"The people at PEPP helped me
understand that I was sick,
and that they could help."

Mental Health Care Program

The Mental Health Care Program at LHSC offers a wide range of services, reflecting the diversity of our clients as well as the range of skills of our staff and physicians. The program's main focus has always been, and will continue to be, on providing the best in patient care.

Our mental health care teams provide evidence-based, compassionatecare in partnership with other LHSC and community programs. We offer inpatient and outpatient services for adults, adolescents and children.

Our adult services include: centralized emergency psychiatry, coordinated intake, consultation-liaison, general adult ambulatory, geriatric outreach, inpatient, prevention and early intervention in psychosis, traumatic stress, andurgent consultation.

For adolescents and children our services include: day treatment, inpatient, outpatient, urgent consultation, eating disorders and outreach.

maybe that
could be me

The day that Fanshawe College student Andrew Minderlein walked through a busy downtown intersection with his eyes closed, is the day that he knew he needed help.

Living on the streets for weeks after leavinghis family home because of paranoid thoughts, Andrew was battling psychosis and feeling totally isolated from the world.

"The first time I got sick I was getting really bizarre ideas and images in my head," says Andrew. "I knew something didn't feel right."

Andrew walked into London's Youth Action Centre, and counselors there made the call to the Mental Health Crisis Line. Andrew admitted himself with the support of the Youth Action Centre Team to LHSC's Inpatient Mental Health Program at the age of 19.

Having been on and off the streets since 15, Andrew was no stranger to hard times andhard luck. His anger and moodiness causedhis mother to put him on a plane to live withhis dad in London when he was 14. The fighting with his father started immediately and within a few months Andrew found himself living in a halfway house for boys.

"Before I got sick, I was in and out of halfway houses, group homes and shelters. I even moved back home a few times, but eventually I would be out again," Andrew says.

Lori Hassall, the PEPP (Prevention and Early Intervention in Psychosis Program), Inpatient Social Worker at the time, was among the first of Andrew's healthcare providers to see him when he admitted himself in 2002. Because of the symptoms Andrew was exhibiting, he was referred to the program for assessment.

"When I first met Andrew he was extremely paranoid and scared. He thought everyone was against him. He was trying to talk clearly but his thoughts were racing. It was really difficult for him to communicate," Hassall remembers.

Hassall called Andrew's father and stepmother right away. Andrew had been out of their house for only a number of weeks this time.

"I was on the streets, but I shouldn't have been," Andrew reflects now. "I had a place to live, but I had become so paranoid and angry that I just couldn't live there anymore. And they couldn't live with me."

After assessment by the interdisciplinary team, Andrew was immediately accepted into PEPP. The program targets patients between 16 and 50 who have experienced a psychotic disorder for the first time. A psychiatrist and case manager work with the client to provide a plan for integrated medical and psychosocial treatment. The program also provides recreation and therapeutic groups, supported employment counseling, psychological services and assistance getting connected with services such as income support, housing and school.

Andrew remained in hospital for one monthand had daily visits from Hassall. On one visit she brought him strips of cardboard and cans of paint after Andrew expressed an interest in art.

"When I returned the next day, Andrew had plastered his walls with his artwork," Hassall says. "The room was covered with bright, abstract designs. I looked around and thought, boy, there is an artist here."

After Andrew left LHSC, he worked withCheryl Taylor, his case manager, to find housing in London. Taylor got Andrew into Piccadilly House, affectionately known as the ‘Pic House' by its residents, a transition house for patients coming from the hospital to the community. There Andrew learned about personal finance and paying rent.

As part of PEPP, Andrew had regular sessions with Taylor and Dr. Sandra Northcott, one of the program psychiatrists. These sessions helped him find the right medication, and understand his illness. Andrew's team also helped bridge the gap with his dad.

"It is normal for family and social relationships to be altered when a person gets sick. Some clients are fearful to disclose what they are feeling for fear that the other person won't understand. We work with the people closest to our clients to help them understand what being sick means," Hassall says.

Andrew's dad and stepmom provided Andrew's PEPP team with information about Andrew's history and development. Both were very supportive of Andrew getting help and eager to be educated on the mental health issues affecting their son, and how they could support him in getting well.

"I understand now how scary the whole time must have been for them," Andrew says. "They didn't know what was going on and didn't have a clue as to how to react."

A PEPP client for over five years, Andrew has had two relapses. Stress and individual responses to medication often play a role in increasing patients' symptoms. Andrew realizes that his relapses may have come from not taking his medication, but he says he didn't initially understand the need for continuing to take the medication.

"Many patients feel they are doing so well that they don't need their medication anymore," Hassall explains. Andrew now says that he won't make that mistake again and takes his medication faithfully.

Andrew has also found satisfaction in volunteering for PEPP. He is the volunteer co-lead of the PEPP Recovery through Activity and Participation group (RAP) for new patients in the program. He also volunteers for the Art, Music and Healthy Living groups. Andrew enjoys arranging social outings and planning events for the groups. He encourages other clients to start socializing again, understanding how important this is for those who may have chosen to be isolated for so long.

Andrew is so involved in PEPP activities that many clients think that he is a staff member. He is always available to listen or tell his story.

"I remember when I was sick how good it was to hear that other people had gone through the same things," Andrew reflects.

Working with new clients and staying on his medication are helping keep Andrew well. He recently sat on an interview panel for the new Supported Employment Counselor in the program and has given presentations to medical students about his experiences to provide them with a better understanding of mental illness. "Andrew has had setbacks, but looking at all he has achieved, he offers hope. New clients see him doing well and think, hey, maybe that could be me," Hassall says.

With the help of PEPP's employment counselor, Shawna Molinaro, Andrew has been working as a custodian at a local fitness club for the past three months. After moving from place to place for so long, he is now happily living in his own apartment.

"I would really like a cat, but for now, I'm just concentrating on taking care of my plants," Andrew says.

Between volunteering, school and work, Andrew's life is busy, but balanced. He is grateful for finding PEPP and for working with the program to get well.

"Getting sick – some people make it sound like getting a cold or something. It's not. The people at PEPP helped me understand that I was sick, and that they could help," he says.

Andrew hopes to volunteer for PEPP for a long time to come and is excited about his future. He is submitting some of his paintings to the PEPP Creative Minds Art Show, and is planning a trip out west to see his mom. His relationship with his dad and stepmom is better and he looks forward to their family dinners on the weekend.

"I am just grateful that I have options," Andrew says. "Being part of PEPP has given me that."

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