Research & information : mental health & child welfare newsletter

64 Pages·1991·12.2 MB·English

by  Alberta. Mental Health/Child Welfare Research Unit

Volume 1 Number 1
Spring 1986
¥0)¥m
Innovative programs for the chronically mentally ill
Pharmaceutical repackaging of employ 8 to 12 Care Centre residents equipped to face competition and job
drugs by vocational rehabilitation and/or Day Care clients. Ultimate control pressures uix)n discharge from the Centre.
personnel of Claresholm Care and responsibility of the operation will be Provision will be made for residents to
Centre the province of the pharmacist (and/or the remain in the program should discharge to
Stan Mitchell Clinical Director) of the Care Centre. the community not be immediately
Director of P harmacy The mandate of the Care Centre feasible.
Claresholm Care Centre has recently changed to include vocational Control of medication and
Sharon Brown rehabilitative functions. PubUc attitudes resident safety has been a primary
Community Employment Supervisor toward mental illness have become more objective in the establishment of policy
Occupational Therapy Department enlightened and gainful employment has and procedure for the pharmaceutical
Claresholm Care Centre become possible in occupations repackaging workshop. Extensive
168-1302 previously unattainable to psycho- measures will be introduced to ensure that
A proposal has been submitted to socially handicapped adults. Vocational repackaging will be the highest calibre and
the provincial government concerning the training is essential if residents of the that any unusual occurrences will be
possibility of Claresholm Care Centre Centre are to be competitive in a labor- handled by following the procedures
residents repackaging medication. The surplus market The namre of the outlines in the proposal. Security of the
repackaging will be done in conjunction repackaging operation will make it building, residents and staff has also been
with the Pharmacy department and under possible for residents to enter the program carefully considered and is presented in
the direct supervision of an Occupational at a low skill requirement level and detail in the proposal.
Therapy Assistant The program will progress through stations until maximum Western Industrial Research and
skill level has been achieved. Upon Training Centre, Edmonton, has been
completion of the program residents will repackaging medicine into blister packages
Introduction
be qualified to compete for repackaging for over three years. Their record for
The Research and Information positions at places such as Fanning quality control is impeccable and their
Newsletter is published by the Mental Centre or Calgary General Hospital — contractor, University Hospital, is consid-
Health/Child Welfare Research Unit in facilities currently engaged in on-site ering employing some of their clients
order to make it p ossible for Departmental packaging. on-site to do stat orders. It is entirely
individuals and groups to keep abreast of Residents participating in the conceivable that the Claresholm Care
current research and information related to program will benefit from the practical Centre repackaging workshop could
Mental Health, Child Welfare, and other training aspects of the job and will also expand to include contractual work for
Departmental programmes. The Newsletter receive positive reinforcement to enhance many hospitals in Southern Alberta.
will present abstracts or summaries of tJieir self-esteem. It will be emphasized Copies of the proposal, or additional
information about the program may be
selected relevant articles or papers prod- that repackaging is an essential service and
uced by D epartmental Staff. These will residents selected for the program will obtained by contacting me at the Care
include new projects, published and hold positions of great responsibility and Centre.
unpublished papers, conference trust The different skills required for each NOTE!! Due to structural
presentations, as well as research news. station will allow residents to see the changes currently being undertaken at the
If you feel you have an article progress they have made. Additional Care Centre the pharmaceutical repack-
which you Uiink should be included in an responsibility will accompany graduation aging operation has been placed on hold.
issue of the Newsletter, please submit a to each successive station. Mastery of the Functional planning at the Centre will
summary of your work (maximum 1000 station requirements will enable residents hopefully include provision in Pharmacy
words). for space to include this program.
to feel "job competent" and belter

Page 2 Research & Information
Spring 1986
house
Patients' self-funded group
Dennis K. Yurkiw Objectives dictated by the prospective and wilhng to pool their skills and
Director, Residential Therapeutic tenants included: a bed by the window, no funds; an available therapeutic and day
Programs direct government handouts, walking activity program; and a pool of potential
Extended Care Services distance to the institution, and a permanent persons able and willing to move from
Mental Health Services arrangement. A supportive environment the institution.
Robert W. Cameron was essential to reintegrate these people Six ladies were discharged in
Executive Director, Extended Care into the community. October of 1983 and have moved into
Services
We found the essential ingredients the newly constructed six bedroom
Mental Health Services of a permanent community housing option house. Since this has been a success,
297-4545 for long-term patients are: A non-profit both therapeutically and fmancially, and
corporation to act as the vehicle through a credit to the general community, the
The challenge met by which housing can be rented, purchased or society, again through subsidized
institutionalized patients was to secure constructed; a board of directors consisting mortgage, will begin construction of its
supportive permanent housing in the of elected lay persons and patients; a group s1e9c8o5.n d six bedroom house in October,
community of Raymond, Alberta. of persons able and willing to live together
Innovative community mental health programs
Adoption reunions: An emotional triangle
Raymond Ensminger search and reunion with birth parents. with the birth parents.) In other words,
Clinical Social Worker/Mental Curiosity and the need to know more about being a parent is primarily a caring,
Health Therapist one's origins can hardly be considered nurturing process which may include a
Mental Health Services, Stony Plain abnormal. biological function.
963-6151 I c an appreciate the concerns of An equally important part of
the issue is the birth parents. A fairly
adoptive parents that they don't want to be
I f eel that mental health profess- "temporary and second-best". I c ertainly common myth exists that conceiving,
ionals have not adequately understood nor agree that adoptive parents are real parents; giving birth and surrendering a child
addressed major issues for members of the however, that does not negate the fact that completes the process. That is not the
adoption community (birth parents, adoptees have another set of parents. In an case. Adoption is a life-long process.
adoptive parents and adoptees). Adoption in adoption, if a strong parent-child relation- Many birth parents (especially mothers)
the western world is a social institution ship is e stablished and then maintained into continue to have questions, concerns and
fraught with myths and misunderstandings. adulthood, an adoptee's search for and hopes regarding the child. Sometimes
Two major myths are: 1) that adoption is a reunion with birth parents will not disrupt these concerns are finally resolved with
time limited process, and 2) that having that relationship. reunion.
children by adoption is no different (or In fact, research indicates very The jury is still out regarding
alternately, that it i s totally different) than the ideal adoption process. If we as
clearly that adoptee's relationships often are
having children by birth. Much profession- confirmed and strengthened as a result of a professionals clearly understand the
al practice has been based on these myths. reunion because the adoptee realizes that process (especially from the experiences
One current issue for adoptees is the real psychological parents are the of the participants) we may even play a
the right to obtain more information about adoptive parents. (That does not preclude role in the development of that process.
their birth origins which often leads to the possibility of an ongoing relationship
and study group
The "Rotten Choice" support
Elizabeth M. Grintals disastrous for themselves and their
Study Group" for the purpose of
Senior Nurse families. The results may mean physical, looking into this whole area with the
Mental Health Services, Lethbridge emotional and sexual abuse, poverty, clients themselves.
depression and life-threatening situations. The group is still going
Jennifer Butterfield But in spite of past experiences, the pattern strong, though with some changes in
Clinical Social Worker would be repeated in the succeeding focus and membership. It is an open
Mental Health Services, Lethbridge relationship. Because we met a number of group, meeting weekly, with breaks
381-5280 such people in our work at Alberta Mental coinciding witii school holidays. Besides
Health Services — clients coming in for discussion arising out of personal crisis
There are always people who personal problems or because of difficulties of members, we have used a variety of
seem to go from one poor relationship to with children, we decided in the spring, instruments to promote group
another or to have relationships tiiat are awareness: self-questionnaires, articles
1984, to organize "The Rotten Choice
Digitized by the Internet Arcliive
in 2014
littps ://arcli iv e . 0 r g/detai Is/researcli in f 0 r m at 1 6al be
Spring 1986 Research & Information Page 3
from page 2
"Rotten Ciioice," continued
from current and popular journals and of the need to change, some attention to engage women in a therapy program of
books, guest speakers. We have gained the other side (the man's side) of the "rotten some length, where, often for the first
some insights into the background and choice", and real support to each other time, in spite of numerous previous
beliefs of the members. They expressed outside sessions. Clinic contacts, ihey actively consider
interesting and significant attitudes to sex, We have had to argue for this their personal histories and difficulties.
marriage and the preferred marital state, group being an appropriate program of Instead of dealing with just the
parent-child relationships, loneliness, Mental Health Services. The reality is that immediate crisis, or of identifying the
name-calling, and personal violence. the vast majority of members already had problem with their children, they are
We see evidence of growth with Clinic involvement for personal and family looking at their particular needs which
the group. Some tangible signs of change problems, and several with lengthy have been significant in the extended
include members increasing ability to histories of even two and three generations. family problem.
analyze past relationships, tJie recognition What the group has been able to do is to
Recent projects approved by AMHS Research and
Ethics Review
1. Neuropsychological Correlates of 5. Social Adjustment and Client 8. Analysis of Effectiveness of AMHS
Emotional and Academic Problems. Satisfaction on Longer Term Patients in from the Perspective of Stakeholders
N. Brodie the Community.
Reports.
Edmonton Region G. Ekisa C. Gregor
427-4444 Edmonton Region Edmonton Region
2. Clinical Evaluation of Reconciliation 427-4444 427-4444
Counselling with Families of Incest 6. Adolescent Parasuicide Behavior and Its 9. A Study of Client Satisfaction with
N. Case Relationship to Family Dynamics. AMHS (Edmonton Region).
Edmonton Region J. EUuk M. Provencher
427-4444 Edmonton Region JS.. E Kuesyt ace
3. Needs Forum on Counselling Native 427-4444 V. Smith
Families. 7. Needs of the Chronically Mentally 111.
N. Case L. Gardner Edmonton Region
Edmonton Region C. Roberts 427-4444
427-4444 K. Radchuck
4. Completed Suicides and Their Head Office
Involvement with AMHS and Child 427-2816
Welfare.
RJ. Dyck
S. Jetha
Head Office
427-2816
Recent publications by departmental staff
1. Bland, R.C., Long Term Mental Illness 3. Ensminger, R.O., Adoption Reunions Lunsden, D.P., (Ed.), Community
in Canada: An Epidemiological Perspective — An Emotional Triangle: Some Mental Health, Action, Ottawa
on Schizophrenia and Affective Disorders. Background. The Social Worker, 52 (2), C.P.H.A., 1984.
Canadian Journal of Psychiatry, Vol. 29, Summer, 1984. Edmonton 427-3365
April 1984. Edmonton 963-6151
Head Office 427-2816 6.Bamsley, R.H., Thompson, A.H.,
4. Ensminger, R.O., Pioneer For Adoption Bamsley, P.E., Hockey Success and
Birtfidate: The Relative Age Effect
2. Brazier, B., MacDonald, L., Should Job Reform. Exchange, An Adoption Research
Canadian Association for Health,
Satisfaction Surveys Be Signed. Journal of Project Publication, 2 (4), 1984.
Practical Approaches to Developmental Edmonton 963-6151 Physical Education, and Recreation
Journal, 18 (1), 1985.
Handicap, 8 (2), 1984.
Edmonton Region 427-2065 5. Gaunce, R.J., Pettifor, J.L., Primary Head Office 427-2816
Prevention and Mental Health Promotion:
The Alberta Experience. (Chapter) in

Page 4 Research & Information
Spring 1986
7. Bamsley, RB., Thompson, Ail., 9. Thompson, A.H., Psychoticism and 11. Thompson, A.H., A Test of the
Gifted or Learning Disabled? The Age of Signalled Versus Unsignalled Reaction Distraction Explanation of D isfluency
Entering School May Make the Difference. Time. Personality and Individual Modification in Stuttering. Journal of
E1a9r8l5y. Childhood Education Journal, 18 (1), D1i9f8f5e.r ences, Vol. 6, No. 6, pp 775-778. F1l9u85e.n cy Disorders, Vol. 10, pp 35-50,
Head Office 427-2816 Head Office 427-2816 Head Office 427-2816
8. Bland, R.C., BrinteU, S., 10. Cameron, R.W., Yurkiw, D.K., Little,
12. Al-Issa, BJ^., Skid Row Services
Electroconvulsive Therapy in a Major B.D., Self-Funded Group Home for — Do They Meet Clients Needs?
Teaching Hospital: Diagnosis and Former Long-Term Residents of a Mental (Chapter) in M.R. Rodway, (Ed.), The
Indications. Canadian Journal of
Health Facility. Canada's Mental Health, Teaching of Social Work Methods,
Psychiatry, Vol. 30. pp 288-91, June, Vol. 33, No. 3, pp 32-33, September, Dimensions and Innovations, Calgary:
1985. 1985.
Faculty of Social Welfare, University of
Head Office All-mS. Extended Care Services 297-4545
Calgary, 1986.
Fort McMurray 136-7450
General news
RESEARCH a
DINlF©[RIMI^Tfi©lhg
RESEARCH GRANTS MENTAL HEALTH &
CHILD WELFARE
NEWSLETTER
Recipients of Research on Aging Grants, 1985-86
is published quarterly by Mental
Health/Child Welfare Research
1. Faculty of Home Economics, The University of Alberta.
Unit and distributed to
"A Study of Taste Perception and Dietary Intake of Elderly Albertans"
Margaret I. G ee/Zenia J. Hawrysh. departmental employees interested
in research issues and related
information.
2. Department of Family Studies, The University of Alberta.
Editor: Deanna Fuhr
"Effects of Vicarious Experience and Learning Materials on the Metamemory
and Cognitive Performance of Senior Adults and Adolescents"
Nancy L. Hurlbut
3. Department of Family Studies, The University of Alberta
If you require additional copies of
"Factors Which May Predict the Institutionalization of Alzheimer's Patients" the newsletter, or know of any
Norah Keating Ph.DySharon Warren Ph.D.
individual or group that would
like to receive future issues,
4. Department of Educational Policy and Administrative Studies, The University of
Calgary. please telephone Deanna Fuhr at
427-2816, Edmonton or write to
"Support System and Adjustment Problems of Aging Persons of South Asian Mental Health/Child Welfare
Origin in Calgary" Research Unit, 4th Floor,
M. Zachariah
Seventh Street Plaza, 10030 - 107
Street, Edmonton, Alberta,
5. The School of Nursing, The University of Lethbridge.
T5J 3E4.
"The Validation of Dance and Exercise Therapy in the Elderly"
Christopher A. Armstrong-Esther/Freda Myco/Mark Sandilands
6. The Department of Sociology, Athabasca University.
"A Study of Volunteers Using the Facts on Aging Quiz"
Dr. John R. Minnis
/dibcrra
SOCIAL SERVICES
AND COMMUNITY HEALTH
COMMUNITY HEALTH DIVISION

volume 1 Number 2 Summer 1986
NTAL HEALTH &
ILD WELFARE NEWSLETTE
Epidemiology of psychiatric disorders in Edmonton
Some clinical and program implications
Overview
The following four papers will be test for non-psychotic psychiatric The paper by Newman ct al. examines
presented as a symposium at the annual disorders). DIS data was analysed using the results of a rapid screening test for
conference of the Canadian Psychiatric the Washington University program. psychiauic disorders (GHQ) when
Association in Vancouver in September, Interviewing commenced in 1983 and is compared with a detailed diagnostic
1986. still continuing. Over 3000 interviews have interview (DIS), and suggest that only for
The four papers derive from the same been conducted thus far. depression is the GHQ an adequate screen.
research and thus have similar Diagnoses from the DIS may be given Dyck et al. present the population rates for
methodology. as lifetime (has the person ever had the attempted suicide and then compares the
Randomly selected adult household disorder), or for specified time intervals, psychiauic disorders in those who attempt
residents of Edmonton were interviewed e.g. the month prior to interview. They suicide to the remainder of the population.
by trained lay interviewers using the may also be generated using the DSM III Bland et al. examines the unemployed and
Diagnostic Interview Schedule (DIS) (an hierarchies (exclusions) or hierarchy free. finds rates for psychiau-ic disorders to be
instrument designed to yield DSM III The symposium papers use various much higher in the unemployed than in the
diagnoses) and the General Health combinations of these. employed, findings with clear implications
Questionnaire (GHQ) (a rapid screening The papers were prepared at various for service organizations. Thompson et al.
stages of data collection and therefore use uses the data to examine tlie relationships
different sample sizes. All were selected between phobias and depression and
Introduction
for their relevance to service delivery or discusses the clinical implications.
The Research and Information
clinical practice.
Newsletter is published by the Mental
Health/Child Welfare Research Unit in
order to make it p ossible for Relationship and course of depression, agoraphobia
Departmental individuals and groups to and panic disorder in the general population
keep abreast of current research and
information related to Mental Health, A.H. Thompson There are numerous indicators in the
Child Welfare, and other Deparmiental Director, Research & Evaluation literature that depression is sUDngly
programmes. The Newsletter will associated with the anxiety disorders of
present abstracts or summaries of H.E. Orn agoraphobia and panic disorder, with panic
selected relevant articles or papers Research Officer disorder being viewed as a near essential
produced by Departmental Staff. These component of agoraphobia. Theory
will include new projects, conference R.C. Bland suggests that depression is primary,
presentations, as well as research Executive Director serving as the subsu^te for anxiety
news.
disorders in general. The inter-relation-
If you feel you have an article Mental Health Services ships between the three disorders was
which you think should be included in (Head Office) examined by analysis of the results of a
an issue of the Newsletter, please 427-2816 survey of 2200 individuals from randomly
submit a summary of your work selected households in Edmonton. The
(maximum 1(XX) words). continued on page 2
Page 2 Research & Information Summer 1986
Relationship and course, continued from page 1
instrument used was the Diagnostic nearly all that did had also suffered major supported in the present study.
Interview Schedule, (DIS) which provided depression. In regard to age of onset, first Implications of the results of this
lifetime DSM-III diagnosis of major symptoms of agoraphobia appeared much study are (1) a need for more
depression, agoraphobia and panic earlier than those of depression for those epidemiological studies on the inter-
disorder. subjects who had experienced both relationship oft hese disorders (2)
Examination of the odds ratios and disorders (approximately 5 years alternative theories need to be developed
lifetime prevalence figures for each of the difference). Panic disorder appeared at (eg. anxiety may play a causative role in
tliree disorders in isolation and in about the same mean age as depression. depression) (3) for the chnician increased
combination confirmed the strong The tendency for phobic symptoms to awareness that child or adolescent cases
association between depression and the be precursors of depression does not with phobias are at high risk for
two anxiety disorders. However, the support the theoretical view that depression depression, and (4) given the retrospective
expected strong relationship between is the substrate for anxiety disorders. One nature of instruments like the DIS, more
agoraphobia and panic disorder was not must also question the hypothesis that research is needed on the validity of long-
observed. A minority of agoraphobics panic disorder is an integral component of term recall of psychiauic symptomatology.
showed evidence of panic disorder, and agoraphobia as this association was not
Suicide attempt and psychiatric disorder
RJ. Dyck may assist in the identification of at risk tended to be aged 25-44 years and divorced
or never married, whereas, female
Provincial Suicidologist persons. With this information,
appropriate clinical interventions can be attempters tended to be over-represented in
R.C. Bland implemented. The purpose of the present the age categories of 18-24 and 25-44
Executive Director study was to delineate further the ydeiavrosr c eadn)d. single (never married, separated,
relationship between suicide attempts and
H.E. Orn various psychiatric disorders and social Examining the relationship between
suicide attempts and psychiatric disorders,
Research Officer problems by means of a standardized and
it w as found that 11.3% of those who had
reliable interview method, the Diagnostic
Mental Health Services Interview Schedule (DIS). a diagnosable disorder at some time in their
(Head Office) The results reported here are based on life and also attempted suicide; almost all
427-2816 the first two thousand, two hundred males (92.3%) and over three-quarters of
interviews conducted in a study of the the females (77.5%) who attempted suicide
Greater emphasis has been given prevalence of psychiatric illness in the city also had suffered from some psychiatric
recently to identifying and describing those of Edmonton, Alberta. Respondents were illness at some time in their life.
who deliberately harm themselves. In part, selected from a randomly generated set of Specifically, such disorders as
this is a result of the increase in the rate of residential addresses. As only one schizophrenia/schizophreniform, affective
suicide attempts both in Western Europe individual in each household was to be disorders, major depression and recurrent
(Dickstra, 1981) and in North America interviewed, a household respondent depression were significantly related to
(Weissman, 1974). Although the ability to selection key (Backstrom and Hursh- suicide attempts. In addition to finding
predict who will deliberately engage in Cesar, 1981) was used. family and other violence related to suicide
suicidal behavior has not improved greatly Of the two thousand, two hundred attempts, unemployment was found to be
(Pokomy, 1983), Murphy (1983) has respondents, one hundred and six (4.8%) related as well. These findings are
argued that clinical descriptive studies of stated that they had attempted suicide at discussed in terms of their implications for
suicide attempters do provide clinicians sometime in their lives (6.2% of females the assessment and treatment of the suicidal
with important and useful information that and 2.9% of males). Male attempters
patient.
Screening for psychiatric disorder with the general health questionnaire
5. Newman
Epidemiologist The General Health Questionnaire instrument against all DIS-DSMin
(GHQ, 30 item version), a brief self- diagnoses present in the month preceding
R.C. Bland administered screening test for recent interview. With GHQ scores dichotomized
Executive Director nonpsychotic psychiatric illness, and the into low and high categories by cutting at
Diagnostic Interview Schedule (DIS), a 4/5, the power of the GHW as a screening
H.E. Orn structured interview designed to make test was assessed. Of those subjects found
Research Officer DSMIII diagnoses, were completed on to have a DIS-DSMin diagnosis, 82%
2144 randomly selected adult residents of (specificity) had a low score. When
Mental Health Services Edmonton. The GHQ, scored by the 0011 individuals DIS -DSMIII diagnoses were
method, was assessed as a screening continued on page 3
(Head Office) 427-2816