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June 1, 2007
More than one hurdle
Book focuses on mental health and other issues.
CYNTHIA RAMSAY
People suffering from mental illness and developmental disability,
and their families, should know that they're not alone in their
struggles – and that there is hope.
Success Stories from the Frontline: Intellectual Disabilities
and Mental Health, compiled by psychiatrist Robin Friedlander
and registered practical nurse Tina Donnelly, and edited by Madeline
Hombert, is an anthology of first-person stories through the experience
of intellectual disability (ID) and mental health needs (MH).
"The rate of ID is three per cent in kids and 15 [per cent
in] adults," explained Friedlander in an e-mail interview with
the Independent. "Thirty to 40 per cent of individuals
with ID have dual diagnosis (DD and serious mental health needs).
"I avoided the term DD in this book, because we just wanted
to focus on the IQ-less-than-70 group (previously called mental
retardation). In my opinion, the term DD should include all those
with neurodevelopmental disabilties, no matter what their IQ. (This
includes those with higher-functioning autism, cerebral palsy, genetic
syndromes like Prader Willi syndrome, etc., but with an IQ greater
than 70.)"
Although the book refers to ID, the term DD (developmental disability)
is more widely used in British Columbia, said Friedlander, who is
the clinical director at Developmental Disabilities Mental Health
Services-Fraser and Vancouver Coastal/Burnaby. Donnelly is the manager
of mental health services at DDMHS. They hope that Success Stories
will serve families and care providers and educate the public about
this "unique group."
According to Friedlander, this is an area of the health-care system
that requires more money.
"No one in government anticipated the frequency of new cases
of complex kids and adults with DD when they closed the institutions
for people with DD (such as Woodlands)," he said, "and
CLBC [Community Living British Columbia] are reluctant to take on
the extra services required for this group. (They are also underfunded,
but also continually reorganizing and so, this is not on their radar
screens, as it should be.)"
He further explained, "CLBC is a Crown corporation responsible
for services for children and adults with DD in B.C. They have not
addressed specialty mental health nor crisis services for complex
clients with DD, because their model is to promote inclusion and
access to generic services. So our patients with dual diagnosis
get good community help, but, if they need urgent access to a specialized
hospital bed, there is no such creature."
As an example, Friedlander said he has two male patients in group
homes, both with severe ID, who have recently been in hospital,
in the urgent psychiatry unit, which is a generic mental health
service under Vancouver Coastal Health. Both clients have been discharged
back into their CLBC-funded group homes, he said, but have shown
either no improvement in behavior or been worse since hospitalization.
"Generic services are great, but can only help so much,"
said Friedlander. "If you have complex heart disease, do you
want admission to St. Paul's specialty cardiac unit? You bet!"
Success Stories contributors managed to get in touch with
Friedlander for help, however, so there are aspects of the system
that are working.
"We provide a specialty mental health service for teens and
adults with DD and mental health issues," he said. "Our
reputation is very good. Why? Our patients usually present to school
or social services because of aggression to self or others. We have
a multidisciplinary team (psychiatry, nursing, psychology), which
can adequately and fully address the complex biological, psychological
and environmental factors involved in the aggression."
While none of the stories in Friedlander's book are written by Jewish
people, he has treated many Jewish patients and Judaism plays a
large role in his life.
"I am very involved with the Jewish community," he told
the Independent. "Our family belongs to Or Shalom. My
kids go to KDHS [King David High School]. I am a very active member
of the Connections Committee (under JFSA [Jewish Family Service
Agency]), which tries to advocate for awareness of disability issues
in the Jewish community of Vancouver."
Success Stories is available from Black Bond Books, Odin
Books and Blackberries Books, as well as from the DDMHS at 604-660-0786.
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