In many cultures around the world, mental illness is still highly stigmatized and rarely talked about. Today, we’ll be taking a closer look at how mental illness is viewed and talked about in the South Asian Community, one of the largest ethno-cultural groups in Canada. Talking about mental illness, getting help, or even getting diagnosed is hindered by generational gaps, language barriers, and perceived taboos, just to name a few.

In this episode, we’ll hear four voices sharing their personal experiences of serious mental illness within the South Asian Community, and speak to Kulpreet Singh, founder of the South Asian Mental Health Alliance. Since 2010, Kulpreet has been tackling these disparities and trying to raise awareness and reduce stigma around mental health -- and serious mental illnesses like schizophrenia by leveraging the expertise and influence of second-generation South Asian Canadians.

This is going to be an honest talk about how culture can play a role in how mental illnesses are seen and treated, in particular within the South Asian community.

Resources for show notes:

• South Asian Mental Health Alliance
• Advocates call for more targeted mental health support for South Asian Community during pandemic (CBC News)
• Silence on mental illness nearly killed Karandeep Gill. Now her honest is helping others (CTV News)
• Need to Culturally Adapt and Improve Access to Evidence-Based Psychosocial Interventions for Canadian South-Asians: A Call to Action (Community Journal of Mental Health)

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Schizophrenia. It's neither new nor rare and in fact it's existed for centuries — and it's the one mental illness that seems to be synonymous with madness. And despite being around for a long time, virtually everything we know about schizophrenia has been learned in the past 200 years — and mostly in the later parts of the 20th and 21st centuries.

With the help of Dr. Adrian Preda, this episode takes us on a brief historical journey of schizophrenia – from then to now – and the stigma that exists around it. Dr. Preda is a psychiatrist and professor at the University of California, Irvine Medical Centre, School of Medicine whose clinical work and research focuses on schizophrenia and other psychotic and cognitive disorders. In December 2020 Dr. Preda wrote an article about the concepts of schizophrenia highlighting the historical debate on one particular theory around “lumpers” and “splitters”.

Resources for show notes:

• Adrian Preda -- Biography
• The Schizophrenia Concept Timeline Highlights
• Benedict Morel and Dementia Praecox
• Krapelin Revisted: Schizophrenia from Degeneration to Failed Regeneration
• Eugen Bleuler and the Schizophrenias: 100 Years After
• The Protest Psychosis: How Schizophrenia Became a Black Disease by Jonathan Metzl
• The Troubled History of Schizophrenia: How Race Shaped An Illness (NAMI Presentation)

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Throughout this season, we have taken a deeper look into serious mental illnesses, like schizophrenia, and dived in headfirst to talk to professionals and family members about the subject. But what if I told you that symptoms of schizophrenia are also experienced by people with autism? Even more revealing, people with autism are at a higher risk of developing schizophrenia. If a person has both a developmental disability and a mental health problem, such as schizophrenia, they have a dual diagnosis. Research has shown that 70% of people with autism have at least one mental health problem, with 50% having two or more.

Today, many professionals in the autism community are calling for a change to how they approach clinical care. Some believe that mental health assessments should be an integral part of treating people with autism. And no one understands the value behind these assessments as well as the difficulty of getting a proper diagnosis more than our guest Dr. Stephanie Ameis from the Centre for Addiction and Mental Health.

Dr. Ameis is a clinician scientist, psychiatrist, and Associate Director at the Cundill Centre for Child and Youth Depression. Dr. Ameis specializes in neuro-imaging, which is taking detailed pictures of the brain using MRI scans. And through her research, she hopes to better understand how to improve their mental health journeys. But for patients with both autism and Schizophrenia, this can be difficult since their symptoms are so similar. Signs of early schizophrenia can be mistaken for pre-existing autistic behaviours and with the added stress of the pandemic, many are left struggling to cope with their new mental health problems. We'll be getting into that and a whole lot more in this episode.

Resources for show notes:

• Stephanie Ameis – Centre for Addiction and Mental Health (CAMH)
• The Social Ties Between Autism and Schizophrenia (Spectrum News)
• Autism Spectrum Disorder and Schizophrenia Are Better Differentiated by Positive Symptoms Than Negative Symptoms. (Frontiers in Psychiatry, June 2020)

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People learn from personal experiences. 1 out of 100 live with schizophrenia and until host Faydra Aldridge's sister was diagnosed with it, she thought it was something that only happened to others. But it isn’t, it's something that happened to and affected her family and affects almost every one of us in some way either directly or indirectly. This episode is a little different as you'll get to be a part of a very real and candid conversation between Faydra and her mother Linda as they revisit the impact of Carissa Lynn's mental illness on her and her family.

Resources for show notes:

• Learn more about BCSS Family Support Groups
  • http://www.bcss.org/familysupportgroups

• Listen to the “Look Again: Mental Illness Re-Examined” episodes touching on anosognosia
  • https://www.bcss.org/lookagain/the-truth-behind-psychiatric-medication/
  • https://wbcss.org/lookagain/hearing-voices/

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Researchers have estimated that about 80 percent of the risk for developing Schizophrenia is hereditary and yet that doesn't mean people with that genetic component in their family history will actually develop the disorder. Sometimes Schizophrenia risk increases through a random mutation that is not passed from parent to child. In this episode, we'll be looking at the role genetics plays in the development and onset of Schizophrenia. Is it all about your genes? Or are there other potential risks that can trigger it? To help answer some of these questions we'll be talking to two people — Dr. Robert Stowe, a behavioural neurologist in the UBC Neuropsychiatry Program and a member of the Genetic Testing Task Force of the International Society for Psychiatry Genetics; and Courtney Cook, who works as a genetics counsellor on UBC's MAGERS project.

Resources for show notes:

Dr. Robert Stowe:

https://www.centreforbrainhealth.ca/stowe-robert

https://www.bcchr.ca/bstowe

https://psychiatry.ubc.ca/person/robert-stowe/

https://www.vchri.ca/researchers/robert-stowe

Metabolic and Genetic Explorations in Refractory Schizophrenia (MAGERS) Project (2021)

https://med-fom-psychiatry.sites.olt.ubc.ca/files/2021/05/Stowe-Metabolic-and-Genetic-Explorations-in-Refractory-Schizophrenia-Project.pdf

Genetic Counselling at Adapt Clinic

http://www.bcmhsus.ca/our-services/genetic-counselling-(the-adapt-clinic)

GenCOUNSEL: Genetic Counsellors and Geneticists

https://www.bcchr.ca/GenCOUNSEL/our-team/genetic-counsellors-and-geneticists

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Today, we’ll be taking a closer look at some of the symptoms of schizophrenia. In particular, the cognitive losses that can be associated with serious mental illnesses like schizophrenia or bipolar disorder. Anosognosia is a medical term meaning 'to not know a disease.' This occurs for people with brain injuries as well as mental illness, and means someone is literally unaware of their own mental health condition or they can't see it accurately. This lack of insight is not a rejection of a diagnosis or denial because they don’t want to face the facts, but an honest inability to consciously to see and understand that their behaviours and experiences are indicators of something wrong.

While it's a common symptom, it's also one of the more difficult aspects to understand for those who have never experienced it. What causes anosognosia? How do people put their hands up and ask for help if they can't see it? What are the cognitive losses associated with schizophrenia and what can people do about them? These are some of the questions we'll be tackling on this episode with Dr. Mahesh Menon, a clinical psychologist with Vancouver Coastal Health, and based at the BC Psychosis Program and the Mood Disorders Program at UBC Hospital.

Additional Resources

• Mahesh Menon Bio (https://psychiatry.ubc.ca/person/mahesh-menon/)
• Anosognosia (https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Anosognosia)
• Eliminating Barriers to the Treatment of Mental Illness (https://www.treatmentadvocacycenter.org/key-issues/anosognosia)
• Lack of Insight Into One's Mental Illness or Anosognosia (https://www.psychologytoday.com/ca/blog/recovery-road/202108/lack-insight-ones-mental-illness-or-anosognosia)
• Cognitive Remediation Programs in BC (https://www.bcss.org/bringing-cognitive-remediation-to-british-columbia/)
• “I’m Not Sick, I Don’t Need Help” – book by Dr. Xavier Amador (https://www.amazon.ca/Not-Sick-Dont-Need-Help-dp-0985206705/dp/0985206705)
• “I’m Not Sick, I Don’t Need Help” – TedTalk by Dr. Xavier Amador (https://www.youtube.com/watch?v=NXxytf6kfPM)
• Cognitive Losses in Schizophrenia (https://livingwithschizophreniauk.org/cognitive-symptoms-schizophrenia/)

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Mental illness touches everyone's lives, whether we want to admit it or not. And yet, mental illnesses like schizophrenia are rarely discussed publicly. That lack of conversation is what our guest is hoping to change. Meet Michelle Hammer, a mental health advocate, entrepreneur and graphic designer. She challenges the idea that schizophrenia should be hidden and hush-hush with bold eye-catching designs. Michelle shares her personal journey around mental illness, what it looks like to let everyone know you have schizophrenia and how she started her Schizophrenic.NYC to start conversations about mental illnesses. No topic is off-limits for this native New Yorker.

Schizophrenic.NYC: https://www.schizophrenic.nyc

Instagram: @schizophrenic.nyc

YouTube: https://www.youtube.com/channel/UCR5_ez7c5rhC6mIpcs6tAWg

Twitter: @SchizophrenicNY

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MORE on the important distinction between identity-first vs. person-first language

Language Matters: Mental Health Commission of Canada (2020)

https://www.mentalhealthcommission.ca/wp-content/uploads/drupal/2020-08/language_matters_cheat_sheet_eng.pdf

Saying ‘person with schizophrenia,’ not ‘schizophrenic,’ can affect clinician beliefs, study finds

https://www.statnews.com/2021/09/22/person-first-language-schizophrenia-study/

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Brought to you by the BC Schizophrenia Society and supporting BC Partner organizations, "Look Again: Mental Illness Re-Examined” returns for a second season this fall beginning October 27. This time the podcast goes deeper with the subjects we tackle, the guests we talk to and the research we dive into — we're pushing you to really look at what it's like to live with mental illness.

Host Faydra Aldridge, CEO of BCSS, will speak with medical experts, family members, and people with lived experiences of mental illness. Not only will there be focus on the personal, but the clinical and the cutting-edge research. It's real conversations with real people — breaking down stereotypes on how mental illness is viewed, researched, and treated.

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It's not easy to live with a serious mental illness, like schizophrenia, and the future sometimes seems daunting and hopeless. But many people living with serious mental illnesses, like schizophrenia, are able to lead full and rewarding lives. It may not be what one imagined, but then life never is. In this episode, host Faydra Aldridge speaks with Erin Emiru, a scientist and young mother who has Schizophrenia, about what’s it like to live with this disorder that may be “incurable” -- but definitely treatable. There are many journeys through mental illness, and there is so much cause for hope. Today on Look Again -- hope is what it’s all about. 

• Erin Hawkes Emiru Bio
• When Quietness Came, a Neuroscientist's Personal Journey with Schizophrenia
• When Neurons Tell Stories A Layman's Guide to the Neuroscience of Mental Illness and Health
• Courage to Come Back Awards - List of 2019 Award Recipients

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Serious question: Why is it that when people show signs of serious mental illness or psychosis -- calling the police for help is often viewed as a "last resort" by families and loved ones? Historically, when law enforcement and mental illness intersect, the results have been patchy. But Sgt. Cara Thomson of Surrey RCMP's Police Mental Health Outreach team wants to change that. Her unit handles police-related mental health and addiction calls for service and staffs the Car 67 program, where a registered Psychiatric Nurse rides with a police officer, attending mental health calls.  Sgt. Thomson joins host Faydra Aldridge for a candid conversation about mental health, violence, and law enforcement. 

Additional Resources

• Combining Police with Nurses for Mental Health Calls Isn't BC's First Came in 1978 
• Breaking the Cycle of Crisis: The role of police in crisis intervention (Visions Journal, 2017, Vol 12(4))
• Building Connections with Police Mental Health Resources

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