THE POETRY OF PAIN

Poetry deals in the language of emotion and I have written a lot of poems when in the grips of a depression.  The following poems that I have written talk about emotional pain and feelings of suicide. This is not to suggest that I am recommending suicide, I am only expressing the way I feel sometimes, so that others can feel that they are not alone. If you feel suicidal please go to your mental health provider or your priest.

When Feelings Howl

By Katherine Tapley-Milton

On this useless night

of continual soul aching,

I wonder why life turns brutal.

My feelings in daylight hours

stay locked in safety deposit boxes,

But when when the sparkling sun

dips down on the blood-red horizon

my emotions howl like a furious blizzard.

Fear, anger, love, guilt, rage

all whip my psyche to battered bits.

Scenes of the past

flash like a kaleidoscope

of Stephen King movies;

until I fall exhausted into a psychotropic sleep.

The Grim Reaper’s Charms

 By Katherine Tapley-Milton

Death, the seducer

Whispers softly

To my lust

For animation.

Offering

Mental peace, cessation of pain

The end of worry

And toil.

Her bony hand embraces mine

And offers me the ride

Down the dark tunnel

Towards the light,

And the sliding down

Before eternity.

Death the sorcerer,

Smooth and eloquent,

Tempting, tempting, me

Towards another dimension.

Wanting to hurtle me

Into immortality

Only half formed,

Prematurely born

Wrested from God’s operating table

And from this mortal coil.

Death takes advantage of my

Struggle with the dual demons

Of depression and despair

She whispers.

  

 Faking Normal

 By Katherine Tapley-Milton

Hide the madness,

Don’t let it splatter

All over the sidewalk

Where descent townsfolk might

Read it.

Hide the madness,

Tuck it in tight

Like your winter scarf.

Neurons misfiring,

Thought  processes tangled,

But don’t ever let on.

Your speech  should be flawless and fluent:

Make small talk and open doors for people

Fake it and hide the cerebral confusion

And the cacophony of  voices

That scream suicide and self injury

Make yourself into another Jane Doe

Whom nothing extraordinary happens to.

COMPANION

By Katherine Tapley-Milton

An understanding

between man and beast,

We cuddle together

on interminable wet Sundays

or frigid winter nights.

While I read, he purrs

in contented feline bliss.

Head on my sneaker

 and body curled close.

Some inexplicable bonds

keeping the different two species

in a quiet, gentle intimacy.

                                    

William Cowper was a popular hymn writer and poet .  He lived from 1731-1800.  Cowper had numerous attacks of mental illness and tried to commit suicide, using various methods.  His poem, "The Castaway" speaks of a shipwrecked individual who drowned in the cold, stormy ocean while his friends tried to rescue him in vain.  Cowper says, "But I beneath a rougher sea, and whelmed in deeper gulfs than he." This refers to his struggle with mental illness and an obsessive fear of eternal damnation.

The Castaway

BY WILLIAM COWPER

Obscurest night involv'd the sky,

         Th' Atlantic billows roar'd,

When such a destin'd wretch as I,

         Wash'd headlong from on board,

Of friends, of hope, of all bereft,

His floating home for ever left.

No braver chief could Albion boast

         Than he with whom he went,

Nor ever ship left Albion's coast,

         With warmer wishes sent.

He lov'd them both, but both in vain,

Nor him beheld, nor her again.

Not long beneath the whelming brine,

         Expert to swim, he lay;

Nor soon he felt his strength decline,

         Or courage die away;

But wag'd with death a lasting strife,

Supported by despair of life.

He shouted: nor his friends had fail'd

         To check the vessel's course,

But so the furious blast prevail'd,

         That, pitiless perforce,

They left their outcast mate behind,

And scudded still before the wind.

Some succour yet they could afford;

         And, such as storms allow,

The cask, the coop, the floated cord,

         Delay'd not to bestow.

But he (they knew) nor ship, nor shore,

Whate'er they gave, should visit more.

Nor, cruel as it seem'd, could he

         Their haste himself condemn,

Aware that flight, in such a sea,

         Alone could rescue them;

Yet bitter felt it still to die

Deserted, and his friends so nigh.

He long survives, who lives an hour

         In ocean, self-upheld;

And so long he, with unspent pow'r,

         His destiny repell'd;

And ever, as the minutes flew,

Entreated help, or cried—Adieu!

At length, his transient respite past,

         His comrades, who before

Had heard his voice in ev'ry blast,

         Could catch the sound no more.

For then, by toil subdued, he drank

The stifling wave, and then he sank.

No poet wept him: but the page

         Of narrative sincere;

That tells his name, his worth, his age,

         Is wet with Anson's tear.

And tears by bards or heroes shed

Alike immortalize the dead.

I therefore purpose not, or dream,

         Descanting on his fate,

To give the melancholy theme

         A more enduring date:

But misery still delights to trace

   Its semblance in another's case.

No voice divine the storm allay'd,

         No light propitious shone;

When, snatch'd from all effectual aid,

         We perish'd, each alone:

But I beneath a rougher sea,

And whelm'd in deeper gulfs than he.

The following poem by  Ella Wheeler Wilcox (November 5, 1850 – October 30, 1919 is sad but true.  For those who suffer clinical depression, the world is hard on them, while those who have a sunny disposition fare better.  All, however, suffer pain.

Solitude

Laugh, and the world laughs with you:
Weep, and you weep alone;
For the sad old earth
Must borrow its mirth,
It has trouble enough of its own.

Sing, and the hills will answer;
Sigh, it is lost on the air;
The echoes bound
To a joyful sound,
But shrink from voicing care.

Rejoice, and men will seek you;
Grieve, and they turn and go;
They want full measure
Of all your pleasure,
But they do not want your woe.

Be glad, and your friends are many;
Be sad, and you lose them all;
There are none to decline
Your nectared wine,
But alone you must drink life's gall.

Feast, and your halls are crowded;
Fast, and the world goes by;
Succeed and give,
And it helps you live,
But it cannot help you die.

There is room in the halls of pleasure
For a long and lordly train;
But one by one
We must all file on
Through the narrow aisles of pain.

TRANSCRANIAL MAGNETIC STIMULATION: ALTERNATIVE TO SHOCK

                                                        

                                                by Katherine Tapley-Milton

     Shock therapy is back in vogue among psychiatrists, a fact which is very disturbing.    While the doctors 

claim it helps the deep depression of bipolar mood disorder and is safe, in reality shock therapy can have the

 side effect of long term or short term memory damage that in a lot of cases can be permanent. An alternative 

therapy, TMS or “Transcranial Magnetic Stimulation” seems to be a less barbaric treatment which does not 

cause brain damage.  General anesthetic is not required with TMS and specific areas of the brain can be 

targeted without causing a convulsion.

     According to the National Alliance for Research on Schizophrenia and Depression, TMS “ ... has been 

successful in helping people who are severely depressed.”  TMS uses an external magnet to stimulate the left 

prefrontal cortex, an area of the brain that is found to be functioning abnormally in depressed individuals.  Dr. 

Mark George comments, “This new tool allows us for the first time in the history of mankind to non-

invasively stimulate the brain while the person is awake and alert.” In a study of 30 depressed, suicidal 

patients who had not been helped by medication, 20 had TMS for 20 minutes five days a week for a 

fortnight.  Ten patients had the magnetic device placed on their heads but didn’t receive the treatment.  None 

of the patients knew if they received the real treatment or not.  The patients who received the TMS therapy 

showed a marked improvement in their depression, while the controls showed no improvement at all.  

Apparently, the only side effect of TMS is that a third of the patients reported a mild headache, which was

 easily relieved with common over the counter remedies like ibuprophen.

      The biological mechanisms that trigger depression are still not well known, however, research done using 

MRI machines has detected abnormalities in the prefrontal cortex of depressed patients.  This reason lead 

scientists to consider TMS as tool to target that area.  Before TMS becomes a standard treatment for 

depression at your local Mental Health Clinic, more studies have to be done to determine why it works, what

 intensity of magnetic power to use, and how frequent the treatment should be.  However, Dr. George feels 

that further MRI research will reveal more of the brains secrets.   Also, there is controversy over whether a 

treatment which does not cause a convulsion is as effective as electroshock which does cause a convulsion. 

   Traditional electroshock requires anesthesia and this can produce over sedation and vomiting afterwards, 

while TMS does not have these discomforts.

        There are a significant number of depressed patients who are not helped by antidepressants or 

experience too unpleasant side effects to tolerate them.  While there is still experimentation going on with

 TMS it has been around for ten years and looks like a humane and viable alternative to shock therapy.  

    

    

    

The Psychiatric Hospital that Had a Dungeon

by Katherine Tapley-Milton

     Twenty-nine years ago I was a prisoner in one of Canada’s oldest, and most terrible psychiatric hospitals called Centrecare.  Today, that institution has been demolished, but my memories of the abuse I received there have not been. At the time I was having a nervous breakdown and needed love and support, however Centrecare made me angry and bitter.  The psychiatrist I had did the foolish thing of taking all my medication away at once, without even tapering any if it off.

       I had been on huge doses of antidepressants, anxiety medication, and antipsychotics that a psychiatrist had me on to try and control my schizophrenia.  Soon, I started shaking and vomiting as a response to sudden drug withdrawal. The staff accused me of making myself sick.  After three months of being violently ill I was almost dead. However, when I couldn’t sit up straight in a chair, the staff slapped me around.  One day as I lay on the bed my roommate commented, “ I think that you are going to die.” I replied, “Yes, I think you’re right.”  The psychologist was a nice guy, but he didn’t understand my condition.  He kept yelling at me, “Katherine, stop you’re shaking!”

     I never got any sleep at Centrecare and yet they wouldn’t give me any sleeping medication or even let me have the light on to read.  Also, when the psychiatrist overdosed me with 30 mgs. of Haldol my neck arched back and my eyes rolled up in my head.  I spent two days staring into a light bulb and could not move from that position.  It was pure, unadulterated agony.  Even though I pleaded with the staff, they would not give me the antidote drug , Cogentin.  Another outrage was the fact that the psychologist did days and days of psychological testing while I was grossly over drugged and falling asleep on Haldol.  I kept telling him over and over that I was too stoned to do the tests, however, he did not believe me.  He tried to get me to retell stories, put together puzzles, remember words and numbers, etc. and in the end told the psychiatrist that I was probably brain damaged. 

     Embedded in my memory forever are all the horrible sounds of Centrecare – the moaning, crying, screaming, and shouting that was always going on.  There was danger too.  One might get a punch in the head if you were not careful. I remember that Centrecare was always permeated with a sickening sulphur smell that came from the pulp mill across the Reversing Falls.  I felt that as if I had died and truly gone to hell.  One man I talked to, who was in jail, told me he was incarcerated in Centrecare’s forensic unit once.  He vehemently declared to me that he was never so damned glad to get back to jail in all his life. This ancient psychiatric institution held in its walls over 100 years of human misery and mistreatment.  It even had a dungeon; a testament to its barbarism.  All that is left of Centrecare is a grassy knoll now, but its victims are doomed to relive forever the horror being abused there.

THE IMPACT OF PSYCHOLOGICAL DISORDERS

Psalms 139:23 “ Search me, O God, and know my heart: try me, and know my thoughts:”

     On the official website for the New England Psychologist --- nePsy.com, the impact of mental illness as opposed to physical illness is discussed:

Approximately one-third of sick days are caused by psychological disorders, according to a survey sponsored by the National Institute of Mental Health.

The survey of more than 9,000 adults was based on the National Comorbidity Survey-Replication and measured sick days for chronic conditions. Adults with mental disorders - including depression and anxiety - miss 1.3 billion days of work, school or other activities every year, more than back and neck pain, which caused 1.2 billion days per year, according to the survey. Americans report 3.7 billion sick days a year because of chronic conditions such as cancer, vision loss and heart attacks.

The study was also unique because it took a comparative perspective of physical disorders and psychological disorders, he says. "It was a surprise to see how enormous (the number of sick days) was for mental health disorders." The fact that one out of every three days is because of a mental disorder is "extraordinary," he says … .

That number is particularly noteworthy if one analyzes another factor. "If I look at how much money is given on research to cancer or heart disease or diabetes, obviously the allocation of resources to tackle these problems are way out of kilter with the magnitude of these problems," Kessler says. "Mental health disorder is not getting the attention it deserves."

That is not only true for research, but also true for treatment. "When we look at some other work we've done on patterns of treatment for mental and physical disorders, we find that, in general, people are more likely to get treatment for a physical than a mental health problem for comparable severity," he says.

"There are two reasons," Kessler continues. "One is that people don't very often code emotional distress as an illness." He notes that one of the lowest rates of treatment is for social phobia or anxiety. "People say, 'I'm shy … it's not an illness.'" Public perception is a factor. "People say, you 'have' a heart attack, but you 'are' mentally ill," Kessler adds… .  Of the 1.3 billion sick days for mental health disorders, depression topped the list with 387 million. Social phobia accounted for 214 million; posttraumatic stress disorder, 113 million; generalized anxiety disorder, 110 million; and bipolar disorder and panic disorders were each just over 100 million. Other issues included substance abuse, agoraphobia and separation anxiety disorder.

Physical conditions that resulted in sick days included arthritis (375 million), stroke (221 million), heart attack (204 million) and cancer (71.5 million).

Public awareness of mental health conditions is rising, Kessler says, but still, there is a misallocation of attention and funds in medicine in general. "It's not just mental disorders. If you look at the amount of research money available for childhood cancer, it's staggering in relation to the number of kids who have cancer," he says. "The reason is, it's just a compelling thing."

Physical conditions that resulted in sick days included arthritis (375 million), stroke (221 million), heart attack (204 million) and cancer (71.5 million).

Public awareness of mental health conditions is rising, Kessler says, but still, there is a misallocation of attention and funds in medicine in general. "It's not just mental disorders. If you look at the amount of research money available for childhood cancer, it's staggering in relation to the number of kids who have cancer," he says. "The reason is, it's just a compelling thing…"

" I know there are an awful lot of people with mental disorders who are suffering and are not in treatment compared to people with less severe physical disorders who are getting treatment." The allocation needs to be changed, "to make society as a whole function better," he says.”  http://www.masspsy.com/leading/0801_ne_disorders.html Job talks about mental anguish in Job 15:24 --“Trouble and anguish shall make him afraid; they shall prevail against him, as a king ready to the battle.”  We need to lobby for better treatment for the mentally ill.  Do you know someone who is struggling with depression or mental illness?  Extend a hand of friendship to them.

PRACTICAL SELF-HELP FOR MENTAL HEALTH CONSUMERS

By

Katherine Tapley-Milton

THE 18 STEPS

     In 2007, Mike Santoro and Daniel Gervais collaborated to create,
”The 80/20 Project”, which is a DVD about mental illness and the benefits of self-help.  This film has already won two prestigious awards – The Accolade Competition Festival in La Jolla, California and honourable mention at the Inspirational Film Festival in Houston, Texas. Mike proposes in his film that psychiatric medication comprises only 20% of recovery and that 80% of rehabilitation is in the mental health consumer’s own hands. In this DVD Mike gives 18 tips on how one can improve their mental health, which are all things that he discovered in his own recovery process. The tips are as follows:

• Keep track of patterns in your illness and mark them on the calendar.  Is there a predictable pattern to your symptoms?
• Build trust with other people and your support network
• Your life is not your illness.  Do not discuss your illness all the time.
• Accept your illness and deal with it.
• Find the right medication
• Learn from your relapses
• Find a doctor that you can feel comfortable with
• Stick to a budget because debt equals stress. Financial stability brings peace of mind.
• Do not indulge in alcohol or street drugs as these can destabilize you.
• Use the “OHIO” method.  This means “Only handle it once.”  If you are working on a project finish it or it will add to the clutter of your mind.
• Talk to your partner about your mental illness and be transparent about it.
• Control your symptoms and get educated about your mental illness.
• Be honest. Nothing is better than the truth.
• Tell your employer about your illness.
• Know your limits and stay within them.
• Show appreciation to those who have helped you and respect everyone.  Treat others as you would like to be treated.
• Keep your appointments.
• Be active and exercise.  Never give up.

I found this DVD to have a surprisingly professional video quality and the actors were very competent as well.  Mike’s purpose for doing this project is, “The 80/20 Project is my vision of how I manage and life my life even though I suffer from a severe mental illness … It has to do with a lot of effort, discipline, perseverance, and taking responsibility.  This gives me the opportunity to learn from my mistakes and focuses on prevention instead of the cure. Reducing anxiety is a key element in the 80/20 Project. “  Mike tells of how for years he would take his medication and he still got sick, but now that he has implemented the twenty-one steps to maintaining wellness it is working for him.  Mike hopes that he can be a role model for other mental health consumers and it looks like he is.

MIKE SANTRO IS HONORED

     This year Mike is featured as a mental health consumer role model during Mental Illness Awareness Week by the Canadian Alliance of Mental Illness and Mental Health.  They say the following about him, “ He is the loving father of a five year old daughter, a dedicated husband, and an administrative assistant at a non-profit organization in Montreal. He loves spending time with his family, barbequing, bowling, and catching up with his many friends over coffee. Mike also lives with a severe and persistent mental illness called schizoaffective disorder. With the support of family, friends and community organizations, and by knowing what triggers his illness and taking appropriate steps when those triggers occur, Mike has learned to live a full, balanced, and rewarding life. Mike is sharing his story to fulfill his dream of helping others face mental illness by letting them know that mental illness can be treated and recovery is possible…”

 

EXTRA SELF-HELP TIPS TO ADD TO MIKE’S

     Michael John Lake on www.WhyHope.com adds ideas that can be added to Mike

 Santro’s self-help steps. These self-help suggestions are all complimentary to the ones

 found in “The 80/20 Project”.  Lake comments:

 Self Help:  Curing your Mental illness or other issues -- Here are my rules to fix what is wrong in your life:

1. Verify the truth. - False information can make you like society, confused and dangerous.
2. There is no universal cure. - Every person is different and needs to find their own solution.
3. Find out what helps. - It can take trial and error.  Remember rule #1 above.
4. Don't be afraid to ask for help. - Doctors and other people can help.  Remember rule #1.
5. If it is not broke, don't fix it! - Changing things which help can cause more harm than good.
6. When things get better, consider why they did. - See #1, are you sure of the reasons?
7. If you succeed, then fail, don't give up.  Remember rule #3.
8. Take it one step at a time. - You can not know what works if you confuse the issues.
9. Do not eliminate bad thoughts, instead replace them. - It is hard to forget, so find better!  It takes time for people to change, including yourself!  Do not give up or accept blame for weakness.  (This information was taken from http://www.whyhope.com/why/living.htm#cure.)  Think about it -- maybe your problem is not your pill or your psychiatrist; it is just your need for diligent self-help.  The fact that 80% of our wellness may be in our hands is very empowering.

That Old Familiar Madness

by Katherine Tapley-Milton

I can feel that old familiar madness

That creeps up most stealthily upon me

And fills my soul with interminable sadness

It’s like crawling over acres of broken glass

And is too terrible for you to see --

What this monster does to this lass

I’m torn and bleeding and scarred within

And the hours are long as time does pass.

I’d like to make an exit, but that would be a sin.

Yet, I remain confused why I have to live in agony

I pray to have this burden off of my back

Because I’m starting to get panicky

As I am being tortured on a medieval rack

With the Grand Executioner turning the screws

God, please deliver me from the Inquisition

I certainly need to hear some good news

It is my sanity that is in question

Please help me Lord, my soul is one big bruise.

Self-Help for Your Anxiety

Make a Worry Date with Yourself

     One technique to conquer worry and anxiety is to make a “worry date” with yourself for ten minutes  in the morning and another ten minutes in the evening.  During the worry session the purpose is to talk into a tape recorder, use a coach, or  talk to yourself and go over your anxieties.  If you run out of worries repeat them over and over again until the ten minutes is up.  Make yourself get as upset as you can and don't introduce any positive thoughts in your worry date.  Try this for at least ten days and you will start to notice that you are getting bored with your worries and they don't get you worked up like they used to.  If you start worrying through the day, remember that you have a worry date where you can focus on your worries.  You are not allowed to worry outside of the prescribed worry times.  This technique looks like it would backfire, but it actually helps anxiety.  One professor in a small town started a club called, “Worry Wednesdays”.  People in the community were supposed to write down all of their anxieties and mail them in by Wednesday.  He didn't look at people's letters, but felt his idea helped keep people from worrying. Writing down all your anxieties on paper and throwing them into the fireplace might achieve the same goal.  It feels satisfying to see your worries go up in smoke.

Journaling to Relieve Anxiety

     One self-help method that therapist recommend is journaling.  It is a very cheap, accessible way of venting your feelings, solving problems, and work though unresolved issues.  You should journal at least twenty minutes a day in a private place.  Don't forget to write the positive experiences along with the negative experiences.  Write about your hopes and dreams, your ambitions, your fears, and worries. Today, a lot of people take journaling into cyberspace and blog on the Internet. If you take this route, you have to ask yourself, “Do I want the whole world to know about my problems?”  For the best result, you should keep your journal private.  Who would want to publish their diary on the Internet?

Your therapist may be interest in reading your journal to know what you are thinking and feeling, but don't show it to anyone else.

The Benefits of Hobbies on  Mental Health

     Hobbies or leisure activities are often viewed by society as unproductive time because our culture emphasizes work so much. This is a throwback to the Protestant Work Ethic.  Therefore we often have guilt when we are pursuing leisure time pursuits.  Researchers have found that hobbies provide benefits not only for the individual, but society as a whole as well.   Beth Driver of the Academy of Leisure Sciences states that ,“The benefits of leisure are increased physical and mental health, economic development, family bonding, and environmental awareness.”  In fact, some of our favorite activities like playing sports, reading a book, or just sitting in a hammock are beneficial leisure activities.  For psychiatric survivors, hobbies reduce the stress that daily life puts on us and provides relaxation, a diversion from our illness, and improves our quality of life.    

     Persons with anxiety should take up a hobby, because it takes the emphasis off of their problems.     Hobbies or leisure activities are often viewed by society as unproductive time because our culture emphasizes work so much. This is a throwback to the Protestant Work Ethic.  Therefore we often have guilt when we are pursuing leisure time pursuits.  Researchers have found that hobbies provide benefits not only for the individual, but society as a whole as well.   Beth Driver of the Academy of Leisure Sciences states that ,“The benefits of leisure are increased physical and mental health, economic development, family bonding, and environmental awareness.”  In fact, some of our favorite activities like playing sports, reading a book, or just sitting in a hammock are beneficial leisure activities.  For anxiety sufferers, hobbies reduce the stress that daily life puts on us and provides relaxation, a diversion from our illness, and improves our quality of life.

Choose from the below hobbies or add one of your own .  Circle the ones that you would be interested in.

Oil painting

Acrylics

Beadwork

tye-dying

Candle and Soap making

Velvet Art

Crocheting

Cross stitch

rescuing animals

Doll House minatures

Drawing

Jewelry Making

scrap booking

Knitting

Abstract art

Painting animal portraits

Quilting

Scrap booking

Sewing

Gardening

Stamp Collecting

Refinishing antiques

Woodworking

Carving

Computer Games

Board Games

Puzzles

Bowling

Pool

Bird Watching

Genealogy

Salt water aquariums

Reading

Writing

Beachcombing

Amateur and Ham Radio

Pottery

Hiking

Ceramics

Collecting rocks, gems, minerals

Cooking

Body Building

Sports

Crossword Puzzles

Dragon Boating

Model trains

Writing

Teaching a skill

Flower Arranging

Bronze Sculpture

Volunteering at a food bank

Chill out with some leisure activities so that you manage your anxiety more effectively. 

You will be helping your own mental health and that of others.

DARE TO IMAGINE;FROM LUNATICS TO CITIZENS

From Asylum to Hospital

     While researching and writing chapter two of the book, “Dare to Imagine: From Lunatics to Citizens”, Nere St- Amand (social worker)  and Eugene Leblanc (Editor) were very fortunate to find two diaries of abused inmates of the lunatic asylum in Saint John, New Brunswick. The first letters were Stephen Innis’s ,who was incarcerated in 1869, and the second one was Mary a lady who was institutionalized in 1883.  Mr. Innis  apparently had a big family row over his sisters upcoming marriage, the police were called,  and he was dumped into the asylum.   His letters to his boss depict a violent environment where he received abuse  from both inmates and staff.  Innis predicted that his stay would be a long one and so he committed suicide.  Mary’s diary was a gem to researchers trying to find out what asylum life at the end of the 19th century was like.  Originally, Mary wasn’t eating or sleeping well and her five sons had her committed to the asylum.  She talks about the abuse of other patients by the staff, the cold, the hunger, the brutality, and the despair.

From 1903- 1980‘s

     In the beginning of the twentieth century the word “asylum” was changed to “hospital”. 
Superintendent Hetherington describes 1903 as a time of great “scientific enlightenment” and
“intense humanity” and Chapter Three of “Dare to Imagine” analyzes this time period to see if these optimistic words come true or if they are just fantasies.  In 1904 Dr. James Anglin  became superintendent of the Provincial hospital and he had the fence torn down and the chains removed from the patients. However, the hospital's capacity originally was 80 patients and at the time 1,500 patients were in it.  In fact so many patients  were admitted at one time that the type of their illnesses and the circumstance of their committal were not even registered. 

     In 1916 a teenage Wendy Tupper was admitted to the Provincial Hospital allegedly because she was afraid of men.  After 60 years of psychiatric care Miss Tupper still had her original complaint and she was playing with dolls and waiting for her mother to come back to her.

“A newcomer to the hospital encounters sighs, sounds, and smells which he has never encountered before.  Everywhere he goes doors must be locked and unlocked.  Everywhere patients have a drugged look. And idleness reigns.” Camp 1976:15  By 1920 conditions at the hospital were considered to be 20 years behind the times, the building was in ruins, and the 35 staff members were inadequately trained.  Patients were placed in restraints, and the dreaded crib beds were still being used.  Twenty years later the same kind of criticisms were levied at the hospital.  By 1929 the Provincial Hospital expanded.  There were to more wards, a store, and another kitchen.  In 81 years the hospital grew 13 times.

     From 1931-56 Superintendent Dr. E. C. Menzies was at the helm of the Provincial Hospital.  His main innovation was to allow the patients to go to the bathroom at night, by keeping the bathroom door open.  Prior to that the patients were chained to their beds at night and had the doors to their bedroom locked.  That left them no choice but to relieve themselves in their beds. Dr. E.C. Menzies boasted that the Provincial Hospital had treated 11,796 and 4,708 were thought to be completely cured.

     By 1936, insulin shock was practised at the Provincial Hospital.  This was the practice of

overdosing patients with insulin to make them go into convulsions.  Insulin shock was a crude form a shock therapy.  During World War II there was a lack of doctors and trained personnel,

since many had gone to war.  There was an influx of patients who were shell shocked and suffering post traumatic stress syndrome from fighting in the war.  By 1942 electroshock was introduced and used on the patients under the supervision of Dr. Fisher. The great writer, Earnest Hemingway, had shock therapy in 1961 and a few days later committed suicide.  Dr. Cerletti invented shock therapy in 1938, calling it “annihilation”.  He got the idea for this kind of treatment or mistreatment by watching pigs being killed in a slaughterhouse.  The pigs were electrocuted before having their throats slit.  Even today in Southeastern New Brunswick15-20% of helpless psychiatric patients are either tricked or forced to have shock therapy which is barbaric. Shock therapy causes permanent memory loss and brain damage and in many cases destroys the person.

     By 1945 three former staff members of the Provincial Hospital wrote to Montreal paper, The Standard” and made complaints about the hospital.  This lead a retired reporter from “Time” magazine to pose as a staff member.  His article, “Eight Days in a Mental Hospital” soon became public.  An excerpt said, “I noticed that eight patients wore hobbles around their ankles which mad it very easy to push them off balance should they become violent.  Four were strapped to benches and were released to be transferred to bed, where they were  strapped down by wrists and ankles to the bed itself.  I was shown dungeons underground where unruly patients were formerly confined.”  When this article came out there was panic among the administration and the politicians in whose riding these atrocities were committed.

     Starting in 1956 people in the United States, England, and Italy started challenging the

way that psychiatric hospitals were handling their patients and by 1968 “A Report of the Study Committee on Mental Health Services' aimed at reforming psychiatric care by treating patients in the community instead of institutionalizing them.  Self-help and consumer-driven groups were encouraged.

COMING TO NEW BRUNSWICK: COMMUNITY TREATMENT ORDERS?

          Community Treatment Orders or CTO’s have been instituted in Saskatchewan, Manitoba, British Columbia, and Ontario and there is a movement afoot to bring them to New Brunswick.  Internationally, CTO’s are law in 41 states of the U.S., in Austrailia, New Zealand, and the United Kingdom.  The goal of CTO’s are to provide seriously ill mental health consumers with a less restrictive treatment than being detained in a hospital or held in the legal system.  The patient is treated in their home

and is followed by a mental health professionals.

THE CRITERIA

    The criteria for patients being put on CTO’s is the following:

1.      a prior history of hospitalization

2.      a CTO plan is in place

3.      the patient has seen a doctor within the last 72 hours of a CTO

4.      the patient’s ability to comply

5.      consultation with the patient or the patient’s decision maker

6.      consent to have a CTO

BENEFITS AND WARNINGS

     An interesting article on “Community Treatment Orders: International Comparisons” by John Dawson at Otago University in New Zealand comments that there are, “… significant therapeutic benefits for the patients; greater compliance with outpatient treatment, especially medication; and reduced rates of hospital admissions.”  However, the same study points out that, “CommTO’s are strongly linked to the use of depot (or inject able) medication, which is disliked by many patients, and patients commonly complain that their treatment is dominated by the use of medication, with little access to other therapies.  CommTO’s tend to be issued for the maximum period permitted by law and discharge is likely to occur shortly before an independent review hearing would be held.  When the patient’s treatment is proceeding satisfactorily, clinicians seem to have a strong preference for maintaining the status quo, so discharge from the order may not be easy for patients to obtain.”

     In Canada, most CTO’s are issued for six months at a time.  Theoretically, they can be rescinded by one of three conditions: 1. by the doctor at the request of the patient or her decision maker 2. non-compliance of the patient or 3. the withdrawal of consent of the patient or the patient’s decision maker.

     Although there are benefits to CTO’s, John Dawson warns that, “Clinicians should avoid assuming that all patients on CommTO’s must be administered medication by injection.  CommTO’s should not be over-used for patients with affective (mood) disorders, for whom their efficacy is uncertain, and whose capacity to consent may swiftly return after their initial treatment.  Nor should CommTO’s be over-used when there is extreme pressure on hospital beds.”  CTO’s have been found most effective in those patients who have psychotic disorders.

     CTO’s may provide a good alternative to jail or psychiatric hospitals in New Brunswick.  However, the cautions put forth by New Zealand’s experience should be kept in mind.