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.”
“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.

Sunday, February 10, 2008

Risky session ahead for Liberals

The MLAs will be back here this week, for the Throne Speech, the budget and all the rest of the spring sitting.
Of course, you might never have noticed they were gone. For people who pay close attention to provincial politics, this will be a big three months. For most people, not so much.
I find it interesting, although most days dispiriting. These are capable people, respected in their hometowns. The ideal would see them coming together to debate measures that would make life better in the province. They might divide along
party lines, but they would respect each other's intelligence and commitment - or if not, the fact that the voters had chosen them. They would be full participants in government.
It's not like that. Much of the session is a weird, ritualistic game, from the rudeness and shouting of Question Period to the set speeches for and against legislation. Useful things get done, but they're islands in a sea of
embarrassing foolishness.
Still, it's what we've got. And, as I said, some useful things do get done.
This session could be the last chance for the government to do take any significant action that requires legislative approval.
The next election will be May 12, 2009. The Liberals haven't been keen on fall sittings; next spring will be an election session, as much show as substance.
This will be the chance to make some good laws.
But that's been a problem for the Liberals. They were elected in 2001 with the basic hope that they would be better than the NDP government they replaced. Competent, in a word.
Generally, the Liberals were suspicious of government and convinced it should be smaller.
Those were broadly justified views and responding to them kept the Liberals going for the first few years.
Then what? Cutting the size of government can't be a perpetual task and at a certain point the public is looking for positive efforts to deal with their concerns.
The Liberals pitched their first budget after the 2005 election as a senior's budget. The 2006 effort was supposed to be a children's budget, an acknowledgement of the mess the government had made in services for families.
Last year, the theme was housing.
But once the snappy graphics and backdrops for the budget announcement come down, interest seems to fade.
It's hard to say that things have got better for seniors, children or the homeless or people struggling to afford housing in any material ways.
This year the theme is likely to be climate change, with a budget that proposes some concrete actions to build on the dramatic rhetoric of the 2007 throne speech.
That's a challenge. The business community is worried the government will go too far and hurt the economy. The public, having been told by Premier Gordon Campbell that this is a global crisis, is expecting some significant measures.
The Liberals will have some other measures to announce - things like the new proposal to encourage burning waste wood to generate power.
There should be announcements about what B.C. will do with its share of the federal $1-billion aid program aimed at helping single-industry towns hurt by the high Canadian dollar. The province is to get about $133 million.
The session also means the New Democrats have question period four days a week to raise tough issues.
There are a lot of good targets. There are the obvious traditional favorites for any opposition - health care wait times, the continued mystery about the direction of the Children and Families Ministry, Olympic costs.
And the NDP will also focus on public safety concerns, from the gang killings in Vancouver to the disorder created by the mounting populations of homeless, addicted and mentally ill people on the streets across the province. The New
Democrats think the Liberals are vulnerable on law-and-order issues.
It all starts next Tuesday with the Throne Speech. With barely a year to go
before the election, the stakes are high for both parties.
Footnote: The big, dangerous issue hanging over the government is the corruption trial in connection with the B.C. Rail sale. Campbell has dodged questions on the case so far, but the government's ongoing efforts to keep evidence from the
court and the special prosecutor's failure to meet the legal requirements for disclosing documents could blow up in the next two months. The trial is to start in mid-March.