Tuesday, August 09, 2011

Banishment our way of treating mental illness

Donovan Seward’s banishment from Saltspring Island is a nice metaphor for the way we deal with mental illness.
Seward was ordered off the Island by a justice of the peace after a bail hearing. He faced several charges, including a dine and dash and assaulting an RCMP officer during his arrest. He was also a nuisance since joining the local homeless community.
So he was banished. Problem solved, at least for Saltspring residents.
But not really.
Seward is 31. He’s suffered from mental illness since childhood, says his mother, Myrna Seward. He’s had past brushes with the law, stints in hospitals and a suicide attempt. He’s tormented by voices in his head sometimes, she says, and if he quits taking his medication, he lives in a fantasy world. “He’s completely delusional,” she told the Times Colonist. “He thinks he’s John Lennon half the time.”
The bail conditions didn’t include a requirement that he get medical help or supervision. The officers didn’t take him to emergency for assessment, a possibility under the Mental Health Act.
Really, the problem has just been pushed along from Saltspring to wherever Seward lands next.
Don’t criticize the justice of the peace, the police or the people of Saltspring. Our whole approach to mental illness is based on pushing people away so they become someone else’s problem if things go wrong. (It’s important to note that most people with mental illness manage quite well, as do most people with diabetes or any other disease.)
The health care system shortchanges people with mental illness. There are always other priorities, usually with more skilful advocates. Boomers demanding timely hip replacements are more likely to be heard than someone struggling with unmanaged schizophrenia.
Alan Campbell, who retired last year as director of mental health and addictions for the Vancouver Island Health Authority, said B.C. and Canada lag. “For every one of the five years I’ve been doing this job, we’ve put forward strong, well-reasoned cases for more funding,” he said. “My understanding is that our requests are given real consideration, but they just don’t fare well in the end.”
The health system manages its costs by denying or rationing treatment. But it’s actually banishing troubled patients, just as Saltspring did.
Sometimes families or social service agencies are forced to pick up the pieces. Communities deal with the fallout, as people who are not treated fall to the streets.
And often, the police, courts and jails take on the responsibility the health care system shunned - as they did in Seward’s case.
Police spend their days dealing with people who are addicted, intoxicated or mentally ill. They face challenges, and sometimes danger, acting as social workers and counsellors.
Officers know that because the root problems aren’t being addressed, they’ll deal with the same people and the same behaviors the next day.
When the problems become serious enough, or annoying enough to the community, then people with unmanaged mental illness end up in court and, far too often, in prison.
Correctional Investigator Howard Sapers, who oversees the federal correctional system’s operations, estimates that 36 per cent of men in federal prisons, and 50 per cent of women, have some form of mental illness. The figures are similar for provincial jails.
There is a cruel irony in all that. Governments closed down large residential mental health facilities, partly to save money and partly because they were considered inhumane. But they failed to deliver the promised health care, housing and community support, with the result that people with mental illness ended up in prisons, which are far more inhumane, and offer no effective treatment.
There is no universal, simple solution. People with mental illness have rights, including the right to refuse treatment. Seward had been living in subsidized housing, with support, in Victoria, but decided to move to Vancouver.
But the current approach is a shambles. And rather than dealing with the issue and providing the health care and community support needed to allow people to deal with their illnesses, we are, like Saltspring, just pushing them along to become someone else’s problem.


Anonymous said...

"The health system manages its costs by denying or rationing treatment. But it’s actually banishing troubled patients, just as Saltspring did."

I think this is wonderful news, Why?
If services are not being rendered, taxes no longer need to be paid, great work paul.

Anonymous said...

Isn't this how regional warrants work?

If a bench warrant is issued in Toronto they won't pay for the airfare to return the suspect from Vancouver. Virtual banishment if you want to stay out of jail. Hence BC's ConAir.

Funny that no news about whether BC issues limited warrants.

How To Make Your Hair Grow Faster said...

i sort of disagree about the right of mental people right of refuse treatment... they cant think for themselves.. doctor should overtake it..