Earlier this year I took my 13 year old son out to lunch to talk about mental health. It just happened that Son #2 and my husband were out for the day and I had a rare opportunity to be alone with Son #1. I didn’t say ‘I’m going to take you out to lunch so that we can talk about mental health.’ I just reckoned that the odds of him listening to me would be higher if a) we were somewhere removed from the all-consuming ‘call of the PS4’, and b) there was a favorite food to both fill his mouth and free his hands from electronic device. So out to eat we went.
I had no idea how to have the conversation I wanted to have. I can tell you that figuring out how to talk him through the gaps left by school sex ed was easy by comparison.
Sophie Soklaridis is an Independent Scientist and the Interim Director of Research in Education at The Centre for Addiction and Mental Health (CAMH) in Toronto, Canada
Almost 23 years ago, I wrote a Master’s thesis that emerged from my experience with breastfeeding my son. After writing the cathartic 260-page thesis, I thought I was done with thinking about breastfeeding. Then I read about a woman with postpartum depression who died by suicide, with one of the main explanations she wrote in a note being that she was unable to exclusively breastfeed her baby. I also read Chaput and colleagues’ enlightening article in CMAJ Open on the link between breastfeeding difficulties and postpartum depression. When I recently started talking to new and expecting mothers, I realized that very little seems to have changed in the discourse around breastfeeding and the experience of being a “good” mother since I went through that lonely and painful time in my life. ...continue reading →
Barbara Sibbald, News and Humanities editor for the Canadian Medical Association Journal, reads the CMAJ Humanities Encounters article "Words, deeds and interpretations". The article is written by Dr. Mary Seeman, professor emerita, in the Department of Psychiatry at the University of Toronto.
In the article, Dr. Seeman, an older psychiatrist, recounts how acting instead of talking can net rather dire results. The events are true but happened decades ago.
“Medical professionals concentrate on repair of health, not sustenance of the soul”.
Atul Gawande’s recently published book, Being Mortal, discusses the treatment of our elderly population and the various flaws of our health care system. One important point from the book is that health care providers such as physicians and nurses are too focused on physical well-being while forgetting about the less tangible necessities of life.
When an elderly individual is sent to a nursing home, safety is the highest priority. Residents are provided with call bells, ramps, elevators, nurses, and physicians who come directly to their rooms. This seems beneficial, as physical health is maintained. With 24 hour nursing surveillance and living in single rooms, residents are less prone to injuring themselves. It is a situation that seems optimal for both the caregivers and seniors. Why, then, is the rate of depression and sadness so high among the elderly population in nursing homes?
Stuart Kinmond reads the CMAJ Humanities Encounters article "Cutting through the shame". The article is written by Stephen P. Lewis, associate professor in psychology at the University of Guelph in Guelph, Ontario. In the article, the author reflects on a period of self-injury and what he learned from it.
David Cawthorpe is a Professor (Adjunct) in the Faculty of Medicine at the University of Calgary, Alberta
By the end of this month the 22nd International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) Congress will have come and gone. As this will have been its second congress hosted in Canada since 1954, it is perhaps time to take stock.
In Istanbul, in 2008, our team got its first whiff of tear gas and we won the 2016 bid; it was the beginning of an exciting journey, wherein the hope was to form a national community around this torch, a mental health Olympics for children and adolescents. Did we succeed? A good question. Regionally, we hoped to gain access for at least 1000 participants who would never otherwise have the opportunity to attend such a world class event. Did we achieve this or will this congress have been just another big business venture? The proof will, no doubt, be in the residual pudding! ...continue reading →
A young doctor took her own life. I wanted to write about it at the time but it was difficult to find the words. It seemed to me a tragedy, a great loss of a young life full of potential. But, these words cannot capture quite what I felt. Where have we gone wrong?
It brought me back. I remembered my first year after qualification. It was brutal; a shock. Suddenly I felt I carried all the responsibility. I saw seriously ill patients in the middle of the night and had to make critical decisions. It was a small hospital. I was the cardiac arrest team. The tiredness was unrelenting, the gnawing anxiety continuous. ...continue reading →
Domhnall MacAuleyis a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
You step off the podium into an abyss. And, that’s if you have been a success. For everyone who competes at top level, medallist or not, the transition is dramatic. If your sporting career has come to a sudden end due to injury, poor performance, or you are unexpectedly dropped from the team, there can be an overwhelming sense of failure or unfulfilled ambition. No one sees what happens when you leave the stage. Adjusting to the real world can create huge challenges for former athletes and often, the greater the success, the more difficult to readjustment.
Richard Doan is a Psychiatrist with Inner City Health Associates and Assistant Professor of Psychiatry at the University of Toronto in Toronto, Ontario
On December 19, the Globe and Mail reported developments in the case of an unprovoked stabbing death of a vibrant young woman in a downtown Toronto drugstore by an also-young, and unknown, female assailant. As it turns out, the alleged assailant, though well-dressed and well-educated, was homeless and living on the street. It also appears that she was likely seriously mentally ill.
This story, as sad as it is, is naturally of interest to me, a psychiatrist who works with a street outreach team serving people who are homeless in Toronto. I never met the alleged assailant, but I wish I had. Then again, it is not certain that any involvement or intervention by our team would have made a difference.
The Globe and Mail reported that the alleged perpetrator habitually wore “an immaculate black suit and dress shirt” and had an MBA ...continue reading →
My street outreach teammates and I saw a slight, older woman who had literally been living in a box for months.* The box was about 6 feet long, 4 feet wide and 3 feet high and was covered by a blue plastic tarp. Her furnishings consisted of a few blankets. The “dwelling” was in an alleyway just behind some shops. The lady was disinterested in any form of housing or treatment and never accessed shelters: she always slept in her box. She repeatedly said that she would soon be moving to a Caribbean island. During a particularly bitter cold spell, we became concerned with her safety, and I completed a form for involuntary psychiatric assessment. The emergency department psychiatrist agreed with me that she likely had chronic schizophrenia, but the client was calm and would not take any medication. She promised the emergency department staff that she would go to a shelter if she was discharged. We made it clear that she was unlikely to do so, but after one night in emergency she was given a subway token to go to a shelter. She disappeared and was lost to follow-up. ...continue reading →