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Centre for Addiction and Mental Health

Coordinates: 43°38′40″N 79°25′03″W / 43.64455°N 79.41761°W / 43.64455; -79.41761
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Centre for Addiction and Mental Health
CAMH Russell Street site
Map
Geography
LocationToronto, Ontario, Canada
Organization
Care systemPublic Medicare (Canada) (OHIP)
TypeAddictions and Mental Health
Affiliated universityUniversity of Toronto
Services
Emergency departmentYes
History
Opened1998
Links
Websitehttp://www.camh.ca/
ListsHospitals in Canada

The Centre for Addiction and Mental Health (CAMH) is a mental health hospital in Toronto, Ontario, Canada, formed in 1998 from the amalgamation of four separate institutions. (The acronym CAMH is most commonly pronounced "Cam-H".) Its name in French is Centre de toxicomanie et de santé mentale. CAMH has 530 inpatient beds and 3000 staff, physicians, and scientists, with an annual operating budget of over $300 million.[1] Its central facilities include 90 distinct services across inpatient, outpatient, day treatment, and partial hospitalization models.

Neurologist, Dr. Catherine Zahn, was appointed President and CEO in 2009.[2]

Among the focuses of the organization are the assessment and treatment of schizophrenia, mood & anxiety disorders, personality disorders and a clinic for gender identity disorder in children There is also a focus on addictions to alcohol, drugs, and problem gambling at the former ARF site. CAMH also has a Law and Mental Health Programme (forensic psychiatry and forensic psychology) and is a major research centre.

CAMH is a teaching hospital with central facilities located in Toronto and 10 community locations throughout the province of Ontario. CAMH is fully affiliated with the University of Toronto and is a Pan American Health Organization and World Health Organization Collaborating Centre.

Facilities

CAMH was formed from the 1998 merger of the Queen Street Mental Health Centre with the Clarke Institute of Psychiatry, Addiction Research Foundation, and Donwood Institute.[3] The main part of the hospital is at 1001 Queen Street, on the site of what was the Provincial Lunatic Asylum that opened in 1850.

Queen Street Mental Health Centre

Queen Street Asylum for the Insane, 1910

The Provincial Lunatic Asylum opened on January 26, 1850. It was subsequently re-named Asylum for the Insane, then Hospital for the Insane, then Ontario Hospital (1919), and then the Queen Street Mental Health Centre (1966). It had also been called the Toronto Lunatic Asylum and 999 Queen Street West.[4][5]

The original buildings were constructed in a series of rigid lines and sharp angles, consistent with the belief at the time that orderly physical structure would facilitate orderly mental states for the patients. High walls segregated the patients from the community, establishing a long-standing stigma about the facility[6] Integration the hospital grounds into the surrounding community was emphasized as a goal for CAMH's redevelopment project.

Reforms were made after a series of deaths at the Queen Street Mental Health Centre and newspaper accounts of involuntary drug treatment, electroshock therapy, and prison-like conditions.[7][8]

Clarke Institute of Psychiatry

CAMH College Street site

The hospital was founded in 1966 and named the Clarke Institute of Psychiatry, after Charles Kirk Clarke, a pioneer in mental health in Canada.

The former Clarke Institute building is now referred to as the College St. site of CAMH.

Addiction Research Foundation

The Addiction Research Foundation (ARF), then named the Alcoholism Research Foundation was founded in 1949, when H. David Archibald, who had studied at the School of Alcohol Studies at Yale University, was hired by the Liquor Control Board of Ontario. His mandate was to determine the scope of alcoholism in Ontario. He was named executive director when ARF opened and remained in that post until 1976. Focusing initially on outpatient treatment, their first facility was Brookside Hospital in 1951, expanding to branch offices and new locations in 1954, the same year they set up in-house research. In 1961, formally renamed the Alcoholism and Drug Addiction Research Foundation of Ontario, ARF expanded its mission to include drugs. In 1971, they expanded to a clinical teaching hospital called the Clinical Research and Treatment Institute. In 1978 ARF opened the School for Addiction Studies and expanded their international role in policy development and research. Following provincial hospital restructuring in the 1990s, ARF was folded in 1998 into CAMH.[9]

Donwood Institute

Founded by physician R. Gordon Bell in 1967,[10] it had 47 beds and a 4-month waiting list in the 1980s. Focusing on substance abuse, boasted a 65% recovery rate for general population and an 85% recovery rate for physicians.[11]

CAMH redevelopment

The Queen Street site of CAMH has been undergoing a three phase redevelopment plan with four goals: 1) Deliver a new model of care and provide a healthy environment that promotes recovery; 2) Bring together the best research, clinical, education, health promotion, and policy experts in one place to change the future of mental health and addictions; 3) Revitalize the City of Toronto by opening up their site and by creating an inclusive new nine-block neighbourhood that benefits all and, 4) Change attitudes by breaking down barriers to eliminate the stigma of mental health.[12]

The Campbell Family Mental Health Research Institute was established with a $30 million donation in 2011 from Linda Campbell, Gaye Farncombe, and Susan Grange, each granddaughters of Canadian magnate Roy Thomson and nieces of Ken Thomson. CAMH CEO, Catherine Zahn, said research on the brain is the most promising pathway to progress in mental illness research.[13]

In 2012, CAMH announced the completion of three new buildings: the Bell Gateway Building for the central administration, a utilities and parking building, and the Intergenerational Wellness Centre which includes 12 new beds for youth ages 14-18.[14]

In 2012, Margaret McCain, the former lieutenant-governor of New Brunswick and widow of McCain Foods cofounder Wallace McCain, donated $10 million to CAMH to establish the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health.[15]

CAMH opened the Gerald Sheff and Shanitha Kachan Emergency Department, in 2014, funded by a $2.5 million donation from the named couple and $4.2 million grant from the Ontario Ministry of Health and Long-Term Care.[16]

Rent increase

In 2015, CAMH’s facilities at the College St. site were put in jeopardy following notice of a rent increase from $1.2 million to $4 million per year, at the renewal of its 20 year lease.[17][18] CAMH valued its property at $25million, whereas Brookfield valued it at $100million, which would cause the hospital’s. The hospital’s landlord, Brookfield Asset Management, turned down CBC’s interview requests. A government arbitrator was appointed who valued the properly at $55 million, yielding a rent increase that CAMH was reportedly able to pay.[19]

Policy on sale of alcohol

CAMH policy opposes the privatization of alcohol sales, citing evidence that the increase in availability increases alcohol-related harms and associated costs. They supported that the Liquor Control Board of Ontario should maintain its monopoly on alcohol sales.[20] CAMH referred to “the plan to allow the sale of VQA wines at farmers’ markets across the province” as “cause for concern” because it would increase access to alcohol.[21] Similarly, together with other health organizations, CAMH called for a provincial alcohol strategy, ahead of Ontario’s plan to permit the sale of beer in grocery stores.[22]

Policy on legalization of marijuana

In a 2014 policy document, CAMH expressed support for the legalization of marijuana with strict control regulations. [23] According to CAMH's director of social and epidemiological research, Jurgen Rehm, "There should be a government monopoly on sales. There should be a minimum age for purchase and consumption. There should be controls on availability. There should be … a ban on marketing, advertising and promotion and plain packaging."

According to CAMH CEO, Catherine Zahn, "Only through legalization can we implement a public-health approach, treating cannabis use as a health issue and not one to be addressed through law enforcement and the court system. This is the approach we take with tobacco and alcohol. As with alcohol, a legal cannabis market can be regulated with controls that address risk factors associated with use"[24]

Workplace safety issues

In 2007, following a series of attacks on staff by patients, the Ontario Ministry of Labour asked CAMH to develop a workplace violence and policy program. In 2008, the Ministry of Labour laid nine workplace safety charges against CAMH in response to allegations by staff that they had been attacked by patients.[25] CAMH was fined $70,000 in 2009 for two attacks against nursing staff in 2007 and 2008.[26] In 2014, the Ontario Ministry of Labour laid charges against CAMH for failing to protect workers from workplace violence following an attack earlier that year.[27]

Child Gender Identity Clinic

Psychiatrist Susan Bradley founded a clinic in CAMH to work with gender dysphoric children, youth who believe they are or want to live as the other sex. Bradley collaborated for many years with psychologist Kenneth Zucker, and they established the clinic as the largest gender identity service in Canada and an international center for research.[28] In their studies, 80% of the children grow out of the behavior. They therefore different approaches with children than adolescents because, over time, children are more likely, over time, to identify with their birth sex.[29]

Regarding adolescents, Zucker “will support a teenager or adult who wants to transition using hormones and surgeries.”[30] Regarding children, however, Zucker says “We are trying to help a child feel more comfortable with the gender identity that matches their birth sex” and that they use a variety of techniques to “help a child think more flexibly” about their gender. According to the New York times, Zucker does this by "encouraging same-sex friendships and activities like board games that move beyond strict gender roles."[31] He said a child could be asked to make a list of pros and cons about being different genders so that the child realizes that “there are both good and not so good things about being a boy and being a girl.”[32]

Activists have criticized Zucker’s approach, claiming that it amounts to reparative therapy.[33] In 2015, following complaints from activists, CAMH commissioned an external review of the clinic.[34] The review was inconclusive, reporting it “cannot state that the clinic does not practice reparative approaches.”[35] Upon the release of the report, CAMH announced that it was closing the clinic and that Zucker was no longer at CAMH.[36] Activists celebrated the news, calling upcoming community consultations “a major step toward establishing a service that will support families, and hopefully receive government funding to do so.”[37] A petition of over 500 sexuality and gender diversity experts decried it,[38] calling CAMH’s decisions “politically motivated” and showing an “indifference to research and scholarship.” [39]

Mood and Anxiety Clinic

Soon after CAMH was founded, its administration was embroiled in a scandal involving Eli Lilly, who donated $1.5 million to CAMH, and Dr. David Healy, a prominent critic of Prozac, the widely used antidepressant manufactured by Lilly. CAMH hired Healy to be the head of its Mood and Anxiety Program, but withdrew the job offer after hearing about Healy’s views.[40]

CAMH aggressively recruited Healy, and CAMH Physician-in-Chief, David Goldbloom, offered Healy a job as the head of the Mood and Anxiety Program. Healy accepted and soon after gave a lecture in which he reiterated his views about Prozac increasing risk of suicide. A few days later, Goldbloom withdrew the job offer, saying “Essentially, we believe that it is not a good fit between you and the role as leader of an academic program in mood and anxiety disorders at the centre and in relation to the university….We do not feel your approach is compatible with the goals for development of the academic and clinical resource that we have.”[41]

The decision caused an “uproar” among Canadian academics, with the Canadian Association of University Teachers calling CAMH actions “an affront to academic freedom in Canada.”[42] Scientists from 13 countries, including Nobel laureates Julius Axelrod and Avid Carlsson, protested CAMH’s actions[43] as did the Society for Academic Freedom and Scholarship (SAFS).[44]

Healy sued CAMH and the University of Toronto, alleging breach of contract, defamation, and denial of academic freedom. The lawsuit sought damages of $9.4 million, including $2.6 million from CAMH CEO Paul Garfinkel, and $1.4 million from the U of T Dean of Medicine.[45] The university distanced itself from CAMH: According to U of T President, Robert Birgeneau, “Everyone is trying to blame the university for something that happened at one of our hospitals.”[46]

The lawsuit was settled with Healy receiving an appointment as visiting professor as the University of Toronto. The president of the Canadian Association of University Teachers, Vic Catano, said “We see the settlement as a complete vindication for Dr. Healy.”[47]

References

  1. ^ http://www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/CAMH_quick_facts.aspx
  2. ^ Globe & Mail. (November 4, 2009). http://www.globeportfolio.ca/servlet/AppNoticeArticleHTMLTemplate?tf=GlobeInvestor/AppNotices/DisplayNotice.html&cf=GlobeInvestor/AppNotices/config-neutral.cfg&slug=Zahn&date=20091104
  3. ^ Scrivener, Leslie (February 25, 2007). Breakout at the asylum. Toronto Star
  4. ^ Everett, Barbara (2000). A Fragile Revolution: Consumers and Psychiatric Survivors Confront the Power of the Mental Health System. Wilfrid Laurier University Press. ISBN 0-88920-342-3
  5. ^ http://torontoist.com/2015/02/the-ongoing-evolution-of-camh/
  6. ^ http://torontoist.com/2015/02/the-ongoing-evolution-of-camh/
  7. ^ Goar, Carol (June 13, 2008). Mental health progress and pain.Toronto Star
  8. ^ (January 1, 2002). No straitjacket required: a growing and vocal group of psychiatric survivors argues that diagnosing mental disorders is just a way to stifle social dissent ... This Magazine
  9. ^ Blocker JS, Fahey DM, Tyrrell IR. Alcohol and temperance in modern history: an international encyclopedia. ABC-CLIO 2003. ISBN 1-57607-833-7 pp. 3–4.
  10. ^ "Dr. Bell's Legacy".
  11. ^ Shilliday, Greg (May 15, 1983). The Donwood Institute: resort of last resort. Can Med Assoc J. 1983 May 15; 128(10): 1220–1221.
  12. ^ http://www.camh.net/News_events/Redeveloping_the_Queen_Street_site/index.html
  13. ^ http://toronto.ctvnews.ca/camh-gets-monumental-30m-donation-for-research-centre-1.732526
  14. ^ CBC News. (Jun 21, 2012 ) Toronto's 'new' Centre for Addiction and Mental Health opens. http://www.cbc.ca/news/canada/toronto/toronto-s-new-centre-for-addiction-and-mental-health-opens-1.1195031
  15. ^ The Canadian Press. (April 25, 2012) Margaret McCain donates $10 million to CAMH. http://toronto.ctvnews.ca/margaret-mccain-donates-10-million-to-camh-1.801326
  16. ^ Hilary Caton. (Nov 04, 2014) CAMH officially opens new $7-million psychiatric emergency department. Inside Toronto. http://www.insidetoronto.com/news-story/4959156-camh-officially-opens-new-7-million-psychiatric-emergency-department/
  17. ^ Jamie Strashin. CAMH says crippling rent increase puts College Street location in jeopardy: Coun. Joe Cressy says property owner using 'bully tactics'. CBC News. (July 7, 2015) http://www.cbc.ca/news/canada/toronto/camh-says-crippling-rent-increase-puts-college-street-location-in-jeopardy-1.3140424
  18. ^ Geoffrey Vendeville. (Jul 07 2015). Toronto Star. http://www.thestar.com/news/gta/2015/07/07/sudden-rent-hike-puts-camh-college-st-facility-in-jeopardy.html
  19. ^ CBC News. (November 19, 2015). CAMH 24-hour College Street location will likely stay. http://www.cbc.ca/news/canada/toronto/camh-stay-college-street-location-1.3326002
  20. ^ http://www.camh.ca/en/hospital/about_camh/influencing_public_policy/Documents/Submission_to_PACGA_2014-08-28.pdf
  21. ^ http://www.camh.ca/en/hospital/about_camh/influencing_public_policy/Documents/JointSubmission-VQAwine_in_farmers_markets_2014-03-21.pdf
  22. ^ Carly Weeks. Why Canada needs a new alcohol strategy. The Globe and Mail. October 2, 2015. http://www.theglobeandmail.com/life/health-and-fitness/health/alongside-marijuana-debate-new-alcohol-strategy-needed/article26633423/
  23. ^ CBC News. (October 9, 2014). CAMH calls for legalization of marijuana. http://www.cbc.ca/news/canada/toronto/camh-calls-for-legalization-of-marijuana-1.2793460
  24. ^ Catherine Zahn. Ottawa Citizen. (October 20, 2014) http://ottawacitizen.com/news/national/catherine-zahn-legalization-is-the-best-approach-to-cannabis-control
  25. ^ "CAMH Hit With Nine Workplace Safety Charges". The Globe and Mail. November 26, 2008.
  26. ^ "CAMH Fined for Failing to Protect Nurses". CBC News Toronto. August 14, 2009.
  27. ^ "Reports of Assaults and Violence Toward Nurses Rising, Statistics Show". Metro News. July 1, 2015.
  28. ^ Tara Paterson (February 21, 2015). National Post. http://news.nationalpost.com/life/as-trans-issues-become-mainstream-question-of-how-to-address-variant-gender-expression-comes-to-forefront
  29. ^ Brown, Patricia Leigh (December 2, 2006). "Supporting Boys or Girls When the Line Isn't Clear". The New York Times.
  30. ^ http://news.nationalpost.com/life/as-trans-issues-become-mainstream-question-of-how-to-address-variant-gender-expression-comes-to-forefront
  31. ^ http://www.nytimes.com/2006/12/02/us/02child.html?pagewanted=2
  32. ^ http://news.nationalpost.com/life/as-trans-issues-become-mainstream-question-of-how-to-address-variant-gender-expression-comes-to-forefront
  33. ^ Erica Lenti. (June 25, 2015) CAMH Supports Bill 77 Despite Criticism of Controversial Gender Identity Clinic. Torontoist. http://torontoist.com/2015/06/camh-supports-bill-77-despite-criticism-of-controversial-gender-identity-clinic/
  34. ^ Jessica Smith Cross. March 18, 2015) Outcry prompts CAMH to review its controversial treatment of trans youth. Toronto Metro. http://www.metronews.ca/news/toronto/2015/03/18/outcry-prompts-camh-to-review-its-controversial-treatment-of-trans-youth.html
  35. ^ Tracy Clark-Flory. (January 13, 2016). Shuttered Clinic Highlights Controversy Over Trans Children: A petition attacks the closure of a children's center accused of "conversion therapy". Vocativ. http://www.vocativ.com/news/270004/shuttered-clinic-highlights-controversy-over-trans-children/
  36. ^ Sheryl Ubelacker (December 16, 2015). CAMH to ‘wind down’ gender identity clinic after damning review. Global News. http://globalnews.ca/news/2404068/camh-to-wind-down-gender-identity-clinic-after-damning-review/
  37. ^ Jake Pyne. (December 17, 2015). Toronto Star Opinion. http://www.thestar.com/opinion/commentary/2015/12/17/discredited-treatment-of-trans-kids-at-camh-shouldnt-shock-us.html
  38. ^ Sheryl Ubelacker. (January 23, 2016) Group protests closure of youth gender identity clinic at CAMH, director’s removal. Global News. http://globalnews.ca/news/2473568/group-protests-closure-of-youth-gender-identity-clinic-at-camh-directors-removal/
  39. ^ http://www.vocativ.com/news/270004/shuttered-clinic-highlights-controversy-over-trans-children/
  40. ^ Sarah Boseley. (May 7, 2001) Bitter pill. The Guardian. http://www.theguardian.com/education/2001/may/07/medicalscience.highereducation
  41. ^ Sarah Boseley. (May 7, 2001) Bitter pill. The Guardian. http://www.theguardian.com/education/2001/may/07/medicalscience.highereducation
  42. ^ http://www.theguardian.com/education/2001/may/07/medicalscience.highereducation
  43. ^ Times Higher Education. (September 28, 2001) Rejected lecturer is suing Toronto. https://www.timeshighereducation.com/news/rejected-lecturer-is-suing-toronto/165048.article
  44. ^ http://www.safs.ca/issuescases/camh.html
  45. ^ Larissa Ruderman. Exclusive: Dr. David Healy interview. The Varsity. http://thevarsity.ca/2001/11/26/exclusive-dr-david-healy-interview/
  46. ^ https://www.timeshighereducation.com/news/rejected-lecturer-is-suing-toronto/165048.article
  47. ^ David Spurgeon. (2002 May 18). Psychiatrist settles dispute with Toronto University. British Medical Journal. 324(7347), page 1177. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1174757/

External links

43°38′40″N 79°25′03″W / 43.64455°N 79.41761°W / 43.64455; -79.41761

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