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Health

‘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

Community

Scott: Healthier weight while taking anti-psychotic meds

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photo of Scott

This story was originally published on the PCN website in May 2018.  

Scott: Healthier weight while taking anti-psychotic meds

My health issue is schizophrenia and the side effects associated with the anti-psychotic medication I take. I had a conversation with my family doctor about the bariatrics clinic at the hospital and he assessed my obesity and referred me to the Health Basics course. I had hoped to get control of my body weight because I have had chronic pain, injuries, and intense frustration with my physical abilities.

A major barrier to my mental concentration was the lack of structure regarding my knowledge around health. I had been advised to control my eating by family and friends but I felt that my weight would naturally sort itself out if I could just get my medications decreased. I had previously connected with a dietitian through AHS however I could not keep a food journal or make adjustments that she recommended.

In the Health Basics program, I committed to the group therapy process and began journaling for the first time. I increased the proportion of fruits and vegetables in my diet. I now plan snacks and focus on “in-control” eating. Further, I practice the 80/20 rule regarding the Healthy Road vs. Easy Street and this keeps my spirits up when I slack off. I simply remind myself that I can make a better choice in any moment to “save the day”.

The last I weighed myself, I had dropped fourteen pounds and my waist was quite a bit smaller. I am getting comments about my physique. I am working through the side effects of my medication with gratitude for the treatment team that helps me, and I am overall noticing less symptoms of depression. In addition, I am maintaining my active lifestyle and achieving the high level of performance that I demand from myself.

I recommend anyone needing weight loss and a healthier lifestyle to take the Health Basics course and attend and participate for yourself AND the others in the group. Make your nutrition a priority because I believe “you are what you eat”. Find a career that forces you to exercise at a high intensity. One big motivator to me is that I need to start a family and I believe that I can have more fun in life with a body that I am happy with.

I am on track to continue to be healthy. I eat enough fruits and vegetables. I continue to journal my food intake. I drink water as my main beverage. I stretch daily. I make my soccer referee job the priority in my career. I am currently participating in the sleep course at the PCN to make sure that I am improving other areas of my health as well.

Here are some other stories from Primary Care Network:

Finally the dam broke

Achieving Mental Health is an Everyday Task

About the Red Deer Primary Care Network

We (RDPCN) are a partnership between Family Doctors and Alberta Health Services. Health professionals such as psychologists, social workers, nurses and pharmacist work in clinics alongside family doctors.

In addition, programs and groups are offered at the RDPCN central location. This improves access to care, health promotion, chronic disease management and coordination of care.  RDPCN is proud of the patient care offered, the effective programs it has designed and the work it does with partners in health care and the community.

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Alberta

Province pumping millions into mental health supports for post-secondary students

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Representatives from the Student Counseling Office and Mental Health at NAIT, Kids Help Phone, United Way and members of Alberta Students’ Executive Council stood with Associate Minister Luan and Minister Nicolaides 

From the Province of Alberta

More mental health supports for students

Government is investing $22 million to deliver more mental health supports for post-secondary students.

Students at the 26 post-secondary institutions across Alberta will have more access to mental health and addiction crisis supports through text and chat, and professional counselling by phone. Those services will be supported by a new digital navigation and crisis hub that will link service providers, including United Way’s 211 service, helplines such as Kids Help Phone, HealthLink/811 and other distress lines.

“Our government is committed to eliminating barriers to mental health and addiction services for post-secondary students. Working together, we’ll make it easier for students to talk openly about mental health and ensure they have access to supports when they need them.”

Jason Luan, Associate Minister of Mental Health and Addictions

In addition, Budget 2019 continues to support a range of on-campus mental health services, including:

  • increased access to counsellors
  • early alert systems
  • peer support programs
  • awareness campaigns and mental health literacy
  • training for faculty, staff and students in suicide-prevention
  • helping others in distress
  • personal coping strategies

“One of the common themes I have heard from our students, from Day 1, is the need to strengthen mental health supports on campus. This initiative will improve access to mental health services and will make sure our students can find help when they need it. I am always listening to students, and this announcement demonstrates their advocacy pays off.”

Demetrios Nicolaides, Minister of Advanced Education

On-campus services are supported by the Post-secondary Mental Health Grant of $7.6 million this year.

In addition, government is funding expansion of digital services by providing $6.75 million to Kids Help Phone to expand its 24-7, free, confidential and professional online and telephone counselling and volunteer-led text-based crisis support. Another $7.5 million will fund a new digital navigation and crisis hub that will link United Way’s 211 service to other helplines such as Kids Help Phone, HealthLink/811 and other distress lines.

“Kids Help Phone is pleased to be a part of this initiative that will help Albertans, particularly post-secondary students, connect to the services they need in a timely fashion. Navigating the mental health system is complex and we are proud to work with partners to ensure all Albertans get the help they need, when they need it most.”

Katherine Hay, CEO, Kids Help Phone

“More than 500,000 Albertans access at least one mental health service each year, with many others unable to get help when they need it. With this partnership, Albertans will have access to information and help at any time no matter where they live in the province, allowing anyone to connect when they need to most.”

Rob Yager, president and CEO, United Way Alberta Capital Region

“Mental health is critical to the success and well-being of everyone. In order to thrive inside the classroom and beyond, mental health needs to be supported.”

Glenn Feltham, president and CEO, NAIT
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december, 2019

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