Liberals challenge B.C.'s outdated mental-health policy

DISCHARGING THE MENTALLY ILL
PATRICK BRETHOUR
September 13, 2007

VANCOUVER -- The B.C. government, preparing to rewrite the province's decade-old strategy on mental health, is taking aim at the policy of discharging the mentally ill into the community - an approach that has turned the streets of Vancouver's Downtown Eastside into a human warehouse for those with serious psychiatric disorders.

Last fall, Premier Gordon Campbell criticized deinstitutionalization of the mentally ill as a "failed experiment," although he said he was not advocating a reversal of that policy.

In an interview this week, Health Minister George Abbott said the considerable number of homeless people in the Downtown Eastside with mental-health problems points to the shortcomings of that policy, adding that the issue will be a prominent part of the development of the new mental-health strategy.

"I think it's a significant part of the legacy of deinstitutionalization," he said. "I think we see among that homeless population a significant number of people who were discharged without appropriate support."

Mr. Abbott said he is not planning a radical break with current policies to discharge patients, although there will likely be a re-examination of the threshold at which the mentally ill are sent out into the community.

Development of the new strategy will get under way shortly, according to the contract bid put out by the provincial government late last month.

Bids on the contract close tomorrow, and the project is to start on Sept. 24 and wrap up by Aug. 31, 2008, when a final plan and a communications strategy are to be delivered.

Mr. Abbott has already begun to set the stage for those consultations, meeting yesterday with advocacy groups and regional health authorities.

One advocate for the mentally ill is urging that the province expand the number of long-term care beds to accommodate those on the Downtown Eastside who are worst off. Darrell Burnham, executive director of Coast Mental Health, said up to 100 of the homeless are ill enough that they need the kind of care that can only be found in a hospital environment.

Right now, there are not enough beds available, leaving them to lurch from crisis to crisis. "You end up with a merry-go-round in the psych wards."

Mr. Burnham said additional long-term beds are only a part of a broader approach that must focus on services for the large majority of mentally ill people who can receive treatment in the community with appropriate support.

Bev Gutray, executive director of the B.C. division of the Canadian Mental Health Association, said she rejected any return to the policy of institutionalizing those with mental-health problems.

Such facilities inevitably create a stigma around mental illness, she said. "There's nothing that would warrant that kind of building."

She said the better approach is to move in the opposite direction, and to tend to the mentally ill in their own homes, even in the early stages of treatment. That method would lessen the trauma of being treated in a hospital setting, she said.

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