Bottom Line Conference on Mental Illness in the Workplace - March 7

Source: CMHA

There is mounting body of research revealing the tremendous personal and economic costs of mental illness in the workplace. Yet, mental illness is a subject many workplaces still don't know how to talk about. CMHA BC Division invites business leaders, frontline and senior managers, human resource specialists, union representatives, benefit providers and mental health service providers to join us at the 2007 Bottom Line Conference, Mental Illness in the Workplace: The Elephant in the Room. Gain insight, be inspired and learn how attention to mental health and mental illness in the workplace will help retain valuable employees, increase employee health, well-being and productivity, as well as decrease absenteeism and disability claims. This year's speakers include Margaret Trudeau, Dr. Linda Duxbury, and Dr. Allan Young. At the Vancouver Convention and Exhibition Centre, 999 Canada Place, Vancouver. Limited seats are available so register today! Learn more and register at www.bottomlineconference.ca.
>> don't miss our pre-conference Mental Health Works workshops - March 6, 2007. Learn hands-on skills for addressing mental illness in the workplace. Details at www.bottomlineconference.ca or contact Margaret Tebbutt at 1-800-555-8222 or mentalhealthworks@cmha.bc.ca for details.

Depression Impacts 500,000 Canadian Workers

Source: CMHA

About half a million Canadian workers experience depression and most of them say the symptoms interfere with their ability to work, according to a study released by Statistics Canada. Data from 2002 indicate that almost four per cent of workers age 25 to 64 had experienced depression in the 12 months before the Canadian community health survey was conducted. Nearly eight of 10 workers who had experienced depression reported that the symptoms had interfered with their ability to work, at least to some extent. Almost one in five said there was a very severe degree of interference with their work. See "Depression impacts 500,000 Canadian workers: study," at www.canada.com, and "Nearly 4% of Canadian workers say depression limits their life," at www.cbc.ca. See also "Expert: Costs of stress likely higher than we think," at chealth.canoe.ca.
>> learn more about the impacts of mental illness in the workplace, at the Bottom Line Conference on March 7. Learn more and register at www.bottomlineconference.ca.

With a little brainpower we can fight the stigma of mental illness

Source: Canadian Institutes of Health Research

As a society, we admire and idolize the wonderful accomplishments of the brain. We glorify efforts made through sheer brain power. We also have a special relationship with the brain because it defines who we are and how we relate to our environment. In short, we tend to put the brain on a pedestal.

But, let's start treating the brain with a more balanced perspective, as we would any other organ in the body. Let's focus our attention and resources on healing this organ when it is ill. Let's erase the discomfort, fear and stigma surrounding mental illness.

According to Statistics Canada, one-in-five Canadians will be affected by mental health problems during their lifetime. Equally distressing is the fact that only 32 per cent of people with a problem seek professional help.

This problem also hits Canada hard in the pocketbook. We lose close to $33 billion in industrial production each year due to mental illness. According to the World Health organization, by 2020, if steps are not taken to control mental illness, depression will overtake heart disease as the leading cause of disability.

Numerous types of mental illness exist. These include depression, anxiety disorders, schizophrenia, behavioural disorders, such as eating disorders, and addiction to drugs, tobacco, alcohol and gambling. The variety and extent of these problems change throughout life as one's environment and circumstances change. There are also well established links between persons undergoing treatment for physical illness, such as cancer, obesity, etc., and the incidence of poor mental health.

Changing how we think about the brain and mental illness is critical for us to improve our treatment of the illness and confronting stigma around it. Stigma about mental illness is pervasive within society in general, within the workplace and even within the healthcare system.

The Kirby Commission raised stigma as a major issue in its landmark report on mental health. Fear of being labeled as having a mental health problem prevents many people from accepting there is a problem, seeking help and being open about their treatment. Stigma in the workplace contributes to perceptions that people with mental health problems are unskilled, unproductive, unreliable and possibly violent. Stigma about mental illness also makes it harder for many people to find good quality, affordable housing. One of the Kirby Report's key recommendations involved creating a Mental Health Commission which would launch a national anti-stigma campaign.

To improve our response to mental illness we must fully acknowledge its impact. Mental illness can be hard to diagnose correctly. Neuroscientists are only now beginning to expand our basic understanding of how the brain is wired, the role of different neurotransmitters and receptors in exchanging information and how the breakdown in these connections lead to mental illness.

Mentally ill persons also face challenges in getting the proper care from the healthcare system. The system is built on the foundations of making medically sound decisions based upon the best available evidence. While this is an excellent practice, it tends to overlook mental health issues which, for the most part, are not life threatening. We need mental health to take its seat at the table. This means we must make changes to medical school training to provide better instruction to students so that they acquire a deeper appreciation of mental health. This also involves changing the view of psychiatry not as some specialized function but as a mainstream health service.

Finally, we also need to continue to invest in research into mental health. The Kirby Report recommended an additional $25 million to be channeled to the Canadian Institutes of Health Research Institute of Neurosciences, Mental Health and Addiction. The Report highlighted the need for such an investment for applied research that would translate existing findings into improved quality of care and services to patients. This research would also play a major role in providing the sound advice and information needed for Canada to create a mental health strategy. Canada is the only G8 country without such a strategy.

The Canadian Institutes of Health Research currently supports a large number of projects to begin to better understand and address these issues. For example, CIHR and the Global Business Economic Roundtable on Addiction and Mental Health recently launched an ambitious research program to document the types and causes of mental health problems found in Canadian workplaces.

As we observe national mental illness awareness week in Canada, I hope that we can begin thinking about the brain and mental health with a new and healthy perspective.

-30-

Dr. Rémi Quirion is Scientific Director of the Canadian Institutes of Health Research Institute of Neurosciences, Mental Health and Addiction (CIHR-INMHA).

Margaret Trudeau fighting to end stigmas attached to mental illness

Source: medbroadcast.com


Feb 12, 2007

Provided by: Canadian Press
Written by: ELIANNA LEV

VANCOUVER (CP) - Margaret Trudeau says she has chosen sanity and that's the choice she wants other Canadians suffering with mental illness to make.

The former wife of the late Pierre Trudeau is using her profile to bring attention to mental illness, which has affected her for 35 years.

"Acceptance. . . is the biggest thing for people to do, just to accept that there is a problem, to accept that they need help," Trudeau told a news conference Monday.

"With mental health issues we're reluctant to accept it because of the stigma that has been played out in the media and the movies."

Trudeau, 58, first experienced depression after giving birth to her second son, Alexandre. That was the first of three times she was hospitalized for her illness. The second time came after the death of her son Michel in 1998 and then after her ex-husband died two years later.

She said she was in such dire straits at that time that she was forced to accept her bipolar disorder and get the help she needed.

"I've chosen sanity, I've chosen to be well," Trudeau said.

She has also distanced herself from marijuana, one aspect of her life that was well-documented when she was thrust into the Canadian spotlight as a 22-year-old flower child and bride of the former prime minister.

She said she's since found the enlightenment she felt from drugs in the form of spirituality. Trudeau is interested in Buddhism and follows the works of the Dalai Lama.

Trudeau said people should treat mental health as they would their physical health, taking days off when they feel unwell.

If Canadians start to talk openly about mental wellness, the stigma will diminish and people help will get the help they need, she said.

"It should be a conversation at the kitchen table, it should be a conversation on the way to work," Trudeau said. "Because recognizing depression in the early stages, you can change the course of the disease."

Dozens of untreated mentally ill found living in chains since Aceh peace deal reached

source: medbroadcase.com

Feb 11, 2007

Provided by: Canadian Press
Written by: ROBIN MCDOWELL

BANDA ACEH, Indonesia (AP) - Auzain, a 38-year-old who has suffered from schizophrenia for his entire adult life, was found locked in a cage in his mother's kitchen. Desperately poor and isolated by a brutal civil war in Aceh province, she saw it as the only way to protect her son.

A peace accord 18 months ago finally ended the decades-long conflict, bringing calm and the beginnings of normality to the region - but also the discovery of some 150 mentally ill people who were chained, shackled or locked up to keep them from hurting themselves or others.

More such people are expected to turn up as nurses fan out across Aceh to visit areas long isolated by war.

Medicine and counselling already have made a tremendous difference for some of the patients. But others, like Auzain, who has been ill for more than 15 years, are harder to help.

Glaring through the wooden bars of the kitchen cell, Auzain speaks bitterly about a man he accuses of wanting to kill his father. He jabs his finger in the air and bursts into laughter before launching into a new tirade.

"He's hallucinating," says Roslaini, a nurse who like many Indonesians has a single name.

She is one of more than 400 nurses in a mental health outreach program that became possible only after the tsunami crashed into the province two years ago, killing at least 131,000 people in devastation that stunned separatist rebels and the government into making peace.

Roslaini tries gently to coax Auzain into conversation, but his darting eyes look past her. "He barely knows I'm here," she says, promising to come back in a few days.

Indonesia estimates 400,000 of its 220 million people suffer from severe mental disorders, a figure the World Health Organization says is roughly in line with other developing countries.

The tsunami intensified high levels of depression and trauma in Aceh, a region already wracked by a 29-year war that killed 15,000 people, many of them civilians slain during army sweeps of remote villages.

While international aid poured in after the killer waves, the long-neglected health system remains underfunded. Aceh's only mental hospital does electric shock therapy without anesthesia, illegal in much of the West, and there is just one full-time psychiatrist for 300 patients.

So physicians are excited about the community outreach program, which initially was funded by WHO and later the Asian Development Bank. It's the first ever for Indonesia and is seen as a potential model for other parts of the sprawling archipelago.

By the end of December, nurses had reached half of Aceh's 21 districts since rebels signed a peace deal with the government Aug. 15, 2005.

Relying on word of mouth, they identified 4,000 people with severe mental disorders and more than 150 living in chains or cages, said Budi Ana Keliat of the University of Indonesia's nursing faculty, who heads the project.

She said once a sufferer is identified, nurses follow up with weekly visits to provide medicine and counselling to patients and their families.

Doctors say Aceh's prolonged conflict increased the prevalence of depression, anxiety disorders, brain injuries and acute psychoses in the worst-affected villages.

In three districts studied from December 2005 to February 2006, the population was found suffering from levels of trauma that rival Bosnia and Afghanistan, according to researchers from Harvard Medical School, the International Organization for Migration, and Indonesia's Syiah Kuala University

For example, among men aged 17 to 29 in Bireuen and Aceh Utara, 67 per cent reported having faced strangulation, suffocation, near drowning or severe head injuries from beatings. Forty-one per cent had a family member or friend killed and 38 per cent reported having to flee burning buildings.

"Simply hearing the history of what the villages went through is disturbing and shocking and providing numbers to this makes even the most seasoned Aceh-watchers grow quiet," said Dr. Byron Good, a Harvard professor of social medicine who wrote the report with his wife, professor Mary-Jo Good.

Mansur, 36, who lives in the former rebel stronghold of Pidie, said he had heard voices in his head for years, but after losing his wife and eight-year-old son to the waves the voices grew louder and angrier.

He started throwing rocks at strangers and threatening to burn down houses, so his family kept him chained to a tree, covering him with a plastic tarp when it rained.

"I felt myself go completely crazy," said Mansur, who managed to free himself one day, poured gasoline on his feet in a village market and set himself on fire. Vendors extinguished the flames, but he suffered severe burns to his feet.

"I have medication now and no longer hear the voices," he said. "I feel much better."

Nurses said that when they first started going to villages, people were too ashamed to identify themselves or others as mentally ill, but have since started opening up.

"I have no reason to feel ashamed. It's normal that I'm tied up because I'm sick," said Amiruddin, 26, who has been chained to the floor of his tiny room since he went on a rampage last June and almost broke his mother's leg.

Now getting medication, he no longer hears voices and talks quietly to visitors, but his family is not ready to release him.

Asked if he thinks he will get better, Amiruddin shakes his head "no." But he smiles when his nurse interrupts, telling him: "You will get better. You are better."

Some types of Psychotherapy and Counselling

Resource: The Canadian Mental Health Association

Cognitive-behavioural Therapy
-Explores patient’s negative thoughts, emotions, and self-defeating behaviours and helps a person to learn to recognize and change negative thinking patterns;

Interpersonal Therapy
-Emphasizes development of specific skills in managing relationships (e.g. assertiveness training, adjusting to transitions)
-Focus on person’s identity issues, unresolved grief, and/or social issues;

Group Therapy and Support Groups
-Enables people to meet others who can relate to their issues and compare solutions;

Creative Therapies
-Brief therapy models (e.g. solution-oriented), art therapy, music therapy, play therapy and;

Psychodynamic Therapy
-Discover and resolve previous conflicts/traumas believed to be related to the present depression.

Hallucinations and Delusions: How to Respond

Below is a 2-page information sheet that was developed for use by everyone: police, public, people with mental illness and family members, paramedics, etc. They are part of the first phase of of the mental health and police project from 2005 (funded by BC Mental Health and Addiction Services and Provincial Health Services Authority).

They can be found here and are written in a simple, direct format, outlining common issues involved in police interactions with people with mental illness.

I thought it was good information for everyone.

Hallucinations and Delusions
Police officers, emergency workers, family members and friends, may at some time have to respond to a person in mental health crisis. It can sometimes be a frightening experience not understanding what is causing the person in crisis to act the way they do and not knowing how to respond most effectively. The most important tool you can have is information: a basic understanding of mental illness and the symptoms of different mental illnesses and, perhaps most importantly, what the person in a mental health crisis is experiencing and how you can best respond to help them.

Hallucinations and delusions can be symptoms of a number of different mental illnesses. Some types of drugs (legal or illegal) may also induce hallucinations and delusions. Hallucinations are when a person senses (sees, hears, feels, smells, tastes) things that do not exist. Delusions are when a person holds personal beliefs that are false, inaccurate or exaggerated (e.g., that people are after them, that they are royalty or a spy or a specific well-known person such as Elvis Presley or the Pope).

Recognizing and Understanding Hallucinations
The most frequent hallucination involves hearing, and often includes hearing voices which tell the person to do something (known as command hallucinations). You may recognize that the person is suffering from auditory (hearing) hallucinations when he or she appears preoccupied and unaware of their surroundings, talks to him or herself, has difficulty understanding or following conversations, and misinterprets the words and actions of others. The person may also isolate themselves or use radio or other sounds to tune out the voices.

A person experiencing other types of hallucination (visual, tactile, smell, taste) are usually identifiable by the person’s interaction with the hallucination: visual focus on something you cannot see, touching, scratching or brushing things off themselves, sniffing or holding their nose, spitting out food, etc., when there is no apparent reason to do so.

Responding to Hallucinations
A person experiencing hallucinations may be very frightened by them and needs your help in establishing a calm environment. Do not invade personal space or touch them without permission. Speak slowly, calmly and quietly, using simple concrete language. Be patient – it may take the person longer to process information. Reduce stimuli: turn off radios, televisions, bright lights, or anything else that may cause stress. Address the person by name or, if you don’t know it, ask them how they would like to be addressed.

The immediate goal of your response should be to help the person focus on reality rather than the hallucination. Do not pretend you also experience the hallucination, but do not try to convince the person that the hallucination does not exist: it does exist to them. Ask questions such as: “Are you hearing voices other than mine? What are they telling you? What do you see/feel/taste/ smell?” Tell the person: “I don’t hear the voices (see what you see, etc.), but I believe that you do.” Instruct the person to listen to your voice and not the other voice(s), or to look at you rather than whatever else they are seeing.

A person experiencing hallucinations needs treatment, and should be taken to a hospital or mental health service provider. Reassure the person that you want to help them, and explain who you are, what you are doing and why. If other people arrive, explain who they are, that they are there to help, and how they are going to help. The person needs to understand what is going on in order to reduce stress and confusion, which can increase hallucinations.

Recognizing and Understanding Delusions
Some delusions may seem relatively harmless in the short term, such as delusions of being a rock star, royalty, or a religious figure. These delusions can be potentially harmful, however, if they include or lead to delusions of having special abilities or characteristics such as flying, walking on water, or invincibility. Most common, however, are paranoid delusions: the belief that someone or something is going to harm the person in some way.

Paranoid delusions are usually evidenced by extreme suspicion, fear, isolation, insomnia (for fear of being harmed while asleep), avoidance of food and/or medication (for fear of poisoning), and sometimes violent actions. A person experiencing paranoid delusions has extreme difficulty trusting others, will frequently misinterpret others’ words and actions, and experience ordinary things in his or her environment as a threat.

Responding to Delusions
Until you know the content and context of the delusion, it is important to keep yourself safe from potentially violent reactions, and provide a comfort zone for the person experiencing delusions. Keep a safe distance or some barrier (such as a piece of furniture) between the two of you. Do not touch the person without permission. Position yourself at the person’s level if it is safe to do so. Do not whisper or laugh, as this may be misunderstood and may increase paranoia. Remember that someone experiencing delusions may not always be honest about what they think or believe; especially if their delusions are paranoid, the person may not trust you enough to be honest.

Ask questions about what the delusion is all about, particularly any elements which indicate the potential for harming self or others (e.g. “Are you having any thoughts about hurting yourself or others?”) Do not attack delusions or try to argue or convince the person that the thoughts are wrong or not real. Nor should you indicate that you believe in the delusion; instead explain “I believe you are telling me this is as you see it.” Do not smile or shake your head when the person speaks – this may lead to misunderstanding.

Ask whether there is anything you can do to make the person feel more comfortable, and explain your intentions before you act. Police officers and other persons in uniform must realize the potentially intimidating impact of the uniform on someone suffering from paranoid delusions. It is important to assure the person that they are safe, that you are not going to harm them, that the uniform and equipment you carry are for protecting them and that is what you want to do – protect them. Earning trust in order to help the person get treatment is the goal, while at the same time maintaining safety for all.

Hallucinations and delusions can be frightening for both the person experiencing them and for those who come in contact with that person, including police officers. Maintaining safety for everyone, and providing a calm, clear and persistent message that you want to help the person in need, while at the same time giving that person the time and space to hear and respond to that message, is the best response you can give as first responder.

Suicide and Mental Illness

Suicide and Mental Illness
From: http://www.ontario.cmha.ca/content/about_mental_illness/suicide.asp?cID=3965
People with mood disorders are at a particularly high risk of suicide. Studies indicate that more than 90 percent of suicide victims have a diagnosable psychiatric illness, and suicide is the most common cause of death for people with schizophrenia. Both major depression and bipolar disorder account for 15 to 25 percent of all deaths by suicide in patients with severe mood disorders. According to Toronto Metro Police Mental Health Act data, the number of documented suicide attempts rose 14 percent from 1996 to 2001. Statistics Canada reports that suicide is the eleventh leading cause of death in Canada.

Today is World Suicide Prevention Day

Some local activities submitted from around the world - From International Association for Suicide Prevention

Australia: Department of Health and Ageing (Australian Government)
The Australian Government's Department of Health and Ageing has funded a Breakfast Forum to commemorate World Suicide Prevention Day. The Forum is being held on Monday 11 September 2006 in Perth, Western Australia. The Forum is being funded under the Department's National Suicide Prevention Strategy, and will be hosted by the State based Advisory Group for the Strategy. It is hoped there will be 150 attendees from across the community in the following sectors: government and non-government; community based service providers; the corporate sector, Divisions of General Practice and the tertiary sector. The following three presentations will occur at the Forum: 1), Mr Michael O'Kane, State Manager, Department of Health and Ageing re: Welcome and overview of the Australian Government's National Suicide Prevention Strategy; 2) Mr Peter Orchard re: Headspace, National Mental Health Initiative; 3) Ms Lorna Hirsch, Livingworks in the Pilbara re: Pilbara Suicide Prevention Project; and 4) Mr Simon Dann, GP Coastal Division of General Practice & Dr Pam Hendry, Perth Modern School re: GP Coastal's Suicide Intervention Program: GPs Life Saver. In addition to Forum attendees accessing valuable information about these topics regarding suicide prevention, the Forum will provide a valuable opportunity for networking.

Australia
Launch 3 quilt creation workshops in Tasmania: Have sought funding to provide counselling and textile artist resources to enable creation of memorial quilts in a supported and therapeutic environment. We do not have support available for people on our island who have experienced the death of a parent, brother, sister, friend, due to suicide. I hope that the spiritual reflection and launch of 3 quilt creation workshops to be held during the next 10 months will draw attention to the need for such support. As the quilt grows it will perhaps also draw attention to the fact that our state has the second highest incidence of suicide in the country and we need to put suicide prevention more strongly onto health policy agendas, and understand more about why we have such terrible losses (statistics).

Austria: Viennese Crisis Intervention Center
Media-workshop `Mass-media Reporting on Suicide´: We organize a workshop for journalists providing them information about suicide prevention, imitational effects, crisis intervention, influence of media reports on suicidal behavior and suicide media coverage (guidelines `How to Report on Suicide´). In order to improve the cooperation between the Viennese Crisis Intervention Center and Austrian journalists we post regularly updated suicide statistics of Vienna, Austria and EU on our website: www.kriseninterventionszentrum.at

Belgium: Centre for Suicide Prevention
Press Conference and breakfast to be held on Friday 8th September. Issues to be discussed at the press conference include: Suicide in Belgium, Suicide as a public health problem, the role of the media in disseminating information about suicide. There will also be a presentation of new suicide prevention activities being undertaken at the Centre for Suicide Prevention. Time will be provided for questions and answers.

Belgium: Suicide Prevention Project of the Flemish Mental Health Centres
On Monday 4 September we will hold a conference for the media and the mental health sector to launch the new website of the Suicide Prevention Project of the Flemish Mental Health Centres: www.zelfmoordpreventievlaanderen.be At this conference, the Minister of Health and Well-Being will present her plans regarding suicide prevention. Several press releases will announce the event.

Brasil: Hospital de Clínicas de Porto Alegre, Serviço de Psiquiatria, Porto Alegre
On September 11th we will deliver a brief training on suicide prevention for the clinical personnel of the hospital (including nursing attendants, nurses, etc.). On September 12th two lectures will be presented (by M.D. Ph. D Cláudio Laks Eizirick, President of the International Psychoanalysis Association (IPA) and Ph. D. Blanca Werlang, a Psychologist who studieshistorical aspects of suicide behavior). These lectures will regard the psychodynamics and historical aspects of suicide. We are also developing a guideline for management of suicide risk on our hospital that will be presented to the hospital staff on September 12th.

Canada: The Casey Project, Suicide Awareness
We have had a newspaper interview (full page), have a radio interview coming up, we will start our walk in New Minas, Nova Scotia, Canada to Kentville, N.S., Can. where we will meet at the recreation centre. We have displays of resources available to people in crisis at the rec. cent. We have a wooden forget-me-not crafted out of cedar on a bamboo dowel with wooden leaves, in the centre is a round engravable plaque that can bear the date and name of the loved one you lost, this can be put in a memory garden or indoor plant pot to honour your loved one lost to suicide. This is a fund raiser for suicide prevention. From the rec. centre we will walk around the town square with our banner for World Suicide Prevention Day (which we will honour on Sept. 9th.in our town). Once we get back to the rec. centre, we will have a charity barbeque. This is our second year for the walk. Last year it involved only Kentville, N.S. Next year I hope to involve more towns. One day, all of N.S. and then all of Canada will pick up the torch.

Canada: Central Vancouver Island Crisis Society
We will be doing a button and poster campaign: "Embrace Life Suicide is everyone's Loss" and will be presenting that message along with the message "With Understanding New Hope" in the media, our local univeristy, banks, doctors offices, community service providers, local businesses. and in all of our local high schools and midle schools. We have also recently begun campaigning with business and service providers to make them aware of this day and to solicit their support in making our plans for awareness a success. Planned events include a workshop and luncheon that will focus on information about suicide and the importance of awareness and self care as a preventative measure, a student booth at our local university, and a candle light vigil on Suicide Prevention Day.

Canada: Embrace Life Council Isaksimagit Inuusirmi Katujjiqatigiit
The objective of the event will be to celebrate life, to create awareness of suicide as an issue where solutions can be identified at the community level; to encourage teamwork within communities, and be a media campaign for youth not to give up. Each community will be requested to: • do a walk and to hold hands in a similar manner as the embrace life council logo; • fly the newly created Embrace life flag; • celebrate Nunavut Embrace Life Day by providing refreshments and prizes for games; • post the newly created Poster with Jordan Tootoos image and Kamatsiaqtut’s Helpline number; • distribute wristbands with the words "embrace life" and Brochures for youth entitled embracing life: this is who i am, which includes images of youth and quotes with their perspectives.

Canada: NEED Crisis and Information Line
On Sunday, September 10th there will be a short walk, to be followed by a short discussion forum. We will hear from people impacted by suicide and people working on prevention. We anticipate some media coverage of the event.

Canada (New-Brunswick): Suicide prevention Society
Public awareness by radio interviews. Walkaton, barbecue and live bands.

Chile: Particular/Fondart
Suicide awareness campaign: With the support of the Ministry of Culture of Chile, we are making a campaign for awareness about the suicide phenomenon. We will distribute to the public of Santiago city a series of artistic photo-postals, each one of them with a brief "infography" about suicide statistics and other facts, with its social and medical consecuences. We'll try to get this activity promoted in several press spaces, planed for the 10/09/06.

Germany: National Suicide Prevention Programme for Germany (NaSPro)
Main special event in Berlin. Special ecumenical service in the Gedächtniskirche. Public meeting with politicians and speeches after the service in front of the church. Other local events.

Germany: Psycho-social crisis center Psychosozialer Krisendienst Gesundheitsamt Dresden
The press-conference is a cooperation project between several crisis-intervention-teams, telephone help-lines, the psychiatric clinic of the University of Dresden and especially Prof. W. Felber, president of DGS. We want to inform about + suicide and suicide prevention where can people find professional help and about media guidelines for reporting.

Ghana: Young Mobilization Association
Conference: Children's health.

Guam, United States of America Territory: Life Works Guam
Collaborate and network with other agencies like University of Guam, Department of Youth Affairs, Guam Public School System, public media like the newspaper and television media on the island regarding our Suicide Awareness, Precvention, and Intervention Campaign: With Understanding , New Hope Campaign starting September 1-30, 2006. Weekly write up in the newspaper media, 2 TV interviews. Candle Light Vigil after the 5 K run walk event. Mememory Trees at the various McDonald's Restaurants (we have started last year), a very profound touching event. September 9-10, 16-17, 23-24, 2006 conduct a two day workshop on the Applied Suicide Intervention Skills Training at the Univeristy Guam and Outrigger Guam Resort Hotel. If you have any questions please do not hesitate to call me: 671-632-0257, 671-777-4624, 671-477-8040, Marie Virata Halloran, Executive Director, Life Works Guam.

Hong Kong: The Samaritan Befrienders Hong Kong
The Samaritan Befrienders Hong Kong will have a radio program in RTHK 2 on 8/9/2006 (Friday)3:30-4:30. The main theme is "With understanding, new hope". The whole radio drama will be divided into three parts to introduce suicide prevention services as well as the importance of listening and understanding. 24-hours hotline volunteers are invited to participate in the drama and share their experience through a storytelling way.

India: Medico Pastoral Association, Bangalore
Rally is being organised to partner with agencies and organisations that provide services to people with emotonial problems and disorders.This will involve representation from students, working professionals,senior citzens, celebrities and volunters of various backgrounds on the theme "Life.You're worth it".

Ireland: Johnstown Therapy Centre, Dublin
Our Centre will be holding an open day on Sunday 10th Sept exhibiting information about suicide. We will also have psychotherapists/counsellors available throughout the day to talk to people who have been affected by suicide.

Ireland: The 3Ts (Turn the Tide of Suicide)
In Dublin, The 3Ts will host a Candlelight Vigil in the city centre to commemorate the many lives that have been lost in Ireland through Suicide both this year and in the past. The Vigil is open to all who have lost loved ones or who have been touched in some way by suicide. Key speakers will join the Vigil to mark the day with music, song, and a minutes silence. Venue: Bank of Ireland (Forecourt), College Green, Dublin 2 Time: 9.00pm - 10.00pm. email: 3ts@alburn.com web: www.3ts.ie

Italy: Department of Psychiatry, Sant'Andrea Hospital, University of Rome
Following the pattern used last year, we are celebrating World Suicide Prevention Day 2006 with various activities, coordinated by Dr. Maurizio Pompili, such as a conference with the participation of a number of speakers that will present updated information on suicide prevention strategies and focus on the issue. Special meetings have been organised to educate medical personnel to deal with suicidal patients effectively. Nurses and doctors have been invited to take part in this event which has been divided into two parts. One took place in July and the other will be held in the second week of September. Dr. Pompili has also organised conferences devoted to psychologists and other mental health professionals. He also provided a number of editorials and press releases in order to attract public awareness of the problem. Dr. Pompili is also taking care of events to celebrate the National Suicide Prevention Week 2006 organised by the American Association of Suicidology. He has also been invited to organise events for the World Mental Health Day 2006 (Oct 10) dedicated to suicide.

Japan: Lifelink
Following up on our conference of last year and with the enactment of the Fundamental Law for Suicide Measures this year, Lifelink, with sponsorship from the WHO, the Ministry of Health, Labour and Welfare (waiting approval), the Johnson and Johnson Contribution Committee and the Central Research Institute, INC, will be holding an all-day forum for invited specialists at the National Institution for Youth Education, Tokyo. The aim of the forum is to create the framework to realise the initiatives for suicide prevention, research and survivor support provided in this new legislation. The forum will begin with Livelink, an interchange between private suicide-related organisations from throughout Japan and will be followed by three sessions to discuss the grand design for suicide measures, surveys of the current state of suicide prevention measures and creation of a regional network for suicide prevention. The forum will end with a party for all participants to deepen their ties and informally exchange ideas. For further information, please visit our website at http://www.lifelink.or.jp.

México: BENEMÉRITA UNIVERSIDAD AUTONÓMA DE PUEBLA
On 14, September, we have organized an activity at the university autonomous of Puebla, this is titled "Meeting about suicidal tendencies: detection and prevention". This activity is organized by the Faculty of Psychology. In this activity professors and students participate in some round tables, and we have made a poster to spread the activity. On 12 and 13, October, we have organized an event titled: "International seminary of integral attention before suicidal conducts". All the information is at:

New Zealand: Canterbury Suicide Project

- A display has been held (27th August 2006) at the Christchurch School of Medicine and Health Sciences Research Open Day.

- In Wellington, New Zealand’s capital city, the Ministry of Health will organise a display for World Suicide Prevention Day which will include suicide prevention resources and materials. This display will be in the foyer of the Ministry of Health offices.

Norfolk Island, South Pacific: Norfolk Island Hospital Enterprise

I will present the LivingWorks program "Suicide TALK", an exploration in suicide awareness. It aims to create to create a community climate of awareness and and interest in learning more about a wide range of suicide prevention activities. To be held on 10th September. I will also write an article for "The Norfolk Islander" local paper and discuss WSPD in a radio interview for Radio Norfolk.

Norway: LEVE (The Norwegian Organization for Suicide Survivors)

There will be, in the period 10th September - 24th September, an art exhibition outside the City Hall in Oslo. The exhibition will be prints of work of arts sent in from all over Norway, and there will also be an exhibition catalogue free of charge available. The title will be "Å LEVE" ("Living").

Pakistan: Fountain House

Fountain House, Lahore is organizing Suicide Prevention Day on 10th September 2006 at 12:00 noon at Prof. Muhammad Rashid Chaudhry Auditorium, Fountain House, Lahore. Eminent mental health experts, famous TV and film artists, teachers, families of the patients and journalists are going to participate in the event. (Public meeting/Suicide awareness campaign.)

Switzerland: Association STOP SUICIDESTOP SUICIDE

organizes various activities around the World Suicide Prevention Day of September 10th, 2006: - an awareness campaign of the population, thanks to the participation of municipalities (Communes) in the Genevan region; - the distribution of brochures, "prêt-à-prévenir", wanting to indicate various help-places, by "mini-theater" in schools; - the participation in a festival of "electro"-music, aiming at to touch young people. All these activities are turned around various solutions which STOP SUICIDE wishes to advance, because suicide is not a solution.

Turkey: Turkish Air Force Command

Messages from commander/high-rank leaders : Emphasizing the importance of suicide prevention efforts and Air Force Suicide Prevention Program (launched on March 2006); informs leadership at all levels to take an active role in suicide prevention. Flyers and brochures : Informational flyers/brochures about mental health/risk factors; messages to air force members that life problems can be solved by different means ;emphasizing social support, interconnectedness, reducing the barriers to seeking help. (with graphics, phares that catch attention etc.)

United Kingdom: Safer Custody Group, Home Office

Various Prison Service establishments are holding events for staff and/or prisoners to mark World Suicide Day. The chaplaincy team at several establishments (eg. Featherstone, Ford, Camp Hill, Gloucester, and New Hall prisons) will be holding themed services in the prison chapel to mark the day. Other prisons are holding special events with various publicity stalls set up. For example, Glen Parva prison will be inviting prisoners and staff to an event in the chapel, with various stalls set up to include: Samaritans, mental health nurses, gym, drug support. Holloway women's prison in London is planning a fete, with money raised being donated to Samaritans. Kirkham prison is planning to hold a yoga afternoon in the gymnasium for staff and prisoners, and will put on a display to publicise yoga and other methods of stress relief. Stoke Heath Young Offenders Institution will be holding an awareness day, and community partners have been invited to put up stands/displays on what help and support is available for young people both inside and outside the prison.

World Suicide Prevention Day - September 10, 2006 Press Release

From: International Association for Suicide Prevention

World Suicide Prevention Day 2006Held on Sept 10th

At a press conference on September 8, 2006 at the World Health Organization United Nations Offices in New York, the International Association for Suicide Prevention (IASP), in collaboration with the World Health Organization (WHO) and the World Federation for Mental Health (WFMH) announced the Fourth World Suicide Prevention Day to be held on September 10, 2006. Throughout the world, national and local events, including conferences, meetings, concerts and activities with spiritual or cultural contents have been organized to enhance understanding about suicide and to demonstrate ways in which knowledge about suicide can be translated into effective suicide prevention programmes. This year’s theme “With Understanding, New Hope” emphasizes the importance of translating our knowledge and understanding of suicide into the development of effective suicide prevention strategies and programmes.

“In this age of preoccupation with global violence, terrorism and homicides, we often ignore the fact that worldwide more people kill themselves than die in all wars, terrorist acts and interpersonal violence combined,” said Professor Brian Mishara, the President of the International Association for Suicide Prevention. “More than a million people worldwide die by suicide each year, many millions make suicide attempts severe enough to need medical treatment and many millions are affected by the disastrous impact of a suicide. We have now developed enough understanding of suicide to prevent a significant proportion of these tragic deaths, to treat suicidal individuals and help families bereaved by suicide. There is a great need to translate our very considerable knowledge about why people attempt to take their lives into effective strategies, policies, programmes and services, to reduce the tragic loss of lives and the devastating effects of suicidal behaviour. Promising areas for suicide prevention include improving mental health treatment and management, educating physicians, restricting access to lethal means of suicide, educating the community, providing help in crisis situations, providing support after suicide attempts and improving media coverage of suicide.”

“We need to use our knowledge to develop coordinated and comprehensive suicide prevention initiatives throughout the world, adapted to local cultures and resources, to reduce the number of completed suicides, suicide attempts and the consequences of suicide and self-destructive behaviours,” said Professor Mishara.

Suicide is the result of a complex interaction of causal factors, including mental illness, poverty, substance abuse, social isolation, losses, relational difficulties and workplace problems. To be effective, suicide prevention needs to incorporate a multi-faceted approach that acknowledges the multiple causes and pathways to suicidal behaviour and involves health and mental health professionals, volunteers, researchers, families and others bereaved by suicide as well as central and local governments, education, justice, police, employers, religious leaders, politicians and the media. “The theme of World Suicide Prevention Day 2006, With Understanding New Hope, is an opportunity for persons with experience in understanding suicidal behaviour, including researchers, clinicians and practitioners, to share their knowledge and highlight ways this knowledge can be applied to suicide prevention activities, programmes and policies. Public forums, educational activities and awareness campaigns throughout the world are being held on September 10. It is our hope that these activities will help change public attitudes and increase awareness and knowledge about suicide as a major public health problem that is preventable,” said Professor Mishara.

The International Association for Suicide Prevention was founded in Vienna in 1960 as a working fellowship of researchers, clinicians, practitioners, volunteers and national and local organizations of many kinds. IASP, in official relation with the World Health Organization and in collaboration with the World Federation for Mental Health, believes that suicide prevention should be given greater priority at national, regional and local levels to incorporate research knowledge that has shown that suicide is preventable. Examples of activities held on this day in different countries are posted on the IASP Website: www.iasp.info.

For further information, contact:

Professor Brian L. Mishara, Ph.D.
President of IASP
Telephone: +1 514 987-4832
e-mail: IASP1960@aol.com

In the Asia Pacific region, you may contact contact:

Professor Annette Beautrais in New ZealandFirst-vice President of IASPe-mail: annette.beautrais@chmeds.ac.nz

Suicide Prevention and the Internet

From: The Centre for Suicide Prevention

In the last decade, the Internet has experienced a phenomenal growth as technology costs continue to fall and more and more people have mainstream access to the network. Statistics show that the Internet represents an increasingly important medium, especially among adolescents and young adults who use it as a source of information and communication. A recent study by Statistics Canada (2001) showed that 90% of 15-19 year old teenagers had used the Internet in 2000, compared to 53% for the overall population. Since the younger age group is characterized by high suicide rates, it would be wise for the suicide prevention community to capitalize on new Internet-based prevention opportunities while anticipating potential new
challenges.

Suicide Prevention on the Internet
Vulnerable and at-risk individuals accessing the Internet can find useful information and support through a variety of Internet services including: informative websites, discussion or support groups, and one-on-one counselling or support.

1. Web Sites
Websites often represent the first contact for users and the first opportunity for the suicide prevention community to reach out to individuals who may be vulnerable or suicidal. The great majority of websites currently dealing with suicide are thoughtfully designed and offer a wealth of helpful information. Many organizations, like the Centre for Suicide Prevention (www.suicideinfo.ca), provide lists of suicide risk factors, warning signs, and guidelines on how best to respond to a friend or loved one in a suicidal crisis. Individuals at imminent risk for suicide are usually directed to a crisis center or help line in their region. Information about suicide risk and prevention can be widely distributed at low cost to vulnerable people, many of whom may choose not to access more traditional services.

2. Discussion and Support Groups
The Internet also offers a variety of more interactive services to users. News groups (often referred to as discussion groups or bulletin boards) and mailing lists are services which are open to the free exchange of ideas between users. It is now possible for people to share ideas and feelings across vast distances and with enormous numbers of people. Well moderated discussion groups can serve as an opportunity for vulnerable individuals to share emotional struggles and get the social support that may be lacking in their own social network. Used in this way, Internet discussion groups may contribute to a reduction in suicide risk. However, the true effectiveness of online support groups is difficult to measure since there is little chance to assess users’ true experiences in “real life” beyond their input
within the on-line group (Stoney, 1998).

3. One on One Counselling or Support
The Internet also offers an electronic means of communication, the most popular being electronic mail, or e-mail. Internet-based modes of communication represent a new opportunity for the provision of counselling or emotional support to vulnerable individuals by trained volunteers or counselolrs. As with telephone befriending, communication is typically initiated by the vulnerable individual via e-mail or a real-time chat service. Once the initial contact is made, e-mail messages between the at-risk person and the volunteer or counsellor are exchanged over a period of time (Wilson & Lester, 1998). In the case of a chat service, a vulnerable individual can “talk” privately with a counsellor or trained volunteer in real-time. These innovative communication methods offer significant privacy for the client, even more so than with the telephone. Interestingly, preliminary research has shown that the percentage of people who are suicidal is much higher among e-mail contacts than among telephone callers or walk-ins (Bale, 2001; Wilson & Lester, 1998).

Examples of Preventive Internet Services
Youth One: Online Support Group and Crisis Chat. ---Youth One (www.youthone.com) offers Peer Support Forums and Crisis Chat services to the on-line youth community. The monitored Peer Support Forums allow youth to post and receive messages from their on-line peers. Vulnerable youth can also “talk” in real-time with a trained Support Team member through the Crisis Chat service. Between April 2002 and March 2004, the site saw a 275% increase in the use of the Peer Support Forums and close to a 2000% increase in individuals accessing the Crisis Chat
service, many with suicide related concerns (Osbourne, 2004).

Youth in BC: Crisis Chat and E-mail counselling. ---Youth in BC (www.youthinbc.com) is an innovative internet based resource for youth in crisis that has been operating since February 2004. The site presents information on a variety of topics, including suicide, and links vulnerable youth with trained volunteer listeners (who are supported by professional counsellors) through a real-time chat service, e-mail communication, or the more traditional toll-free telephone number (Miller J. et al., 2004).

Samaritans: E-mail counselling.
In 1994, the Samaritans of the United Kingdom and Republic of Ireland decided to enhance their already well-established befriending services by adding the option of e-mail contact as another means for offering emotional support. A 1999 survey showed that 53% of e-mail contacts had suicidal feelings, compared to 26% of telephone callers. It has also been observed that men are using the e-mail service more than women by ratio of two-to-one (Bale, 2001).

Preventing Suicide

From: The Canadian Mental Health Association

Suicide. We would rather not talk about it. We hope it will never happen to anyone we know. But suicide is a reality, and it is more common than you might think. The possibility that suicide could claim the life of someone you love cannot be ignored. By paying attention to warning signs and talking about the "unthinkable," you may be able to prevent a death.

Who is at risk?
People likely to commit suicide include those who:

- are having a serious physical or mental illness,
- are abusing alcohol or drugs,
- are experiencing a major loss, such as the death of a loved one, unemployment or divorce,
- are experiencing major changes in their life, such as teenagers and seniors,
- have made previous suicide threats.

Why do people commit suicide?
There are many circumstances which can contribute to someone's decision to end his/her life, but a person's feelings about those circumstances are more important than the circumstances themselves. All people who consider suicide feel that life is unbearable. They have an extreme sense of hopelessness, helplessness, and desperation. With some types of mental illness, people may hear voices or have delusions which prompt them to kill themselves.

People who talk about committing suicide or make an attempt do not necessarily want to die. Often, they are reaching out for help. Sometimes, a suicide attempt becomes the turning point in a person's life if there is enough support to help him/her make necessary changes.

If someone you know is feeling desperate enough to commit suicide, you may be able to help him/her find a better way to cope. If you yourself are so distressed that you cannot think of any way out except by "ending it all," remember, help for your problems is available.

What are the danger signs?
Some warning signs that a person may be suicidal include:

- repeated expressions of hopelessness, helplessness, or desperation,
- behaviour that is out of character, such as recklessness in someone who is normally careful,
- signs of depression - sleeplessness, social withdrawal, loss of appetite, loss of interest in usual activities,
- a sudden and unexpected change to a cheerful attitude,
- giving away prized possessions to friends and family,
- making a will, taking out insurance, or other preparations for death, such as telling final wishes to someone close,
- making remarks related to death and dying, or an expressed intent to commit suicide. An expressed intent to commit suicide should always be taken very seriously.

Prevent a suicide attempt
If you are concerned that someone may be suicidal, take action. If possible, talk with the person directly. The single-most important thing you can do is listen attentively without judgement.

Talking about suicide can only decrease the likelihood that someone will act on suicidal feelings. There is almost no risk that raising the topic with someone who is not considering suicide will prompt him/her to do it.

Find a safe place to talk with the person, and allow as much time as necessary. Assure him/her of your concern and your respect for his/her privacy. Ask the person about recent events, and encourage him/her to express his/her feelings freely. Do not minimize the feelings involved.

Ask whether the person feels desperate enough to consider suicide. If the answer is yes, ask, "Do you have a plan? How and where do you intend to kill yourself?"

Admit your own concern and fear if the person tells you that he/she is thinking about suicide but do not react by saying, 'You shouldn't be having these thoughts; things can't be that bad." Remember, you are being trusted with someone's deepest feelings. Although it may upset you, talking about those feeling will bring the person relief.

Ask if there is anything you can do. Talk about resources that can be drawn on (family, friends, community agencies, crisis centres) to provide support, practical assistance, counselling or treatment.

Make a plan with the person for the next few hours or days. Make contacts with him/her or on his/her behalf. If possible, go with the person to get help.

Let the person know when you can be available, and then make sure you are available at those times. Also, make sure your limits are known, and try to arrange that there is always someone that he/she can call at any time of day.

Ask who else knows about the suicidal feelings. Are there other people who should know? Is the person willing to tell them? Unfortunately, not everyone will treat this issue sensitively. Confidentiality is important, but do not keep the situation secret if a life is clearly in danger.

Stay in touch to see how he/she is doing. Praise the person for having the courage to trust you and for continuing to live and struggle.

What to do following a suicide attempt
A person may try to commit suicide without warning or despite efforts to help. If you are involved in giving first aid, make every effort to be calm and reassuring, and get medical help immediately.

The time following an attempt is critical. The person should receive intensive care during this time. Maintain regular contact, and work with the person to organize support. It is vital that he/she does not feel cut off or shunned as a result of attempting suicide.

Be aware that, if someone is intent on dying, you may not be able to stop it from happening. You cannot and should not carry the responsibility for someone else's choice.

What can you do if you are feeling suicidal?
The beginning of the way out is to let someone else in. This is very hard to do because, if you feel so desperate that suicide seems to be the only solution, you are likely very frightened and ashamed. There is no reason to be ashamed of feeling suicidal and no reason to feel ashamed for seeking help. You are not alone; many people have felt suicidal when facing difficult times and have survived, usually returning to quite normal lives.

Take the risk of telling your feelings to someone you know and trust: a relative, friend, social service worker, or a member of the clergy for your religion. There are many ways to cope and get support. The sense of desperation and the wish to die will not go away at once, but it will pass. Regaining your will to live is more important than anything else at the moment.

Some things that you can do are:

- call a crisis telephone support line,
- draw on the support of family and friends,
- talk to your family doctor; he/she can refer you to services in the community, including counselling and hospital services,
- set up frequent appointments with a mental health professional, and request telephone support between appointments,
- get involved in self-help groups,
- talk every day to at least one person you trust about how you are feeling,
- think about seeking help from the emergency department of a local hospital,
- talk to someone who has 'been there" about what it was like and how he/she coped,
- avoid making major decisions which you may later regret

Do you need more help?
If you or someone you know is feeling suicidal and you need more information about resources in your area, contact a community organization, such as the Canadian Mental Health Association, which can help you find additional support.

World Suicide Prevention Day - September 10, 2006

From the Canadian Health Network

World Suicide Prevention Day is organized on September 10 each year by the International Association for Suicide Prevention (IASP) and the World Health Organization (WHO) to draw world attention to one of the world's largest public health problems.

With understanding, new hope is the theme for 2006. This year focuses on the need to take current research and knowledge on suicidal behaviour and translate it into practical programmes and activities that can save lives.

Despite our increasing knowledge about the causes and consequences of suicidal behaviour, our understanding of what works best in preventing suicide is relatively underdeveloped.

Facts about suicide:
- About one million lives are lost each to suicide each year.
- Suicide is one of the leading causes of death, particularly in young people.
- More lives are lost to suicide around the world each year than from all wars and homicides.
- Depression is one of the risk factors for suicide.

Preventing suicide—who can help?
To be effective, suicide prevention will require a response from the entire community, including researchers, health practitioners, community and social service workers, governments, police and legal systems, religious organizations, educators and employers.

There are many ways to get involved:
- Organize an event or launch an initiative to raise awareness on suicide.
- Hold a press conference to highlight research findings.
- Hold training courses on the causes of suicide.

For more ideas, and to see a sample of activities around the world, visit the website for World Suicide Prevention Day 2006, or the Centre for Suicide Prevention.

Considering Suicide?

Considering suicide: Don't let despair obscure other options
MayoClinic, April 15, 2004

Depression and hopelessness can cloud your thinking, and you may consider taking your own life. Learn about healthy coping strategies to get through a crisis.

When life doesn't seem worth living anymore or your problems seem insurmountable, you may think that the only way to find relief is through suicide.

You might not believe it, but you do have other options, options to stay alive and feel better about your life. Maybe you think you've already tried them all and now you've had enough. Or maybe you think your family and friends would be better off without you.

It's OK to feel bad, but try to separate your emotions from your actions for the moment. Realize that depression, other mental disorders or long-lasting despair can distort your perceptions and impair your ability to make sound decisions. Suicidal feelings are the result of treatable illnesses. So, try to act as if there are other options, even if you may not see them right now.

No, it probably won't be easy. You may not feel better overnight. Eventually, though, the sense of hopelessness can lift. You can find support, appropriate treatment and reasons for living.

When you need immediate help
If you're considering suicide right now and have the means available, contact someone for help. The best choice is to call 911 or your local emergency services number.

If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:
-Contact a family member or friend.
-Contact a doctor, mental health professional or other health care professional.
-Contact a minister, spiritual leader or someone in your faith community.
-Go to your local hospital emergency room.
-Call a crisis center or hot line.

Crisis centers or suicide hotlines are often listed in the front of your phone book or on the Internet. They offer trained counselors, usually volunteers, who can help you through an immediate crisis. Some crisis centers with an Internet presence offer e-mail contact, but remember that responses may not be as prompt as with telephone support.

Talking to someone about your feelings, connecting with them, can help relieve the burden of despair and isolation, even temporarily. It may help you shift perspective and more clearly see your other options.

Daily coping strategies
You may struggle with suicidal feelings frequently, perhaps many times a day. Develop a strategy to cope with those feelings in a healthy way. Consider asking a doctor, family member or friend to help create a strategy tailored to your specific situation.

It may mean doing things you don't feel like doing, such as talking to friends when you'd rather hole up in your bedroom all day with the curtains drawn, or going to the hospital for a mental health evaluation. But stick to your strategy, especially when you're in the grips of despair and hopelessness.

As part of your strategy, consider these measures:
-Keep a list of contact names and numbers readily available, including doctors, therapists and crisis centers.
-If your suicide plans include taking an overdose, give your medications to someone who can safeguard them for you and help you take them appropriately.
-Rid your home of knives, guns, razors or other weapons you may consider using for self-destructive purposes.
-Schedule daily activities for yourself that have brought you even small pleasure in the past, such as taking a walk, listening to music, watching a funny movie, knitting or visiting a museum. If they no longer bring you at least a modicum of joy, however, try something different, particularly if these familiar activities induce painful reminders.
-Get together with others, even if you don't feel like it, to prevent isolation.
Avoid drug and alcohol use. Rather than numb painful feelings, alcohol and drugs can increase the likelihood of harming yourself by making you more impulsive, more open to giving in to self-destructive or despairing thoughts.
-Write about your thoughts and feelings. Remember to also write about the things in your life that you value and appreciate, no matter how small they may seem to you.

Some organizations recommend creating a "plan for life" or similar plan of action that you can refer to when you are considering suicide or are in a crisis. This is a checklist of activities or actions you promise yourself to take in order to keep yourself alive or stay on course with treatment. For instance, it may stipulate that you contact certain people when you begin considering suicide. It may also include commitments to take medication appropriately, attend treatment sessions or appointments, and to remind yourself that your life is valuable even if you don't feel it is.

Also, consider creating a list of specific activities to try when you're feeling suicidal or just feeling bad. The key is to engage in self-soothing for a range of negative feelings, not just when you reach the point of suicidal thoughts. Make sure they're activities that would normally offer enjoyment and that can help comfort you, not cause additional stress. Then, do each item on your list until you feel like you can go on living. It can include such things as:
-Practicing deep-breathing exercises
-Playing an instrument
-Taking a hot bath
-Eating your favorite food
-Writing in a journal
-Going for a walk
-Contacting family, friends or other trusted confidantes

Even if the immediate crisis passes, consult a doctor or mental health professional, or seek help through an emergency room if your area isn't served by mental health professionals. They can help make sure you're getting appropriate treatment. Medication and psychotherapy, either individual or group, are often effective treatments for depression, anxiety, substance abuse and other mental disorders, and they can help you feel better about yourself and your life. Although you may not want to consider psychiatric hospitalization, it can help protect you and give medication and psychotherapy a chance to work more effectively.

Seeing beyond the despair
The despair and hopelessness you feel as you consider suicide may be the side effects of illnesses that can be treated. These emotions can be so overpowering that they cloud your judgment and lead you to believe that taking your own life is the best, or only, option.

But even people with long-standing suicidal thoughts can learn to manage them and to develop a more satisfying life through effective coping strategies. Take an active role in saving your own life, just as you would help someone else. Enlisting others for support can help you see that you have other options and give you hope about the future. Suicide isn't a solution, it's an ending.

Housing and Mental Illness

Link: Housing and Mental Illness

It is estimated that 1/3 of the homeless population suffers from some form of mental illness.

This number increases to 75% for homeless single women.

Homelessness is not considered a major cause of mental illness but does increase its' duration and severity.

Two thirds of the homeless will have a lifetime experience with mental illness, three times higher than the general population.

75% of homeless people with mental illness will also have a substance abuse problem.
Correctional facilities are increasingly becoming ‘home’ to people with serious mental illness who are more likely to be detected and arrested and incarcerated for non-violent and nuisance offences. There is widespread agreement that people with mental disorders are increasingly and often unintentionally, caught in the justice system.

What Causes Depression?

Link to: What Causes Depression?

We still do not know for sure what causes depression. However, research suggests there may be more than one cause and most likely, it is a combination of factors, which leaves some individuals more vulnerable to developing a depressive disorder. The "kindling theory" suggests that the more factors that combine together the more at risk an individual is to developing a major depressive illness.

Some known factors, which contribute to depression, include:

Genetic factors- depression does runs in families.

Medical research demonstrates that people with depression have a chemical imbalance of neurotransmitters, the important chemical messengers in the brain.

A history of childhood physical and emotional abuse, trauma, or parental loss is associated with higher rates of depression.

Women are twice as likely to develop depression, which can be associated menstruation, childbirth, and menopause suggesting hormones may play a role.

There are times in life when family and work pressures are higher and during which time people are more likely to get depressed.

Depression can follow significant losses such as the death of a loved one, an unexpected job loss, or retirement.

Depression is also strongly associated with medical illness and chronic disability.

Temperament and personality also plays a role. Those who are more pessimistic and negative in their interpretation of life events, less resilient to change, perfectionist and lack a supportive social network are at greater risk of developing depression.

Some prescription and non-prescription drugs are also known to cause depression by interfering with important brain neurotransmitters.

Depression is also found to be more common in those with low income, are unemployed, unmarried or divorced.

Alcohol is a known central nervous system depressant and prolonged use is associated with a greater incidence of depression.

http://www.cpa-apc.org/Publications/Clinical_Guidelines/depression/clinicalGuidelinesDepression.asp

Facts About Mental Illness In The Workplace

Link to: Facts About Mental Illness In The Workplace

o Percentage of Canadian employers who consider the continuous rise in employees’ mental health claims to be a top concern: 56%

o Percentage of short term disability claims related to mental illness in Canada: 75%

o Percentage of long term disability claims related to mental illness in Canada: 79%

o Percentage increase in long term disability costs: 27%

o Percentage of employers who track disability claims costs as a percentage of payroll: 28%

o Percentage of employers who have plans to address mental health and mental illness in the workplace: 31%

Source: Mental health claims on the rise in Canada: Watson Wyatt’s
Staying @ Work Survey (Sept 2005). Available at: www.watsonwyatt.com/canada

o Fastest growing category of disability costs to Canadian employers: Depression

o Annual losses to the Canadian economy due to mental illness in the workplace: $33 billion

o Amount employer will save, per employee per year, for those who get treatment: from $5000 - $10,000 in average wage replacement, sick leave and prescription drug costs.

Source: Mental Health Works, Mental health facts. Available at:
http://www.mentalhealthworks.ca/facts/index.asp

o Percentage of people with serious mental illness who are unemployed: 70 – 90%

Source: Fact Sheet, Employment and mental illness. Available at: www.ontario.cmha.ca

o Percentage of people with serious mental illness who want to work: 80%

Source: World Health Organization (2000). Mental health and work:
Impact, issues and good practices. Available at: www.who.int/mental_health/media/en/712.pdf

Stigma has serious health and social consequences

Link: Stigma has serious health and social consequences


· Mental illness and addiction is common (one in five Canadians) however because of stigma and the fear of discrimination only one third seek treatment. [ii]

· People deny painful symptoms and are reluctant to seek help at an early, more treatable phase of their condition, resulting in delays in beneficial treatment making treatment more complicated, less effective resulting in greater disability.

· The drop-out rate for psychiatric treatment is estimated to be one half because people do not want to be seen attending psychiatric treatment - leading to relapse and greater disability. [iii]

· People with mental illness and addictions often hold the same negative attitudes of society at large and blame themselves for their illness and the resulting social and economic losses.

· The major way people cope with the effects of self-stigma and shame is by withholding information from family, friends, employers and treatment providers, leading to feelings of emptiness, alienation and rejection which can further trigger depression and substance abuse and relapse. [iv]

· Consumers expect to be rejected by the community. This perception interferes with their sense of belonging and is more acutely felt by those with less social support and greater social skills deficit. [v]

· Stigma, discrimination and the resultant social withdrawal has been found to have a greater impact on the quality of life than the actual symptoms of illness. The loss of friendships and socio-economic status affects people long after their symptoms are treated.

· The elderly experience the double stigma of being old and mentally ill. Although they have high levels of illness they are also the least likely to seek medical treatment because of feelings of embarrassment and shame. They also have the lowest rates of detection of a mental illness because the belief that depression and anxiety are a normal part of the aging process[vi].[vii]

· Family members are also harmed by stigma and are blamed for causing or contributing to the illness with the result that they will also withdraw from social engagement, become isolated and experience higher levels of depression, anxiety and substance abuse.[viii]
· Community attitudes and discriminatory behaviours can negatively influence the degree and speed of recovery.

· Mental Health professionals are also stigmatized holding a diminished status in the eyes of other medical professions making recruitment challenging.[ix], [x]

· Many mental health professionals share negative attitudes towards people with mental illness and addictions and hold a reduced belief in their capacity to work, cope with stress, achieve advanced education or make a contribution to their community. These diminished views contribute to propagating self-stigma.

· The diminished attitude towards consumers is applied to self-help and peer-support programs. Identified as an element of ‘best practice’ this modality is ignored by clinicians, consistently under-funded by governments, and an under researched area of practice.

· People with mental disabilities suffer “double disadvantage”, having to cope not only with the disability itself, but with the added burdens of compromised health and inaccessible, inadequate health-related services. People with mental illness and addictions are less likely to be treated for medical conditions and research identified that they are more vulnerable to poverty and not treated equitably across health care systems.[xi], [xii]

· Institutions, governments and policy makers also contribute to stigma by systematically under-funding mental health and addictions services proportional to their degree of prevalence, morbidity and mortality.

· Discrimination towards people with mental illness and addictions is widespread resulting in diminished employment opportunities and educational opportunities including unemployment, lack of career advancement, hostility in the workplace resulting in increased self-stigma and increased disability. Although most people with mental illness and addictions are willing and able to work the rate of unemployment is estimated to be between 80% and 90%.[xiii]

· Discrimination is also experienced through a loss of human rights including forced treatment, finding or keeping housing, the right to parent, access to loans, immigration, denial of insurance coverage, and over representation in the criminal justice system.

· Stigma contributes to persistent under-funding of research and treatment services. Despite extremely high burden of illness, research funding has lagged behind other diseases such as cancer and heart disease when considering morbidity and mortality. This is particularly true in research about addictions and co-occurring disorders. [xiv]

· Canada’s Aboriginal, Inuit and First Nations Communities suffer a disproportionate burden of the stigma and discrimination of mental illness, mental health and addictions that exists.

· Stigma and discrimination occurs in many different guises throughout Canada, in our urban centres, our rural communities, our ethnic communities, among others and thus, regional consultations are a necessity.

Befriending: The Hug Drug

The Hug Drug
by Natasha Raymond, Psychology Today

It just may be that no drug is more effective than a good, meaningful chat. A British study has demonstrated the healing power of friendship.

A group of chronically depressed women living in London were randomly assigned to receive a volunteer "befriender" or were placed on a waiting list for one. The befrienders were instructed to be confidants to the depressed women, meeting them regularly for chats over coffee or outings.

Tirril Harris, of Guy's, King's and St. Thomas' schools of medicine in London reports that among the women who saw their volunteer friends regularly throughout the year, 72 percent experienced a remission in depression compared with just 45 percent in the control group. That's about the same success rate as antidepressants or cognitive therapy, says Harris.

The women who benefitted most from the friendship prescription typically experienced some kind of "fresh start": they reconnected or made amends with a person who was estranged from them, or left an unpleasant job for another that seemed more promising.

In one case, Janet, a depressed woman who took part in the study, had been working overtime for no extra pay. Her befriender pointed out that this was unfair and suggested she ask for compensation. Janet approached her boss, who was "amenable and apologetic," Harris recalls. "These types of experiences—an acknowledgment of respect—made the formerly depressed women feel differently about themselves and about the world."

Publication: Psychology Today Magazine
Publication Date: Nov/Dec 1999

Some Mental Health Facts

From the World Health Organization (WHO)...

450 million people worldwide are affected by mental, neurological or behavioural problems at any time.

About 873,000 people die by suicide every year.

Mental illnesses are common to all countries and cause immense suffering. People with these disorders are often subjected to social isolation, poor quality of life and increased mortality. These disorders are the cause of staggering economic and social costs.

One in four patients visiting a health service has at least one mental, neurological or behavioural disorder but most of these disorders are neither diagnosed nor treated.

Mental illnesses affect and are affected by chronic conditions such as cancer, heart and cardiovascular diseases, diabetes and HIV/AIDS. Untreated, they bring about unhealthy behaviour, non-compliance with prescribed medical regimens, diminished immune functioning, and poor prognosis.

Cost-effective treatments exist for most disorders and, if correctly applied, could enable most of those affected to become functioning members of society.

Barriers to effective treatment of mental illness include lack of recognition of the seriousness of mental illness and lack of understanding about the benefits of services. Policy makers, insurance companies, health and labour policies, and the public at large – all discriminate between physical and mental problems.

Most middle and low-income countries devote less than 1% of their health expenditure to mental health. Consequently mental health policies, legislation, community care facilities, and treatments for people with mental illness are not given the priority they deserve.