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Doug Allan

Shortage of personal support workers in Ontario home care feared | Ontario | News | Tor... - 1 views

www.torontosun.com/...rs-in-ontario-home-care-feared

PSW homecare

shared by Doug Allan on 02 Jul 13 - No Cached
  • She and a whole generation of PSWs like her, who look at the work as a vocation, will be retiring in droves over the next two decades. The Canadian Research Network for Care in the Community estimates that 45% of PSWs are over the age of 50 and may retire in the next 15 years.
  • “I’ve trained many, many girls over the years,” she said. “At the end of the day, they’ll look at me and say ‘I think you’re absolutely stupid. Why are you doing this when you can go into a facility and earn twice the money and you’re not running your ass off.’”
  • But already, the need for home care services is increasing. According to the Canadian Home Care Association demand for home-care services has increased across the country by 55% over the past five years. Seniors represent 70% of that demand.
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  • The workers depended upon to deliver that front-line care in most cases are personal support workers. But according to Service Employees International Union Healthcare president Sharleen Stewart, who represents approximately 8,000 PSWs, their work is under-appreciated and under-funded.
  • Stewart says being a personal support worker is far from a path to financial security. Workers who deliver home care make between $12 and $14 an hour on average. That compared to $17 to $20 an hour working in a nursing home or $20 to $25 an hour working in a hospital. Stewart says increasingly young workers train in home care and then leave. According to a study done by Personal Support Network of Ontario, 7,000 PSWs are trained every year in Ontario, 9,000 leave the profession annually.
  • Stewart’s concerns are echoed by one of the country’s largest not-for-profit home care providers, the Canadian Red Cross. National director of health programs Lori Holloway says any plan to make Canada’s health care system sustainable has to include a human resources plan the focuses on retention, and that includes PSWs specifically, she said.
  • Ontario Home Care Association executive director Sue VanderBent says the disparity between PSW wages has been created by a traditional view of the sector, which have always seen it diminished or funded after other areas like nursing homes and hospitals.
  • Doug Allan on 02 Jul 13
     
    Shortage of home care PSWs claimed in this story.  
Govind Rao

'We have the evidence ... Why aren't we providing evidence-based care?'; Mental illness... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150523|221089241

from heather mental health privatization

shared by Govind Rao on 26 May 15 - No Cached
  • The Globe and Mail Sat May 23 2015
  • It's 4:30 on a Friday afternoon at her Sherbrooke, Que., clinic and Marie Hayes takes a deep breath before opening the door to her final patient of the day, who has arrived without an appointment. The 32-year-old mother immediately lists her complaints: She feels dizzy. She has abdominal pain. "It is always physical and always catastrophic," Dr. Hayes will later tell me. In the exam room, she runs through the standard checkup, pressing on the patient's abdomen, recording her symptoms, just as she has done almost every week for months. "There's something wrong with me," the patient says, with a look of panic. Dr. Hayes tries to reassure her, to no avail. In any case, the doctor has already reached her diagnosis: severe anxiety. Dr. Hayes prescribed medication during a previous visit, but the woman stopped taking it after two days because it made her nauseated and dizzy. She needs structured psychotherapy - a licensed therapist trained to bring her anxiety under control. But the wait list for public care is about a year, says Dr. Hayes, and the patient can't afford the cost of private sessions.
  • Meanwhile, the woman is paying a steep personal price: At home, she says, she spends most days in bed. She is managing to care for her two young children - for now - but her husband also suffers from anxiety, and the situation is far from ideal. Dr. Hayes does her best, spending a full hour trying to calm her down, and the woman is less agitated when she leaves. But the doctor knows she will be back next week. And that their meeting will go much the same as it did today. In its broad strokes, this is a scene that repeats itself in thousands of doctors' offices every day, right across the country. It is part and parcel of a system that denies patients the best scientific-based care, and comes with a massive price tag, to the economy, families and the health care system. Canadian physicians bill provincial governments $1-billion a year for "counselling and psychotherapy" - one third of which goes to family doctors - a service many of them acknowledge they are not best suited to provide, and that doesn't come close to covering patient need. Meanwhile, psychologists and social workers are largely left out of the publicly funded health-care system, their expertise available only to Canadians with the resources to pay for them.
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  • Imagine if a Canadian diagnosed with cancer were told she could receive chemotherapy paid for by the health-care system, but would have to cough up the cash herself if she needed radiation. Or that she could have a few weeks of treatment, and then be sent home even if she needed more. That would never fly. If doctors, say, find a tumour in a patient's colon, the government kicks in and offers the mainstream treatment that is most effective. But for many Canadians diagnosed with a mental illness, the prescription is very different. The treatment they receive, and how much of it they get, will largely be decided not on evidence-based best practices but on their employment benefits and income level: Those who can afford it pay for it privately. Those who cannot are stuck on long wait lists, or have to fall back on prescription medications. Or get no help at all. But according to a large and growing body of research, psychotherapy is not simply a nice-to-have option; it should be a front-line treatment, particularly for the two most costly mental illnesses in Canada: anxiety and depression - which also constitute more than 80 per cent of all psychiatric diagnoses.
  • Why aren't we providing evidence-based care?" .. The case for psychotherapy Research has found that psychotherapy is as effective as medication - and in some cases works better. It also often does a better job of preventing or forestalling relapse, reducing doctor's appointments and emergency-room visits, and making it more cost-effective in the long run.
  • Therapy works, researchers say, because it engages the mind of the patient, requires active participation in treatment, and specifically targets the social and stress-related factors that contribute to poor mental health. There are a variety of therapies, but the evidence is strongest for cognitive behavioural therapy - an approach that focuses on changing negative thinking - in large part because CBT, which is timelimited and very structured, lends itself to clinical trials. (Similar support exists for interpersonal therapy, and it is emerging for mindfulness, with researchers trying to find out what works best for which disorders.) Research into the efficacy of therapy is increasing, but there is less of it overall than for drugs - as therapy doesn't have the advantage of well-heeled Big Pharma benefactors. In 2013, a team of European researchers collated the results of 67 studies comparing drugs to therapy; after adjusting for dropouts, there was no significant difference between the most often-used drugs - selective serotonin reuptake inhibitors (SSRIs) - and psychotherapy.
  • The issue is not one against the other," says Montreal psychiatrist Alain Lesage, director of research at the Douglas Mental Health University Institute. "I am a physician; whatever works, I am good. We know that when patients prefer one to another, they do better if they have choice." Several studies have backed up that notion. Many patients are reluctant to take medication for fear of side effects and the possibility of difficult withdrawal; research shows that more than half of patients receiving medication stop taking it after six months. A small collection of recent studies has found that therapy can cause changes in the brain similar to those brought about by medication. In people with depression, for instance, the amygdala (located deep within the brain, it processes basic memories and controls our instinctive fight-or-flight reaction) works in overdrive, while the prefrontal cortex (which regulates rational thought) is sluggish. Research shows that antidepressants calm the amygdala; therapy does the same, though to a lesser extent.
  • But psychotherapy also appears to tune up the prefrontal cortex more than does medication. This is why, researchers believe, therapy works especially well in preventing relapse - an important benefit, since extending the time between acute episodes of illnesses prevents them from becoming chronic and more debilitating. The theory, then, is that psychotherapy does a better job of helping patients consciously cope with their unconscious responses to stress.
  • According to treatment guidelines by leading international professional and scientific organizations - including Canada's own expert panel, the Canadian Network for Mood and Anxiety Treatments - psychotherapy should be considered as a first option in treatment, alone or in combination with medication. And it is "highly recommended" in maintaining recovery in the long term. Britain's independent, research-guided scientific body, the National Institute for Health and Care Excellence, has concluded that therapy should be tried before drugs in mild to moderate cases of depression and anxiety - a finding that led to the creation of a $760million public system, which now handles therapy referrals for nearly one million people a year.
  • In 2012, Canada's Mental Health Commission estimated that only about one in three adults and one in four children are receiving support and treatment when they need it. Ironically, anti-stigma campaigns designed to help people understand mental illness may only make those statistics worse. In Toronto, for instance, putting up posters in subway stations in 2010 had the unexpected effect of spiking the volume of walk-ins at nearby emergency rooms by as much as 45 per cent in 12 months. Dr. Kurdyak treated many of them at CAMH. The system, he says, "has been conveniently ignoring this unmet need. It functions as if two-thirds of the people suffering won't get help." What would happen if the healthcare system outright "ignored" two-third of tumour diagnoses?
  • Essentially, argues Dr. Lesage, adding therapy into the health-care system is like putting a new, highly effective drug on the table for doctors. "Think about it," he says. "We have a new antidepressant. It works as well as many others, and it may even have some advantages - it works better for remission - with fewer side effects. The patients may prefer it. And [in the long run] it doesn't cost more than what we have. How can it not be covered?" ..
  • A heavy price This isn't just a medical issue; it's an economic one. Mental illness accounts for roughly 50 per cent of family doctors' time, and more hospital-bed days than cancer. Nearly four million Canadians have a mood disorder: more than all cases of diabetes (2.2 million) and heart disease (1.4 million) combined.
  • Mental illness - and depression, in particular - is the leading cause of disability, accounting for 30 per cent of workplace-insurance claims, and 70 per cent of total compensation costs. In 2012, an Ontario study calculated that the burden of mental illness and addiction was 1.5 times that of all cancers, and more than seven times the cost of all infectious diseases. Mental illness is so debilitating because, unlike physical ailments, it often takes root in adolescence and peaks among Canadians in their 20s and 30s, just as they are heading into higher education, or building careers and families. Untreated, symptoms reverberate through all aspects of life, routinely trapping people in poverty and homelessness. More than one-third of Ontario residents receiving social assistance have a mental illness. The cost to society is clearly immense.
  • Yet, when family doctors were asked why they didn't refer more patients to therapy in a 2008 Canadian survey, the main reason they gave was cost. For many Canadians, private therapy is a luxury, especially if families are already wrestling with the economic fallout from mental illness. Costs vary across provinces, but psychologists in private practice may charge more than $200 an hour in major centres. And it's not just the uninsured who are affected.
  • Although about 60 per cent of Canadians have some form of private insurance, the amount available for therapy may cover only a handful of sessions. Those with the best benefits are more likely to be higherincome workers with stable employment. Federal public servants, notably, have one of the best plans in the country - their benefits were doubled in 2014 to $2,000 annually for psychotherapy. Many of those who can pay for therapy are doing so: A 2013 consultant's study commissioned by the Canadian Psychological Association found that $950-million is spent annually on private-practice psychologists by Canadians, insurance companies and workers compensation boards. The CPA estimates t
  • These are the patients that family doctors juggle, the ones who eat up appointment time, and never seem to get better, the ones caught on waiting lists. Sometimes, they have already been bounced in and out of the system, received little help, and have become wary of trying again. A 40-something mother recovering from breast cancer, suffering from chronic depression post-treatment, debilitated by fear her cancer will return. A university student, struggling with anxiety, who hasn't been to class for three weeks and may soon be kicked out of school. A teenager with bulimia removed from an eatingdisorder program because she couldn't follow the rules. They are the ones dangling on waiting lists in the public system for what often amounts to a handful of talk-therapy sessions, who don't have the money to pay for private therapy, or have too little coverage to get the full course of appointments they need.
  • Canada's investment does not match that burden. Only about 7 per cent of health-care spending goes to mental health. Even recent increases pale when compared to other countries: According to a study by the Canadian Mental Health Association, Canada increased per-capita funding by $5.22 in 2011. The British government, meanwhile, kicked in an extra 12 times that amount per citizen, and Australia added nearly 20 times as much as we did. Falling off a cliff, again and again
  • In Winnipeg, Dr. Stanley Szajkowski watched for months as his patient, a woman in her 80s, slowly declined. Her husband had died and she was spiralling into a severe depression. At every appointment, she looked thinner, more dishevelled. She wasn't sleeping, she admitted, often through tears. Sometimes she thought of suicide. She lived alone, with no family nearby, and no resources of her own to pay for therapy. "You do what you can," says Dr. Szajkowksi. "You provide some support and encouragement." He did his best, but he always had other patients waiting.
  • hat 30 per cent of private patients pay out-ofpocket themselves. When the afflicted don't seek help, the cost isn't restricted to their own pocketbook. People with mental-health problems are significantly more likely to abuse drugs and alcohol, and to become physically sick, further increasing health-care costs. A 2014 study by Oxford University researchers found that having a mental illness reduced life expectancy by 10 to 20 years, roughly the same as did smoking and obesity. A 2008 Statistics Canada study linked depression to new-onset heart disease in the general population. A 2014 U.S. study found that women under the age of 55 are twice as likely to suffer or die from a heart attack, or require heart surgery, if they have moderate to severe depression. The result: clogged-up doctors' offices, ERs, and operating rooms. And an inexorable burden for the patients' families forced to fill the gaps in caregiving - or carry on when they lose a loved one.
  • Patients refer to it as falling repeatedly off a cliff. And they can only manage the climb back up so many times. Family doctors interviewed for this story admitted that they are often "handholding" patients with nowhere else to go. "I am making them feel cared for, I am providing a supportive ear that they may not get anywhere else," says Dr. Batya Grundland, a physician who has been in family practice at Toronto's Women's College Hospital for almost a decade. "But do I think I am moving them forward with regard to their illness, and helping them cope better? I am going to say rarely." More senior doctors have told her that once in a while "a light bulb goes off" for the patients, but often only after many years. That's not an efficient use of health dollars, she points out - not when there are trained therapists who could do the job better. However, she says, "in some cases, I may be the only person they have."
  • Family doctors aren't the only ones struggling to find therapy for their patients. "I do a hundred consultations a year," says clinical psychiatrist Joel Paris, a professor at McGill University and research associate at the Montreal Jewish General, "and one of the most common situations is that the patient has tried a few anti-depressants, they have not responded very well, and from their story it is obvious they would benefit from psychotherapy. But where do they go? We have community clinics here in Montreal with six-to-12-month waiting lists even for brief therapy." A fractured, inefficient system
  • "You fall into the role that is handed to you," says Antoine Gagnon, a family doctor in Osgoode, on the outskirts of Ottawa. He tries to set aside 20-minute appointments before lunch or at the end of the day to provide "active listening" to his patients with anxiety and depression. Many of them are farmers or self-employed, without any private coverage for therapy. "Five of those minutes are spent talking about the weather," he says, "and then maybe you get into the meat of the problem, but the reality is we don't have the appropriate amount of time to give to therapy, even to listen, really." Often, he watches his patients' symptoms worsen over several months, until they meet the threshold of a clinical diagnosis. "The whole system could save on productivity and money if people were actually able to get the treatment they needed."
  • But these issues aren't insurmountable, as other countries have demonstrated. Britain, for instance, has trained thousands of university graduates to become therapists in its new public program, following research showing that, as long they have the proper skills, people don't need PhDs to be effective therapists. Australia, which has created a pay-for-service system, also makes wide use of online support to cost-effectively reach remote communities.
  • Except for a small fraction of GPs who specialize in psychotherapy, few family doctors have the training - or the time - to provide structured therapy. Saadia Hameed, a GP in a family-health team in London, Ont., has been researching access to psychotherapy for an advanced degree. Many of the doctors she has interviewed had trouble even producing a clear definition of therapy. One told her, "If a patient cries, than it's psychotherapy." Another described it as "listening to their woes." A 2007 survey of 163 family doctors in Ontario found that almost four out of five had not received training in cognitive behavioural therapy, and knew little about it. "Do family doctors really need to do that much psychotherapy," Dr. Hameed asks, "when there are other people trained - and better trained - to do it?"
  • What further frustrates treatment for physicians and patients is lack of access to specialists within the system. Across the country, family doctors describe the difficulty of reaching a psychiatrist to consult on a diagnosis or followup with their patients. In a telling 2011 study, published in the Canadian Journal of Psychiatry, researchers conducted a real-world experiment to see how easily a GP could locate a psychiatrist willing to see a patient with depression. Researchers called 297 psychiatrists in Vancouver, and reached 230. Of the 70 who said they would consider taking referrals, 64 required extensive written documentation, and could not give a wait-time estimate. Only six were willing to take the patient "immediately," but even then, their wait times ranged from four to 55 days. Psychiatrists are in increasingly short supply in Canada, and there's strong evidence that we're not making the best use of these highly trained specialists. They can - and often do - provide fee-for-service psychotherapy in a private setting, which limits their ability to meet the huge demand to consult with family doctors and treat the most severe cases.
  • A recent Ontario study by a team at CAMH found that while waiting lists exist in both urban and rural centres, the practices of psychiatrists in those locations tend to look very different. Among full-time psychiatrists in Toronto, 10 per cent saw fewer than 40 patients, and 40 per cent saw fewer than 100 - on average, their practices were half the size of psychiatrists in smaller centres. The patients for those urban psychiatrists with the smallest practices were also more likely to fall in the highest income bracket, and less likely to have been previously hospitalized for a mental illness than those in the smaller centres.
  • And those therapy sessions are being billed with no monitoring from a health-care system already scrimping on dollars, yet spending a lot on this care: On average, psychiatrists earn $216,000 a year. There is nothing to stop psychiatrists from seeing the same patients for years, and no system to ensure the patients with the greatest need get priority. In Australia, Britain and the United States, by contrast, billing for psychiatrists has been adjusted to encourage them to reduce psychotherapy sessions and serve more as consultants, particularly for the most severe cases, as other specialists do.
  • As the Canadian system exists now, says Benoit Mulsant, the physician-in-chief at CAMH and also a psychiatrist, the doctors in his specialty "can do whatever they please. If I wanted, I could have a roster of actor patients who tell me entertaining stories, and I would be paid the same as someone who is treating homeless people. ... By treating the rich and famous, there is zero risk of being punched in the face by a patient." Left out in all this, by and large, are other professionals who can provide therapy. It doesn't help that the rules are often murky around who can call themselves psychotherapists. While psychologists and social workers are licensed under their professional associations, in some provinces a person can call himself a marriage counsellor or music therapist with no one demanding they be certified. In 2007, Ontario passed a law to regulate psychotherapists, requiring them to register with a provincial college that would set standards and handle complaints. Currently, however, the law is in limbo, although the government has said it will finally bring it into force by December. The brain keeps many secrets
  • Science, however, has yet to find depression's equivalent of insulin. Despite being scanned, poked and stimulated over and over and over again, the brain keeps its secrets. The "chemical imbalance" theory is now viewed as simplistic at best. It may not do much for patients, either: A 2014 study published in the journal Behaviour Research and Therapy suggested that, rather than reassuring them, focusing on the biological explanation for depression actually made patients feel more pessimistic and lacking in control. SSRIs work by increasing the amount of serotonin, a chemical that helps deliver messages within the brain and is known to influence mood. But researchers aren't sure why the drugs help some patients and fail with others. "Basically, it's like we have a bucket of water and we pour it over the patient's head," says Dr. Georg Northoff, the University of Ottawa's Michael Smith chair of Neurosciences and Mental Health. "But you want a drug that injects the water in a very specific brain regions or brain system, which we don't have."
  • Critics of therapy have argued that it's basically "good listening" - comparable to having a sympathetic friend across the kitchen table - and that in the real world of mercurial patients and practitioners of varying abilities, a pill just works better. That's true in many cases, especially when the symptoms are severe and the patients is suicidal: a fast-acting medication is safer, and may even be necessary before starting talk therapy. The staunchest advocates of therapy do not suggest it should be the first course of treatment for psychosis, or debilitating chronic depression, or mania - although, in those cases, there is evidence that psychotherapy and medication work well in tandem. (A 2011 meta-analysis found that patients with severe depression who received a combination approach had higher recovery rates and were less likely to drop out of treatment.) But drugs also don't work as well as the manufacturers would like us to think. Roughly one-third of patients given a drug will see no benefit (although they often respond to a second or third medication). In randomly controlled trials, drugs often perform only marginally better than sugar pills.
  • Yet it's talk therapy that the public often views most skeptically. "Until you go to a therapist, or a member of your family has a serious psychological problem, people are unsympathetic [about therapy]," says Dr. Paris, the Montreal psychiatrist. "They are very skeptical, and they don't believe the research. It's amazing, because pharmaceutical trials will get approval for a drug on the basis of two clinical trials that they paid for. And we have 100 clinical trials and no one believes us."
  • Dr. Ajantha Jayabarathan, an assistant professor at Dalhousie University's medical school, spent her early years as a family doctor in Spryfield, N.S., trying to manage an overload of mental-health cases. Most of her patients had little insurance; there was one reduced-cost counselling service in town, but the waiting lists were long. In 2000, her group practice became a test site for a shared-care project, which gave the doctors access to a mental-health team, including weekly in-person consultations with a psychiatrist. "It was transformative," she says. "We looked after everything in-house.
  • Over time, Dr. Jayabarathan says, she learned how to properly assess mental illness in patients, and how to use medication more effectively. "I just made it my business to teach myself what to do." It's the kind of workaround GPs are increasingly experimenting with, waiting for the system to catch up. Who would pay - and how?
  • The case for expanding publicly funded access to therapy is gaining traction in Canada. In 2012, the health commissioner of Quebec recommended therapy be covered by the province; it is now being studied by Quebec's science-based health body (INESSS), which is expected to report back next year. A new Quebec-based organization of doctors, researchers and mental-health advocates called the Coalition for Access to Psychotherapy (CAP) is lobbying the government.
  • In Manitoba, the Liberal Party - albeit well behind in the polls - has made the public funding of psychologists one of its campaign platforms for the province's spring 2016 election. In Saskatchewan, the government commissioned, and has since endorsed, a mental-health action plan that includes providing online therapy - though politicians have given themselves 10 years to accomplish it. Michael Kirby, the former head of the Canadian Mental Health Commission, has been advocating for eight annual sessions of therapy to be covered for children and youth in need.
  • There are significant hurdles: Which practitioners would provide therapy, and how would they be paid? What therapies would be covered, and for how long? Complicating every aspect of major mentalhealth change in Canada is the question of who should shoulder the cost: the provinces or Ottawa. In a written statement in response to questions from The Globe and Mail, federal Health Minister Rona Ambrose lobbed the issue back at her provincial counterparts, pointing out that the Canada Health Act does not "preclude provinces and territories from extending public coverage to other services or providers such as psychologists."
  • One result can be overloaded family doctors minimizing mental-health problems. "If you have nothing to offer someone," asks Dr. Anderson, "how much are you going to dig around to find out what is going on?" Some doctors also admit that the lack of resources can lead to physicians cherry-picking patients who don't have mental illness. And yet family physicians alone bill about $361million a year for counselling or psychotherapy in Canada - 5.6 million visits of roughly 30 minutes each. This is a broad category, and not always specifically related to mental health (some of it includes drug counselling, and a certain amount of coaching is a necessary part of the patient-doctor relationship). When it is psychotherapy, however, doctors admit it's often more supportive listening than actual therapy.
  • So how would Canada pay for access to such therapy? It wouldn't be cheap, in the short term. The savings would come from what Canadians would not have to spend in the long term: in additional medical and drug costs, emergency-room visits and hospital stays, and in unnecessary disability payments, to say nothing of better long-term health outcomes for patients given good care earlier. Some of the figures being tossed around sound staggering. Rolling out a version of Britain's centre-based program across Canada would cost $950-million. Michael Kirby's plan would amount to $1,000 annually per patient. A 2013 report commissioned by the Canadian Psychological Association calculated that, based on predicted need, and assuming no coverage from private health-care plans, providing an average of six sessions of therapy a year would cost an estimated $2.8-billion annually.
  • But any of those figures would still be a fraction of the roughly $210-billion that Canada spends annually on health care. Figuring out how to make the system most costeffective is, according to sources, currently delaying the INESSS report to the Quebec government. "You need to facilitate the government," says Helen- Maria Vasiliadis, a professor of community health at the University of Sherbrooke. "You can't be going to policymakers and showing them billions and billions of dollars. People start having heart attacks. With evidence in hand, we have to present possible solutions."
  • An insurance-based plan is the proposal that has emerged from the Quebec-based CAP group, which sent its proposal to Quebec's health minister last month. In its design, the system would work much like Quebec's public drug plan - Quebeckers not covered through work plans would contribute to a provincial insurance program for therapy. That would be similar to the system that Germany has used for decades. One step forward, one step back
  • Last year, the Sherbrooke clinic where Marie Hayes works received provincial funding for a part-time psychologist and a full-time social worker. With a roster of 25,000 patients, the clinic team laid out clear guidelines for the psychologist, who would consult on cases and screen patients, and be limited to a mere four sessions of actual counselling with any one patient. "We wanted to be careful she didn't become a waiting list - like everything in the system," says Dr. Hayes. The social worker helps guide patients into services such as housing and addiction counselling. They have also offered group sessions for depression management at the clinic. As stretched as those new professionals are in such a large practice, Dr. Hayes says the addition of that mental-health team is improving the care she can provide patients. Recently, for instance, the 32- year-old mother with anxiety attended sessions with the psychologist. "She is making progress," says Dr. Hayes, "slowly."
  • At Women's College Hospital in Toronto, Dr. Grundland is not so lucky. Asked to describe a difficult case, the family-practice physician mentions a patient suffering from depression after a lifechanging accident. Every month, doctor and patient would repeat the same conversation they'd already had more than a dozen times - and make little real headway. Her patient, says Dr. Grundland, needs a trained therapist: someone she can see regularly, to help her move past her frustration, counsel her about addiction, and ease the burden on her family.
  • But there's no extra money in the patient's budget for a psychologist. "I do my best," Dr. Grundland says, "but it's not my area of expertise." Meanwhile, the patient isn't getting better, and in the time that it takes to make it through one appointment with her, Dr. Grundland could see three other people with problems she was actually trained to treat. "But," says Dr. Grundland, "she has nowhere else to go." Erin Anderssen is a feature writer at The Globe and Mail. OPEN MINDS How to build a better mental health care system
  • The Centre for Addiction and Mental Health has purchased advertisements to accompany this series. While CAMH professionals are quoted in this story, the organization had no involvement in the creation or production of this, or any other story in the series. $20.7-billion The cost, according to a 2012 Conference Board of Canada report, of lost productivity each year due to mental illness. What else does $20-billion represent?
  • $20B: Canadian spending on national defence, 2012-13 $20B: Market valuation of Airbnb, 2015 $21B: Kitchener-CambridgeWaterloo region's GDP, 2009 $21B: Amount food manufacturing contributed to the economy, 2012
Govind Rao

Canada needs policies guaranteeing sick time for its workers - 0 views

policyoptions.irpp.org/...ing-sick-time-canadian-workers

from heather benefits

shared by Govind Rao on 04 Apr 16 - No Cached
  • Canadians shouldn't have to choose between their health and their job.
  • Despite being eligible for five or nine paid sick days per year, the typical employee used only three, and a quarter used none.
  • food handler going to work with a cough, a parent sending their sick child to school or an emergency room nurse making snap decisions through the fog of a flu. It doesn’t take a medical degree to appreciate the counterproductive consequences of these decisions, yet far too often, these are the stories of our patients and countless others like them. For far too many, struggling to make ends meet, afraid to lose even a day’s pay — going to work sick is the only choice they have.
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  • With the exception of Prince Edward Island, no province or territory guarantees a minimum number of paid sick days for employees. Across the country, young people, seniors and low-wage workers are the hardest hit
  • San Francisco, a city many associate with high-tech start-ups and the innovation economy, has been a leader on using paid sick days to keep its residents healthy.
  • Danyaal RazaRyan Meili March 18, 2016 
  • In Ontario, the provincial government has commissioned a review of the Employment Standards Act, legislation that has seen no major revisions since the end of the Second World War. There, a coalition of doctors, nurses, researchers and workers, have launched a campaign for change along the lines of the San Francisco model.
  • and has been estimated to cost Canadian businesses $15-25 billion per year.
  • The phenomenon of presenteeism (people coming to work despite being sick) is endemic in our work culture
  • It’s high time we had policies guaranteeing sick time for Canadian workers.
Govind Rao

Income gap for younger workers rises, report finds - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|243387|ntgm|20140923|204615858

from heather young workers wages

shared by Govind Rao on 23 Sep 14 - No Cached
  • The Globe and Mail Tue Sep 23 2014
  • Canada has made huge strides narrowing the pay gap between men and women, but the big challenge now will be to fix a rapidly growing generational divide. It's a chasm that risks hobbling the economy and sowing social strife as the population ages. A sobering new report being released Tuesday by the Conference Board of Canada says the income gap between older and younger workers has expanded massively since 1980s, leaving today's twentysomethings the first generation of Canadians to be worse off than their parents. The income gap between older and younger workers has jumped substantially over the past three decades, according to the report, which is based on an analysis of 27 years of income tax data. The average disposable income of today's 50- to 54-yearolds is now 64 per cent higher than 25 to 29-year-olds, compared with a gap of 47 per cent in the mid-1980s. The trend holds true for both men and women, single workers and couples, as well as before and after tax. The most tangible manifestation of this inequality is found in two-tier workplaces, where many employers offer new hires less pay and reduced pensions for the same job.
  • "Our generation fought for the principle of equal pay for work of equal value, and yet young people are coming into workplaces today and are being paid less for the same work," David Stewart-Patterson, the report's co-author and a Conference Board vice-president, said in an interview. "Age, rather than gender, is becoming the new divide in our society." Ariadna Cornei, 29, learned that having an undergraduate degree wasn't going to get her fast enough up the income ladder at the bank where she landed her first job. So she went back to school. "I thought that once I had my degree, all these doors would open for me," lamented Ms. Cornei, who is now taking her PhD in economics at the University of Ottawa. "Very fast I learned that it would take a very long time to move up."
Govind Rao

Ten health stories that mattered this week: Feb. 2-6 - 0 views

www.cmaj.ca/...E148

from heather cma

shared by Govind Rao on 16 Mar 15 - No Cached
  • CMAJ March 17, 2015 vol. 187 no. 5 First published February 9, 2015, doi: 10.1503/cmaj.109-4992
  • Lauren Vogel
  • The Supreme Court of Canada unanimously struck down the ban on physician-assisted death to mentally competent patients who are suffering and deemed impossible to remedy or cure. The court ruled that the ban infringes on provisions for life, liberty and security of person in Section 7 of the Charter of Rights and Freedoms. Parliament has 12 months to draft new legislation. Physicians will not be compelled to assist
  • ...9 more annotations...
  • Four measles cases in Toronto and a possible outbreak in Quebec prompted health officials across Canada to urge parents to vaccinate their children. “We know that vaccines are safe,” Health Minister Rona Ambrose told CBC News. “I believe this debate is almost bordering on the ridiculous at this point … you’re putting children who are more vulnerable than your own at risk of getting sick and potentially dying.”
  • British Columbia announced a new clinical intake process at 72 child and youth mental health offices that will allow young people in distress to see a clinician immediately, rather than go on a months-long waiting list. The province also launched an interactive online map of some 350 service providers and mental health intake offices to help young people find help near them.
  • BC Member of the Legislative Assembly Adrian Dix asked the province to release the full, unredacted December 2014 report by an independent reviewer on the firing of seven health researchers in 2012. Of the seven workers fired, several have returned to their positions, two are pursuing wrongful dismissal suits and one researcher, Roderick MacIsaac, committed suicide in January 2013.
  • Alberta New Democrats called the province’s mental health care system among the worst in the country, citing an Alberta Health Services briefing note that outlines problems at hospitals across Edmonton. The document lists unsafe facilities, major capacity issues and safety risks to patients and front-line workers.
  • The Wellesley Institute issued a scathing report on racism against indigenous people in the health care system, including pervasive and unconscious “pro-white bias” among health care workers that continues to harm Aboriginal health. Among possible solutions, the report recommends the creation of indigenous-directed health services, increased cultural sensitivity training and the use of indigenous patient navigators to serve as a bridge between patients and the system.
  • The Ottawa Hospital and Winnipeg’s Health Sciences Centre will conduct the Canadian arm of a large clinical trial studying the use of stem cells to treat multiple sclerosis. The trial is being conducted in nine countries with the aim of developing safe protocols for therapy involving mesenchymal stem cells, which have been shown to suppress inflammation and repair nerve tissue.
  • Ontario Health Minister Dr. Eric Hoskins said hospitals in the province will adopt a “bundled” approach to care. This means patients will be paired with a care coordinator — usually a registered nurse — throughout their medical treatment. Pilot testing of the system found it improved patient outcomes and enabled patients to receive more care at home.
  • Quebec’s Liberal government confirmed it will invoke closure in order to force through controversial health care reforms. Bill 10 would see the administration of more than 100 health and social services centres merged into regional boards. Critics say the restructuring will slash hundreds of jobs and put English services at risk.
  • Health union hearings got underway to reassign some 24 000 Nova Scotia health workers into new bargaining units. Arbitrator Jim Dorsey gave the province the green light to slash the number of unions representing health workers from 50 to 4.
Heather Farrow

Angus, Bennett to fly to Attiwapiskat, MPs get emotional during late-night debate on su... - 0 views

www.hilltimes.com/...58531

aboriginal suicide

shared by Heather Farrow on 18 Apr 16 - No Cached
  • More funds and youth involvement are crucial for a long-term solution for remote First Nations communities, says NDP MP Charlie Angus.
  • Monday, April 18, 2016
  • PARLIAMENT HILL—NDP MP Charlie Angus, who is flying to Attawapiskat First Nation on Monday with Indigenous Affairs Minister Carolyn Bennett to meet with Chief Bruce Shisheesh, is calling for immediate action to provide critical services to the 2,000 residents of this northern Ontario community located in his riding.
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  • We need to stabilize the situation in Attawapiskat in terms of making sure they have the health support they need,” Mr. Angus (Timmins-James-Bay, Ont.) told The Hill Times last week. “We need a plan to get people who are needing help in any of the communities to get that help.”
  • A rash of attempted suicides prompted Mr. Angus, who’s also the NDP critic for indigenous and northern affairs, to call for an emergency debate on the ongoing suicide crisis in the James Bay community of about 2,000. As a result, the House of Commons convened until midnight last Tuesday for an emotionally charged discussion on mental health services following a string of incidents in northern reserves in recent months. Several MPs choked up during their statements, recounting suicide incidents in their ridings and personal lives.
  • Sometimes partisan politics need to be put aside and members need to come together to find solutions to prevent another unnecessary loss of life,” Conservative MP Todd Doherty (Cariboo-Prince George, B.C.) said during the debate. NDP MP Georgina Jolibois (Desnethé-Missinippi-Churchill River, Sask.) said the suicide rate went up in her home community of La Loche in northern Saskatchewan after a shooting spree that killed four people last January.
  • Liberal MP Robert-Falcon Ouellette (Winnipeg Centre, Man.) recalled visiting the northern Manitoba Pimicikamak Cree Nation, which declared a state of emergency over a series of suicide attempts last month.
  • Mr. Angus made an emotional appeal to action in his opening remarks during the emergency debate. “We have to end the culture of deniability whereby children and young people are denied mental health services on a routine basis, as a matter of course, by the federal government,” he said. Eleven people attempted to take their lives in Attawapiskat two Saturdays ago, prompting the First Nation to declare a state of emergency—the fourth one since 2006. There has been more than 100 suicide attempts in the reserve since the month of September, many of which involved children. The community has been plagued by flooding and several housing crises in recent years.
  • Eighteen mental health workers were dispatched to Attawapiskat on Tuesday, including two counsellors, one crisis worker, two youth support workers, and one psychologist. While there is no set timeline, they’re not expected to leave for at least two weeks, said Health Canada assistant deputy minister Keith Conn during a teleconference last week.
  • Some of the people treated for mental health problems last week had previously been airlifted out of the community for assessment before being sent back after their examination, according to Mr. Conn. This past Tuesday, at least 13 people, including a nine-year-old child, had made plans to overdose on prescription pills as part of a suicide pact. The Nishnawbe-Aski Police Service apprehended them before sending them to the local hospital for a mental health assessment.
  • Mr. Conn said he’s heard criticism of the mental health assessment process from Attawapiskat First Nation Chief Bruce Shisheesh. Individuals who are identified as likely to commit suicide are typically sent to a hospital in Moose Factory, Ont., to be psychologically evaluated by a psychologist or psychiatrist. They are then discharged and sent back to the community, where some try to take their life again. Mr. Conn said Health Canada does not “control the process,” but he personally committed to review the mental health assessment effectiveness.
  • No federally funded psychiatrists were present in the region prior to the crisis, despite reserve health-care falling under the purview of the federal government. Mr. Conn said the Weeneebayko Area Health Authority (WAHA), a provincial health unit servicing communities on the James Bay coastline, is usually responsible for the Attawapiskat First Nation following an agreement struck with the federal government about 10 years ago.
  • A mental health worker position for the reserve has been vacant since last summer, in part because there’s a lack of housing for such staff. The community has been left without permanent, on-site mental health care services. Since then, the position has been filled by someone already living on reserve. During the emergency debate in the House last week, Health Minister Jane Philpott (Markham-Stouffville, Ont.) emphasized the need for short- and long-term responses to the crisis.
  • We need to address the socio-economic conditions that will improve indigenous people’s wellness in addition to ensuring that First Nations and Inuit have the health care they need and deserve,” she said. Ms. Philpott pointed to the Liberal government’s budget, which includes $8.4-billion for “better schools and housing, cleaner water, and improvements for nursing stations.”
  • “Our department and our government are ensuring that all the necessary services and programs are in place,” she said during the debate. “We are currently investing over $300-million per year in mental wellness programs in these communities.” Yet, Mr. Angus said the budget includes “no new mental health dollars” for First Nations communities. In addition to allocating more funds for mental health services to indigenous communities, Mr. Angus said there needs to be a concerted effort to bring in the aboriginal youth in the conversation.
  • We need to bring a special youth council together,” he told The Hill Times on Wednesday. “We need to have them be able to come and talk to Parliament about their concerns, so we’re looking at those options now.” Emotion was audible in Mr. Angus’ voice when he read letters he received from Aboriginal youth during the emergency debate, which expressed a desire to work with the federal government to solve the crisis.
  • The greatest resource we have in this country is not the gold and it is not the oil; it is the children,” he said. “The day we recognize that is the day that we will be the nation we were meant to be.” Mr. Angus met with Indigenous and Northern Affairs Minister Carolyn Bennett (Toronto—St. Paul’s, Ont.) earlier in the week to discuss potential long-term solutions to the suicide crisis. “I’ve always had an excellent relationship with Carolyn Bennett, and as minister we’re trying to find ways to work together on this, to take the tension down, to start finding solutions,” Mr. Angus said. Mr. Angus criticized “Band-Aid” solutions that have been thrown at First Nations issues over the years and said there needs to be a “transformative change” this time.
  • That’s where we have to move beyond the positive language to actually the brass tacks,” he said. During the emergency debate, Mr. Angus supported the idea of giving more resources to frontline workers such as on-reserve police, and health and treatment centres. 0eMr. Angus’ riding sprawls from shores of the Hudson Bay to the Timiskaming district on the border with Quebec, an area roughly equivalent in land size to that of Guinea. He holds two constituency offices in Timmins and Kirkland Lake.
healthcare88

Why society's most valuable workers are invisible - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20161031|259524904

ltc

shared by healthcare88 on 31 Oct 16 - No Cached
  • The Globe and Mail Mon Oct 31 2016
  • Economists have, traditionally, paid little attention to women such as Shireen Luchuk. A health-care assistant in a Vancouver long-term-care residence, she trades in diapers and pureed food for those members of society no longer contributing to the GDP. She produces care, a good that's hard to measure on a ledger. She thinks about cutting her patients' buttered toast the way she would for her own aging parents, and giving a bath tenderly so she doesn't break brittle bones. She often stays past her shift to change one more urine-soaked diaper because otherwise, she says, "I can't sleep at night."
  • Last week, a resident grabbed her arm so tightly that another care worker had to help free her. She's been bitten, kicked and punched. She continues to provide a stranger's love to people who can't say sorry. This past Monday, as happens sometimes, she did this for 16 straight hours because of a staff shortage.
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  • But let's not be too hard on those economists. The rest of us don't pay that much attention to workers such as Shireen Luchuk either - not, at least, until our families need her. And not until someone such as Elizabeth Tracey Mae Wettlaufer is charged with murdering eight residents in Ontario nursing homes. Then we have lots of questions: Who is overseeing the care of our seniors? Are our mothers and fathers safe? Will we be safe, when we end up there?
  • The question we might try asking is this: If the care that Luchuk offers is so valuable, why don't we treat it that way? Dr. Janice Keefe, a professor of family and gerontology at Mount Saint Vincent University and director of the Nova Scotia Centre on Aging, says "the emotion attached to these jobs removes the value."
  • Caregiving, Keefe says, is seen "as an extension of women's unpaid labour in the home." Those jobs are still overwhelmingly filled by women. And, while times are changing, the work they do is still mostly for women - whether it's the widows needing care who are more likely to outlive their husbands, the working moms who need child care or the adult daughters who are still most likely to carry the burden of aging parents.
  • Yet it's as if society wants to believe that professional caregivers should do their work out of love and obligation - as if care would be tainted by higher pay and better benefits. That's an argument you never hear for lawyers and accountants. It's certainly not one that Adam Smith, the founding father of political economy, made for the butcher or the baker.
  • In last year's book, Who Cooked Adam Smith's Dinner?, Swedish writer Katrine Marcal argued that the market, as Smith and his fellow economists conceived it, fails to accept an essential reality: "People are born small, and die fragile." Smith described an economy based on self-interest - the baker makes his bread as tasty as he can, not because he loves bread, but because he has an interest in people buying it. That way he can go to the butcher, and buy meat himself. But Smith missed something important. It wasn't the butcher who actually put the dinner on his table each night, as Marcal points out. It was his devoted mother, who ran Smith's household for him until the day she died.
  • Today, she'd likely be busy with her own job. But care - the invisible labour that made life possible for the butcher and the baker (and the lawyer and the accountant) - still has to be provided by someone. Society would like that someone to be increasingly qualified, regulated and dedicated, all for what's often exhausting, even dangerous, shift work, a few dollars above minimum wage. One side effect of low-paying, low-status work is that it tends to come with less oversight, and lower skills and standards. That's hardly a safe bar for seniors in residential long-term care, let alone those hoping to spend their last days being tended to in the privacy of their homes. We get the care we pay for.
  • It's not much better on the other end of the life cycle, where staff at daycares also receive low wages for long days, leading to high turnover. "I am worth more than $12 an hour," says Regan Breadmore, a trained early-childhood educator with 20 years experience. But when her daycare closed, and she went looking for work, that's the pay she was offered. She has now, at 43, returned to school to start a new career. "I loved looking after the kids. It's a really important job - you are leaving your infants with us, we are getting your children ready to go to school," she says. But if her daughter wanted to follow in her footsteps, "I would tell her no, just because of the lack of respect."
  • It's not hard to see where this is going. Young, educated women are not going to aspire to jobs with poor compensation, and even less prestige. Young men aren't yet racing to fill them. Families are smaller. Everyone is working. Unlike Adam Smith, we can't all count on mom (or a daughter, or son) to be around to take care of us. Who is going to fill the gaps to provide loving labour to all those baby boomers about to age out of the economy? Right now, the solution is immigrant women, who, especially outside of the public system, can be paid a few dollars above minimum wage. That's not giving care fair value. It's transferring it to an underclass of working-poor women. And it doesn't ensure a skilled caregiving workforce - all the while, as nurses and care assistants will point out, the care itself is becoming more complex, with dementia, mental illness and other ailments.
  • Ideally, in the future, we'll all live blissfully into old age. But you might need your diaper changed by a stranger some day.
  • Maybe robots can do the job by then. Rest assured, you'll still want someone such as Luchuk to greet you by name in the morning, to pay attention to whether you finish your mashed-up carrots. When she's holding your hand, she will seem like the economy's most valuable worker. Let's hope enough people like her still want the job.
healthcare88

Our responsibility to fight for a better Canada | Canadian Union of Public Employees - 0 views

cupe.ca/onsibility-fight-better-canada

cupe precarious

shared by healthcare88 on 26 Oct 16 - No Cached
  • Oct 20, 2016
  • Workers continue to face a growing list of challenges that make their work increasingly more precarious. These challenges include almost non-existent job security, fewer and inferior benefits, less control over working conditions, and employers demanding ‘flexibility’ that really means more casual, part-time and term positions.
  • And if you are a woman, or under 35 years old, or a part of an equity-seeking group, the odds that your work is precarious are even higher.
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  • Women are more likely to work less than 30 hours per week with no benefits. Young workers, or those below 35 years of age, are less likely to have workplace pensions, or sick leave.
  • Racialized workers, non-citizens, those whose first language is other than English or French, are far more likely to be precariously employed. This is not the way to build a better Canada.
  • Our campaigns and political action work are an important part of this fight, but we must never lose sight of the most powerful tool we have. We must organize these workers, allowing them the single best way to fight precarity and inequality in the workplace – a union.
Govind Rao

Strategic Directions: Our plan for the next two years | Canadian Union of Public Employees - 0 views

cupe.ca/ctions-our-plan-next-two-years

from heather cupe

shared by Govind Rao on 16 Nov 15 - No Cached
  • Nov 6, 2015
  • Delegates have passed a final version of CUPE’s action plan for 2015-17. The National Executive Board subcommittee presented revisions that integrate the debate on Strategic Directions over the past three days. Our action plan focuses on building workers’ power to improve our workplaces and communities, and to build a better country – and world.
  • The needs of precarious and young workers were top priorities in the final debate Friday morning. Delegates spoke about the importance of winning full rights and stable, well-paying jobs for precarious workers. This work is a crucial step in removing barriers to participation in our union. Connecting with members, building a more inclusive union, creating safe and healthy workplaces, and fighting privatization were common threads.
Govind Rao

Ontario pension proposal would benefit young workers most - Business - CBC News - 0 views

www.cbc.ca/...t-young-workers-most-1.2637915

from heather ontario pensions

shared by Govind Rao on 13 May 14 - No Cached
  • Only those not covered by workplace plans would get supplement to CPP
  • May 11, 2014
  • The proposed Ontario Registered Pension Plan would not likely do much good for the baby boom generation, but it would be a big benefit for people who are now in their 20s and 30s. The plan, proposed in Ontario's budget May 1 and never publicly debated because of the province's election call, is nonetheless getting attention from across the country because of its potential to fill a significant gap in pension coverage.
Govind Rao

Profile: Sarah Smith - The busy life of a young worker | Canadian Union of Public Emplo... - 0 views

cupe.ca/h-smith-busy-life-young-worker

from heather PEI cupe ems

shared by Govind Rao on 08 Oct 15 - No Cached
  • Oct 8, 2015
  • primary care paramedic with CUPE 3324 in Charlottetown, PEI,
  • an unpaid internship for Advanced Care Paramedic training.
Heather Farrow

Socialist Action will stand up for the people - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|sjet|20160524|247747304

nl cuts campaign

shared by Heather Farrow on 25 May 16 - No Cached
  • The Telegram (St. John's) Tue May 24 2016
  • Socialist Action is gaining a foothold in Newfoundland Labrador and it is needed now more than ever. The provincial government has tabled an austerity budget that will have drastically regressive effects on public services, seniors, women, youth, those most vulnerable, and the provincial economy as a whole. The provincial government's budget is a stark contrast to Alberta's budget, where low commodity prices have also taken a big bite and the NDP government has taken a different course than that of the Liberal government in N.L. There is nothing in our b
  • Socialist Action also has participated in town halls to rally support against the austerity budget. "This is the most miserable budget I've ever seen, except for Greece, and Greece's was forced on them" is how one CUPE economist put it.
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  • Socialist Action participated in the NL Rising! rally on May 5 at the Confederation Building. The event was organized by the Newfoundland and Labrador Federation of Labour and was attended by public and private sector unions, social justice groups, women and youth rights groups, and all those affected by the cuts to services, axed jobs and unfair tax measures. There were about 2,500 in attendance and a Socialist Action member held an SA banner on the main stage with the help of a member of Anonymous.
  • udget about creating jobs, eradicating poverty, improving literacy, providing opportunities for young Newfoundlanders and Labradorians, enhancing life in rural communities and for seniors, eliminating the gender wage gap, and improving mental health programs.
  • Socialist Action is also involved in starting a local NDP socialist caucus within the ranks of the provincial NDP modelled after the socialist caucus in the federal NDP. The finance minister has made some of her money thanks to temporary foreign workers working at her fast-food restaurants. She was previously the biggest cheerleader for the Muskrat Falls project when sitting on the board of directors for Nalcor, the provincial utility and energy company. Now she says she has to implement this budget because of the cost overruns on the dam project. It is a project lacking transparency and accountability, and making a lot of people from outside Newfoundland and Labrador wealthier, including foreign construction companies that have never done jobs like this in Canada, a Canadian engineering company that was involved in a bribery scandal with Libya when Moammar Gadhafi was still in power, and foreign banks, bond holders and credit rating agencies. Her goal seems to be to obey the credit rating agencies and please them.
  • Newfoundland and Labrador is in a more precarious position now than in 1933, when Newfoundland was bankrupt and Canada and Britain were worried about their own credit ratings. The British and Canadian governments appointed a Commission of Government which was controlled by two private bankers. This was the start of a 15-year political breach which eventually led to the Crown selling off Newfoundland and Labrador to the Canadian bourgeois wolves to pay off their war debt in 1949.
  • Socialist Action NL has unanswered questions about Don Dunphy, an injured worker who was seemingly killed for a tweet when an RNC officer on the then premier's security detail showed up at his home on an Easter Sunday. What is happening to the pensions of iron ore miners from Labrador who have provided raw material to Hamilton Steel Mills for years? We still have foreign multinational corporations willing to exploit our fishery resources. Those corporations and the provincial government are stomping on indigenous peoples' rights in Labrador.
  • Socialist Action is on the ground in Newfoundland and Labrador, active in the labour movement, social justice, international solidarity, feminist and environmental campaigns. We will continue to make the socialist caucus visible in the NDP provincial party, to be at the table at the N.L. independence debate, to actively support indigenous peoples' struggles, as well as in anti-war, anti-poverty and the human rights movements. Socialist Action NL is in solidarity with the Fourth International worldwide. Chris Gosse St. John's
Heather Farrow

Pharmacare: Why millennials should pay attention - Healthy Debate - 0 views

healthydebate.ca/...es-millennials-care-pharmacare

pharmacare

shared by Heather Farrow on 04 Aug 16 - No Cached
  • August 3, 2016
  • Author: Melisa Foster
  • Traditionally, the advocacy around pharmacare has focused on better protecting the health of Canadians, especially children and seniors. But one prominent group is often overlooked in the debate: a growing number of millennials don’t have access to employer-funded prescription drug plans, nor do they meet the requirements to access publicly funded plans.
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  • Today, young Canadians are searching for jobs in an economy with high levels of precarious employment, unemployment or underemployment. According to a recent Statistics Canada labour force survey, approximately 39% of workers 15 to 29 are precariously employed. That means that almost half of millennials between 15 and 29 are part-time, temporary or self-employed workers, and likely don’t have access to employer-run private health insurance plans. An estimated one out of every four Canadians who are uninsured cannot afford their prescriptions.
  • Melisa Foster works with Global Public Affairs in Toronto and also serves as a Communications, Media and Marketing Lead for Toronto’s Emerging Health Leaders (EHL) Executive.
Irene Jansen

Unions sound privatization warning - NovaScotia - TheChronicleHerald.ca - 0 views

thechronicleherald.ca/...1266010.html

privatization consultant ns

shared by Irene Jansen on 23 Jan 12 - No Cached
  • The Nova Scotia Government and General Employees Union, Nova Scotia Federation of Labour, CUPE Nova Scotia and the Nova Scotia Nurses’ Union, which together represent about 26,000 health-care workers, have teamed up to fight what they say is the province’s attempt to privatize some health-care services.
  • Earlier in the day, the province announced it had hired Ernst & Young, at a cost of almost $100,000, to provide recommendations for reducing health-care costs.
  • The consulting firm will examine 13 administrative and support services for three months and then will provide recommendations on how to run six of those services more efficiently.
  • ...3 more annotations...
  • The areas being looked at are: health records, registration and booking, laundry, payroll, central sterilization, food service, human resources, information technology and telecommunications, library services, general administration, finance and supply chain and material.
  • The consulting firm is being overseen by a steering committee made up of senior staff from the province’s district health authorities. However, no one representing the province’s front-line, health-care workers is on the steering committee.
  • The unions believe that cleaning staff may be the first to go and they fear that might lead to superbugs in hospitals.
Govind Rao

Home support workers concerned - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|cbpo|20150424|219100577

from heather NS home care

shared by Govind Rao on 24 Apr 15 - No Cached
  • Cape Breton Post Fri Apr 24 2015
  • I am a continuing care assistant in Sydney, working as a home support worker for 12 years. My job is to give my clients support they need to maintain some independence in their own home for as long as possible. When I enter a client's home, the first thing I do is make sure I am entering a safe environment for me and my client. During the initial greeting, I gauge my client's breathing, gait and speech. If something seems off the mark, I will react and use my training and experience to ensure that my client gets the best care. CCAs report back to their supervisors when a client's circumstances change or if they are compromised in any way - similar to a hospital setting. We constantly receive updated information and training.
  • Nova Scotia has the highest proportion of seniors in Canada, and the province's senior population continues to grow. And the young continue to leave for work. Who will be here to take care of our elderly who want to stay in their own homes for as long as they can? Many CCAs will leave Nova Scotia to find guaranteed work that pays fair wages with decent benefits so they can support their families. Don't we deserve to know that when we need assistance, we will have well-trained, caring professionals looking after us? The government wants to keep people in their own homes, stating that it's the cheaper option, especially if they can hire private companies to do the work.
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  • Other provinces that have tried a similar model are trying to reverse it. Health care is in shambles, Veteran Affairs offices no longer exist, and now much-needed services may be provided by companies that are in it for the money and that could hire unqualified people for a lesser wage and no benefits. Karen Wilton-Epifano Whitney Pier
Govind Rao

Photo project gives human face to health care; Initiative aims to use portraits, storie... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150718|225121478

from heather research support services

shared by Govind Rao on 21 Jul 15 - No Cached
  • Toronto Star Sat Jul 18 2015
  • Andreas Laupacis is the first to admit he is a policy wonk. The doctor, who co-directs a 500-employee research institute and chairs a provincial agency that strives to improve health quality, is also the first to admit there are gaping schisms between health policy-makers like himself and those working and being cared for on the front lines. So he has conceived of a novel way to bridge the gaps: a photojournalism project that tells it like it is from within each of those silos. Faces of Health Care, unveiled Thursday, is modelled after Humans of New York, the wildly popular blog by photographer Brandon Stanton, which documents images and stories of regular folk in the Big Apple. Laupacis' project features portraits and short narratives, collected from the bedside, front lines and back offices.
  • "I am increasingly convinced that patient and health-care worker stories about the good, bad and the complex in health care are important, especially for those of us making policy. We can become a bit distant from the impact of our policies on the people we serve," he says. One profile features Kieran Quinn, an internal-medicine resident at the University of Toronto. Quinn describes how one of his most challenging cases involved caring for a young woman with advanced cancer.
  • ...4 more annotations...
  • Her husband refused to accept that she was close to death and battled with hospital staff to keep her alive with a breathing machine and feeding tube. "Looking back, I don't like the fact that we were treating the woman this way, but I also don't like that we were battling her husband," Quinn related to Faces of Health Care. "He'll probably remember her death as a battle with the health-care system to provide care. In some ways I feel like we failed him - he's the one who is living; he'll carry that with him the rest of his life," Quinn adds. Laupacis has held some of the most senior positions in Ontario's health system.
  • He is currently executive director of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, board chair of Health Quality Ontario and a board member of Cancer Care Ontario. He holds a Canada Research Chair in Health Policy and Citizen Engagement and formerly served as president of the Institute for Clinical Evaluative Sciences.
  • Trained as a medical internist, he continues to see patients as a palliative care specialist. The photojournalism project has grown from his belief that the health system would be better if there was more informed public input. "I think these stories are great learning tools for those of us who practise health care, and many of them are just darn interesting to almost anyone," he says.
  • "Our hope is that it will bring a human face to the articles about health care that we write on the site," he adds. Faces of Health Care is put together by a team of writers and photographers and is part of the online health policy magazine HealthyDebate.ca, another Laupacis creation. Because it is not a typical health-care project, there are no typical health-care grants to fund it. So Laupacis is also launching a crowd-funding campaign in hopes of raising $50,000 to see the project through its first year.
healthcare88

UN alarmed at how Canada treats black people; Delegation critiques nation on poverty, e... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20161103|259762429

racism

shared by healthcare88 on 03 Nov 16 - No Cached
  • Toronto Star Thu Nov 3 2016
  • A UN working group on issues affecting black people is raising alarm over poverty, poor health, low educational attainment and overrepresentation of African Canadians in justice and children's aid systems. The findings were made by the United Nations Working Group of Experts on People of African Descent after its cross-Canada mission in October - the first ever since it was established in 2002. Previous attempts to visit Canada by the group failed under the former Conservative government, but it was made possible this time with an invitation by the Trudeau Liberals.
  • "The working group is deeply concerned about the human rights situation of African Canadians," the group wrote in its preliminary report, the final version of which will be submitted to the UN Human Rights Council next September. "Canada's history of enslavement, racial segregation and marginalization has had a deleterious impact on people of African descent which must be addressed in partnership with communities." Dena Smith of Toronto's African Canadian Legal Clinic was happy the working group acknowledged some of the key issues faced by the community.
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  • While the findings and recommendations are not binding, Smith said they highlight the challenges faced by African Canadians for the international community and hopefully put more pressure on Ottawa to rectify the inequities. "The situation is only going to get worse," Smith said. "We have families in the community torn apart at an alarming rate. "The future looks pretty bleak for our young people."
  • The UN delegation was in Toronto, Ottawa, Montreal and Halifax to meet with government officials, community members and rights groups to identify good practices and gaps in protecting the rights of black people. "We had been trying to secure a visit to Canada for a long time. It's a great joy that we were officially invited here," the working group's chair Ricardo Sunga told the Star in a phone interview Tuesday. "We look at Canada as a model in many ways when it comes to human rights protection.
  • We appreciate Canada's effort in addressing discrimination in various forms, but no country is exempt from racism and racial discrimination." Despite the wealth of information on socio-economic indicators in Canada, the investigators criticized the "serious" lack of race-based data and research that could inform prevention, intervention and treatment strategies. "The working group is concerned that the category 'visible minorities' obscures the realities and specific concerns of African Canadians," its report said. "There is clear evidence that racial profiling is endemic in the strategies and practices used by law enforcement. Arbitrary use of 'carding' or street checks disproportionately affects people of African descent."
  • The overrepresentation of black people in the criminal justice system was of particular concern for the group, who found African Canadians make up only 3 per cent of the population but account for 10 per cent of the prison population. In the last decade, the number of black detainees in federal correctional facilities has grown by 71.1 per cent, it warned. Among other findings by the UN experts: Across Canada, African Canadian children are being taken into child welfare on "dubious" grounds. Forty-one per cent of children in Children's Aid Society of Toronto's care were black when only 8 per cent of children are of African descent. The unemployment rate for black women is 11 per cent, 4 per cent higher than the general population, and they earn 37 per cent less than white males and 15 per cent less than white women.
  • A quarter of African Canadian women live below the poverty line compared to 6 per cent for their white counterparts. One-third of Canadian children of Caribbean heritage and almost half of continental African children live in poverty, compared to 18 per cent of white Canadian children. Chris Ramsaroop, an advocate with Justicia for Migrant Workers, hopes the report will raise awareness of the plight of African Canadians. "We need every opportunity to hold the feet of the federal and provincial governments to the fire," he said. The UN experts recommend a national department of African-Canadian affairs to develop policies to address issues facing black people and implement a nationwide mandatory disaggregated data collection policy based on race, colour, ethnic background and national origin.
  • Odion Fayalo, of Justice is Not Color Blind Campaign, protests racial profiling before a Toronto Police board meeting. • René Johnston/TORONTO STAR file photo
Cheryl Stadnichuk

Ontario pledges $222-million to improve First Nations health care - The Globe and Mail - 0 views

www.theglobeandmail.com/...article30145129

aboriginal health ontario

shared by Cheryl Stadnichuk on 25 May 16 - No Cached
  • Ontario has pledged to spend $222 million over three years to improve health care for First Nations, especially in the north where aboriginal leaders declared a state of emergency because of a growing number of suicides.The Liberal government also promised to contribute $104.5 million annually — after the initial three years — to the First Nations Health Action Plan, which will focus on primary care, public health, senior’s care, hospital services and crisis support.
  • The James Bay community of Attawapiskat declared a state of emergency
  • in April because of an increasing number of suicides and suicide attempts, especially by young people.“We have learned from the recent health emergency declarations that communities need support in times of crisis and need to know that they can count on the provincial government,” Health Minister Eric Hoskins said Wednesday.“So we will establish dedicated funding, expanding supports including trauma response teams, suicide prevention training, positive community programming for youth, and we will fund more mental health workers in schools.”
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  • Canada ranked No. 8 last year on the United Nations human development index, but the same indicators would place indigenous people in Canada at about 63, added Hoskins.“These inequities can no longer be ignored,” he said. “It’s not up to First Nations to right the wrongs of colonization. Government must invest in meaningful and lasting solutions so communities can heal and have hope.”
  • The Ontario plan will increase physician services for 28 communities across the Sioux Lookout region in the north by up to 28 per cent, and establish up to 10 new or expanded primary care teams that will include traditional healing.There will also be cultural competency training for front-line health-care providers and administrators who work with First Nations communities, more public health nurses and a dedicated medical officer of health.The government says it will also increase access to fresh fruits and vegetables for about 47,400 indigenous children, and expand diabetes prevention and management in northern and remote communities.
Irene Jansen

CUPE Nova Scotia concerned about what we don't know in Shared Services Review < Health ... - 0 views

cupe.ca/...cotia-concerned-what-dont-know

shared services ns cupe

shared by Irene Jansen on 05 Mar 12 - No Cached
  • CUPE Nova Scotia President Danny Cavanagh says, “We are not surprised that private consultants Ernst and Young recommended privatizing some services in our health care system. The company’s track record clearly supports this direction.
  • the government did not accept their recommendation to privatize laundry services
  • who will be providing these merged services? The minister talked about an ‘alternative service delivery’ model. What is this agency? Who are these workers? Will they be union, or non-union?
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  • But this is only phase one of the review exercise. We are quite worried about future cuts and mergers of services.
  • more than 50 job losses in finance and administration
Govind Rao

HOW TO FIX CANADA'S MENTAL HEALTH SYSTEM; Too many patients seeking mental health diagn... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150602|221788724

from heather mental health

shared by Govind Rao on 02 Jun 15 - No Cached
  • The Globe and Mail Tue Jun 2 2015
  • OPEN MINDS How to build a better mental health care system A weary-looking single mother brought her son into the London, Ont., walk-in clinic where Christina Cookson works on a weekday evening. Her son, who recently attempted suicide in another city, was sent home from hospital with no follow-up. Now, with a doctor they had never met before, they were trying to get help. Dr. Cookson asked a few questions about his current treatment, learned of a new antidepressant that his mother said seemed to be working.
  • With no history of care, Dr. Cookson had no way to know for sure. She advised him to make sure he told his mom if he had suicidal thoughts again and wrote a referral to see a psychiatrist, though even an urgent request would take weeks. Other than that, she had little to offer. They had no coverage for psychotherapy, which ideally, she would have prescribed. Since the young man was a walk-in patient, there is no guarantee she will see him again. "I want to be able to give them the care they deserve, and I know will benefit him, and I have no way of arranging that," she says. "It's a pretty helpless feeling."
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  • And one to which many family doctors, struggling to help mentally ill patients, can attest. After months of research, and as detailed in our Open Minds series, The Globe and Mail identified some of the top evidence-based approaches to building a mental health system that will work for Canadians. These are changes that would move the country beyond its patchwork, fragmented mental health system in which the care patients receive is too often determined by what they can afford, or where they live or what they are savvy enough to cobble together on their own. These initiatives abide by the principals of Medicare and good science, and treat the disorders of the mind as diligently as the diseases of the body.
  • Expanding access to publicly funded therapy One in five Canadians will be affected by mental illness in their lifetimes. The cost to the country's economy is staggering: $50billion a year in health care and social services, lost productivity and decreased quality of life, estimates the Mental Health Commission of Canada. The personal costs are more devastating - unemployment, family breakup, suicide. Canadians who seek help for a mental illness will most often be prescribed medication, even though research shows that psychotherapy works just as well, if not better, for the most common illnesses (depression and anxiety) and does a better job at preventing relapse. According to a 2012 Statistics Canada study, while 91 per cent of Canadians were prescribed the medication they sought, only 65 per cent received the therapy they felt they needed. Access to evidencebased psychotherapy, which experts say should be the front-line medical treatment, is limited and wait-lists are long.
  • No provinces cover therapy delivered in private practice by a psychologist, social worker or psychotherapist, creating a twotier system, which means families without coverage through work - those more likely to be low-income - often either pay out of pocket or go without or, if they are lucky, rely on a non-profit group working to fill a gaping hole in a flawed health-care system. Even Canadians with coverage rarely have enough for a proper dose that meets treatment guidelines. This kind of inconsistent, unequal and scientifically flawed approach to care would be untenable for diabetes, cancer or heart disease. Yet it persists for some of the most debilitating illnesses suffered by Canadians. "Clearly this is the biggest gap we have, and the one that most needs to be fixed," says psychiatrist Elliot Goldner, director of the Centre for Applied Research in Mental Health and Addiction. Psychotherapy is a medically necessary treatment, he argues, that should be publicly funded. The question is not whether Canadians need it, but how to deliver it.
  • A system that responds nimbly to patients' needs would have clear treatment guidelines, appropriate screening and good data collection to ensure that therapies are working for patients. There should be a role, for instance, for non-profit groups on the ground to be woven into a comprehensive system to provide additional supports, particularly in areas such as housing, employment and mental health promotion - without expecting them to patch up shortfalls in services the system should provide. That should include, says Dr. Goldner, non-physicians with training in psychotherapy who are integrated into the mental health system, so that access to care is based on sound science and the best treatment plans for individual patients, rather than what happens to be available. Canada doesn't have to start from scratch. As Dr. Goldner points out, Britain and Australia have both made huge investments to expand public access for all citizens to psychotherapy, recognizing both its clinical value and cost-effectiveness over the long run. Britain's system, especially, has been designed to be accountable, to track outcomes with extensive data and to be flexible enough to incorporate changes to the system to improve results.
  • Using technology to deliver therapy into the homes of Canadians It can be hard enough to get timely treatment if you only have to drive a few blocks to find it. But what if access to care for, say, an anxiety disorder requires traversing a sprawling wilderness, for hours by car, sometimes through a blizzard? These were the stories that Fern Stockdale Winder heard often from Saskatchewan patients, as the psychologist charged with developing the province's new mental health strategy. Even when mental health care was available, reaching treatment was often one more layer of stress. It doesn't have to be this way. Chief among the strategy's recommendations: a provincewide online therapy system. The evidence for tech-delivered therapy, with support over the phone, is strong - for many patients with depression and anxiety, it can be just as effective as face-to-face sessions. It allows patients to manage care around their work and school schedules, to maintain privacy and to take control of their own recovery in a way less likely to happen with medication.
  • And it's cost-effective, says Dr. Stockdale Winder, potentially reducing appointment no-shows and cutting down on travel time for patients and therapists to and from remote communities. Canadians have ready access to medication for mental illness not because it's the best option, but because it's the easiest - even though psychotherapy works as an effective early intervention, a standalone treatment or in combination with drugs, and to prevent relapse. This front-line treatment can also be delivered in a modern and increasingly convenient way that gives patients more choice in how they receive their care.
  • It's very much about how people like to learn. Whether for reasons of stigma or personal preference, many people like to work on life challenges by themselves," says Chris Williams, a psychiatrist at the University of Glasgow, whose self-guided program is used as a first-stage treatment in Britain's publicly funded psychotherapy system. It has also been adapted in British Columbia and is being piloted in other provinces by the Canadian Mental Health Association. Self-guided therapies vary - some use DVDs or booklets, others are delivered online - but the evidence is strongest for ones that also link patients to therapists, either by e-mail or with brief phone calls.
  • A separate online program at the University of Regina has already had promising results. (Even so, the government is taking a wait-and-see attitude: Health Minister Dustin Duncan said last week that the government is keeping an eye on the project and will consider whether to expand the service after the pilot concludes next year.) What Dr. Stockdale Winder envisions is a system in which family doctors could use depression and anxiety screening to easily steer appropriate patients away from medication and toward accessible, online therapy.
  • "She clicks a button, and the patient is in," she says. Such a system would also monitor the progress of participants and direct them into more intensive care if their conditions worsened. The need for early intervention is pressing, and the evidence for online therapy is already convincing. In a country of wide open spaces, with remote communities difficult to reach even in the best weather, it's necessary. What are policy-makers waiting for? Teaching the next generation about mental health
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