Trustees and leadership donors to the Foundation
Subject: News about the Douglas Hospital and its Research Centre
There are many developments at the Douglas that the Foundation would like to share with donors and volunteers. These developments and news items of interest are described in this Leadership Memo. The information comes from press releases, articles, the website, etc. It is our intention to send you the Memo on a regular basis. We hope you find this first one informative. If you have comments, we would love to hear from you. We also invite you to visit our website: www.douglasfoundation.qc.ca
Suicide: can we prevent it? Douglas offers new comprehensive depressive disorders program
We all get bouts of the blues, but for some this is more serious and severe. Some of us are clinically depressed and affected by a lifelong mood disorder. Depression doesn’t only affect adults. Children as young as six-years old may be afflicted. How can we help those
who have suicidal thoughts before they take action? The Douglas Hospital is offering a new service – the Depressive Disorders Program. This program, which recently opened its doors, provides cutting edge treatment for patients of all ages and offers family support. “Evidence indicates that depression in youths is often not recognized by their primary care provider and as many as 75 percent of these depressed youths fail to receive any kind of care,” says psychiatrist, Johanne Renaud, MD, FRCPC, responsible for the youth section of the program. “Considering that approximately 10 percent of youths suffer from a depressive disorder, there is a clear need for a specialized service that will accommodate them in their youth and which will continue into adulthood.” “We are providing a unique super-specialized service - comprehensive care from childhood to adulthood” says Program Director, Gustavo Turecki, MD PhD (photo). “Most of these individuals will be affected throughout their life. With this program there is no need to shuffle between institutions. In addition, we frequently see families where more than one of the members has a depressive disorder. We are able to provide therapy to the whole family and treat them as a complete unit.” The Depressive Disorders Program treats:
Youth (aged 6 to 18 years) who present with mood disorders such as major depression or dysthymia; Adults with major refractory disorder (those who are not responding to treatment); Individuals with a personal or family history of suicidal behaviour; Individuals with problems related to pathological bereavement (extended mourning).
The Depressive Disorders Program offers:
Standardized, and detailed psychiatric evaluation from a multidisciplinary team. Treatment intervention including family, and group therapy with or without pharmacotherapy. Interventions aimed at suicide prevention. Support and liaison with referring physicians.
Dollars, Sense, and Mental Health A testimonial “I’m the kind of person who likes to set and reach goals,” says long-time Douglas board member and mental health champion James (Jim) Tremain. “I’ll do whatever I can to support the Hospital, Research Centre and Foundation with their upcoming major campaign. Over the years, domestic violence, alcoholism, child abuse, cancer
and AIDS have become destigmatized. We must do the same with mental illness.”
He continues, “We are sorely lacking funds to promote mental health, when compared to support for problems like cancer and AIDS. One in four Quebecers has a mental illness and most do not seek help. This has to change.”
Jim’s passion for mental health issues arises from having lived the unthinkable nightmare of losing a child to suicide. He and his wife Elizabeth, affectionately known as Kiki, lost the youngest of their three daughters, Loretta, at the age of 27.
When Jim retired from a successful business career, he looked for ways to share his expertise in management in marketing, human resources and corporate planning. Convinced that mental health issues were lacking attention, he became a Foundation trustee in1990. He then joined the Hospital board in 1993. Today, he is one of the Board’s most passionate and active mental health advocates.
He speaks with pride of his daughter Loretta, “She was a natural leader—the co-president of her high school’s student council,” he pauses, and then adds with a smile, “and she was the brains of her basketball team. Though she was just 5’9”—not tall for a basketball player—she was the one who made the plays.”
But as Loretta entered her twenties, her life changed. She was struck with health problems, most notably Crohn’s Disease, an inflammation of the intestines.
He recalls, “She lost weight, became increasingly stressed, and gradually slipped from moderate depression into a black despair. Over the years, she became worn down by depression and severe chronic pain resulting from fractures from her first suicide attempt. Loretta died of carbon monoxide poisoning in 1991.”
While Loretta’s problems were escalating, Kiki was having mental health problems of her own. She had begun to experience psychotic symptoms in 1976. Although she began seeking treatment in 1976, she was not properly diagnosed with bipolar disorder till 1999—a diagnosis she credits to Douglas psychiatrist Dr. N.P Vasavan Nair.
Despite having battled mental illness for over twenty years, and endured three bouts of various forms of cancer, Kiki has thankfully survived—a fact that Jim credits to sheer determination and a self-effacing sense of humor. Looking back, Kiki is convinced that her grandmother and aunt also had a mental illness. She sees herself and Loretta as the latest in a long line of casualties in their family’s history.
“Having been a businessman,” he explains, “I tend to look at the dollars and cents of an issue. Take, for example, the Douglas Hospital’s outstanding PEPP Program for young people experiencing their first episode of psychosis. Right now, I’m asking for an estimate of what it costs to maintain this program, versus what it would cost if they were left untreated for a longer period and didn’t receive a specialized approach. I believe that it will show that the PEPP Program is dramatically more cost effective. It is certainly more humane.”
Ending the Nightmares Douglas Research is Hopeful for New Treatment What if you had a nightmare that you couldn’t shake? What if it haunted not only your dreams but also your waking hours? For people with Post Traumatic Stress Disorder (PTSD), this waking nightmare follows them through their life drawing them back into a
violent experience from their past. Fortunately, researchers at the Douglas Hospital Research Centre may have found a way to lessen the terror.
“Some traumatic memories remain very vivid and do not fade with time,” says Douglas researcher and principal investigator Alain Brunet, PhD (photo). “Our study is looking at how to dampen these emotions using the
common blood pressure drug, propranolol. Our initial findings suggest that this drug successfully lessens the intensity of the past experience and thereby relieves the PTSD.” So far Brunet and colleagues Karim Nader from McGill University and Roger Pitman from Harvard University have studied the effects of propranolol on 19 long-term PTSD sufferers who have experienced symptoms for an average of 11 years. They are asked to describe their experience as vividly as possible which brings on a physical response such as increased heart rate, sweaty palms, etc. The propranolol is then administered. “Two doses have significantly decreased their PTSD symptoms,” says Brunet. “We believe that the propranolol is blocking in part the engraving of the bad memory in the long-term memory, lessening its emotional impact. It’s not that people will no longer remember the trauma, but the memory will be less painful. We need about 10 more patients to confirm these results.” PTSD, originally known as “shell shock”, is one of the most common disorders among soldiers, though it can occur in anyone who has suffered a high degree of trauma, including rape victims, battered women, abused children, and even emergency service personnel. Within hours following a traumatic event, the brain generates large numbers of proteins that move the memory from short term to long term. Brunet believes that propranolol may inhibit this process immediately after the trauma or later.
A birthday for the Douglas
Celebrating 125 years of patient care in 2006 The initial “push” for the creation of the Douglas Hospital came from Alfred Perry, a prominent citizen and a Montreal fire marshal. Mr. Perry was determined to improve the quality of care for the mentally ill. In the 1870s, he criticized Quebec’s “farming out” system, where private citizens were paid to care for patients. Mr. Perry claimed that many did so as cheaply as possible, in order to pocket the money for their personal use. Historical accounts of the day support his claim.
When the Roman Catholic Asylum at Longue-Pointe (today’s Hôpital Louis-H Lafontaine) was built in 1875, Mr. Perry was not satisfied. Although he acknowledged that the asylum supplied patients with food, clothing and shelter, he believed that no attempt was being made to improve their mental condition, and complained that no religious services were offered for Protestant patients.
After repeated lobbying by Mr. Perry, Protestant clergymen, and other citizens, the Quebec Government passed an act titled “An Act to Incorporate the Protestant Hospital for the Insane” and the idea for our hospital was born.
Nature, Nurture or Both? New $6 million research facility at Douglas to help understand the causes of mental illness One out of four individuals will be diagnosed with a mental illness during their life. Some of them will thrive and others will flounder. Understanding why this occurs is the goal of the new Douglas Hospital Research Centre’s Neurophenotyping Centre. Thanks to funding from the Quebec Ministry of Economic Development, Innovation and Export, the Douglas Hospital Foundation and in association with McGill University, this goal is one step closer. The $5 million contribution from the Ministry, announced January 30th and the $1 million to be raised by the Douglas Hospital Foundation will fund the construction of a state-of-the-art animal and research facilities. It will accommodate the needs of the more than 60 internationally-renowned researchers, and 180 graduate students and post-doctoral fellows working at the Douglas.
“The last few years have seen huge progress in identifying the genetic basis of mental illnesses,” says Neurophenotyping Centre Director, Claire-Dominique Walker, PhD. “However, it is important to remember that there is an environmental and genetic aspect to the development of the diseases and it is the interaction between the two that will determine the onset or resilience of the illness. This new Centre will enable us to study both
aspects of disease progression”, adds Walker. For instance, using the design of natural environments, researchers from the Douglas will be able to determine whether social pressure can precipitate the onset of depression. On the other hand, they will examine whether a genetic predisposition to schizophrenia can be “silenced” by a comforting environment, social networks, etc. The facilities will enable them to better explore animal models of human pathologies such as Alzheimer Disease and identify –through more sophisticated testing- some of the environmental factors that trigger expression of the illness.” “Work at the Centre will directly benefit patients,” adds Rémi Quirion, PhD, scientific director at the Douglas Hospital Research Centre. “For example, many of our researchers are interested in the role of genetics on drug response. We will be able to evaluate why some medications work better for some patients. This will ultimately lead to patient-tailored drug regimes and overall better treatment of the disease. The research will benefit patients including those with mood disorders, anxiety and impulsivity, aging and Alzheimer disease and schizophrenia.” Construction of the 15,000 square feet Neurophenotyping Centre will begin the fall. It will have specialized equipment and amenities including specialized animal environments and behavioural analysis laboratories. About the Douglas Affiliated with McGill University and the World Health Organization, the Douglas Hospital is a centre of excellence for care, research, and teaching in mental health. Care is offered for people suffering from depression, anxiety, eating disorders, schizophrenia, autism, attention deficit hyperactivity disorder, and
degenerative illnesses such as Alzheimer Disease. Its
Douglas Facts & Figures
Research Centre is the second largest of its kind in
the country, with a team of over 60 scientists and
the Douglas’ internationally-renowned adult eating
clinical researchers. The Douglas team is devoted to
making better sense of the causes of mental disorders
• Number of inpatient beds for adult patients: 6
– whether genetic, environmental, cultural or social –
• Length of treatment for adult patients
as well as developing or improving diagnostic tools,
• Number of people seen last year: 340
• Number of patients on the wait list: 300
To contact us at the Douglas Hospital Foundation:
- Quebec’s first (and only) large-scale, clinical-
research-teaching program for Eating Disorders
- Quebec’s first (and only) specialized ED Day Hospital - Quebec’s first (and only) established base of research on Eating Disorders
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