Thursday, February 14, 2008

The premier used to think mental health was important

Things are badly out of control on Victoria’s downtown streets, and in communities across the province. More and more addicted and mentally ill people have ended up on the streets and the problems have hit a critical point.
How did this happen? The short answer is that government — and most of us — chose to ignore the problem. It just wasn’t a priority.
Premier Gordon Campbell can explain that as well as anyone.
Back in 2001, Campbell eliminated the office of the mental health advocate. The office was created in 1998. That was four years after the ombudsman had recommended an independent monitor in a critical report on mental health services. The NDP government was no better at paying attention to these issues.
Campbell said the advocate wasn’t a strong enough response. That’s why he was naming a cabinet minister to be responsible for mental health and addiction services.
“A minister of state for mental health is clearly a requirement,” Campbell told the legislature in 2001. “Let’s assume that the last government cared about mental health. They failed people with mental illness miserably.”
Why?
“I would suggest that they did it because there was no one focusing on mental health issues,” said Campbell.
But the minister of state for addictions and mental health never seemed to get much done, beyond some reports and useful mailings to doctors. The evidence on the streets and from families showed things were getting worse.
After the 2005 election, Campbell decided mental health and addictions didn’t need a minister after all. The job followed the advocate onto the dust heap. Since then, people in desperate need of help have created growing street problems.
Some communications person is likely even now preparing a letter to the editor for the health minister to sign in response to this column. The government spent more than $1 billion on mental health and addictions last year and did this and that.
But that’s like boasting about how much you spent fixing your car, without acknowledging that it still doesn’t run. Governments are not elected to spend money, but to help solve problems and provide needed care.
Look at the streets. Talk to families trying to get help. Things are worse.
The answer is also misleading. The government allocates almost no money for mental health or addictions — $8 million for the entire province in 2005-6. It tells the six health authorities how much they can spend on all services and leaves the rest — mostly — up to them.
The budgets aren’t based on what’s needed to provide care. So the authority managers and medical staff decide where the money should go. Fixing knees or catching up on seniors’ long-term-care needs tend to be more compelling than treatment beds for the mentally ill or addicted.
Those people don’t have influence. They don’t hire lobbyists. They aren’t effective in advancing their own needs; if they could do things like that they wouldn’t be on the streets.
So until they become a sufficient irritation, they are ignored.
If you are diagnosed with cancer in B.C., you’ll get excellent care. If you’re alcoholic, or schizophrenic, you won’t. Even the throne speech this week didn’t deal with addiction and mental illness as health issues.
Things might be changing. The problems have become big enough that the community has taken notice. Politicians respond to that.
But how wasteful this has been. In lives, in preventable crime, in health-care costs.
Campbell was right in 2001. Unless someone is focused on the issues, advocating for the ill and holding government to account, we’re likely to see more years of failure.
It’s time to bring back the mental health advocate.
Footnote: Another gap needs to be filled. The Liberals had a minister responsible for seniors’ long-term care in their first term, but axed the position in 2005. The Premier’s Council on Aging recommended in 2006 that a minister of state for aging be appointed “to champion a co-ordinated change agenda across government.” At the least, a seniors’ advocate could ensure that their interests — particularly around issues like residential care — are represented. Many seniors don’t have family or friends to advocate for them or raise concerns.

2 comments:

  1. Thanks for the article Paul.
    Fundamentally, Gordon Campbell and his government DO NOT CARE one tiny bit about the mentally ill or senior's for that matter. They don't care about developally disabled children and adults, or people who need to be on income assistance. I guess I've passed the point of even cynicism and wonder why people even try to take this government to task anymore.
    THEY DO NOT CARE ABOUT ANYONE but themselves and how to line their pockets and those of their friends.
    They are unable to be accountable or responsible and frankly I don't even think they know what it means.

    The only reason they are jumping into housing again and buying up hotels in the DTES is that the optics and the vision of the devastation and failure is too unsightly and embarassing. This will not do in a city and province that will be hosting the world for the biggest cluster f$#* this province will ever see and it will cost us and our future generations bitterly in every way. I don't really care why they're buying them though, more housing is needed, so this is to be welcomed. But quite rightly, that's only one part of the equation. Mental health systems around the province are maxed out and someone needs to be a voice. I suspect many agencies are gagged as they need the funding. That's how it is in the social service world. Speak out, lose your funding and close down. Fear, perception and perhaps reality stifles dissent. It's how these people work.

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  2. "Some communications person is likely even now preparing a letter to the editor for the health minister to sign in response to this column.

    Careful, now Paul.

    Otherwise you just might receive a visit from a fresh-face public affairs officer who will make notes while he watches you work and then force you to file an FOI to find out what he wrote about you.

    Of course, the whited-out parts will be unreltated to the the concept of a 'mental health advocate'.




    (Apologies - was seized by a bout of snarkolepsy there for a minute)

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