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In Denial about Mental Illness
Humane care? Government doesn't want to know.
Riverview Hospital for the mentally ill is closing and the government insists that the patients will be transferred to new, smaller facilities around British Columbia. Riverview will remain open for new patients unable to care for themselves.
Not answered is this: what about those now homeless and living in the streets?
The current budget sets aside $8 million over three years to deal with this horrible and embarrassing situation.
This government knows dick-all about mental illness and chooses not to learn anything because that would open the treasury to huge sums for mental illness not now covered.
Set up to fail
The first Campbell government set up a minister for mental illness which was condemned to failure as soon as Mental Health Advocate Nancy Hall was let go in November 2001. Her first report to the Liberal government noted that "while treatment and care for the mentally ill is moving the right direction, the current system is not achieving acceptable results." The report is also critical of the province's bureaucracy for its non-caring attitude. [She] says that mental illness is like no other affliction and demands sensitive handling and more than simple health care services.
"Clearly, British Columbians do not understand mental illness. We do not understand that one in five of us, some 643,000 in any one year, may experience a mental disorder." (emphasis added)
Nancy Hall's mandate was to look for the mentally ill who needed help. For her efforts, she was fired. At that time, I editorialized thusly. "I believe the minister, Dr Cheema, to be a very sensitive, well motivated man who sincerely wants to make things better for the mentally ill. I believe the premier shares that feeling. But they are not going to identify the problem, nor be able to bring solutions to bear, without help from those whose jobs don't depend upon results."
The Campbell government, concerned only with the bottom line, could see that if Nancy Hall were kept on much longer, the mentally ill would be found and that would add significantly to burdens on the health care system. It is not, therefore, extravagant to say that a solid part of the first Campbell government's fiscal savings were on the backs of the mentally ill.
Why does this happen? If we were talking about cancer victims here, or AIDS or Hepatitis 'C', not only would the patients rise as one to protest, but the public would back them. There would be crowds swarming the parliament building.
Disbelievers
Mental illness isn't neat and tidy like most physical illness. Physical illness can be detected for the most part. No one disbelieves it when a woman goes to the doctor with a lump on her breast. Yet, while the ability to actually see causes of some mental illness is greater each year, the public, and especially the media, just don't believe in most mental illness. Unless the patient is running around slitting throats, the public suggestion for those who claim mental illness is "Go home, have a large scotch and hum a few bars of 'Land of Hope and Glory' like your father did before you."
Even if helping the mentally ill had no positive effect on public expenditures, surely as decent people, we would want them helped. The fact is there's a big public saving. When one assesses the problems raised by mental illness, also included must be the untold thousands in our province who self-medicate with alcohol and other drugs.
The toll on families, friends, employers and fellow employees, on the costs born by social services ministries and the attorney general, whose law enforcement people are on the front line, is incalculable but obviously is enormous.
Courage and delay
The real tragedy is this: a person in mental distress finally summons up the considerable courage it takes to seek help, goes to the doctor who doesn't know much about depression and so passes the patient over to a psychiatrist who can give an appointment in six to 12 months time!
There are simple remedies:
1. Every doctor, before getting a licence, must have a thorough grounding in mental illness. This requires the coming together of government, the medical school, the British Columbia Medal Association and private agencies.
2. The BCMA should maintain a list of family doctors who are able to deal with mental illness and will take new patients.
3. Recognizing that dealing with mental illness requires more time with the patient that usually expended on patients, Medicare must recognize this fact with a better fee schedule.
4. The office of mental health advocate must be resurrected with the mandate to see that those who are mentally ill have access to help as well thus guiding the ministry of health to where the problems are.
I know something about this subject since I was diagnosed with depression nearly 20 years ago and because I was lucky enough to have the right doctor, thus having been treated and able to lead a full, productive life.
I close with a line I've used many times before but it's no less apt. If physically ill people were treated by the system as mentally ill people are, the legislature would be jammed with protesters.
Rafe Mair writes a Monday column for The Tyee. His website is www.rafeonline.com. ![]()



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tommymoore
6 years ago
Comments on "In Denial about Mental Illness"
Parliament building? Rafe, Rafe, Rafe.. I think you may be referring to the LEGISLATURE, but even so, this AIN'T GONNA HAPPEN. 1 in 5 of us has a bad reaction to pepper spray. Another 1 in 5 of us is allergic to being brutalized by police. 1 in 5 of us is too freakin busy trying to make ends meet to protest. The rest don't care.
Mental illness is widespread and prevalent. We all act like lemmings, wasting, consuming, polluting, driving endlessly, flailing and tilting at our own windmills, while sunk nose deep in excrement. And on the weekend Campbell goes water skiing.
Kam Lee
6 years ago
Raif,
Well done! Again you bring out one of the many failings of Gordo and his gang. He is all about the bottom line, not people. His track record shows this over and over again. Remember, we as a province are been directed by a convicted drug abuser. He seems to have found his meds.Time almost to take out the trash.
G West
6 years ago
Rafe
You may actually be another of those things, like good scotch and fine wine, that gets better with age. Bravo. Would that someone in Victoria were listening.
The brain
6 years ago
Another excellent article, Rafe. Nice work.
Avicenna
6 years ago
I think this is a timely issue, but one that may take as long to figure out as it will for the Middle East to find peace. The problem with mental illness is its elusive nature, and I would bet that its ontogeny is as individual as the genetic imprint of each cancer. What I fear most is the pharmaceutical companies eyeing this market and appealing to well-meaning advocates to lobby the gov't to dispense with drugs that have the potential to do more harm than good. There have been a multitude of studies that have found that strong social support are more beneficial for the long term recovery of some mood disorders than the ubiquitous prozac. There has also been the danger of "normalization" of behaviour to a point that patterns become categorized and pills subsequently dispensed. We are just beginning to see the detrimental effects of giving anti-depressants to expecting mothers. It is a tangled web we've weeved - and mayhap we need to go back into investigating what about our consuming, highly functional society makes us so prone to mental illness - what makes us so addicted to food, drugs, attention - angst? Like every other disorder - there is obviously a nature-nurture paradigm, and I wonder at the insight or sophistication of our current gov't and medical system to address that to the benefit of society versus the free market monster.
G West
6 years ago
We can be sure of one thing, given this government's record, and that's that they won't be doing much to enhance and encourage networks of social and community support. Simply dumping more damaged citizens onto the streets with almost no help, other than the ever-present handfuls of pills, seems a much more likely outcome, as Avicenna observes above.
Positive changes in this, as in so many other areas, requires the kind of commitment to people that Premier Campbell, outside of a small circle of friends, just can't understand.
haraldkann
6 years ago
i remember when the NDP put the mentaly ill on the streets and the liberals bitched and qvetched.
then matthew vaudrills mentally ill mother beat him to death and the liberals screamed.
now the LIBERALS ARE IN POWER and i see them DOING NOTHING.
but the MENTALY ILL ARE STILL ON THE STREETS AND SOMEHOW 716 CHILDREN ARE DEAD ON THEIR WATCH.
something is TERRIBLY WRONG WITH THIS PICTURE.
Nana
6 years ago
http://www.searpubl.ca/Hoffer_Into.pdf
We've had the giant of Orthomolecular medicine, Dr. Abram Hoffer in Victoria for nearly 30 years, and each government of no matter what ideology has ignored the success of mega-vitamin therapy in the treatment of mental disease.
Niacin and Vitamin C are really cheap compared to the drugs prescribed, so one would think that an honest medical system would be interested in an inexpensive, proven and effective therapy.
Until the unholy alliance of establishment medicine, big pharma and government is broken, we will continue wasting lives.
jackrusell
6 years ago
Good point Rafe. I think we will be seeing those protests soon.
jesterjogger
6 years ago
The mentally ill arer useful pawns for the provincial liberal party. By not only allowing, but increasing their presence on the streets the liberals and municipal henchmen like sullivan and korpan can justify brutal, repressive "policing" policies to appease the ruling class. This ratcheting up of systemic abuse of the disadvantaged creates a mental climate, eventually, where average people no-longer question the inevitable darwinian brutality associated with a society where 5% of the population controls 85% of the wealth.
In such a society there can be no real democracy or any semblance of a social safety net. Welcome to the TRUE "new era"!!!!!
Colin
6 years ago
Pushing the Mentally ill out on the streets helps the provincial government balance the health care budgets and makes it appear that they are making headway on health care costs, meanwhile the costs to municipalities for policing and other social services goes up. Not to mention the danger that some of these people pose to the staff that have to deal with them.
Mental health hospitals are very expensive to run and for the very sick it can mean a lifetime of intensive care. Very few of the smaller rural communities can afford to provide that level of care. A larger centre makes sense from a economic point of view, but can be impersonal and make it difficult for families to take part in the care giving process. I would like to see 4 larger centres for Vancouver, Victoria, Kamloops and Prince George for the more severely ill and smaller centres for day clinics and low care requirement patients.
My heart goes out to those poor souls wandering the streets being tortured by their own personal demons.
Truman Green
6 years ago
Another great link, Nana. I didn't realize that Pauling was first inspired to do his work with Vitamin C by Dr. Hoffer. I'm definitely going to take a look at Hoffer's ortho-molecular studies. Thanks again!
G West
6 years ago
Colin
Makes sense to me. In many ways, mental health problems are family tragedies, as the Premier's own life experience ought to have taught him. However, one shouldn't expect much more than studied indifference from Mr. Campbell anymore. He is, with each passing day, much more focused on greasing the skids for his own remunerative transition back into the private sector. Look to others to make a difference in this area, the Premier has other things on his tiny mind. Perhaps an appeal to the Gucci lady might be in order.
Marysue
6 years ago
One day, a fellow in our village told a co-worker he wanted to kill someone. His red face and wild eyes showed his seriousness and his inability to control that urge. Already, this person had a history of increasing workplace violence. He had guns and expressed his intention to use them. He was gently adivsed to see the doctor and he did. (The police were also informed and immediately got all his registered guns.)The doctor, fortunately, realized this person was way beyond the pale of Paxil or Zoloft, needing major psychiatric help. So the doc shipped the poor chap to a mental health centre. A month later, he was pronounced "no longer an immediate danger to self an others" by the ethically derelict psychiatist in charge and was sent back to his small village pumped full of Prozac. There was no supportive professional help for him within 200 miles.
Fortunately, even he knew Prozac wasn't enough to quell the demanding murderous demons in his head, so he started taking other street drugs that did the job, while rendering him into vegetative material. He never worked a day since. Anywhere else but in his tiny village, he would be homeless, in jail or dead. However, he is still basically helpless, not looking after himself well enough to survive to his full lifeterm. He is not able to use his talents that used to afford him a decent living. He has become a human wasteland.
All that destruction could have been prevented by a simple change in the wording in the Mental Health Act 24.
This ACT is being incorrectly applied, because it is being conveniently misinterpreted by psychiatrists, taken too literally by lawyers ignorant of mental illness, and ignored by the court (there are so many morally lazy judges, IMHO).
To qualify for incarceration and mental treatment, you have to be deemed "immediately dangerous to self and others". That weak phrase should be changed to include, "the chance of being a danger to self and others sometime within a year or more". Then there's no way the mentally ill could be denied the necessary help, even should self-delusion may deny him from seeking or accepting that help. A great many drug addicts, alcoholics, sex addicts, gamblers and OCD sufferers would then become treated before they go bankrupt, get AIDS and/or destroy other lives.
haraldkann
6 years ago
marysue,you back the same kind of laws that the RUSSIANS used to INCARCERATE anyone they wanted.
the mental health act is as dangerous as the people who penned it.the vagueness of the wording puts everyone in the public at risk .not only that,the police can assault the victim in any manner they want and they will claiming it their right to be secure in the workplace.it does'nt matter that the victim loses all rights,because the act deems it necessary and all they need is an incompetent mental health nurse to say,i think you need help marysue.
where do you live marysue,i will phone police and tell them i think you are a threat...
THAT IS ALL IT TAKES...THEN LETS SEE IF YOU CAN KEEP YOUR COMPOSURE AND STAY OUT OF THE HA HA HOTEL.
now you see we all have differences in who should be getting treatment and different agendas on how we should PROPERLY treat the mentally ill.
sammy
6 years ago
[
Let me be the first to point out that s. 24 of the Act relates to involuntary committal - would there be anyone left outside if the test was changed as suggested?
But I understand the frustration behind the comment - resisting or refusing treatment can be a symptom of the illness, and the alternative to involuntary committal is watching the person suffer from the illness indefinitely.
And for those who want treatment, it isn't available anyways.
jamez
6 years ago
Good article.
One thing the powers that be don't understand is that mental illness can affect more than the sufferer, his family and so on.
Society suffers by having so many in dire need. If you can get help to people with mental illness they'll become more productive people and it's a wave effect.
But nope, so many would rather just not put money toward mental health treatment and then piss and moan about all the homeless people.
Usually the same who say being homeless is a choice.
godsChild
6 years ago
You win some, you lose some.
I remember attending the recent last rites for "Speedo" or "Nitro" or some such lovely police animal. I was admittedly very shook up and recall a good friend taking me back to the Bentley when we were accosted by a disheveled, barely coherent, babbling "ill" person. As I reached into my purse for my pepper spray, a police officer appeared and led him away from the proceedings.
It led me to think - if we had more dogs like "Speedo" or "Nitro" on the streets, I suspect the mentally ill would be far less likely to approach and be approached by people.
It's a win-win as far as I see it.
The answer to mental illness could be more police dogs. It's worth a thought.
haraldkann
6 years ago
godsChild,i have read your previous posts and you are on the right track.
once they are down,never let them up,yes ,i see your reasoning clearly now.
and more police dogs? why we can exercise them chasing the poor and disabled.that's a win win as well.
we should get together and share a few snifters of courvoisier initiale.
maybe when i get back from rome,i have to pick up some cinzano
ciao sweetie
Bailey
6 years ago
Geez, Talk about undiagnosed mental illness....
I wonder, in light of the recent research about the relationship between psychosis and power whether the neglect of services which might identify the mentally ill in society might not be more intentional than we're thinking.
Avicenna
6 years ago
haraldkann, you have the dual ability to wretch laughter with streaming tears at times. But in defense of godschild, at least we're forewarned of the level of maturity with which we should contemplate the post. And please - no speedos on the street regardless of turmoil - mental or otherwise.
This thread brings to mind a book I read by Paulo Coehlo called Veronika decides to die - I recommend it to anyone who has struggled with issues surrounding mental health and finding stability after finding yourself unanchored.
haraldkann
6 years ago
having had close friends ending their being because of disinterested incompetents makes one a little open to black humour.
i find fighting fire with fire,refreshing and cleansing,because out of the ashes...we rise again
G West
6 years ago
Fire with fire, by all means harald, but this kind of hatred gets very close to requiring once again the services of Fritz Gerlich and Der Gerade Weg.
haraldkann
6 years ago
the intellect properly used makes short work of difficult situations.godsChild is but a gnat in the great scheme of things.
i don't plan on giving my enemies the time of day ,let alone my life.gerlich was principled but foolish and lost his life writing when he should have been running.desperate times,desperate measures
he knew how dangerous hitler was,yet he stayed to write,in essence,he commited suicide,not a good use of intellect.
G West
6 years ago
harald
It's nice to know someone else reads and remembers my friend.
Kam Lee
6 years ago
Gordo and him clan are not at all concerned with mental patients, babies, young teens,
and other non-voters. Gordo has mental instability running in his family. One would think
he of all people would know their plight. It seems maybe the booze and drugs have again
misguided him. Now with the every hardening erection known as the olympics nearing, I
will guarantee again he will again sweep them under the carpet, or run them out of town
with Sam's help. When is the next election?
thomas49
6 years ago
the mention of the mental health act and section 24 is volatile because it can do more damage than good in most cases.it deals as others have said with involuntary admission of a suspected mentally ill person.
the point i would like to make is that while this act and section often fall short of getting the desired results(getting people help) there is a part of the section where a person(relative or total stranger)can petition a judge for involutary admission of a mentally ill person.you do have to provide some proof and the act gives a guideline.
incarcerating/admitting ,whatever you wish to call it,gives the system 24hours to do an initial diagnosis.so if you are really in need for a family member or a close friend something can be done to get help.
it's not much,but it's a start for those that have lost hope in the system and as a friend of mine found out it saved a brother from committing suicide.
jackrusell
6 years ago
that is true Thomas49 but then the Dr that is on staff in the small emergency room in the small community lets him sign himself out with out a diagnosis. Again they have to be ready to accept the hepl or they can fien that they are well because that is what we all want to believe anyway.
Working Man
6 years ago
I am glad there weren't any mentally ill people in the streets when the NDP were in power.
thomas49
6 years ago
jackrussel,i only meant to use that in an emergency for an intervention,as it was used for a friend who was at his wits end.this was pointed out to him by a GOOD POLICE OFFICER ,who knew of these little things,not many know or care.
and Working Man you memory is SHORT,the NDP opened the doors to COMMUNITY INTEGRATION FOR THE MENTALLY ILL.they figured making them OUTPATIENTS would save money.
the NDP started all of this BULL$H!T !
Bailey
6 years ago
They gain the whole world. They lose their souls. They think they profit.
They seem for all the world to be utterly incapable of understanding or even seeing the true nature of their duty to those who don't resemble themselves, who don't bask in the dazzle of that perceived profit.
That inability or unwillingness to share the emotions, experiences and insights which are central to the human condition, the human experience, is the essence of the diagnosis of psychosis.
They continually claim free will as their excuse for turning their backs on these expensive unfortunates. They seem to miss the irony of the claim, or the Faustian cost traditionally exacted for making such a claim for such a reason.
Maybe they think they'll never have to pay the cost of their choices. Another symptom, I think.
Working Man
6 years ago
thomas, I was being sarcastic, for 99% of the posters here the NDP is incapable on bad judgement or policy. The unions and their NDP lap dogs are not known for being very good at taking responsibility for anything negative.
thomas49
6 years ago
and i was just making sure that the situation is known to all ,as well.
i am a leftie/centrist/humanitarian,not an NDPer
Bailey
6 years ago
Dear Working Man; 99% of nobody are anything.
You seem quite attached to the idea that propagandistic ideologies are real things. Consider the idea that, with only very small and insignificent exceptions, BC has never had either a true right wing or a true left wing party.
Try this. Instead of the usual stereotypes you use, substitute "untrustworthy opportunists" and "hopeful wellwishers".
You choose who to place in which category.
ripponfalls
6 years ago
Rafe, I sympathize with your having suffered from depression, but the truth is (to quote you in another context) "Unless the patient is running around slitting throats" no one, not even psychiatrists and psychologists, know what is or is not mental illness.
They write long-winded articles, replete with referrences to "validation studies" and employ statistics to determine that basically, we are all nuts... since the terms they use to describe any and all conditions are not quantifiable. Unfortunately, most of the time the so called professionals in mental health are just blowing smoke up our proverbials, yet in spite of the non-existent evidence, the prognostications of mental health professionals are accepted in court and can have very serious consequences indeed for those unfortunate enough to be so labelled, even when the umbrella organizations admit that their members in fact do not possess the tools to make such evaluations.
If you have a year or two, I would suggest a marvelous three volume tome entitled "Coping with Psychiatric and Psychological Testimony" by Jay Ziskin, Ph.D, LL.B.
I have not yet found a better more lucid and erudite discussion of exactly what is... and is not... Science. Just skimming these books is a treat. You might also look into the writings of Dr. Thomas Szasz, as he is really one of the first of that field to seriously question what was being done in the name of Justice. Currently, there is no shortage of books which demand - and do not receive (eg. Wood, Nezworski, Lilienfeld, and Garb) - the empirical evidence linking these 'studes' to actual behavior; because the empirical evidence does not exist.
On the other hand, your points on what should be done to alleviate suffering, especially the third, are extremely well taken. When people are suffering, surely we want to help them... but it appears to be more of a clinical art than a science, and yes, this is going to cost money.
We should all ask ourselves "how much is it worth to help another human being?"
Apparently, as far as the Liberals are concerned, it isn't worth anything.
haraldkann
6 years ago
the politicians know that mental illness abounds in these times so they make vague laws,like the mental health act and that way any person that might look like they may cause trouble can be incarcerated.just like the russians used to do it.
they care not one whit,as was pointed out,most business people and politicians are pyschopaths looking for personal fulfilment not the public good.
mentally ill people don't fit onto the agenda of success ,the mentally ill embarass those super egos who think they are homo superior
allan
6 years ago
I think we are going to see a lot more mental illness as the fruits of global warming arrive.
Confusion and chaos will not be easy on anyone except those who can escape the reality through madness.
In the meantime, don't panic and shop as often as you can.
haraldkann
6 years ago
i think the bonobo chimps have the best idea about what to do when stressed out and going mad is evident.
they have sex ! as a matter of fact they use any excuse to have sex.maybe that's why they are considered the most socially adaptable and laid back group scientists have studied.
then again,maybe those scientists just like monkey porn.