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Need for permanent chief medical officer of health 'dire,' says Alberta Medical Association

Need for permanent chief medical officer of health 'dire,' says Alberta Medical Association

Yahoo03-05-2025
Alberta's health minister says the search for a permanent chief medical medical officer of health is in the early stages, prompting concerns about health leadership as the province continues to battle its worst measles outbreak in nearly three decades.
The total number of confirmed cases since the outbreaks began in March surged to 210 on Friday. That's the highest case count since 1997, when 242 cases were reported.
The escalating case numbers come at a time when the province is without a permanent top doctor.
The provincial government appointed an interim chief medical officer of health after Dr. Mark Joffe opted not to renew his contract in mid-April. He had been in the role since November 2022.
Joffe left as calls grew for him to take to the podium and speak directly to Albertans about the measles outbreaks. At the time, doctors raised concerns about whether he was allowed to speak publicly on the matter.
The province has not yet found a permanent replacement.
"I think the need to get someone who has expertise in the role is dire," said Dr. Shelley Duggan, president of the Alberta Medical Association.
"It could be tricky. But I think it's important. There's lots of people trained in public health. We need to get somebody in Alberta. And we need to let them develop a campaign and work with their team to get the messaging out."
When asked by CBC News about the search for a replacement, Health Minister Adriana LaGrange did not say how much interest there is in the job. Nor did she say how many candidates have been interviewed.
"We're at the initial stages of the search," she said at a news conference on Thursday.
"We were quite hopeful that Dr. Joffe would have extended his contract. Since that hasn't happened, we are just at the initial stages of the search. And I'll keep you posted as we go along this road."
When it comes to concerns about how the province will handle its surging measles cases without a permanent CMOH in place, she said she's confident in the work of the public health teams.
"It's the local [medical officers of health] that are in the communities, that are on the ground working with those communities, that are most affected. They report up to the CMOH. So there's obviously a lot of interaction that happens."
LaGrange said measles immunizations have increased this year compared to last year due to the work of those teams.
When asked if she ever refused to greenlight any requests Joffe made about how to handle the measles outbreak, LaGrange did not answer directly, noting instead that she had many conversations with him about how to reach impacted communities.
"There are hot spots, but we do not have a provincial outbreak of measles," she said when pressed further.
"Recruitment and retention of qualified public health leaders and health leaders, in general in this province, has become increasingly difficult," said Lorian Hardcastle, associate professor in the faculty of law and the Cumming School of Medicine at the University of Calgary.
She said concerns about politicization of public health could be a deterrent.
"And given the revolving door of public health officials — of [Alberta Health Services] CEOs, of the AHS board — I think it's going to be difficult to recruit and retain qualified people to these kinds of roles in this province."
It's problematic, she said, to be facing measles outbreaks with people moving in and out of the job.
"You don't want to have those transitions in the context of a public health crisis. You want consistent, clear messaging from the same trusted authority. And I don't think they're positioned to do that."
The Alberta NDP said it, too, is skeptical about Alberta's ability to recruit a new top doctor.
"[Premier Danielle Smith] ran a leadership campaign showing disrespect to science, to public health, to experts, and it continues. And now she's got control over that office and it's caused a lot of chaos," said NDP health critic Sarah Hoffman, adding she's not surprised a permanent replacement is not in place.
"It is concerning because there should be separation between those who are in charge of gathering evidence and those who are in controlling political messaging."
Changes coming about through the UCP government's health system overall could be a further deterrent, according to Hoffman.
Bill 55, the Health Statutes Amendment Act, was tabled on Thursday. If passed, zone medical officers of health who are now part of Alberta Health Services will move to Alberta Health.
The plan has sparked concern about the consolidation of decision-making power — for matters relating to the health of Albertans — within the ministry.
"It is really important that we have experts that are entrusted to give their very best advice and direction. And when you're within the department, you don't have that same independence," said Hoffman.
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AISH recipients panicked over looming provincial deadline: health providers
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AISH recipients panicked over looming provincial deadline: health providers

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Debate on forced mental health treatment continues as one woman's costs top $800K
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Debate on forced mental health treatment continues as one woman's costs top $800K

In the fight to better help people with severe and persistent mental illness in Ontario — which can sometimes result in costly detention in jails and hospitals — two opposing camps are lobbying the Ministry of Health in very different directions. On one side are those who think unwell patients are given too much freedom to reject treatment, putting them at risk of having their mental illnesses progress and become entrenched. On the other side are the patient advocates who say there are already enough mechanisms to force treatment on people, that giving patients the help they ask for leads to better outcomes, and that insufficient community support is the real problem. Meanwhile, health and justice systems as they exist today can spend much to achieve little. In one woman's ongoing case, a CBC News analysis estimates the costs since 2018 at $811,600 — and counting. She has bipolar I disorder, characterized by episodes of extreme emotional highs that last at least a week, followed by depression. Click here for source data Yet despite Barbara Cleary's dozens of stints in hospital psychiatric wards, emergency housing, jail cells and living rough — as well as brief periods of stability and several months in an assisted living facility last year — today the 76-year-old is again unhoused, living in a tent encampment in Cornwall, Ont., continuing the cycle. 'An extremely high cost to the system' "It is an extremely high cost to the system when people are unwell," said Dr. Karen Shin, chief of psychiatry at St. Michael's Hospital for Unity Health Toronto and chair of the Ontario Psychiatric Association. "And you have to remember, she's one person. If you went in and reached out to any psychiatrists in the system that are working in a hospital, they can tell you numerous people they care for that have a similar story." Cornwall police say they're dealing with 20 people like Cleary on a daily basis. The force picked five individuals from that group and found each averaged 53 occurrences requiring police response in 2024. So, what to do? Shin founded and co-leads the Ontario Psychiatric Association's mental health and law reform task force, which is calling on the province to expand forced treatment in certain circumstances. From her organization's perspective, some forced care protects the right to health for vulnerable people whose illnesses can cause delusional thinking. "Choice is extremely important, but that choice has to be a capable choice, and a capable choice needs to include that there's an understanding of the symptoms of the illness and the consequences of saying, 'No, I don't want treatment,'" Shin said. The task force wants the province to: Permit treatment during a patient's court appeal after the Consent and Capacity Board upholds a finding that they're incapable of making a decision. Remove the requirement that people have had to respond to treatment in the past from involuntary admission criteria under the Mental Health Act. Extend a first involuntary admission from 14 days to up to 30 days. An organization called the Empowerment Council takes an opposing view. It says medication comes with risks that not every patient can tolerate, including the possibility of neurological damage, and that the trauma of having something forced into the body and mind can interrupt therapeutic relationships and scare people into avoiding it altogether. "Why not exhaust providing the services that evidence shows help people, rather than spending a half a million dollars on your more carceral responses?" said Jennifer Chambers, the council's executive director. "Instead, people are just in and out, in and out, and it makes no sense." Cleary spent a few months in an assisted living facility last year after CBC first covered her story. She was removed last August by police after her illness deteriorated. In late October she was arrested and charged by Cornwall police for the 23rd time, according to court records — this time for breaching probation and trespassing at her former apartment building. She spent a month and a half in jail getting back on medication before she pleaded guilty in December. She was sentenced to the time she had already served, bringing her total time in jail since 2018 to about 347 days. Near her tent encampment on Wednesday, she recalled being removed from the assisted living facility and being strapped down on a bed in an anteroom of the hospital's emergency department for half a day. "Then they admitted me for 12 days. The doctor released me onto the street again," she said. Asked what she thinks she needs, Cleary said Cornwall has only one psychiatrist and requires more, and that she needs to live with someone who can help her with things like getting around and getting dressed. Many people in the unhoused community help her out on a daily basis, she said, though in the past she has been taken advantage of by some. She wants housing, but in light of her history since 2018 it's unclear how long it would last. Chambers said Ontario used to be a leader in peer support, but that it's been first on the chopping block with funding constraints. And a transitional support system would help people adjust after being released from institutions like hospital and jail. "Peers can be really creative and supportive with just where people are, rather than concentrating so much on wrenching them into a different space against their will," she said. 'So much has changed' Shin agrees that more wrap-around social supports and services are necessary. But she also thinks Ontario's Mental Health Act needs beefing up. 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Mental health resources Do you need help, or does someone you know need help? Here are some mental health resources in the province, which differ depending on where you are: 211 Ontario maintains a database of services. You can search by topic (mental health/addictions) and your specific location. Live chat is available Monday to Friday from 7 a.m. to 9 p.m. ET, and a chatbot is available 24/7. You can also text 211, call 211 or email gethelp@ ConnexOntario is a directory of community mental health and addictions services in Ontario. You can connect with someone for information and referrals to services in your community 24/7 via 1-866-531-2600, texting "CONNEX" to 247247, live web chat or email. The Suicide Crisis Hotline can be reached 24/7 by calling or texting 988.

Debate on forced mental health treatment continues as one woman's costs top $800K
Debate on forced mental health treatment continues as one woman's costs top $800K

Yahoo

time3 days ago

  • Yahoo

Debate on forced mental health treatment continues as one woman's costs top $800K

In the fight to better help people with severe and persistent mental illness in Ontario — which can sometimes result in costly detention in jails and hospitals — two opposing camps are lobbying the Ministry of Health in very different directions. On one side are those who think unwell patients are given too much freedom to reject treatment, putting them at risk of having their mental illnesses progress and become entrenched. On the other side are the patient advocates who say there are already enough mechanisms to force treatment on people, that giving patients the help they ask for leads to better outcomes, and that insufficient community support is the real problem. Meanwhile, health and justice systems as they exist today can spend much to achieve little. In one woman's ongoing case, a CBC News analysis estimates the costs since 2018 at $811,600 — and counting. She has bipolar I disorder, characterized by episodes of extreme emotional highs that last at least a week, followed by depression. Click here for source data Yet despite Barbara Cleary's dozens of stints in hospital psychiatric wards, emergency housing, jail cells and living rough — as well as brief periods of stability and several months in an assisted living facility last year — today the 76-year-old is again unhoused, living in a tent encampment in Cornwall, Ont., continuing the cycle. 'An extremely high cost to the system' "It is an extremely high cost to the system when people are unwell," said Dr. Karen Shin, chief of psychiatry at St. Michael's Hospital for Unity Health Toronto and chair of the Ontario Psychiatric Association. "And you have to remember, she's one person. If you went in and reached out to any psychiatrists in the system that are working in a hospital, they can tell you numerous people they care for that have a similar story." Cornwall police say they're dealing with 20 people like Cleary on a daily basis. The force picked five individuals from that group and found each averaged 53 occurrences requiring police response in 2024. So, what to do? Shin founded and co-leads the Ontario Psychiatric Association's mental health and law reform task force, which is calling on the province to expand forced treatment in certain circumstances. From her organization's perspective, some forced care protects the right to health for vulnerable people whose illnesses can cause delusional thinking. "Choice is extremely important, but that choice has to be a capable choice, and a capable choice needs to include that there's an understanding of the symptoms of the illness and the consequences of saying, 'No, I don't want treatment,'" Shin said. The task force wants the province to: Permit treatment during a patient's court appeal after the Consent and Capacity Board upholds a finding that they're incapable of making a decision. Remove the requirement that people have had to respond to treatment in the past from involuntary admission criteria under the Mental Health Act. Extend a first involuntary admission from 14 days to up to 30 days. An organization called the Empowerment Council takes an opposing view. It says medication comes with risks that not every patient can tolerate, including the possibility of neurological damage, and that the trauma of having something forced into the body and mind can interrupt therapeutic relationships and scare people into avoiding it altogether. "Why not exhaust providing the services that evidence shows help people, rather than spending a half a million dollars on your more carceral responses?" said Jennifer Chambers, the council's executive director. "Instead, people are just in and out, in and out, and it makes no sense." Cleary spent a few months in an assisted living facility last year after CBC first covered her story. She was removed last August by police after her illness deteriorated. In late October she was arrested and charged by Cornwall police for the 23rd time, according to court records — this time for breaching probation and trespassing at her former apartment building. She spent a month and a half in jail getting back on medication before she pleaded guilty in December. She was sentenced to the time she had already served, bringing her total time in jail since 2018 to about 347 days. Near her tent encampment on Wednesday, she recalled being removed from the assisted living facility and being strapped down on a bed in an anteroom of the hospital's emergency department for half a day. "Then they admitted me for 12 days. The doctor released me onto the street again," she said. Asked what she thinks she needs, Cleary said Cornwall has only one psychiatrist and requires more, and that she needs to live with someone who can help her with things like getting around and getting dressed. Many people in the unhoused community help her out on a daily basis, she said, though in the past she has been taken advantage of by some. She wants housing, but in light of her history since 2018 it's unclear how long it would last. Chambers said Ontario used to be a leader in peer support, but that it's been first on the chopping block with funding constraints. And a transitional support system would help people adjust after being released from institutions like hospital and jail. "Peers can be really creative and supportive with just where people are, rather than concentrating so much on wrenching them into a different space against their will," she said. 'So much has changed' Shin agrees that more wrap-around social supports and services are necessary. But she also thinks Ontario's Mental Health Act needs beefing up. "So much has changed with our knowledge of mental health care, the importance of access to treatment, the concerns around repeated episodes of illness and how that leads to more intractable illness, how it can lead to medications not working as well," she said. "Most jurisdictions consider the potential risks and harms related to treatment refusal. They have legislative safeguards to ensure involuntary admission is with treatment, so that people get the treatment they need and are not indefinitely detained untreated." The provincial ministries of health and the attorney general, which oversees the justice system, have not responded to repeated requests for comment. Where our numbers come from According to figures provided by the Cornwall hospital about how much it costs to run its short-term crisis housing program ($100,000 per bed, per year), it cost about $14,600 to fund her bed for seven weeks this past winter. Mental health resources Do you need help, or does someone you know need help? Here are some mental health resources in the province, which differ depending on where you are: 211 Ontario maintains a database of services. You can search by topic (mental health/addictions) and your specific location. Live chat is available Monday to Friday from 7 a.m. to 9 p.m. ET, and a chatbot is available 24/7. You can also text 211, call 211 or email gethelp@ ConnexOntario is a directory of community mental health and addictions services in Ontario. You can connect with someone for information and referrals to services in your community 24/7 via 1-866-531-2600, texting "CONNEX" to 247247, live web chat or email. The Suicide Crisis Hotline can be reached 24/7 by calling or texting 988.

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