The psychiatry department closes at Saint Sacrement hospital

In November 2018, the 8 emergency beds were closed, now it has been announced that the 44 remaining beds will be closing.  The CIUSSS wants to concentrate psychiatry services in Quebec city at CHUL, Enfant Jesus hospital and Institut Universitaire de Santé Mentale de Québec.
Of the 327 beds devoted to psychiatry available in april 2017, only 257 will be left in april 2021.
Patrick Duchesne, director of programs for mental health and addictions for the CIUSSS, resources will be directed at a new 40 beds residence, at CHSLD du Haut Saint Laurent and at Residence Mansfield.  "We are short 8 psychiatrists in the Quebec City region, and 100 in the province"
Besides the hospitals, there is a 27 bed crisis center which is always operating at capacity.  The police gets 15 calls per day of mental health nature.

Death of Jean Vanier

Jean Vanier joined the british navy at the age of 13 in 1942.  He later joined the Canadian navy which he left in 1950 to study theology and philosophy.  Scandalized by the horrible conditions of institutionalized mentally retarded, he welcomes two of them in his Paris home.  This was the beginning of l'Arche movement which now has 152 homes where 5-6 mentally handicapped persons live with 5-6 carers.  He also founded "Faith and Light" meetings which get together in 86 countries.  Jean Vanier also wrote more than 30 books, many available in various translations.
He said: "What is important is not to do things for the poor and weak.  It is to enter in relationship with them, be with them, help them build their confidence and discover their gifts."
Jean's father was Georges Vanier, former diplomat and Governer General of Canada.
Jean passed away on may 7, 2019.  More information is available on:  JeanVanier.larche.org

Killed by prison guards!

Matthew Ryan Hines (age 33 in 2015) died on may 26, 2015 of asphyxiation by pepper spray while handcuffed in the back.  The office of the correctionnal investigator has just handed-in his report and it is scary resding!  Public security minister Ralph Goodale approves the recommendations of this report.
The chain of events goes like this:  on the night of may 25:
at 10:03 PM , Hines is tackled by 4 agents who handcuff him.
at 10:16 Hines is held on the ground in the kitchen by 5 agents and pepper spray is applied to his face
at 10:22 More pepper spray, twice.  Hines begs for help.  He is sent to the shower.
at 10:26 he is in the shower, more or less conscious
at 10:29 He has convulsions.  He is removed by the feet.  He is taken to the nursing station.  The nurse does not take the vital signs, but a 911 call is made at 10:31 for an ambulance.  The nurse's noteswere later found to have been falsified. He still has more convulsions and spits blood, transfer to the ambulance at 11 PM.  The death is reported by the hospital at 00:27 AM. to the RCMP
Since adolescence, Hines has a mental illness.  He was taking an antidepressant.  His family was first informed that Hines had died of a crisis, suggesting drug abuse.
After the death, some employees were blamed but only one was fired.  The ful report is available at: www.oci-bec.gc.ca/cnt/rpt/oth-aut/oth-aut20170215-eng.aspx
The correctionnal investigator reports that the way correctionnal services investigate and write their reports on prison deaths and the lessons learned are inadequate. How nany prisoners were injured at the Dorchester pen in a similar way before this death?

Recours collectif contre les services correctionnels du Canada

Arlene Gallone vient d'obtenir la permission de demander une compensation pour tous les prisonniers qui ont été isolés pour plus de 72 heures durant les 3 dernieres années.  Pendant son séjour de 9 mois à la prison de Joliette, elle a subi deux fois un isolement de 3 mois.  Le juge ontarien qui a donné le feu vert au recours collectif a critiqué les soins de santé (y compris de santé mentale) et la ségrégation abusive.  La fermeture de la prison Tanguay pour les femmes a entrainé la nouvelle vocation d'une section de la prison Leclerc qui est désormais réservée prisonnières.  La compensation demandée est de 10,000 $.  L'avocate qui pilote le dossier est Clara Poissant-Lespérance.  8300 prisonniers ont été isolés en 2014-2015 selon Howard Sappers.

USA:land of freedom or prisoners?

There are 49,000 prisoners serving a life sentence in the US.  The incarceration rate is 707 prisoners per 100,000 population.  In Russia it is 474, in the UK it is 148 and in Canada it is 118 (per 100,000).  The incarceration rate is therefore 6 times greater in the USA than in Canada.  Parole supervision is extended to 480per 100,000 in Canada; in the USA it is 5 times greater at 2400.
There are 220,000 prisoners in federal prisons, mostly for major crimes, 1,360,000 prisoners in state prisons and 730,000 in local jails (mostly waiting for their trial).  The total is trerefore 2,300,000 prisoners in the USA!  The worst states are Texas, Oklahoma, Louisiana, Mississipi and Alabama.
It wasn't always like this.  The incarceration rate for drug offences is 10 times what it was 30 years ago.  Minimum sentencing rules, 3 strikes and you are out! sentences judges and procecuters elected by a worried public have all contributed to increasing the prison population.  The National center on addiction and substance abuse poll reveals that 2/3 of prisoners have a drug problem but only 1/9 of them have found help.
Teaching activities have been squeezed out of budgets.  New York and California are cuting populations by freeing prisoners early.  It has been demonstrated that social workers helping the transition out of prison (does he have a social security number? helpful family? a realistic view of the labor market?) is a cost effective way of preventing prisoners from being sent back to prison. The Michigan prisoner re-entry initiative has been a success : prisoners are released early and receive help in the transition to freedom.

Housing first ; a winning approach

The At home/chez soi housing first approach was given a 110,000,000$ - 5 year budget by the federal mental health agency.  5 teams were deployed : in Moncton, Montreal, Toronto, Winnipeg and Vancouver.  The 1158 patients selected for the program were assigned to assertive community treatment(those with the highest needs) or intensive case management (those with more moderate needs).  All had a mental health need and 90% of them had another physical health need.  A good presentation of the project is available by the NFB "Here at home" movie.  Costs are estimated at 22,000$ per person per year in ACT, and 14,000$ per person per year in ICM.
The usual model of treatment involves a gradual shift from the street to shelter to temporary housing to permanent housing.   With the housing first approach, we go from the street to an independent appartment with the Agency garanteeing the rent.  If that doesn't work (maybe he invites his friends at drug parties at his place, for example) then a supervised appartment is the next step.
A training team has been established and now 61 communities are going ahead.  The Fraser valley has 6 or7 teams reporting great results.  Waterloo distributes rent subsidies.  Ontario and the United States federal government have had rent subsidies for the mentally ill for a long time.  In Montreal 2 of 3 teams were disbanded but one is still active.  The positive results of the project will justify its expanding out!

Recent publications

How can I help?  by Dr David Goldbloom
Open heart open mind  by athlete Clara Hugues
I am Brian Wilson - a memoir
Blackout: remembering the things i drank to forget
Waiting for first light by ret. gen. Romeo Dallaire
My heart can't even beleive it written by the mother of a mongol child
Better now : 6 big ideas to improve health care, by Lionel Desmond
May 2018 update:
Insane consequences : How the mental health industry fails the mentally ill, by DJ Jaffe