Donors: Supporting Mental Health
‘We remember dear Jacquie with tender love and profound affection. Her family, friends and loved ones miss her dearly every day, especially her spirited sense of humour, her admirable determination in the face of adversity, and her generous and vivacious character.’
IN MEMORIAM, Montreal Gazette, July 10, 2014.
Senator David Angus and daughter Jacquie Angus
Born to Margot and David on a crisp Thanksgiving weekend in 1965, Jacqueline had the potential and optimism for a full and happy life of independence that all bouncing babies deserve. The reality, as her young life unfolded, told a rather different story due to the onset of epilepsy at the tender age of 12 months and subsequently paranoid schizophrenia diagnosed during her late teens.
Her formative years were plagued by an illness characterized by “strange” and, to some, even “scary” behaviour resulting in insensitive treatment by her peers who did not understand her condition and dependence on complex medication and a system then woefully ill-equipped to deal with her not-so-unique needs. Forty seven years, ultimately, of challenges for her and her family and, fortunately, many (but still too few) happy and even inspiring times.
“When our daughter passed away,” says David Angus, former Senator and Chairman of the Board of MUHC, “we created a fund in her name, with a principal goal of supporting research into severe mental illness, a condition which directly or indirectly impacts at least a quarter of all Canadians. While it is a project that I would never wish on another parent, Jacquie's fighting spirit, positive attitude and good humoured approach to life gave us no choice: something good has to come from her struggle.”
It was not supposed to be like this but a chance encounter seemed to point the way forward – both bad and good. “My roommate at Princeton back in the 1950’s became a leading expert in diseases of the mind, especially schizophrenia – Dr. E. Fuller Torrey. Years later, he was the man who finally diagnosed Jacqueline’s condition. Dr. Torrey also became well-known as an advocate of the now mainstream idea that severe mental illness is due to biological factors and not social factors. “Not only did he help us understand the gravity of what we were dealing with,” adds Mr. Angus, “but he also provided us with clarity about how we could best cope with these issues and, finally, what we could do to address the bigger issues of mental health, an area that is grossly underfunded and misunderstood by the public.”
According to Mr. Angus, it is misunderstood for good reason: “mental illness, especially the ‘crazy, strange disease of schizophrenia’ (as Dr. Torrey describes it) can be highly disruptive, costly, and lead to criminality, shootings, family breakup, and homelessness. Thankfully,” he adds, “in recent years it is starting to get the attention and support it deserves.”
“When we started down this path, we couldn’t understand it and had little guidance. We had some means and tried everything, the best schools, the best care, the best available counsel, but to little avail. And when our daughter was going through particularly bad periods we were unable to identify the appropriate facilities to protect her,” he says. “But I have to say that, with all this, I have been very fortunate. I’m 78 now, healthy, I have had a wonderful life really. But I have also seen this disease through rational eyes and eventually came to the conclusion that I and my family had to do our part,” adds Mr. Angus.
A first round of Angus Family funding resulted in Melvyn G. Angus Family Acute Care wing at the Montreal General Hospital which was subsequently added to by the Senator W. David Angus acute care facility. This 4th floor unit is a key part of a new system that begins with mental health emergency triage, and a protocol for medication or other treatment and to either short-term care at the hospital or longer-term treatment as an out-patient.
“I have also committed to supporting the Care At The Highest Level campaign (note: $1.5 million is being sought for the mental health emergency short stay unit) and I am hopeful that others will recognize the importance of this illness both in personal terms and in its devastating social and financial costs to society at large,” says Mr. Angus.
“For five months before Jacquie passed away she was a patient in the 4th floor unit that carries our family name. I have to say I was touched by the support we received by the staff there and my daughter herself called me frequently to tell me how much she was impressed by the care she was receiving. Bitter irony, I suppose, but her voice sounded so full of life on those occasions,” says Mr. Angus. “As it does to me now.”
Our mission is your mental health
“So much has changed in the perception of mental illness,” says Dr. Nadia Szkrumelak, Chief of the Department of Psychiatry at the MUHC, “thanks to two converging factors. One is the ‘halo’ effect of well-known people – athletes, actors and others – ‘coming out’ about their own problems and the second is the tremendous advances being made in research.”
As a result of the former, the stigma of afflictions such as depression is declining – for the first time. And more people are seeking treatment instead of ignoring or hiding symptoms. As a result of the latter, the distinction between the physical brain and the notion of the mind or soul is becoming blurred, if not broken down completely. In the past, people assumed someone had a problem with his/her mental state because of upbringing or even a weak character. Today, the psychological model of mental illness (and treatment) is being supplemented and replaced by a biological one; and shame and guilt are being replaced by treatments based on the physical sciences. “Think of how we thought about – and approached – post-partum depression 40 years ago, for example,” says Dr. Szkrumelak, “now we know it to be a real disease with real therapies that work.”
This shift is a welcome one to the Psychiatrist-in-Chief: “there is no physical health without mental health” she says, “and the need for a full spectrum of integrated solutions – from lifestyle choices to medication – is essential. It is hard to imagine treating other common illnesses such as diabetes, for example,” Dr. Szkrumelak adds, “by just diet or just insulin; we need them both to get the best outcomes. Mental health is the same.”
Preventive care is, of course, a key part of the puzzle and the domain of specialists in the community – psychologists, the family doctor, and others, but it is, in fact, only a part. The Montreal General Hospital is now better equipped to handle the most serious patient crises – attempted suicides, overdoses, and other psychiatric conditions, thanks to the recently inaugurated Brief Intervention Unit, integrated with emergency services.
The new facility provides a state-of-the-art approach to assessing the patient and determining whether they return to the community (and/or seek out patient support) or are admitted for a 2-5 day period for further evaluation and treatment. The MGH Foundation helped fund the 8-bed unit on the hospital’s first floor that provides a space in which patients and their families can access the highest quality of care in a calm and reassuring environment.
Challenges remain, of course, and some quite significant. Out-patient services remain at the Royal Victoria’s Allen Memorial, for example. But with the support of the MGH Foundation and its many friends, solutions are certainly at hand.
Patients inside
“At the Montreal General’s in-patient unit we treat patients with a variety of disorders, including schizophrenia, major depression, bipolar, personality disorders, forensic cases, chronic pain, and others,” says Dr. Thomas Milroy, Director of the MUHC Adult In-Patient and ECT Services in Psychiatry. “Addictions also account for four of the 42 beds currently available. And, while a fifth of patients are admitted for longer stays (up to two years),” he adds, “most are here for up to 20 days.”
While the challenges faced by this unit are familiar ones to those working in the healthcare sector – shortage of trained nurses, anesthesiologists, research funding – Dr. Milroy is positive in his description of where the MGH is now compared to the past. “Thanks to donations from people like the Angus Family, Lundbeck and the MGH Foundation, facilities here have improved dramatically.” The new 4th floor unit boasts more single and double rooms than before, it’s air conditioned, has Wifi and, importantly, has modernized staff working spaces. “And we also hope for good results from the new Brief Intervention Unit,” he adds.
The problems remain, of course, particularly with regard to providing timely care out in the community; a lack of housing (or appropriate housing) for many is a big issue and continues to put pressure on the hospital. Without enough space outside the institution, many patients end up at the General’s emergency room with no-where to provide them the kind of care they need. Conversely, when it’s time for an in-patient to go back into the community, resources there are scarce. All this creates a bottleneck which leads to delays or interruptions in treatment, or no treatment at all.
“We remain hopeful,” however, adds Dr. Milroy, “that we will begin to get some clarity about how these issues will be resolved in the recently restructured healthcare system with responsibilities shifted from agencies to the Ministry.” In the meantime, the question of out-patients remains unanswered.
Looking forward, Dr. Milroy is optimistic: “donors continue to step up and provide us with new and much appreciated equipment, such as an exercise bikes, furniture and artwork – all things that can make a real difference to those being treated at the General.”
Source: https://www.mghfoundation.com/wp-content/uploads/2015/12/newsletterWinterENWEB.pdf