Sunday, May 24, 2015

New House Addition

Calvin and I have not been internet shoppers in the past, compared to many people our age. The odd time if we find something we really want to buy a friend or family member, and it's only online, we'll go for it. One of our most recent purchases was a set of 3 really cute kitchen themed "iconograph" style prints from an artist in Poland, to put up in our kitchen. We purchased Ikea frames and they look adorable.

Last week we bought two of these gorgeous lights from an ex-electrician who now runs an Amazon shop.

It was pretty inexpensive and exactly the style we were looking for. He sells all sorts of different modern lights. And at Home Depot we found the exact "Edison" bulbs for under $10.

Saturday, May 23, 2015

The Forensic Mental Health Care System and “Not Criminally Responsible" Designation

As some of you may know, I work at the South West Centre for Forensic Mental Health Care, in the Food and Nutrition Services department. I used to split my time between multiple sites, whereas now I am here 100% of the time, unless one of our buildings at Parkwood Institute in London is really in need. In this short time of being more devoted to this facility, my passion for it has grown so much. I am excited to write more about the forensic mental health care system today, and try to explain what the ‘not criminally responsible’ designation means. (Catch my post about the public opinion, especially sparked by Vincent Li, here.)

I really apologize if this is more boring or less relevant than my usual posts. I am well aware that my blog has NO perceivable theme or subject-continuity - haha. I could talk about this subject ALL DAY and I think it's something the average person doesn't know a lot about, so if you'll bear with me, it's a really interesting topic and I hope you enjoy.

What does “Not Criminally Responsible” mean?

All over Ontario we have hospitals that offer support for people suffering with mental illness. Occasionally one of these people will come in contact with the law (we don’t use the term “break the law” in our line of work). When a person is in a situation of standing trial for a crime it is possible to use a defence of being not criminally responsible due to mental illness (NCR).

Often, before standing trial, a person will be held on “form”. This can mean a few things. Form 1 means that a physician has deemed it mandatory for a person to be held for a psychiatric assessment, involuntarily for up to 72 hours. If the person is still meeting the conditions for involuntary admission, they are given a Form 3, a “Certificate of Involuntary Admission” and can’t leave for up to two weeks. Beyond that time frame requires a Form 4 which is a “Certificate of Renewal”.

A court deciding someone is NCR does not simply mean that the person suffers from mental illness and will be pardoned from the crime. A person can suffer from mental illness and still be responsible for a crime. What this defence means is that their mental illness rendered them incapable of appreciating the nature and quality of their act or omission, or of knowing it was wrong. This comes straight from the Criminal Code of Canada. You cannot say “Well, I was very depressed so I set fire to my ex-girlfriend’s house.” In this case, the depression did not stop them from knowing the destruction it would cause, or that arson is against the law.
They must prove two things: that they were in fact suffering from a disease of the mind at the time, and that it was the cause of their inability to understand the nature or wrongness of the act or omission. I say omission because sometimes not doing something can be criminally wrong, like feeding your child or paying your taxes. (Wrong can mean legally, or morally, wrong.) This is similar to the ‘pleading insanity’ that you see in movies. Much of the time this situation involves delusions, and often ones of a schizophrenic nature.

In the famous case of Luka Magnotta, we saw that he was found in a dire psychiatric state (out of touch with reality) at the time of killing a woman, but had promised he would commit murder months earlier which negated his defense of NCR.

Another case in which NCR did not apply is Christopher Husbands who committing a mass shooting in Toronto’s Eaton Centre a few years ago. Though it was argued that he suffers from Post-Traumatic Stress Disorder, the courts found that the shooting itself was a deliberate act of retaliation.

The assessment is done by a forensic psychiatrist who spends time talking with the individual, and possibly their family and friends.

There is also the case of being “Unfit to Stand Trial”. This means they cannot properly represent themselves or be represented. The conditions of this are chosen by ORB (the Ontario Review Board). It is possible to be considered “permanently unfit to stand trial” but also “non-dangerous to the public”. To be considered unfit to stand trial it must be proven that the person cannot understand the nature, object or consequences of what happens in court or that they are unable to communicate with or instruct their lawyer. Sometimes a judge will call for a Treatment Order which requires the person to take a medication, and if they refuse they are given an injection of it. This is to assist them in being considered fit to stand trial.

How they end up at the South West Centre for Forensic Mental Health Care

If the court finds the person NCR or Unfit they are seen by ORB (the Ontario Review Board) which is made up of three people, most often a judge, psychiatrist and psychologist. They determine how dangerous the person is to the public, and how restrictive their next moves should be; ultimately they want to keep the most amount of freedom for the person while still keeping the public safe. Think of this example, if a person is charged with not paying $500 worth of parking fines but it is found that they ignored these bills because of a period of psychosis, it is not necessarily essential to have them spend time in a forensic mental health care facility. In all likelihood, the public is perfectly safe having a person who did not pay parking fines in their vicinity. They would do best receiving mental assistance at a non-forensic facility. However, if someone has committed a violent crime, it is not safe to discharge them to the public without further rehabilitation. The possible outcomes are: absolute discharge (continue living in their home, some restrictions or supports may be offered), conditional discharge (with continuous overseeing from a forensic team), or being detained in a hospital. That’s where we come in. The decision doesn’t specify how “sick” or “cured” the person is, simply how much of a risk they pose. Keep in mind, proper psychiatric medications can aid a person greatly in making better moral and lawful decision. This has been well proven over time. In fact, recidivism rates (how often a person re-commits an offense) of individuals found not criminally responsible on account of a mental disorder are much lower than rates among individuals found guilty of a crime.

What happens in the South West Centre?

It is much like a hospital you’d be used to seeing, only we are treating the mind not the physical body. There are 5 “wards” (living areas of the hospital) that have individual bedrooms for clients, as well as common areas. Nursing staff work around the clock. Each person is also assigned to a physician. We have recreational therapists, occupational therapists, spiritual advisory, and more. Medications often offer a lot of improvement. Our food and nutrition team works to support the client through meals and snacks, and also help them achieve dietary-related goals like losing weight or increasing energy levels. We plan special themes like brownies with pink and red icing for Valentine’s Day. There are floor hockey tournaments and band nights, we watch hockey games and play cards. Clients can take classes. They spend time in the garden. We have a “corner store” as well as a cafeteria and a small library (which gets all the latest magazines much to my amusement.)

Our facility is not maximum-security: there is only one in Ontario which is located in Penetanguishene. Our clients range in age, and we have males and females. We also have varying levels of security within the building, but those with the lowest level (in other words the highest level of privileges) can be granted day passes or even Leaves of Absence.
Staff are outfitted with personal alarms in case they ever feel at risk, and security are quick to respond if a personal alarm is activated. All doors are locked by sensors and can be opened by a FOB card. Clients wear a bracelet which governs where they can and cannot go (by locking and unlocking doors). If a client is particularly aggressive we have “seclusion rooms” available to make sure they do not harm anyone. Depending on privileges, most clients can have visitors but they must sign in and go through security before entering, much like at an airport.

When can they leave?

Clients are reviewed by ORB every 12 months at which time they can decide again: detainment, conditional discharge, or absolute discharge. At one time they tried to pass a change which would maximize the length of time in the forensic mental health system to the length of time they would have served if convicted of the crime, but it didn’t go through.

ORB’s four main questions are:
Are they a risk to members of the public? How is their mental health now and how has it been over the past year? How well integrated into society are they (could they hold a job)? Do they have any other needs that should be considered?
ORB decisions can be appealed.

Why it works

This system is built entirely for the mutual benefit of patients and the public. It helps EVERYONE if these people get better. If we can transition a person from a life that is riddled with mental illness and unlawful behaviour, to our secure admissions department, to another unit where they have more independence, to a personal apartment within the facility, to a group home for people with mental illness, and then to an independent apartment building (with check-ins from forensic staff) - we are happy campers. But everything must be done in the right time. It's a great, and gradual, transition that has impressive effects.

Thanks for taking the time to read about Forensic Mental Health. I don't promise it'll be the last time I write about it, but I do promise that most of the time I will stop myself from posting a 10,000 word rant that is better served as a personal journal entry.

Tuesday, May 19, 2015

How I built 3 big raised garden beds for under $100!

I really wish I could have posted this content earlier so that if anyone wants to follow my tutorial that they'd have ample time to buy the materials and do the work before planting time. The truth is, I've only JUST finished getting them filled with soil and getting my own plants. So, as quick as I could, here is my tutorial for building THREE big raised garden beds - made of CEDAR! - for under $100.

P.S. How worth it is this?
If you spend $30 this year, on seeds or seedlings, you'll easily save $30 every week on groceries until October. The raised bed itself keeps the soil warmer so your season is longer, and the plants you grow are more successful, and it keeps the soil nicely watered but drained. It's also easier on your back for leaning down to plant, weed and harvest. And it looks cleaner! And the weeds can't get in as easily - nor the little bunnies or neighbourhood cats. I am huge lover of raised beds!!

Step one: hit your local Home Depot or favourite building supply store and get the following:
- 18 cedar boards that are 5 feet long x 1" thick x 6" tall - have 6 cut exactly in half lengthwise (so now you have 12 long boards and 12 short boards)

- Cedar screws long enough to go decently into your corner posts (I got 6 x 1 5/8's)

- If you want, you can get mending plates & shorter screws for holding the side boards to each other, but this is just extra

- Corner posts (my dad had some kicking around but these are 4x4's and we cut them to be 12" tall - i.e. the height of 2 cedar boards stacked on top of each other) - you will need 12, because 4 corners for 3 beds

Here are the corner posts after we cut them. I didn't use cedar but certainly it's the best (and what I used for the rest of the beds) because it lasts a long time!

Step two: Screw your short boards (2 1/2 feet long) to your corner posts. When one is one, stack another on top, so it's two boards tall. Creating a rectangle, screw your longer boards, two tall, to the corner posts.

I used the mending plates to make sure the boards stay together even if they begin to warp a bit. One screw on each side. Make sure to use short screws (these are 8 x 5/8's) so that it doesn't go all the way through.

Here is the finished product - so easy! I prefer them without a bottom because being open to the earth is better for drainage. Just remember to pull up the grass first, and any weeds that are hanging around. Keep the worms!

After pulling up the sod under the entire area (not exactly hard, our house is newly built so the sod is pretty fresh and simple to pull up) I leveled the ground and then placed them. If it wouldn't make mowing the lawn so hard I would have left space between them to walk but I can't be trusted to use a weed wacker often enough. Then I purchased organic 3 in 1 veggie soil (I only used 3 bags per bed but I'm sure 10 would easily fit if you wanted it filled to the top) and began planting right away.

Not a huge amount of work, or expense, and such pay off. I love my raised beds.

Friday, May 15, 2015

Staff coffee break party!

I have such fun working at the Southwest Centre but sometimes get a bit bummed out if I'm stuck in the Food and Nutrition department all day (it's in the windowless basement!) 

Luckily, I recently connected with our building's secretary and found out that they needed a host for the monthly "staff coffee break party" which rotates departments and allows everyone from the whole hospital to hang out and meet each other.

Because Food and Nutrition is a smaller department, we teamed up with our buddies in Environmental Services who also work out of the basement. It was a great opportunity for the glorious people of the naturally-lit, sun-soaked upper floors, to come socialize in the dungeon with us celldwellers ;)

We brewed a bazillion cups of coffee - Fire Roasted Coffee of course - put out half n half, raw sugar, disposable mugs, plates, spoons, napkins, etc. and tons of goodies all homemade! We also had a hand drawn banner & some gorgeous flowers thanks to my mom.

Here I am ready to welcome the masses to our coffee party.

Team bosses! Here I am with the Environemental Services leader, Dino. His team helped us a lot by bringing in tons of good food, and by moving tables around.

We set up camp in the long hallway and were glad for the space because we have tons of staff come join us. We estimate 100 people! At the time of this photo there were about 35.

I brought bacon-chocolate-peanut butter tarts and they were a big hit. And the coffee was delicious. We only had one security officer make it down, so when things were wrapping up we made a big plate of goodies and brought it up to their security station, especially for the night crew.

The banner says Welcome from Environmental Services and Food and Nutrition Services. Then it has a coffee mug that defies physics.

It was sure a good change from the usual lonely basement! So fun to have people from all areas hanging out and enjoying a treat.

Saturday, May 9, 2015

Myths about Forensic Mental Health

Just yesterday a local news station covered a story about Vincent Li (the Canadian man who beheaded another passenger while riding a Greyhound in 2008) and the fact that he is being released to a group home. People were shocked to discover that someone who had taken another life so recently could be given such freedoms. Many comments were made, most of which were not based on fact. So I’m here to set the record straight! From someone who is passionate about forensic mental health, who works with the population 30+ hours a week and who spends countless hours keeping up to date on new information, here is the truth about forensic mental health (FMH).
Note: I have a lengthy post written up about all the details of the FMH system, but I’ve been reluctant to post it because it’s … uh, boring. Ha ha. It’s still a possibility for the future, but this is a quick version.

The system

People enter the FMH system for 2 reasons: they’re not fit to stand trial (their mental state makes it so that they cannot understand the weight of what’s going on in court) or they’re found not criminally responsible due to mental illness (the act or omission that they’ve been charged with was committed when their mental state was the reason for what they did, or why they didn’t understand the gravity of it). Once they are placed in a facility – my place of work being one of them – they meet with the Ontario Review Board on an annual basis to discuss their progress and future. They can either stay in the facility for further rehabilitation, be granted a conditional discharge (ability to go into the community, with stipulations) or an absolute discharge (extremely rare, and done very conservatively). Their decision attempts to balance the individual’s liberties with the risk to the public.

What people don’t understand

The first comment, or myth, to address is “these people are getting away with murder.” No human being can inflict schizophrenia or any other psychotic disorder on themselves in order to avoid prison time. The assessment teams are very thorough with their analysis. In many cases, the length of time a person stays in our system is actually longer than the prison sentence they would have served if found criminally responsible. That is the interesting thing about FMH: while the traditional justice system is mostly based on fitting the sentence to the crime (likening it to more of a punishment), a stay in a mental health facility is entirely based on recovery needs (likening it to more of a personalized rehabilitation). For every “Vincent Li” case where a horrific crime seems to be linked to a shorter recovery period, there are dozens of people who enter the system for much pettier thing and stay for decades. I understand that the families who mourn the loss of their loved ones (who seem to be most vocal about the issue) are desperate for justice, however ensuring that the reason for the altercation (which is mental illness) is eradicated, is the most important thing.

“They are just going to go attack someone else.” This myth can be easily dispelled by simple statistics. The recidivism rate (percentage of times they re-committed an offence) is under 10% here, upon absolute discharge from FMH, and the rate drops even further when looking at only violent crimes. Comparatively, the Canadian average within the traditional criminal justice system is over 33%. Also, the likelihood of someone discharged from the FMH system attacking a stranger on the street is almost non-existent. The victims of these acts is by and large family members, other individuals close to the person, as well as enforcement officers and mental health staff. In the majority of cases they do not pose a risk to the general public.

“These people are monsters/animals/psychos/evil…” I take personal offence to these statements because of the time I’ve spent with my clients. I liken it to hearing people make jokes about seizures being that my dad has epilepsy, or even knowing that people think gluten-free diets are ridiculous, when my four immediate family members have Celiac disease. If you don’t understand something, it’s not okay to use ignorant words to express your distaste. People with mental illness are suffering with a disease the same way that a cancer-suffer is. In fact, it can be more socially challenging because of the stigma around it. Many people struggle with their mental illness alone because it is not widely accepted as a true illness the way physical ailments are, in our society. Everyone needs to educate themselves in this way.

“They did the act so they need to pay for it.” Please consider the following example and then decide if you agree. You are driving down the road carefully when suddenly a very-low blood sugar attack hits you, from Diabetes you have not yet been diagnosed with, and it causes you a great deal of impairment. Through your struggle, your vision is clouded and your vehicle strikes a woman on a bike. She is disabled for life. In the next weeks you see a doctor about your blood sugar issues, describe some events that have happened in the past that help the doctor come to a diagnosis, blood work confirms the concerns, you get on a treatment plan, and so long as you take your insulin at regular intervals you are very unlikely to have this ever happen again. Naturally if you ever forgot to take your insulin, and happened to be driving at the time with a bike on the street near you, the event could potentially happen again. You are embarrassed about, and regretful of, what happened, but everyone assures you it wasn’t your fault. You play the events over in your head daily, and you deeply wish the cyclist could have the use of her legs back. This is the story of a person whose physical illness allowed them a chance at wellness and going on with their life after tragedy. The plan that “they need to pay”-folks are suggesting, takes mental illness and says ‘you did what you did, now do the time’. Should a diabetic be jailed for an unforeseen blood sugar attack? Should a schizophrenic be jailed for an unforeseen delusion?

“The Ontario Review Board should be accountable for all of the violence that occurs after a person is discharged.” Just to set the record straight, the ORB is extremely conservative in the liberties that they extend to clients in the FMH. Their utmost concern is public safety: after all, they are members of the community in which clients are discharged. Their job is a difficult one because they need to balance everyone’s rights. Our clients have basic human rights too: the right to seek rehabilitation and the right to enter the community once they are rehabilitated. The same way that any person has the capacity for an act of aggression, discharged clients do too. We cannot hold a person in a mental health facility simply for their capacity to re-commit, only for their likelihood to do so. The process is complex, lengthy and very successful.

“They should not be walking the streets alone.” Cases of a person committing a violent act and then being discharged without supervision or continuing care are extremely rare. When clients leave our facility they most often enter a staffed group home. And this is after they’ve gone through all of the stages of privileges here. They begin in our admissions unit where they are unable to leave the ward for any reason. In time, when they have proven self-control, stability and responsibility, they’ll be transferred to a secondary unit where they are able to have free access to the entire hospital. They can eat in our staff cafeteria, shop at the corner store, watch tv in the main room, explore outside in our gated courtyard, play some floor hockey, and then book a haircut. We have a mini “downtown” to ease the transition back to the community. At a certain point they can be transferred to a readiness unit which allows them to leave the facility in controlled ways. Perhaps it’s just to the road for a cigarette, sometime it’s going into town with a few staff members to grab a coffee at Timmy’s. As they advance in their treatment they can receive day passes. If there is any concern, they are supervised. The final step is making plans to join a group home. Once they leave our facility they are linked up with a forensic treatment unit in the community who see them regularly and also ensure that their medication is taken exactly as scheduled. Vincent Li will not have an opportunity to “go off his meds” like people are suggesting. Mental health staff spend hours of their day making rounds to dispense medication and most of the time the act is followed by asking for an open mouth to inspect that the capsules are swallowed, like you do with a child. There isn’t an honour system here.

“But Vincent Li took two lives: the man he killed, and the officer who reported to the scene who later committed suicide over the events.” Isn’t this a perfect testament to why we need stronger mental health care in Canada (and everywhere)?

“Imagine if that was your kid who was killed.” As much as I wouldn’t like to, I will say this: if my child or anyone close to me is ever the victim of a mental illness-related crime, it would be of utmost importance to me that the person who committed the offense is treated in a way that the act does not occur again. If you have any doubt that healing and support is possible between family members of mental illness-related homicides, and the client being treated, look no further than the documentary Out of Mind, Out of Sight, which tells the story of a man whose mother’s life was taken at his hands while in a schizophrenic episode. His own father, sister, and two brothers are unwaveringly supportive of him, despite having lost their loved one. When asked how they found it in themselves to forgive him, one brother answered (and I’m paraphrasing): “To even suggest forgiveness is necessary is to blame the victim. When schizophrenia killed my mother that day, there were two victims, and one survived, and lives to suffer from it.”  

Edited to add: here is a virtual tour of my FMH facility.

Friday, May 8, 2015

My sister, the brilliant

I've always laughed at the stereotype that the oldest is the brightest/ most ambitious/ biggest go-getter of the family. Not when you're the eldest over two clever & charismatic women... one of which is my dearest Angela Rose.

Angela graduated with a Masters in Occupational Therapy from Western University (where I went as well). She received the gold medal award for her top marks. She went on to be chosen for an incredible job with an Assertive Community Treatment team that is associated with the mental health facility that I work for.

Angela is a perfect example of a mental health advocate. She is constantly striving to change people's perception about mental illness. She is a one-woman stigma-fighting machine! 

Just last month she was nominated - AT AGE 24! - for a Champion of Mental Health award from the Canadian Mental Health Association. Together we attended the "Breakfast of Champions" ceremony which featured incredible food, great networking, and an inspiring talk from Mariel Hemingway (granddaughter of the beloved writer, Ernest). 

Congratulations Angela! I'm so proud to call you my sister. Every, every, every day you are changing lives.

Tuesday, April 28, 2015

Mother's Day Gift Guide

You have to love Google. I typed in "when is Mother's Day" and it came back in huge print, no need to click a link, IT'S SUNDAY MAY 10! Thanks Google. Not to mention there's a full May calendar sitting right beside me as I type, that actually has Mother's Day noted on it. Brain-to-oatmeal conversation complete.

So, being a mom I naturally forgot when Mother's Day is. Not that I'd miss an opportunity to celebrate my own mother, but when it comes to something celebrating me it's not exactly the first thing on my mind. (For the record, the first thing on my mind is: does Dakota need to go up a size in diapers?/ does Oliver need an earlier bed time?/ haha that's hilarious/ coffee.)

Mother's Day really is a special thing. It is so important to take a day to tell the significant moms in our lives that we love and appreciate them!

I have the distinct joy of not having to drop hints around early May about what I want for Mother's Day (if I remember that it's coming) because I pretty much want the same thing every year. since 2011, a GARDEN CENTRE SHOPPING SPREE. This is the most fun gift ever. Really, plants are only around $2 or under so it doesn't get too crazy but I really do go in there and get everything I want with no limits. It's a BLAST.

So that's one idea for you.

Or, how about this gorgeous metal Starbucks card? It is made of metal and ceramic and comes in a nice box, pre-loaded with $50. It's only a low price of $200. .... Yes, $200. WHAT? This made me laugh.
Limited-Edition Mother’s Day Premium Starbucks Card

Something nice and relaxing that you could get for the mom in your life is one of Honest Company's new candles. And hey, right now if you're going to get a bundle any way (as long as it's your first one) the candle is FREE. It comes in an 8oz recycled glass container and is made from non-GMO soy and essential oils. Click here for the deal:
Free Aromatic Soy Candle with first bundle purchase with promo code CANDLE4MOM at checkout, valid 4/27-5/10

Lastly, what about a kit of totally natural and long lasting Norwex products? My friend Joy was recently talking to me about how they can totally help busy moms. She said "Norwex significantly reduces the time and effort required for regular household tasks. Plus, it's environmentally friendly - no more paper towels for all those sticky juice spills! Not only does it make the cleaning that you do easier, kids get excited about Norwex too! Can you imagine your kids fighting over who gets to mop the floor? or dust the furniture? Instead of it being a dreaded chore, many moms find that their kids love to help clean with Norwex!" Definitely a cool gift idea and if you agree go to to find someone who sells it near you!

I might need Google to help me remember what day it's on ("Siri, please remind me to buy my mom a gift on Saturday May 9 at 2pm") but I won't forget that there are tons of sweet gift options out there and our mamas are worth it!