Schizophrenia Fellowship Canterbury Inc.

Seeking the best quality of life possible for people with Schizophrenia and related disorders and for their whanau and caregivers Established 1977 Charities Commission Registration CC27101

Summer 2013 MENTAL HEALTH ( COMPULSORY ASSESSMENT & TREATMENT) ACT 1992 THESE NOTES CANNOT SUBSTITUTE FOR READING THE ACT- AVAILABLE ON GOOGLE. Ministry of Heath guidelines about seclusion are also helpful. DEFINITION (s.2) Mental Disorder in relation to any person, means an abnormal state of mind ( whether of a continuous or an intermittent nature),characterized by delusions, or by disorders of mood or perception or volition or cognition, of such a degree that ita- Poses a serious danger to health or safety of that person or of others, or b-Seriously diminishes the capacity of that person to take care of him/her self . xxxxxxxxxxx May the road rise to meet you May the wind be ever at your back May the sun shine Warm upon your face May the rain fall softly upon your fieldsAnd until we meet again May God hold you in the palm of his hand. xxxxxxxxxxxxx

Dr Andrew Collie & Robert Perry, Senior District Inspector Canterbury, at recent Seminar Application- Any person who has seen the proposed patient within the last three days may complete a section .8A application for assessment which must be accompanied by a.8B Medical Practitioner Certificate stating (among other matters) that there are reasonable grounds for believing that the person may be suffering from a mental disorder. A s.9 assessment examination must than be completed in most circumstances by a qualified Psychiatrist. If the Psychiatrist considers that there are reasonable grounds for believing that the proposed patient is mentally disordered and that it is desirable that the proposed patient be required to undergo further assessment and treatment,s.11 will then apply, requiring 1

the proposed patient to be assessed and treated usually -but not always-in hospital for up to 5 days. Within 5 days, a further assessment examination, pursuant to s. 12 must be completed by the Responsible Clinician/ the Psychiatrist responsible for the patients care and treatment. If the Responsible Clinician is of the opinion that the patient is not then fit to be released from compulsory status, the patient will be required to undergo the s,1314 days further assessment and treatment. COMPULSORY TREATMENT ORDER If before the expiry of the 14 days period of assessment and treatment, the Responsible Clinician considers that the patient remains unfit to be released from complulsory status, the Responsible Clinician must then apply for a Compulsory Treatment Order. The application must then be heard within 14 days of the making of the application, before a Judge- usually a Family Court Judge. Mental Health Review Tribunal The Tribunal consists of a Lawyer, a Psychiatrist, and a lay-person. It hears applications for discharge from compulsory status. Appointments to the Tribunal are made by the Minister of Health. Panelists are drawn from elsewhere in the country so that the case is considered afresh. High Court Judicial Inquiry On rare occasions, such an inquiry would be held, only for inpatients. Health & Disability Commissioners Code of Right Section.59 & s.60 (Electro-Convulsive Treatment) provide options for reassessme.Then follows sections to 75 dealing with rights of patients.

Judges travel to Princess Margaret Hospital generally on Tuesdays of each week to hear applications for Orders or Section reviews. They are at Hillmorton Hospital generally on Wednesdays of each week to hear applications. Each week District Inspectors ( Lawyers specializing in Mental Health) in Canterbury (Robert Perry, Nicola Ebert, Greg Trainor) receive certificates in respect of many people and will endeavor to see them, write, or speak to them. In addition patients may be supported by advocates, and community organizations, for example the Community Law Centre. Legal assistance can also be sought, and in most cases is available under Legal Aid. These days most patients are Voluntary, as treatment is more effective with cooperation. HAPPINESS Happiness engages,she could fill up many pages Lifting the spirits and lighting the atmosphere Happiness,though intangible,makes her presence clear Whether she permeates or radiates as she finds her place to please Happiness through many forms puts everyone at ease The silent observer she sees where :sorrow sits So there she shines her power, and joyful rays emits Remodeling and re-inventing her face, they influence afar Beyond wages,war and weapons,she transcends all this Giving that sense of satisfaction which when without, we all do miss. Pieta Valentine 2

DEMENTIA IMPLICATIONS People with ALZHEIMERS often become agitated and erratic later in the day (a phenomenon know as Sundowning) and are wakeful during the night. One line of thinking is that this is partly the body clock, disconnecting from other parts of the brain. The normal sleep patterns degenerate with age, but data suggests that process is accelerated by Alzheimers. The idea is: can we reinforce the body clocks by giving people in the early stages of Dementia more patterned exposure to bright lights, and more patterned exposure to EXERCISE. A group in Belgium is working with LED engineers to create ceilings made of lights that can be programmed to create day/night cycles. You can have summer in Bermuda. The technology will be targeted at Rest Homes. For those of us suffering from noral workaday sleep deprivation, the best medicine might be to just switch off the Idiot Box. Light from computers, tablets, cell-phone screen and televisions is thought to confuse our body clocks, especially if we are absorbing it after dark. Then theres our tendancy to zone out in front of the late night movies. Says Professor Philippa Gander of Massey University : If somebody asks me what would be the most important public health thing we could do in NZ, to improve sleep, I facetiously sometimes say: bring back the Goodnight Kiwi. Catherine WoulfeNZ Listener 03.08.13

ALL I NEED TO KNOW I LEARN FROM SANTA Encourage People to believe in you. Always remember whos naughty and whos nice. Dont pout. Its as much fun to give as it is to receive. Some days its ok to feel a little chubby. Make your presents known. Bright red can make anyone look good. Wear a wide belt and no-one will know how many pounds youve gained. If you only show up once a year, everyone will think youre very important. Whenever youre at a loss for words,say: HO,HO,HO. THE JOY OF LAZINESS How to slow down and live longer. By Dr Peter Axt & Dr Michael AxtGadermann. Published by Bloomsbury. Based on scientific research The Joy of Laziness reveals why the speed at which we live affects our energy and longevity. The authors- both former (& reformed) champion athletes- explain how. UNKNOWN REINDEER The Game-show contestant was only 200 points behind the leader, and about to answer the final question worth 500 points. To be todays champion; name two of Santas reindeer. Rudolph came the reply and Oliver. Yes, well accept Rudolph, please explain Oliver? You know, Rudolf the Red nosed Reindeer, had a very shiny nose, and if you ever saw it, you would even say it glowed, Oliver the other reindeer used to laugh and call him names 3

KILLING US SOFTLY Professor Paul Offit of the Childrens Hospital, Philadelphia USA, has published another book on a controversial topic The Sense and Nonsense of Alternative Medicines. There is a perception that vitamins boost energy, reduce stress, help you live longer. The word itself vita for life, is always perceived as a good word. People cant imagine it is possible you can get too much of a good thing. Its like the peoples medicine. You can walk into a health food store and buy whatever you want; you can shrink your prostate, lower your cholesterol, improve your heart health, treat joint pain. Even if studies show that none of that is true, the perception is true. Natural, organic,anti-oxidant,-these are big selling words, but just because it is natural or organic doesnt mean it is safe. Gingko biloba for memory,StJohns wort for depression,garlic for cholesterol ,glucosamine for joint pain, in each case sales exceed claims. THE PLACEBO (sham form) EFFECT Although often given as a standard comparison point in drug trials , placebos have repeatedly been found to release stress, reduce pain, encourage healing. In the early 1970s, US scientists discovered chemicals made by the human pituitary gland and hypo-thalamus that acted like morphine. These were endorphins, naturally released in response to pain, spicy foods, exercise, excitement , orgasm. It became clear that psychologists hadnt appreciated the whole story. What alternative healers had been calling the mind-body connection had a physiological basis. THE SINGLE MOST IMPORTANT MOMENT IN YOUR HEALTH OCCURRED WHEN YOUR PARENTS CONCEIVED YOU. That was a moment of genetic roulette that probably determined more than anything else how long you will live and what you will die from. Professor Offit sites research showing that mega-doses of vitamins, particularly A and E can actually increase the risk of heart disease and cancer. Half of Americans, about 156 million people use alternative medicines. According to the 2008-09 NZ Adult Nutrition Survey,48% of NZers, aged 15 year and over, use supplements- vitamins, minerals, herbal and botanical preparations, oils such as fish oil, or products containing glucosamine and/or chondroitin. In his book Offit charts the development of bio-identical hormones as the natural alternative to hormone replacement therapy (HRT) for meno-pause-related problems even though bio-identical hormones are probably as risky as their conventional counterparts. The difference isnt that one is natural and safe and the other isnt. It is that one is the product of an unsupervised industry and the other isnt. Offit suggests, after checking with your GP, supplements that can be taken are:- folic acid for pregnant women, B vitamins particularly B12; calcium and vitamin D for post menopausal women; and omega-3 fatty acids to prevent heart disease. SALLY BLUNDELL NZ LISTENER 9.11.13 4

NOT GUILTY BY REASON OF INSANITY A Spreydon man who killed his partner by wounding her 26 times in a frenzied knife attack has been found not guilty on the grounds of insanity and ordered to be held in hospital as a special patient. [Mr X] was before the High Court in Christchurch for the murder of [Ms Y], 47, at a.... house on September 27, 2011. [Mr X] 55, and [Ms Y] had histories of mental illness, the court was told before Justice John Fogarty gave his decision. Health assessors' reports had been prepared on [Mr X] before the hearing...... [Mr X] had a longstanding diagnosis of schizophrenia that could include a sense of superiority & "command hallucinations". "This can give a person a sense of belief in the right of what they are doing even when what they are doing is incredibly ghastly and violent," the judge said. A homicide committed by a person with a diagnosis of schizophrenia is a sad, but, thankfully, rare event. However, some cases have the power to disturb the public, especially when there are bizarre or lurid details. Our society has mercifully recognised that people who commit crimes while under the influence of an intense mental illness may not have the ability to distinguish right from wrong. As such, they cannot be held accountable for their actions. This does not mean that the Court does not regard the case lightly. Instead of being found guilty and being sent to prison as punishment and as a deterrence to others, the perpetrator is sent to a secure hospital to receive treatment for the mental illness which led to the crime.

Taking the Girls to the Maternity Ward Culnerden After a homicide, the Courts typically make an order directing one of a few designated hospitals to care for the offender as a Special Patient, whose treatment and eventual release is closely supervised by the Ministry of Health in Wellington. For lesser offences, the perpetrator who is ill may be placed under a Treatment Order [under the Mental Health Act] and directed to receive treatment. In severe cases, the ill offender has typically experienced auditory hallucinations which are threatening, fearsome, taunting, and derogatory. When the voices are threatening, the sick person may believe utterly that he or she is at grave danger of being harmed or killed. There is typically a total absence of insight into the fact that the voices heard are the products of a mental illness. Instead, the threats are experienced as completely real and unarguable. But a kind of rationality remains - the sufferer knows that people should not simply hear voices, as it were, out of the ether. So he seeks their origin: perhaps his wife, neighbour or the guy down the road is the source of the intolerable threats. When family members or health professionals seem not to be able to understand or help the patient deal with the threat he is experiencing, then, ultimately, the terrified 5

patient may take matters into his own hands and kill the presumed source of the voices. Sometimes, the voices not only utter threats to the sufferer, but directly give commands to harm or kill other people. The commands have an intensity and urgency which may be irresistible. Or, the key, culpable symptom is not a voice, but a false, delusional belief that the sufferer is under threat. Again, the paranoia may be so intense, and so frightening, that the only rational response seems to be to act, to kill the person or people responsible for the intolerable threat. Such delusions cannot be removed by someone, for example, a family member, pointing out that the ideas are wrong and the fear unnecessary. Such discussions may only serve to persuade the sufferer that everyone is against him. Mental sickness of this intensity can overwhelm totally the sufferer's life, so that every minor event seems saturated with threat. It is not surprising therefore that the crime is sometimes notable for its wanton violence, which, when the details emerge, horrifies members of the public. Of course, if a sufferer is already under treatment, one of the aims of treatment will be to eradicate the auditory hallucinations or the delusions. If that is not possible, their intensity and frequency, or the pervasiveness of the disturbance in the patient's life, can usually be reduced. The case manager and the psychiatrist will try to understand the content of the patient's thoughts and psychotic experiences. When symptoms are intense, it may be wise to admit the patient to hospital for closer observation, the trial of a new treatment, or to remove the patient from an inflammatory situation. The types of cases discussed above are rare.

In NZ there are typically not more than about 120 Special Patients at a time.. Given that the prevalence of schizophrenia is estimated to be about 1% in all societies, all over the world, we should expect there to be about 40 000 people with schizophrenia in New Zealand.. Of course, we must remember that most violence in society is not associated in any way with mental illness. Alcohol is frequently cited by experts as the most significant common factor in incidents of violence. As well as recognition that a person may be found "not guilty by reason of insanity", the Courts also acknowledge that people with mental illness, like everyone else, are capable of committing a crime. The fact of having a mental illness, by itself, does not mean that a person is incapable from distinguishing right from wrong.

A colorful anecdote makes the point. Mr Q had a mental illness and suffered a grandiose delusion that he and he alone owned all the red cars in New Zealand . When therefore he stole a red car from a parking lot, he was found not guilty by reason of insanity. But when he stole a green car, he was convicted of car theft. ---Dr Andrew Collie THE ROSIE PROJECT By Graeme Simsion Although there are many laughs to be found in this novel, The Rosie Project is a serious reflection on our need for companionship and identity. Text Publishing Company Melbourne 2013. 6

Keep Calm And Carry On Wednesday September 18 at Government House Wellington was the first time in NZ that an Investment ceremony was held for Women only. Twenty women received accolades announced in the Queens Birthday Honors by Her Majesty Queen Elizabeth 2. Government House sits atop hills which overlook the Basin Reserve, and occupies 12 ha. Originally it was the site of the Mount View Lunatic Asylum, which replaced the first Asylum in NZ at Karori. The 4200 m2 building was begun in 1908 and completed in 1910. The House was closed for 3 years for renovation and reopened in 2012. The investiture ceremony was held in the Ballroom. Drum Roll, Doors Open : Please stand for his Excellency Sir Jerry Mate-par-ae and Lady Janine. But where was Lady Janine ? Observed Sir Jerry once in place : You will notice that Janine is not here. Laughter. Not a move out of the Immaculately Uniformed Aid, who stared unflinchingly into the future. No doubt thinking that he would chew an Administration ear later. That was the only hiccup in a Ceremony which moved with clockwork precision. Thursday 19 September, 120 years since NZ women gained the right to vote -first in the world. Ninety people sat down to dinner. Jerrys speech honoured many NZ women. The March of the Waitresses was much admired. Ten people to a table. Five waitresses ( students from Victoria

University) marched in with a plate in each hand, stood between 2 guests, at signal deposited their plates, stood back : Ready to jibe ? The Marchers were gone. Eight students from Aotea College harmonized before and during the meal. Finalising with Te Aroha, sung by all: Love, Faith,and Peace,Be among us all. On our way out , we were presented with a Camelia plant- remembering Kate Shephardthe most prominent member of N.Zs Suffrage movement ( the movement to allow women to vote in NZ). She also appears on the NZ $10 note. Said Jerry as we left : When you get back, to Christchurch, look after your people. Remember the TV 3 advert with George Clooney and the girl arriving at the hotel? I always feel like a star when I come here. That was the way I felt Clare Mouat Queens Service Medal . For Services to Mental Health. PEACE IS BREATH Peace is the simmering silence that reveals the unspoken word She emits her tranquil presence and doesnt need to be heard Always gracious in her ways,she never intrudes or asks for praise Peace is power in conflict,anger,hate and war The silent strong observer, she can melt to the utter core Take peace and embrace her comfort, in all her various ways Let her console the comfortless, with her cool engaging grace. PIETA VALENTINE

P.O. Box 80050 Christchurch 8440.

sfcanterbury@paradise.net.nz

Our Services are made possible through Grants from: CANTERBURY COMMUNITY TRUST, L B MILLER TRUST, BE SEEN SIGNAGE,& MARKETING HORNBY, NZ POST, TELECOM, CHRISTCHURCH CITY COUNCIL, COMMUNITY ORGANISATION GRANTS, MEYER & CO ACCOUNTANTS, PHILIP STOCKBRIDGE OF AINGER TOMLIN AUDIT, NZ.PRINTING.COM, DR JONATHAN STANGER FOR I.T. EXPERTISE THE LATE GUNARS KALNINS ESTATE. K LAUGESON TRUST. ANDREW LOGAN-Solicitor Mortlock Mccormack Law . As well as generous donations of time and money from volunteers, members & supporters.TO YOU ALL- OUR GRATEFUL THANKS 8