New hope in the battle against chronic mental illness

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Christina’s son was almost 18 years old and about to graduate from Grade 12 when she noticed something was wrong. His sleep patterns were changing, he was depressed and he was having verbal outbursts that made it tough for him to socialize.

Over the following summer, she eliminated the likely suspects for his personality shifts: hormonal changes, peer pressure, drug and alcohol abuse. But his symptoms-all classic markers for psychosis-escalated to the point of landing the teenager in Belleville General Hospital.

During that stay and another, he checked himself out of hospital and refused to take his medication. All the while, impairments to his thoughts, feelings and ability to communicate were playing havoc with his capacity to deal with reality.

Still desperately searching for help, Christina discovered an innovative psychiatry clinic at Hotel Dieu Hospital in Kingston that specialized in the early treatment of first-episode psychosis through a combination of medication, psychotherapy, vocational planning and family support.

She eventually persuaded her son to enter the new program. “It turned out to be,” she says, “a lifesaver.”

Started in late 2001, the Southeastern Ontario District Early Intervention in Psychosis (SEODEIP) program recently expanded and is now positioned to profoundly influence the lives of other young adults across a wide swath of this province, making it less likely they will be robbed of their potential by chronic mental illness.

This year, the Ministry of Health and Long-Term Care is injecting just over a $1 million into the program, and hopes are high for enhanced funding in the future as the number of psychosis cases increases in the district: About 50 new cases of psychosis are diagnosed annually, with adolescents and young adults hit the hardest. More than 250 clients have used the Hotel Dieu program since 2001.

“The research shows we can reduce the torture of this illness if we get to it early, before it becomes chronic and highly resistant to treatment,” says Dr. Kola Oyewumi, SEODEIP Program Director and Professor of Psychiatry, Queen’s University. “Instead of suffering the severe damage that happens when a mental illness is neglected too long, people can have an improved quality of life. They can return to work or school. They can have hope again.”

Staffed by seven clinicians (psychiatrist, psychologist, nurses, social workers, occupational therapist) and two administrative staff, the SEODEIP program links clients, caregivers and treatment teams in new ways. The emphasis is on treating patients promptly and closer to home, and on taking deeper root in communities – in Kingston, for instance, the local clinic has purposely expanded some activities from Hotel Dieu to a storefront location.

Making that faster, closer access happen are more staff, satellite sites and telepsychiatry technology, a videoconferencing tool that plugs remote patients, their families and treatment teams into real-time consultations with psychiatrists and psychiatric residents who staff Hotel Dieu, Kingston General Hospital and Providence Continuing Care Centre (PCCC), Mental Health Services.

Several communities in the district-Napanee, Smiths Falls, Perth, Belleville and Brockville-are home to SEODEIP satellite offices and telepsychiatry set-ups, already available locally at Kingston’s hospitals.

Early psychotic episodes are very traumatic for the patient, who is not necessarily functioning in the real world, and equally stressful for the family, according to Dr. Troy Savage, SEODEIP Program Coordinator.

“The telepsychiatry component lets us provide vital, first-hand assistance in properly assessing the individual without requiring that person or family members to travel to Kingston,” says Dr. Savage. “We can intervene quickly and without causing more stress to these individuals in terms of travel time and costs.”

SEODEIP’s mandate also extends to stepping up public awareness about early intervention so that family doctors, teachers, friends and community agencies can recognize the early signs of illness. Its outreach efforts include an annual conference, quarterly newsletter, public education materials, participation in secondary school health promotion programs, information and education sessions with key community mental health agencies, family education groups and quarterly family alumni groups.

Christina’s son has now complied with his medication for more than a year and continues to see Dr. Oyewumi regularly. His mother credits the unwavering support of SEODEIP program staff for keeping her hopes up. “For the first few years, I felt very isolated in dealing with my son’s illness, but the more knowledge and support we gained from the clinic, the more promising his situation became to us. I really had the ‘Wow, so I’m not alone!’ experience. It made all the difference in the world to my family.”

For more information about the SEODEIP program at Hotel Dieu Hospital, visit www.recoveryconnections.ca