The Last Word

Dr. Mark Gold

In the early 1980s, it became clear to me that appetite was related to drugs of abuse. After we detoxified people with opiate addiction, those who stayed drug-free reported increased appetite and weight. During intoxication and chronic use, appetite diminished. Progressively, drug use competed with food, and users ate sporadically and for survival. We also found that cocaine use and dependence were associated with weight loss.

Shelly Ben-David 

Parents hope their children will grow up to be successful members of society. A parent's worst nightmare is seeing their child winding up homeless, without prospects of career or family. I'm not a parent, but as a social worker who over the years has worked with young adults with severe mental illness, as well as their parents, I have witnessed the desperation that parents feel when their child is at risk for severe mental illness.

Wayne Skinner

What should an academic health sciences centre do if it had the opportunity to redevelop a historic 27-acre site? For the Centre for Addiction and Mental Health (CAMH) in Toronto, the answer was to build an "urban village." Equipped with that appealing phrase to represent the concept and the strategy, CAMH has embarked on one of the most ambitious redevelopments of a health care campus in the world today.

Ann-Marie O'Brien

Community treatment orders (CTOs) are part of a complex landscape of law, policy and practice. Defining and measuring their effectiveness depends on who you ask; policy makers, practitioners and the people who fall under CTOs all present different perspectives. CTOs do not exist in a vacuum. Many factors affect how, when and with whom they are used, including the availability and willingness of physicians and the mental health infrastructure to support them. Ten years after the introduction of CTOs in Ontario, there exists only a handful of studies to inform opinions on their usefulness. Many important questions remain unanswered.

Ted Ridley

"You're not going to tell me to put my child on Ritalin!" The alarm in the mother's voice is palpable, her reaction familiar to child and youth mental health workers. The clinician has just reviewed this mother's account of her son's persisting and worsening academic performance, his inability to maintain relationships with family, friends and teachers, his repeated abandonment or rejection from community activities. The standardized behaviour checklists completed by parents and teachers coincide with the interview findings, and rate him above the 95th percentile for ADHD symptoms. But the boy's mother has rejected medication before it has even been suggested.

Stephen Gaetz

In recent years, "housing first" has emerged as a key response to homelessness in North America. With its growing popularity in Canada comes increasing interest in understanding how the approach works, different program models and its effectiveness for specific populations. One key factor that undoubtedly shapes the success of any housing first program is the nature and supply of affordable housing.

Raymond Cheng

The power of language in health care is an understated one. For those of us who pass our days as stakeholders, whether on the front lines, during policy discussions or in meeting rooms, jargon is the lifeblood of rhetorical discourse. But do we ever consider its effect on those people who use services and programs?

By Ramona Alaggia

Abuse and violence have long been constructed along gender lines, with the dominant framework emphasizing male perpetrators and female victims. Although most sexual crimes are committed by men, this should not discount the reality that males, especially in childhood, are as vulnerable to sexual victimization as females. Reported rates of child sexual abuse have long been regarded as the "tip of the iceberg," with Canadian rates of female victimization estimated at about one in four for girls before age 18 and about one in six for boys. However, recent studies suggest that prevalence rates of sexual abuse of boys have been significantly underestimated and may be closer to those of girls.

By Jan Wallcraft

Madness has been stigmatized for centuries. The madhouses and asylums of yore simply removed the "mad" from society, often permanently. Nathaniel Lee, a 17th-century English playwright who spent five years in the notorious Bedlam asylum, said: "They called me mad, and I called them mad, and damn them, they outvoted me."