuse. Alcohol addictions are just one of the injustices facing Indigenous people and their ongoing fight with oppression. I am going to examine the implications of residential schools in Canada where Aboriginal children were forced from their homes and had to endure serious emotion, physical, and sexual abuse (Llewellyn, 2002). The pain and suffering, coupled with years of neglect, left residential survivors unable to cope emotionally causing a generational ripple effect on their families. I believe this led to the social problem of alcoholism on reservations. Through video documentation from residential survivors (The Projector), alcohol is a common outlet used to help cope and heal from the psychological trauma they were faced with. I will display the positive progression Aboriginals are taking with the Truth and Reconciliation Commission, as indicated in the newspaper article “Truth commissioners evaluate 1^st event,” from CBC News Manitoba. Lastly through my personal experiences with First Nations friends, I will share stories depicting the ongoing generational repercussions of residential schools and substance abuse.

Historically, Europeans believed Christianity was considered “fundamental to civilization” (Mawhiney & Hardy, 2009, p. 97) and they deemed it necessary to convert, the already self-governing, Aboriginals into replicas of the Europeans. Through assimilation, in the form of residential schools, Aboriginals were to become productive members in European society (Mawhiney & Hardy, 2009). According to Mawhiney and Hardy, the Europeans did not appreciate “that aboriginal cultures had achieved integrated systems for ensuring the physical, mental, emotional, and spiritual well-being of all community members” (Mawhiney & Hardy, 2009, p. 97). Aboriginal children were taken from their parents, off the reservations, and housed in Church run schools that were supported by the government.  At the hands of their care givers, they suffered years of abuse and neglect, stripping them of their culture and identities.  The children were allowed to return back to their homes when they became adults at the age of 18 (“A history of residential,” 2010).

I believe decades later, that in trying to force the Aboriginals to conform to European standards, the Government of Canada has stripped the positive values of Aboriginal culture. Also, the self-governance previously part of the indigenous civilization should not have been disrupted, allowing the Aboriginal children to grow up with a positive sense of identity, fostered from a nurturing environment. In the schools Aboriginals lost their culture, language, and identity (Fenwick, 2000). According to Fenwick “many native people blame some of the identified difficulties in native communities such as family breakdown, sexual and physical abuse, and alcoholism on the residential school system” (Fenwick, 2000, p.33). I strongly believe there is an obvious correlation. The mental turmoil faced by the survivors, not only from the abuse, but when trying to adjust back into the Aboriginal culture lead many to turn to alcohol. Through the negative conditioning most Aboriginal children, now parents, imitate the abuse and neglect they learnt in the residential schools. A form of ripple effect on the rest of Aboriginal culture has introduced these alcohol addictions into the youth and the legacy of alcoholism is in light of the overall dislocation and disruption

According to a CBC News article, the Truth and Reconciliation Commission held a national event in Winnipeg, Manitoba in June 2010 at the Forks historic site. The purpose of this event was public information and the chance for the survivors to have their voices heard; sharing experiences (“Truth commissioners,” 2010). The importance of this event, for the purpose of mental illness and alcohol addictions, was to have a positive outlet to help deal with the sufferings and distress resulting from residential schools and “show those individuals that they no longer walk alone” (“Truth commissioners,” 2010, para.2). Sharing and talking with others about experiences allows for another avenue for healing, making the use of alcohol less important.    

I actually grew up near a First Nations reserve in Northern Manitoba. Many of my friends were Aboriginal and as an adult I witness firsthand the addictions issues overwhelming the Indigenous population. Many of these friends still live on the reserve, and decades later, are imitating the substance abuse issues related to the influences of residential school on their elders through the generations. Unfortunately several indigenous social problems, such as CFS dealings, alcohol and drug abuse, and criminal histories are common place in their lives. As children, and now as adults, my friends are very good people dealing with some very unfortunate historical implications of residential schools, oppression, and cultural genocide.

In conclusion, “In total, well over 100,000 Aboriginal children, or approximately 20 to 30 per cent of the Native population in Canada, attended residential schools. In practical terms, this means that as many as nine out of every ten Native people know someone who went to a residential school” (Llewellyn, 2002, p. 258). These residential schools are responsible for the problems indigenous people face in our current society. The survivors of residential schools and the generations of families have residual effects from the emotional trauma that the indigenous people still currently face through healing. Through the Truth and Reconciliation Commission, hopefully the Aboriginals will find a better outlet for helping them deal with their emotional injustices as a better alternative to alcohol abuse.

-Darcie B.

(2010, June 14). A history of residential schools in Canada. CBC News. Retrieved from http://www.cbc.ca/canada/story/2008/05/16/f-faqs-residential-schools.html

(2010, June 21). Truth commissioners evaluate 1^st event. CBC News. Retrieved from http://www.cbc.ca/canada/manitoba/story/2010/06/21/mb-truth-reconciliation-event-wrap-winnipeg.html

Fenwick, F. (2000). Residential School Update. LawNow, 25(3), 33-36.

Llewellyn, J. (2002). Dealing with the legacy of Native residential school abuse in Canada: Litigation, ADR, and restorative justice. University of Toronto Law Journal, 52, 254-300.

Mawhiney, A., Hardy, S. (2009). Aboriginal peoples in Canada. In J. C. Turner and F. J. Turner (Eds). Canadian social welfare (pp. 95-109). Toronto, ON: Pearson Canada.

Where are the Children? Healing the legacy of the residential schools. Retrieved from http://www.wherearethechildren.ca/