OTTAWA - Interim Liberal leader Bob Rae is calling for a public inquiry to get to the root of the tragedy that befell Ashley Smith, the troubled teen who choked to death in her prison cell as guards stood watch.
And he wants the inquiry to go beyond the particulars of Smith's death to expose the general inability of the prison system to cope with mentally ill offenders.
Rae made the call Thursday after concluding the government of Prime Minister Stephen Harper won't on its own reveal everything it knows about the Smith case.
He expressed frustration that the Conservative government has not responded to his repeated questions as to whether more videos exist documenting the mistreatment of Smith and other mentally ill offenders.
Since the release last week of two disturbing videos showing Smith being restrained with duct tape and injected with powerful anti-psychotic drugs against her will, the government has said it's ordered corrections officials to co-operate fully with a coroner's inquest into Smith's death.
That's sufficient to ensure the inquest will get to the bottom of the tragedy, Public Safety Minister Vic Toews suggested Thursday.
"This matter is being dealt with in a public forum and in a fully transparent way," he told the House of Commons.
But Rae said that's not enough, since the inquest is only empowered to look into the last 12 months of Smith's five years in custody.
"The government must have other videos of Ashley Smith in its possession. It's inconceivable that it would only have two and none others. It must have some that relate to all her period in prison," Rae said later outside the Commons.
"And secondly, it defies logic to think that they only have two videos of one patient or one client of the system."
Based on calls and letters received by Liberals, Rae said there are evidently numerous other cases in which mentally ill offenders have been mistreated.
"And I'm saying if (corrections officials) kept video evidence with respect to how they treated Ashley Smith, they must be sitting on a ton of other evidence."
NDP public safety critic Randall Garrison pointed out that correctional investigator Howard Sapers and his staff reviewed more than 60 hours of video tapes regarding Smith's treatment while in custody before making recommendations two years ago aimed at preventing another similar tragedy.
Among other things, Sapers recommended that the correctional service update and publicize a mental health strategy, allocate resources to fully fund it and implement it by the end of 2012.
Garrison urged Toews to commit to implementing those recommendations immediately. Toews did not directly respond.
He reiterated the government's line that the mentally ill do not belong in prison and that it has taken "concrete steps" since 2006 — including an investment of $90 million — to improve access to mental health treatment and train corrections staff.
In a recent interview with CTV's Question Period, Sapers said there were 160 "use of force" incidents involving Smith during the 11-and-a-half months she spent in federal custody. Following her death, he said he examined nine other in-custody deaths and found "some very similar circumstances and patterns of behaviour."
Smith, was first arrested at 13 for assault and causing a disturbance. She got into more trouble for making harassing phone calls and pulling a fire alarm and was finally thrown in jail at age 15 for throwing crab apples at a postal worker.
She was bounced around to various prisons across the country. Much of her final year of life was spent in segregation due to numerous instances of self-harm and choking herself.
Smith died at age 19 at a prison in Kitchener, Ont., after wrapping a strip of cloth around her neck and strangling herself. Guards who were standing watch outside her cell did not step in. They've said they were instructed not to intervene unless Smith stopped breathing.
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Seasonal Affective Disorder (SAD) is most commonly associated with winter blues, and it afflicts about 5 percent of Americans. But for less than 1 percent of those people, this form of depression strikes in the summer. Warm weather depression arises when the body experiences a "delay adjusting to new seasons," says Alfred Lewy, MD, professor of psychiatry at Oregon Health and Science University, in Portland. Instead of waking and enjoying dawn, the body has a hard time adjusting, he says, which could be due to imbalances in brain chemistry and the hormone melatonin. <strong>More from <a href="http://www.Health.com" target="_hplink">Health.com</a>:</strong> <a href="http://www.health.com/health/gallery/0,,20419609,00.html" target="_hplink">10 Tips for Dating With Depression</a> <a href="http://www.health.com/health/gallery/0,,20483493,00.html" target="_hplink">The Most Depressing States in the U.S.</a> <a href="http://www.health.com/health/gallery/0,,20428990,00.html" target="_hplink">Depressing Jobs: Career Fields With Hight Rates of Depression</a>
Smoking has long been linked with depression, though it's a chicken-or-egg scenario: People who are depression-prone may be more likely to take up the habit. However, nicotine is known to affect neurotransmitter activity in the brain, resulting in higher levels of dopamine and serotonin (which is also the mechanism of action for antidepressant drugs). This may explain the addictive nature of the drug, and the mood swings that come with withdrawal, as well as why depression is associated with smoking cessation. Avoiding cigarettes -- and staying smoke free -- could help balance your brain chemicals.
When the thyroid, a butterfly-shaped gland in the neck, doesn't produce enough thyroid hormone, it's known as hypothyroidism, and depression is one of its symptoms. This hormone is multifunctional, but one of its main tasks is to act as a neurotransmitter and regulate serotonin levels. If you experience new depression symptoms -- particularly along with cold sensitivity, constipation and fatigue -- a thyroid test couldn't hurt. Hypothyroidism is treatable with medication.
Poor Sleep Habits
It's no surprise that sleep deprivation can lead to irritability, but it could also increase the risk of depression. A 2007 study found that when healthy participants were deprived of sleep, they had greater brain activity after viewing upsetting images than their well-rested counterparts, which is similar to the reaction that depressed patients have, noted one of the study authors. "If you don't sleep, you don't have time to replenish [brain cells], the brain stops functioning well, and one of the many factors that could lead to is depression," says Matthew Edlund, M.D., director of the Center for Circadian Medicine, in Sarasota, Fla., and author of "The Power of Rest."
Spending too much time in chat rooms and on social-networking sites? A number of studies now suggest that this can be associated with depression, particularly in teens and preteens. <a href="http://news.health.com/2010/02/03/internet-addicts-more-prone-depression/" target="_hplink">Internet addicts</a> may struggle with real-life human interaction and a lack of companionship, and they may have an unrealistic view of the world. Some experts even call it "Facebook depression." In a 2010 study, researchers found that about 1.2 percent of people ages 16 to 51 spent an inordinate amount of time online, and that they had a higher rate of moderate to severe depression. However, the researchers noted that it is not clear if Internet overuse leads to depression or if depressed people are more likely to use the Internet.
End Of A TV Show Or Movie
When something important comes to an end, like a TV show, movie, or a big home renovation, it can trigger depression in some people. In 2009, some "Avatar" fans reported feeling depressed and even suicidal because the movie's fictional world wasn't real. There was a similar reaction to the final installments of the Harry Potter movies. "People experience distress when they're watching primarily for companionship," said Emily Moyer-Gusé, Ph.D., assistant professor of communication at Ohio State University, in Columbus. With "Avatar," Moyer-Gusé suspects people were "swept up in a narrative forgetting about real life and [their] own problems."
Where You Live
You can endlessly debate whether city or country life is better. But research has found that people living in urban settings do have a 39 percent higher risk of mood disorders than those in rural regions. A 2011 study in the journal Nature offers an explanation for this trend: City dwellers have more activity in the part of the brain that regulates stress. And higher levels of stress could lead to psychotic disorders. Depression rates also vary by country and state. Some <a href="http://www.health.com/health/gallery/0,,20483493,00.html" target="_hplink">states have higher rates</a> of depression and affluent <a href="http://news.health.com/2011/07/25/depression-affluent-nations/" target="_hplink">nations having higher rates</a> than low-income nations. Even altitude may play a role, with <a href="http://news.health.com/2010/09/21/is-high-altitude-linked-to-suicide-risk/" target="_hplink">suicide risk</a> going up with altitude.
Too Many Choices
The sheer number of options available -- whether it's face cream, breakfast cereal or appliances -- can be overwhelming. That's not a problem for shoppers who pick the first thing that meets their needs, according to some psychologists. However, some people respond to choice overload by maximizing, or exhaustively reviewing their options in the search for the very best item. Research suggests that this coping style is linked to perfectionism and depression.
Lack Of Fish In The Diet
Low intake of omega-3 fatty acids, found in salmon and vegetable oils, may be associated with a greater risk of depression. A 2004 Finnish study found an association between eating less fish and depression in women, but not in men. These fatty acids regulate neurotransmitters like serotonin, which could explain the link. Fish oil supplements may work too; at least one study found they helped depression in people with bipolar disorder.
Poor Sibling Relationships
Although unhappy relationships with anyone can cause depression, a 2007 study in the American Journal of Psychiatry found that men who didn't get along with their siblings before age 20 were more likely to be depressed later in life than those who did. Although it's not clear what's so significant about sibling relationships (the same wasn't true for relationships with parents), researchers suggest that they could help children develop the ability to relate with peers and socialize. Regardless of the reason, too much squabbling is associated with a greater risk of developing depression before age 50.
Birth Control Pills
Like any medication, the pill can have side effects. Oral contraceptives contain a synthetic version of progesterone, which studies suggest can lead to depression in some women. "The reason is still unknown," says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University, in New York. "It doesn't happen to everyone, but if women have a history of depression or are prone to depression, they have an increased chance of experiencing depression symptoms while taking birth control pills," Dr. Hutcherson says. "Some women just can't take the pill; that's when we start looking into alternative contraception, like a diaphragm, which doesn't contain hormones."
Depression is a side effect of many medications. For example, Accutane and its generic version (isotretinoin) are prescribed to clear up severe acne, but depression and suicidal thoughts are a potential risk for some people. Depression is a possible side effect for anxiety and insomnia drugs, including Valium and Xanax; Lopressor, prescribed to treat high blood pressure; cholesterol-lowering drugs including Lipitor; and Premarin for menopausal symptoms. Read the potential side effects when you take a new medication, and always check with your doctor to see if you might be at risk. <strong>More from <a href="http://www.Health.com" target="_hplink">Health.com</a>:</strong> <a href="http://www.health.com/health/gallery/0,,20419609,00.html" target="_hplink">10 Tips for Dating With Depression</a> <a href="http://www.health.com/health/gallery/0,,20483493,00.html" target="_hplink">The Most Depressing States in the U.S.</a> <a href="http://www.health.com/health/gallery/0,,20428990,00.html" target="_hplink">Depressing Jobs: Career Fields With Hight Rates of Depression</a>
The "Saved By The Bell" actress's mother told <em>People</em> magazine Voorhies has been <a href="http://www.people.com/people/article/0,,20635697,00.html">diagnosed with bipolar disorder</a>, after <a href="http://abcnews.go.com/blogs/entertainment/2012/10/saved-by-the-bell-star-lark-voorhies-has-bipolar-disorder-mom-says/">video from an interview taped for Yahoo!</a> in which Voorhies seemed to struggle through her answers went viral, ABC News reported. "There are things that have traumatized her," her mother Tricia told <em>People</em>, but <a href="http://www.people.com/people/article/0,,20635697,00.html">the actress maintains that she isn't sick</a>.
Jesse Jackson Jr.
The Mayo Clinic released a statement in August that the congressman and son of the Rev. Jesse Jackson was <a href="http://www.huffingtonpost.com/2012/08/13/jesse-jackson-jr-bipolar-_n_1773433.html" target="_hplink">receiving treatment for bipolar II depression</a>, after taking an unexplained medical leave two months earlier. His wife had previously <a href="http://www.huffingtonpost.com/2012/08/04/jesse-jackson-jr_n_1742382.html" target="_hplink">called his depression "debilitating"</a>, the AP reported. The Mayo Clinic has stated he was responding well to treatment.
After spending three months in a rehab facility for bulimia, anorexia, cutting and depression, Lovato also announced she'd been diagnosed with bipolar disorder. Lovato told <em>People</em> magazine <a href="http://www.people.com/people/article/0,,20483380,00.html" target="_hplink">she didn't know she had the disorder</a> until she entered treatment. Lovato told AOL Music she <a href="http://blog.music.aol.com/2011/07/21/demi-lovato-skyscraper-rehab/" target="_hplink">plans to continue speaking out </a>about her experience to help others. "I feel like it's no coincidence that God put me through all of this and has also given me the voice that I have. I feel like my purpose on earth is much greater than just being a singer, a musician or actress. I think it's to reach out to people and to raise awareness of these issues that not many people speak about."
Actress Catherine Zeta-Jones publicly disclosed her diagnosis after seeking treatment. Though she wasn't initially going to come public (on an episode of "The Oprah Winfrey Show," husband Michael Douglas said he <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DOmH9M4-ZlHk" target="_hplink">suspects someone at the hospital </a>leaked information to the press), Zeta-Jones has nonetheless voiced her support for those who also suffer from bipolar disorder. In an interview with <em>People</em>, Zeta-Jones said there is <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.people.com%2Fpeople%2Farticle%2F0%2C%2C20483309%2C00.html&sa=D&sntz=1&usg=AFQjCNHb0YcIEs1RlfUJc_pDHH_f561kog" target="_hplink">"no need to suffer silently,"</a> and that if her speaking up encourages just one person to seek help of their own, then her experience was worth it.
Jean-Claude Van Damme
The action star told E! Online he was being <a href="http://www.everydayhealth.com/bipolar-disorder-pictures/famous-people-with-bipolar-disorder.aspx#/slide-4" target="_hplink">treated for bipolar disorder</a> with the drug sodium valproate, Everyday Health reported. "Since I'm doing that it's, like, BOOM! In one week, I felt it kick in. All the commotion around me, all the water around me, moving left and right around me, became like a lake," he said.
The reality TV star has experienced a number of high-profile ups and downs on camera. She told <em>People</em> magazine that she takes medication for bipolar disorder after being <a href="http://www.people.com/people/article/0,,20502981,00.html" target="_hplink">diagnosed in 2008</a>. "I don't think I'm bipolar, to be honest with you," she said at the time. "I'm just really outgoing. I think everybody thinks they're bipolar these days. You're a teenager, you have hormones. You're gonna switch up every two seconds!" But she spoke more vulnerably <a href="http://www.eonline.com/news/279100/teen-mom-s-amber-portwood-i-ve-been-diagnosed-with-extreme-bipolar-and-disassociative-disorder" target="_hplink">about her diagnosis later with E! News</a>, saying "I struggle with it. I hate it. I grieve over it" of her diagnosis.
In 2007, Grammy-winning artist Sinead O'Connor appeared on "The Oprah Winfrey Show" to talk about her battle with bipolar disorder. She said receiving treatment for the disorder <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.oprah.com%2Fhealth%2FUnderstanding-Bipolar-Disorder%2F4%23slideshow&sa=D&sntz=1&usg=AFQjCNH4MY_Fwhv-hogwsgQF5vh8dlVLbw" target="_hplink">made her reborn</a> and gave her at chance at building a new life.
In July, after canceling a number of the band's tour dates, Passion Pit's lead singer told <em>Rolling Stone</em> he had been <a href="http://www.huffingtonpost.com/2012/08/05/michael-angelakos-passion-pit-bipolar-disorder_n_1744463.html" target="_hplink">diagnosed with bipolar disorder when he was 18</a> and was experiencing a particularly debilitating bout of depression when the band was set to tour, HuffPost reported. "My depression was so bad three weeks ago when we had to cancel everything -- people don't understand this. People don't understand that <a href="http://www.rollingstone.com/music/news/passion-pit-singer-on-battling-mental-illness-and-taking-new-songs-on-the-road-20120804" target="_hplink">it's not just debilitating; it's all-encompassing</a>," he told <em>Rolling Stone</em>.
Fisher first publicly discussed her experience with bipolar disorder with Diane Sawyer in 2000, telling Sawyer she was convinced for many years <a href="http://www.google.com/url?q=http%3A%2F%2Fabcnews.go.com%2FPrimetime%2Fstory%3Fid%3D132315%26page%3D1&sa=D&sntz=1&usg=AFQjCNFLybkKZWWhJE-aqv9VFMow8K1kSQ" target="_hplink">she was a drug addict</a> before finding out she was manic depressive. Fisher has since been very open about her struggle with the disorder, including the <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DHUrZ21n32uQ" target="_hplink">time she spent in a mental hospital </a>following a particularly difficult episode. "At times, being bipolar can be an all-consuming challenge, requiring lots of stamina and even more courage," Fisher wrote in her <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.amazon.com%2FWishful-Drinking-Carrie-Fisher%2Fdp%2F1439102252&sa=D&sntz=1&usg=AFQjCNEf-vwrc82jVrWCDKnSGe4INPgZrw" target="_hplink">2008 memoir "Wishful Drinking."</a> "So if you're living with this illness and functioning at all, it's something to be proud of, not ashamed of."
The Academy Award-winning actress was diagnosed with bipolar disorder at 35 years old. In an interview with "Everyday Health," Duke said the <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.everydayhealth.com%2Fdepression%2Fmylife%2Fpatty_duke%2Flanding.aspx&sa=D&sntz=1&usg=AFQjCNH7e5EfIZSYT0Qo7JqE2qhT5--xng" target="_hplink">diagnosis came as a relief</a>, because it meant she wasn't the only person in the world feeling the way she did. In her memoir <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.amazon.com%2FBrilliant-Madness-Living-Depressive-Illness%2Fdp%2F0553560727%2Fref%3Dpd_sim_b_1" target="_hplink">"A Brilliant Madness: Living With Manic-Depressive Illness"</a>, Duke says she knew from a young age there was something wrong with her, "but I thought it was just that I was not a good person, that I didn't try hard enough." Duke has been an advocate for bipolar disorder awareness for years. She's spoken out about her experience on numerous occasions, including on "20/20," "The Oprah Winfrey Show" and during a 1997 interview with Barbara Walters on "The View." Duke told Walters <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DQfoTxHSmRAs%26feature%3Drelated" target="_hplink">she considered herself lucky</a> to have had "access to the media, to write a book and talk about" her experience. Duke continues to speak out; in 2005, she was asked to testify before Congress on mental health-related issues.
The former "Dateline" NBC host discussed her <a href="http://www.msnbc.msn.com/id/5887567/ns/dateline_nbc-books/t/jane-pauley-shares-her-story/" target="_hplink">bipolar disorder diagnosis</a> in a 2004 interview with Matt Lauer. After struggling with minor depression for several months and not getting better, Pauley said she was shocked when the doctor explained she was actually suffering from bipolar disorder. In her 2004 memoir <a href="http://www.amazon.com/Skywriting-Life-Blue-Jane-Pauley/dp/140006192X" target="_hplink">"Skywriting: A Life Out of the Blue,"</a> Pauley writes she doesn't know if or when she'll have another bipolar episode, but that she's now adapted and learned to be more aware of her moods and how she's feeling. "The world has not become spontaneously organized to make accommodations for my weaknesses while nurturing my newly discovered strengths," Pauley wrote.
The star of "Terminator" told Larry King in 2005 that the <a href="http://archives.cnn.com/TRANSCRIPTS/0510/14/lkl.01.html" target="_hplink">bigger her life and career grew</a>, the worse her mental health and bipolar disorder became. And because she suffered from depression while growing up, Hamilton said she now has a very open dialogue with her children and reminds them it's okay to speak up about their feelings. In a <a href="http://www.youtube.com/watch?v=LdSA2Bk4riA" target="_hplink">2006 interview for "Sidewalks</a>," Hamilton described the mood swings she often suffered before being diagnosed and receiving proper care for the condition. "I like to speak out to let people know that they're not alone," Hamilton said.