Archway
clinic: a profile
Community care for people
with schizophrenia
Since
its inception 26 years ago, the Archway Community Mental Health Clinic
has had about as many addresses as a week has days. Yet in spite of all
the relocations, one thing has remained constant in the life of the clinic:
the commitment of its staff to comprehensive treatment for people with
a severe mental illness who live in the surrounding community.
The
idea for launching Archway came in 1974, when staff at the Queen Street
Mental Health Centre (now the Queen Street site of the Centre) realized
few resources, if any, existed for people once they were discharged from
the hospital. Shortly afterwards, at a church on Roncesvalles Avenue,
two nurses provided care and assistance to patients when the clinic was
open on two afternoons a week. Since that time, a board of directors was
formed with members of the community, and the clinic slowly took on a
broader role in the care of people with schizophrenia. Now the program
is
one service within the Centre's Schizophrenia and Continuing Care Program.
Darryl
Yates is the manager at the Archway Clinic. He is a nurse by training
and has over 12 years of experience in psychiatric settings. He says that
people who come in to the clinic benefit not only from attentive clinical
care, but also gain opportunities for building social networks and learning
job skills. "Between attending group sessions, camping trips and
holiday get-togethers, the people that come to Archway can learn to enrich
their lives by creating bonds with staff and with one another. These relationships
go a long way to minimizing the isolation that characterizes living with
a severe mental illness," says Darryl.
Archway
values collaborative work and links up with other agencies to help people
find housing and work, though they also can help people in both these
areas. Because the clinic is situated in Parkdale, one of Toronto's less
affluent neighbourhoods, several people who come to the clinic to live
in nearby rooming houses and subsist on relatively small incomes. There
are also several homeless people who come to Archway for care. This is
why the clinic offers -- in addition to psychotherapy, counseling and
Life Skills assessments -- additional services such as a food bank, a
laundry facility, a daily drop-in and a clothing bank. Also available
are job incentive programs and vocational assessments.
Clients
who come to Archway are grateful that there is a place they can go where
they feel comfortable and where they can find assistance. One client describes
Archway as "a place where I come to, where I can relate to others
who have the same problems as I do." Says another: "I think
of Archway as being fabulous. My worker and doctor have been able to help
me with my goal, finding me a job. I've gained self confidence because
of the support of Archway and the Vocational Rehabilitation Centre."
To
become a client at Archway, you either have to be referred by an agency
or a healthcare professional -- or by referring yourself. If you would
like to refer yourself, the first step is to call and make an appointment
for an assessment. An assessment is a meeting with a therapist to explore
your needs and goals, and to help you determine what types of activities
and programs will help you. If what Archway offers meets your needs, you
will be registered as a client. To learn more or to refer yourself, please
call the Central Intake number of the Schizophrenia and Continuing Care
program at
(416) 535-8501 ext. 2069.
Addressing
the needs of African Canadian and Caribbean youth
Centre's SAPACCY program
helps youth reach full potential
While
Kermit the Frog may not have been the first to sing about the difficulties
of being different from his peers, his song 'It's not easy being green'
captures many of the issues faced by those of us who don't see our experiences
reflected in the world around us.
This
can be especially true for teenagers who happen to be growing up in a
predominantly European culture and whose heritage is different. The added
pressures that come in the form of racism and prejudice can make young
people feel alienated and vulnerable.
It
comes as no surprise, then, that youth from ethnoracial communities with
substance use issues have a particular set of needs that differ from those
of mainstream society. It should come as even less of a surprise that
the best way to help African Canadian and Caribbean youth is to offer
them services with their specific needs in mind -- delivered by therapists,
social workers and other caregivers who share their culture and ethnicity.
This is the one of the main premises of the Substance Abuse Program for
African Canadian and Caribbean Youth (SAPACCY). SAPACCY is guided by the
vision of a vibrant African Canadian community, where youth can reach
their full potential by choosing a healthy lifestyle over a one that involves
alcohol and other drugs. The program provides treatment and promotes prevention
and early intervention against substance use in vulnerable African Canadian
and Caribbean youth. The supportive family-based orientation of the programs
aims to equip the family and young people with skills to avoid experimenting
with substances, or to reduce harm to self and family. The program serves
youth between the ages of 13 to 29 years.
"Cultural differences are not just about colour," explains Teresa
Marsh, who runs the program. "They are also about language, family
history and heritage. Our program aims to empower Black youth by meeting
them where they are, both in the physical place they are in, like home
and community, but also to meet them where they are emotionally, spiritually
and culturally."
As
an addiction therapist with the SAPPACY program, Charles Senior does much
of the leg work to reach youth of African descent. His typical work week
might include meeting with young people in a social services agency located
in a mall, or spending time with youth in conflict with the law at a probation
office. That the program makes a difference in young people's lives is
evident, says Charles. "When you see clients you met three or four
years ago who have turned their lives around and are now giving back to
the community, it's tremendously rewarding," he says. "SAPPACY
empowers youth at the most basic level -- by providing them with role
models and skills. We tell kids 'you are meant to be so much more then
what drugs offer you' and we show them how to get there."
An
African-Centred Addiction Treatment Model
SAPACCY's
work is based on Afrocentric values and beliefs including MA'AT, the traditional
African principles of virtue, truth, justice, reciprocity, propriety,
harmony, balance and order. These principles are combined with the Afrocentric
value system developed by Maulana Karenga, called the Nguzo Saba, or the
seven principles of Kwanzaa. This system uses seven principles or pillars:
unity, self-determination, collective work and responsibility, co-operative
economics, purpose, creativity and faith. These principles run through
the program like a golden thread.
The
treatment model is based on a socio-cultural, harm reduction approach.
Some goals that are worked towards as part of the therapeutic process
involve addressing the fears and misconceptions youth have about addiction,
assisting them in developing self-esteem, and introducing values and skills
to help young people overcome obstacles.
Many
of the young people who come out of the program are eager to help their
peers. Says Teresa: "When youth do the work they need to with us
and have learned to model healthy behaviour, they can give back to the
community through becoming mentors to others. Now that's success."
To
learn more about the program, please call (416) 535-8501 ext. 7055 or
7026.
Clients
are asking... What is recreation therapy?
"I
am recovering from an addiction. My caseworker suggested I look into recreation
therapy as part of my treatment. What is it and how can it help me?"
Craig Hamilton, Chief of the Recreation Therapy Council, responds:
Congratulations
on taking steps to create a healthier life for yourself! You may have
discovered that since you have stopped using drugs or alcohol, you have
between 35 to 70 hours a week of free time -- time you may have used in
the past on getting and using drugs. Life can get pretty boring if you
don't have exciting activities to look forward to and for some people,
the temptation to start using drugs again to regain the feelings of excitement
they once had can be pretty hard to ignore. This is why it's important
to make lifestyle changes when you kick drugs, including changes to your
daily routines. People recovering from an addiction may need help finding
activities that provide the pleasure and enjoyment that getting high or
drunk once provided. This is where a therapeutic recreationist can help
you.
Recreation
therapy is a process that uses treatment education and participation in
recreational activities to help people with physical, mental, emotional
and/or social limitations gain and keep specific skills, knowledge and
behaviours. Clients who participate in recreation therapy learn to enjoy
their leisure as much as they can, function independently and participate
as fully as possible in society.
The
first thing you need to do if you want to learn how to make
these lifestyle changes is make an appointment to meet with a recreation
therapist like myself. After completing an assessment where you learn
more about your needs and goals, your recreation therapist will work with
you to build a lifestyle that meets your recovery goals and constructively
fills your time with fun, entertainment and enjoyable activities.
As
a recreation therapist in addictions, I have observed four types of clients
and how they view their leisure in recovery without counseling.
First,
there are clients who do not believe in having fun and treat their recovery
with the utmost seriousness. Others isolate themselves from any social
support with clean and sober people. Yet another type of person won't
make any changes in their life and continues to hang out with the same
'using' friends, work in a stressful environment and make no effort to
alter regular routines. In these three situations, relapse frequently
occurs. The fourth and most successful type of person is the one who make
efforts to enjoy their life in recovery.
Of course, it's not easy to make changes. Many people from all walks
of life lack the motivation to follow through on recommended programs,
even when they know they'll feel better if they stick to them. But with
the help of a recreation therapist, there's a very good chance you'll
succeed.
I
hope you will make an appointment to see me or another member of the recreation
therapy team and we will plan on how to make your recovery fun and enjoyable
so you can appreciate life again. I can be reached at (416) 535-8501 ext.
7008 or email craig_hamilton@camh.net.
Is
a clinical trial for me?
"I've
been diagnosed with clinical depression and I've been asked to consider
taking part in a clinical trial of a new medication for treating people
with depression. What do I need to know to make a decision if this is
right for me?"
The editor responds:
First
of all, depression is a common mental health problem. Currently, over
1.5 million Canadians are experiencing depression, so remember: you are
not alone.
Secondly,
depression is a treatable mental health problem. Several medications and
therapies are available and your doctor can help you select one that best
meets your needs.
However,
because not all patients respond well to the medications that currently
exist, newer and better drugs are constantly being developed. Part of
the process for a new medication to be approved by the government department
that regulates prescription drugs is that it must have been tested on
people with the condition. These people must willingly volunteer to be
a part of a drug study, also called a clinical trial. All medications
are tested extensively prior to this stage, either in a laboratory or
in tests using animals so the risk to clinical trial volunteers is minimal.
There
are advantages and disadvantages to participating in a clinical trial.
On the plus side, you will have the chance to be treated with the most
recently-developed drugs designed to be better than others already available.
In addition, you will be closely monitored by a team of experts, including
a psychiatrist, and if you feel you are not getting the results you hoped
for, you can drop out at any time and receive follow-up treatment for
up to a year. Some clinical trials also pay volunteers the costs of travel
and parking to attend their appointments.
While
your health is never in danger, there may be some disadvantages to participating
in a clinical trial. Because they are designed to be 'double blind,' meaning
that neither you nor the psychiatrist know if you are actually taking
the drug or a placebo (also known as a 'sugar' pill), you may not see
any improvement because you are in the test group that is not taking the
medication. Yet for reasons that are still unclear to researchers, about
40 per cent of participants in a clinical trial who receive placebos do
very well and have a 'response.' Also, it is possible that if you are
taking the medication, it may have side effects that make you feel worse.
The
main thing to remember is that participation in a clinical trial is completely
voluntary -- it is up to you to make the decision. If you choose to participate,
you will be helping researchers in the development of better medications
that can benefit a lot of people. If you decide not to, your doctor will
work with you to select a treatment from the ones already available. Either
way, you will be treated.
If
you are asked to participate in a clinical trial, ask your doctor what
you can expect. You have the right to know as much as there is to know
before you agree to participate. Ask if there is material you can read
about the drug that is being tested or about the nature of the test you
are being asked to participate in. You can also call the Centre to learn
more about other treatments before making a decision.
For
general information about treatment options for depression and other mental
health problems, please call (416) 979-6878. For addiction concerns, call
(416) 595-6128. To learn more about participation in clinical trials,
call 1-877-464-4472.
Got
a question about your treatment? Breakthough will help you get the answer.
Please contact Lisa Schmidt at (416) 535-8501 ext. 6663 or <lisa_schmidt@camh.net>
Home
is where the heart is
"Living with a mental illness is difficult even in the best of
circumstances. Without a decent place to live, it is virtually impossible."
--Report of the 1993 Human rights and Equal Opportunity
commission's enquiry into
Human Rights of People with Mental Illness
Appropriate
and adequate housing is integral to the well-being of all individuals
and a fundamental determinant of physical and mental health. Adequate
housing is essential to the quality of life of people with mental health
and addiction issues. However, people with mental illness or a history
of substance abuse face barriers in securing and maintaining permanent
and safe housing -- barriers such as inadequate income and social supports,
and the stigma of potential landlords or neighbors. These factors, combined
with shortage of adequate and affordable housing, place them at risk of
homelessness.
In
the Fall of 1999, the Centre launched a Steering Committee to guide the
Centre's role in housing. Through the work of a housing sub-committee
and through surveys of staff and stakeholders, recommended roles for the
Centre were identified. These include: liaising with the government to
build better and more housing units; monitoring housing quality; and establishing
an effective Centre-wide housing vacancy and information service -- areas
the Centre is now focusing its efforts on.
The
committee also suggested advocating a 'best practice' approach to mental
health and addictions housing services, as no single model can meet the
complex needs of mental health, concurrent disorders and addictions clients.
This approach would be used in talks with potential funders and housing
providers.
In
response to staff and family member concerns regarding the lack of availability
of housing information, the Community Support and Research Unit at the
Centre's Queen Street site in collaboration with Product Development,
is currently putting together a Housing Guide. The guide will list all
housing options and resources for clients of the mental health and addictions
systems and will assist workers, clients and family members in locating
and accessing appropriate housing. For a copy of the Housing Guide, call
Patrick Olisemeka at (416) 535-8501 ext. 2739.
Uzo Anucha is a Community Support Specialist and Peter Ilves, a Senior
Community Support Specialist, in the Community Support and Research Unit
of the Centre.
The Housing Guide will soon be available online at www.camh.net.
Community
Resources
by Chris Hendry
The
following community agencies are available to help you train for, look
for or land a job. For more information, please contact each program directly.
The Oasis Employment Program
The
Oasis Employment Program provides a comprehensive approach for people
in recovery from drug and alcohol addiction find and retain employment.
The program provides help to those who are looking for employment and
to those who are employed.
A
Pre-Employment Program offers one-on-one counseling, computer awareness
training and a variety of workshops designed to build self-esteem, set
personal goals, develop interest inventories, adjust one's attitude and
teach how to job search. The program offers work experience through volunteering
and job shadowing, and provides opportunities for advanced training and
upgrading.
In
addition to providing one-on-one counseling and computer awareness training,
the Employment Program includes personality, interests values and skills
self-assessment along with an intensive job search workshop. The program
teaches participants how to craft effective cover letters and resumés,
and provides them with interviewing and networking skills and techniques.
As in the Pre-Employment Program, work experience is provided through
volunteering and job shadowing, and there are further opportunities for
skills training and upgrading. Participants in both the Pre-Employment
and Employment Programs receive employment assistance with the Oasis job
developers.
Located
at 50 Euston Avenue in Toronto, the program is open to people in recovery
from drug or alcohol addiction receiving social assistance,
EI, ODSP or who have no source of income.
For further information contact the Oasis Addiction Recovery Society
(Employment Program) at (416) 461-7739.
Work on Track
The
Seneca College-based Work on Track program assists individuals with mental
health issues achieve self-reliance through employment. The program works
to build confidence and self-esteem and to create valuable employees.
Work on Track focuses on the potential of the individual and graduates
leave equipped to cope in today's increasingly complex work environments.
Work on Track strives to create realistic and supportive workplaces with
enlightened employers.
Work
on Track consists of three phases totaling a possible 28 weeks: assessment,
training and placement. Each trainee's program is individually planned
and every trainee will need the full 28 weeks to complete the program.
At intake, each trainee is assigned an employment assistant and a trainer,
to support him or her through the program, and to maintain support once
placement is achieved. Located at Seneca College in North York, the program
is open to individuals coping with a mental health problem who receive
social assistance.
For
more information about Work on Track call (416) 491-5050 ext. 4741 or
e-mail <workontrack@hotmail.com>.
The Salvation Army P.L.U.S. (People Learning Useful Skills) Program
The
P.L.U.S. Program seeks to teach and maintain work adjustment skills and
provide personal support to adults with mental health issues. The program
features a central work activity component complemented with work adjustment
training, individual counseling, life skills training and community job
placement. Further recreational activities are scheduled throughout the
year to enhance socialization skills.
The
P.L.U.S. Program is open to residents of Scarborough or East Toronto between
the ages of 16 and 65 who are socially isolated and coping with a mental
illness. Participants must be willing and able to perform the essential
functions of the job for a minimum of 12 hours per week. The program operates
from 9 a.m. until 4 p.m. Monday through Friday and participants may determine
their own individual attendance schedule to meet the minimum requirement
of 12 hours. For more information about the P.L.U.S. Program, call (416)
693-2116.
Community Resource Consultants of Toronto
Community
Resource Consultants of Toronto is a multi-service community mental health
agency serving adult consumer/survivors of mental health services (16-65)
in Toronto. Among other activities, they publish a resource book called
Making Choices that has a very detailed chapter on work and training.
To learn more, call (416) 482-4103. If you have access to a computer and
the internet, you can look at it on their web site at <www.crst.org/mconline>.
Chris Hendry works in Public Affairs at the Centre.
When
you need information...
The
Centre's information guides and pamphlets offer key information about
many mental health and addictions issues, including depressive illness,
first episode psychosis, schizophrenia, couples therapy, women and psychosis,
low-risk drinking and methadone maintenance. Designed to help clients
and patients become informed participants in their own treatment, these
materials can help you and your family understand the nature, treatment
and management of mental disorders and addictions.
Free
to patients, clients and their families, these guides are available throughout
the Centre in each program area and through Volunteer Resources. Please
speak to a physician, therapist or nurse to receive a copy -- or ask a
volunteer. You may also call the Family Resource Centre at (416) 535-8501
ext. 4015 for more information or to receive a free copy.
The next issue of Breakthrough will focus on creativity. If you have
a story idea, please share it with the editor at <lisa_schmidt@camh.net>.
Breakthrough is published by the Public
Affairs Unit of the Communications, Education and Community Health
Department at the Centre for Addiction and Mental Health.
It appears four times per year.
Editor/designer: Lisa Schmidt <lisa_schmidt@camh.net>
Proofreader: Chris Hendry
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