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‘Clients fall off:’ Calgary program helps recently released prisoners with hep C

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CALGARY — Imagine adjusting to life after serving prison time, then add mental- health struggles, addiction or homelessness.

Now, throw in hepatitis C, a blood-borne virus that can cause serious liver problems and is several times more prevalent in federal prisons than the general population.

A specialist in addictions and internal medicine who focuses on vulnerable populations has launched a pilot program in Calgary to ensure recently released inmates with a history of injection drug use are screened and treated for the virus.

“It takes a lot of willpower and effort on their end to come out of this. And if we don’t provide them with enough support, they’re not going to be able to,” says Monty Ghosh, a University of Alberta professor who splits his time between Edmonton and Calgary.

The program connects newly released prisoners with so-called peer navigators who have lived through similar experiences. The navigators accompany the former inmates to medical, legal and social services appointments — interactions that many avoid for fear of judgment or because more pressing issues are at hand.

“Clients often tell me that they’re confused about resources in the community. They don’t know where to go or how to get there sometimes. They have very little money to take a bus to get to where they need to be,” says Ghosh.

“Sometimes they have to decide between food and lining up to get into the shelter versus actually making their medical appointment.”

In a best-case scenario, Gosh says, it can take five months to clear the body of the hepatitis C virus. Usually, it’s more like nine or 10 months. There are numerous blood tests and followups a patient must go through over that time.

“We find that every time we add another step, clients fall off. But if you add a peer navigator, they make it to each and every one of those steps at a high, high rate.”

The program, which began in April, aims to reach 120 clients in its first year and have 80 per cent of them follow through with their treatment to the end. Ghosh says about 40 per cent of incarcerated people usually complete the treatment.  

The initiative is funded with $46,000 through what pharmaceutical company Gilead Sciences Canada calls a “micro-elimination” grant. The grants are meant to help organizations combat hepatitis C in the most affected groups.

“We recognize that it will take more than just science to eliminate the burden of (hepatitis C) on patients, our health system and Canadian society as a whole,” says Gilead general manager Kennet Brysting.  

The Correctional Service of Canada says hepatitis C rates in federal prisons dropped to just under eight per cent in 2017 from 32 per cent in 2007. In the general population, the decrease is less than one per cent.

Spokeswoman Stephanie Stevenson says 80 per cent of federal inmates with the virus are diagnosed before incarceration or at intake. The rates are higher than the general population because there is often a history of high-risk behaviour, such as injection drug use or unprotected sex, she says. The virus can also be spread through snorting drugs or getting a tattoo.

In addition to medical treatment, Corrections also offers educational, counselling, peer support and harm reduction programs, including needle exchanges.

“Prior to release, (Corrections) health-care professionals liaise with community health-care providers, including infectious disease specialists, to facilitate effective transition and followup in the community,” Stevenson says. “Once in the community, provinces and territories are responsible for offenders health-care needs.”

The head of the John Howard Society of Canada, a group that advocates for an “effective, just and humane” criminal justice system, says inmates are sometimes released without a provincial health-care card and only a few weeks worth of medication.

“If they’re going into a halfway house or going into a parole situation, those with whom they’re staying will go to great lengths to try and make sure that their health-care needs are being met,” Catherine Latimer says.

“But it’s often challenging.” 

Lauren Krugel, The Canadian Press

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So many losses to cope with

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So many losses to cope with

Shaylyn is only 26. She experienced miscarriages and lost multiple friends, relatives, and pets starting in 2012.  The losses continued and just kept on building with 8 souls lost in 2019 alone. She was working through it her way but in the back of her mind she knew some help may allow her to move towards a better quality of life.  She put her thoughts out there asking the universe for some assistance when she saw a bus ad “Got Grief?” and the phone number to register for the RDPCN Grief program.  She immediately called to register for the program and is very glad that she did.

One of the valuable lessons that she learned was not to feel any anger or resentment to the person who passed. She could be mad at the situation they left her in but not mad at the person. She found comfort in the class exercise of writing a letter to the person lost and then writing a response from them. It felt like she was receiving comfort and support, and this helped her shift to the positive. She also realized she is a caregiver, but she needs to take some time and care for herself and give herself some time to work through all of this. She gained knowledge on how to do this.

Overall the Journeying through Grief program helped her to get on a more positive path. She realized how resilient she is and how she can move forward with her life. She gained self-confidence and can now walk away from non-constructive conversations. She learned it is okay to ask for help and okay to be vulnerable. The program gave her space to express what she was feeling and give in to her emotions. Often people don’t know how to be around you during your time of loss but having experience communicating with others in similar situations in the program gave me the practice and confidence that I needed to move forward. Shaylyn says, “I would highly recommend Journeying through Grief to anyone with loss in their life.

Self-care series: Lift your mood

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Dealing with Distress 

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Dealing with Distress

Learn some ways to deal with distress in this video with Renee, one of our Mental Health Counselors. For more ideas watch this video in the link below. Commit to trying one new strategy to manage when you find yourself dealing with a situation you have no control over.

In her video, Renee references this video.

Click to learn more about the Red Deer Primary Care Network.

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july, 2020

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