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Summer 2008 | Vol 11 No 4

A view from CAMH

Dr. David Goldbloom

The focus of this issue on older adults coincides with an increased emphasis within our own academic health sciences centre on understanding and treatment for this segment of our population.

CAMH provides Ontario’s largest geriatric mental health and addiction program, with 48 inpatient beds, five outpatient clinics and 10 ongoing research initiatives – including the use of rapid transcranial magnetic stimulation and the role of brain imaging, taking advantage of CAMH’s positron emission tomography scanner (the only such research tool consecrated exclusively for mental health and addictions research in North America). Additionally, ongoing studies are examining cognition in older adults with schizophrenia and bipolar disorder and treatment interventions for these individuals. The program’s education activities have increased substantially with medical students, residents, research fellows and advanced students from the other mental health disciplines. Patient safety initiatives have focussed on preventing falls, as well as medication errors in older adults, who often take multiple drugs.

Among CAMH’s inpatients over age 60, 46 per cent have a documented concurrent disorder; this aspect, as well as a focus on late-life schizophrenia and bipolar disorder, provide unique emphases for this program. Additionally, 43 per cent of the inpatients are immigrants to Canada in the last 10 to 15 years, reflecting the reality of 21st-century Toronto. Similarly, over 80 per cent of the staff are either born or trained outside of Canada. Because most older adults with mental health and addiction problems live beyond the walls of our hospital, CAMH provides clinical outreach to 26 Toronto long-term care facilities and educational outreach to more than 80 of them.

Patients and families are represented on its program advisory committee, where in addition to clinical, academic and policy concerns, issues such as the “triple whammy” of stigma related to mental illness, addictions and ageism are considered.

The Mental Health Commission of Canada, launched in September 2007, has placed particular emphasis on older adults through its Seniors Advisory Committee. A number of initiatives at a national level, supported through the Mental Health Commission, will help to raise awareness, change attitudes, increase knowledge, improve care and enhance the quality of life of older adults living with a mental illness. We owe it to them.

David S. Goldbloom, MD, FRCPC
Executive Editor, CrossCurrents;
Senior Medical Advisor,
Education and Public Affairs, CAMH
Professor of Psychiatry, University of Toronto