Bring Back the Mental Health Advocate

Many long years ago, governments around the country, and in other countries too, decided that hospitals for the mentally ill was not the way to go.

What was needed was a return to society of the mentally ill so they could become part of the mainstream.

Part of the deal was that the government would provide special services to make up for their care on the inside. Governments didn't do this, so major cities all over the globe have mentally ill people living on their streets with politicians at all levels blaming some other politician.

It's important to note some facts here. It's not all that long ago the Londoners went down to Bedlam Hospital to watch the inmates, finding them funnier than monkeys at the zoo. The straitjacket and padded cells were the norm. When I practiced law, the Supreme Court rule book still contained the "Lunacy Rules." People referred to Essondale mental health hospital (re-named Riverview 1966) as the "funny farm."

Stigma still attaches to the mentally ill, who remain the butts of jokes. Well known members of the media talk about how "so-and-so should have take his Paxil," or whatever. A broadcaster I know talked about his school being so small that the debating team was one schizophrenic. He didn't understand when I told him that this was a very hurtful thing to say to people who lived with schizophrenia either personally or through family members or friends.

How willing would any reader be to see a doctor about your inability to cope, knowing that you would be stating to the world that you were "crazy"?

Would you like your boss to know this?

Don't we all remember how, when an uncle or a friend was a bit eccentric, one would laugh and making a twirling motion of the index finger point it to one's head?

Enlightened treatment?

The causes of and treatments for mental illness are many. Sometimes, as in my case, the problem is quickly diagnosed by my family physician who prescribed just the right medicine. Most people aren't that lucky. For many, the proper diagnosis is not made and the treatment not easily found.

That is partly the fault of the medical profession, whose members graduate ill-prepared to deal with mental illness.

Part of the challenge also is the difficulty in diagnosing something that can't be seen. Often it's the patient's inability to articulate their problem for fear of the stigma attached to it.

How big is the problem? One in five of you reading this will have mental illness at some time, and all of you will face it in your family and friends.

Before I bring the government into the discussion, let me say that a lot of good is being done privately. The B.C. Branch of the Canadian Mental Health Association helps sponsor the Bottom Line conference, dealing with mental health issues in the workplace, and it's become crystal clear that much alcoholism and drug abuse is the method of self-medication for the mentally ill. They're frightened to see a doctor and seek refuge in drugs and booze.

Mental health advocate fired

The government of British Columbia's record is appalling. At the beginning of the B.C. Liberals' first term, they established a small mental health division of the ministry with a minor post of minister of state leading it. Many of us told the government that this was the wrong way to go for a lot of reasons.

They then made the colossal mistake of firing Nancy Hall, the mental health advocate who sought out and found areas in the mental health field where government attention was needed. Her post was not renewed because, said the B.C. Liberals, ministry staff could do the same thing. That was horse buns. No bureaucrat or junior minister wants to show premiers and finance ministers where they should spend more money.

To be poor, of course, doesn't mean you are mentally ill. But lots of people living in poverty are. By no means are all the homeless people mentally ill -- though many of them are.

Premier Campbell has suddenly seen the light: why, some of those people without shelter are mentally ill!

A few weeks ago, the government sent increased housing allowances to the needy, except those on welfare. In short, if you were poor, you got more money but if you were really poor, you didn't. Ah, but the premier said that perhaps the social cuts made in his first term went too deep. Wow! Now there's some admission for you.

And wow! again: many people are on welfare because they are mentally ill!

Afraid of the facts?

How many mentally ill are there? We don't know because the government doesn't want to know.

Because, you see, if mentally ill people were treated like the physically ill, the cost would erode the surpluses the B.C. Liberals ran up on the backs of the poor. As mentioned, this was the reason Nancy Hall had to go -- she would look for and find areas of sick people, and that would never do.

The Campbell government likes its vote-getting surpluses, you see, and doesn't want to find mentally ill people eating away at the profits. Even though finding and treating the mentally ill is the right and decent thing to do, and would pay substantial dividends down the road, this government isn't interested.

The tragedy is that the government, after finally finding sick people under bridges, gives out more funds to those who need more housing money and thinks he has taken the sick off the street. A shelter allowance only benefits those who have shelter. That the premier won't listen tells you where he's really at when comes to mental health.

Restore an independent advocate

The premier and his government are not evil -- they simply don't understand and think that because there aren't thousands complaining, probably there isn't a real problem. It's not in the nature of any government to look for more fires to put out.

What must happen is simple: restore the role of independent mental health advocate to assess the problem, then deal with it.

Am I perhaps being too hard on the Campbell government?

Do they simply not know of these things?

That scarcely seems much better than knowing and doing nothing.

The fact is that all of us need to know a lot more about mental health, for when voters understand, the penalty to a government that doesn't listen is loss of government, and that's something Gordon Campbell and his colleagues do know something about.

Related Tyee stories:

• Screening Mental Illness
• Welfare's New Era in BC (series)
• The New Lobotomy?