Tag Archives: Centre for Addiction and Mental Health

Mental health centres must reduce risk to staff and patients

Local 500 President Nancy Pridham during a 2008 press conference addressing assaults at the Toronto hospital. Six years later the same problems persist with the union calling on the Ministry of Labour to charge the employer under the Occupational Health and Safety Act.

Local 500 President Nancy Pridham during an October 2008 press conference addressing assaults at the Centre for Addiction and Mental Health. Six years later the same problems persist with the union calling on the Ministry of Labour to charge the employer under the Occupational Health and Safety Act.

Client Empowerment Council at Ottawa’s psychiatric hospital say they became advocates for the safety of the care team because a “safe place for staff members increased patient safety as well.”

In a statement issued by The Royal November 26, mental health advocate Claude Lurette spoke about his own regret at lashing out at others while a patient at the hospital. “It wasn’t until I became solid in my own recovery of living with bi-polar disorder that I came to understand that the best thing I can do is to own my behaviour and learn what I need to learn in order to minimize the chances of it happening again,” he writes. “It is hard to find the words to express how much I appreciate the nurses and other staff who took care of me even when my behaviour was unpredictable.”

The Royal was publicly responding to the court proceedings following charges laid against the hospital under the Occupational Health and Safety Act. In the alleged incident a patient choked and assaulted two nurses and a support worker in the Royal’s Recovery Unit.

The Royal faces numerous charges around failing to take reasonable precautions to protect worker safety.

Their woes may not be entirely over with these court proceedings. In October, a nurse at the Royal’s Brockville site was allegedly stabbed multiple times in the neck, narrowly missing her carotid artery. She survived the encounter, but the hospital has received an extraordinary interim order by the Ontario Labour Relations Board to provide formal security in the nurse’s unit 24-7.

Stories about patient assaults are always very difficult because of the risk of further stigmatizing persons with mental illness. The truth is that a person with mental illness is more likely to be the victim of violence than the perpetrator of it. With so few beds left in Ontario’s psychiatric hospitals, there is a filtering process that takes place so that patients finding their way into one of these beds are more likely to be a risk to themselves or to others. That should be a call to administrators to step up their efforts to keep everyone safe.

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Phase II of mental health plan serves up crumbs from the health care table

Above: Arthur Gallant — one of the more inspired choices for the Mental Health and Addictions Leadership Advisory Council.

Ontario Health Minister Dr. Eric Hoskins has been doing a lot of tweeting this week about the second phase of Ontario’s 10-year Mental Health plan. You may recall that the 10-year plan really was a three-year plan in 2011, which is being followed by another three-year plan now. We presume they’ll just continue making it up as they go along.

First the good news: The government is investing $16 million to create 1,000 more supportive housing spaces, opening a 12-bed paediatric residential treatment unit at Ontario Shores Centre for Mental Health Services, and spending $2.75 million to improve access to mental health and reduce wait times at four of the big psychiatric hospitals – The Centre for Addiction and Mental Health (Toronto), Waypoint Centre for Mental Health (Penetanguishene), The Royal Ottawa (Ottawa and Brockville), and the aforementioned Ontario Shores (Whitby). He is also creating a Mental Health and Addictions Leadership Advisory Council and is “partnering” with the province’s public health units to increase awareness, fight stigma, and promote mental health in schools and in the workplace. The largest chunk of cash — $138 million over three years — will go to community service agencies to increase access to peer support groups, treatment programs, and crisis and early intervention initiatives.

Now the bad news: It’s called perspective.

$2.75 million added to those four hospitals amounts to less than half a percentage point on the nearly $650 million a year they presently spend.

The $16 million in supportive housing will be over three years, or a little more than $5 million per year. There are 8,000 people presently waiting for supportive housing – just in Toronto alone.

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CAMH asks staff to mail patients’ cigarettes back home

Ah, Rosie.

Toronto Star columnist Rosie DiManno recently used her shotgun style prose to take the Centre for Addiction and Mental Health (CAMH) to school.

While addiction is part of CAMH’s mandate, not everyone who seeks help there has arrived to engage in a smoking cessation program.

True, smoking tobacco is addictive. Its negative health consequences are well documented.

CAMH has been escalating its war on tobacco for some time, starting with the elimination of smoking rooms back in 2003. Since then they have prohibited patients from smoking anywhere on the property – both inside and out. Now the patients are told they cannot even store their ciggys in lockers on site, even if they have to run out into the streets to actually smoke them.

April 18 DiManno called CAMH’s war on tobacco a “pathology,” noting derisively that they (CAMH) “can act as coercively as they please against some of the most vulnerable people among us and call it a matter of health.”

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Mental Health CEOs outliers when it comes to executive pay

What is it about being a CEO of a psychiatric hospital in Ontario that warrants much greater compensation than executives of similar-sized general hospitals?

Last month we took a look at who was making more than double the Premier’s salary. While not uniform, most CEOs in that compensation range worked for very large hospitals, such as Bob Bell, who earned $753,992 in compensation for helming the University Health Network, which has an operating budget of about $1.8 billion, or Jack Kitts who earned $630,485 on a budget of $866 million as CEO of The Ottawa Hospital.

What was more surprising was that two of four major stand-alone psychiatric hospitals placed leaders on this list. Of the four CEOs, only one lists a clinical background in her on-line curriculum vitae. Dr. Catherine Zahn, President and CEO of Centre for Addiction and Mental Health (CAMH), is a practising neurologist. Glenna Raymond (Ontario Shores), Carol Lambie (Waypoint) and George Weber (Royal Ottawa Group) are career administrators. Weber has an MBA with extensive advanced management training. Raymond states she is a certified health executive. Lambie is a certified general accountant, although her contract calls on her to finish her MBA by the end of 2011.

These qualifications are not unusual among Ontario hospital CEOs, yet two of four appear to be collecting compensation that is far beyond those at comparable sized facilities.

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Did McGuinty err in his mental heath campaign announcement?

Premier Dalton McGuinty might have found a better venue for his campaign mental health announcement today at the Centre for Mental Health and Addictions (CAMH).

CAMH has experienced significant layoffs over the past two years, yet McGuinty’s announcement really had more to do with support for mental health services delivered mostly elsewhere.

For the first time, however, we have a glimpse of how the Liberals plan to support mental health issues for adults.

After waiting three years for the comprehensive 10-year mental health plan, the McGuinty government instead gave us a three-year plan for child and adolescent mental health this spring. There is no question this is needed – three of four children with mental illness are going without treatment, and waits are frequently more than a year. But what about the adults?

At McGuinty’s announcement he said Ontario would commit $30 million more per year on adult mental health – but not until 2014. This surely must be a mistake on the Premier’s part.

If it’s true, this is insulting on two counts: the first forcing adults with mental illness to wait another three years before their issue can be addressed, the second being the pittance he is offering.

$30 million is a fraction of the cost of the bricks and mortar his government is putting into hard infrastructure at CAMH, North Bay, Windsor, Cambridge and other mental health facilities. If a concrete beam could provide mental health care, this might be a good plan.

This is $30 million on what by then will be a health budget of at least $53 billion (quite literally by Conservative standards). That’s .006 per cent.

Ontario lags far behind other provinces on mental health spending and it’s not even close to reaching the World Health Organization standard, which suggests eight per cent of health care spending should be committed to mental health. Ontario is a little over five per cent.

Ironically CAMH is part of the Ontario Mental Health and Addictions Alliance, which is calling for a comprehensive basket of services in every community, complaining of “wildly uneven” access.

The Alliance states: “In communities across the province, there are shortfalls in service across the many parts of the continuum including access to psychiatric assessments, hospital beds, residential addiction treatment and peer support, to name but a few.”

After a three-year plan that delivered little, the Alliance is calling for “a number of critical policy, planning, and funding capacities” at the provincial level to meet broader system reforms.

They say the needed reforms include clearly articulated goals and objectives, the capacity to plan and fund based on population need, and the ability to monitor and report on the functioning of the system. Wasn’t this all supposed to be in the 10-year plan?

The cost of inaction on this file is huge – the Alliance estimates the economic cost of mental health to be $39 billion annually in Ontario.

There is also a further question about support for mental health issues that fall outside the Ministry of Health and the Ministry of Children and Youth Services. The PC campaign shows programs outside the health and education envelopes being frozen until at least 2017, which raises questions about where the money will come from to address the social determinants of health, including supportive housing. Clearly there is some silo thinking going on in the Tory camp.

Unless Dalton misfired, the Liberal commitment appears to be a smoke screen to a public that is unaware of the scale of this problem. The NDP tell us they still support the all-party plan, which is far from being implemented. To date they have not addressed the issue publicly. The Tories say people have been lost in the mental health system, but offer no remedies in Changebook.

A year ago the three parties were all fired up about addressing the injustices in mental health. A year later nobody appears to want to talk about it.