Showing posts with label mental illness. Show all posts
Showing posts with label mental illness. Show all posts

Tuesday, December 12, 2023

In case you were wondering: A surfeit of social realities to explain (a bit) about how we got here

Image by Taken from Pixabay

I haven't worked as a full-time journalist for almost 20 years now, but people still pay me to go find things out. I have a habit of finding way more information than the person who hired me wanted, the curse of a curious nature. 

Here's some of the surplus I've accumulated recently from some of that work, all of it related to the multiple layers of social crises we're seeing emerging in virtually every BC community. I drive along 900-block Pandora Street sometimes and am at a loss to grasp just what the hell is happening to us, but when I consider all the snippets of social tragedy below, it makes a very, very sad kind of sense. 

For instance:

We shut down institutions and never really replaced them with much

Riverview Hospital used to be BC’s largest mental institution, housing 4,300 people at its peak in the 1950s. But by the early 1990s, locking up people deemed "mentally disordered" for indefinite periods of time, with or without their consent, had fallen from favour. Riverview had been scaled back to 1,000 beds, and plans to replace institutional care with community care were in their final stages.

But from the start, the political motivations for closing Riverview were as much about cost savings as they were about philosophical shifts in how best to support people with mental illness. Between 1994 and 1998, spending on in-hospital psychiatric units was cut almost in half, and spending on community services for mental health was reduced as well, despite years of political promises to the contrary. 

Riverview was permanently closed in 2012. The long-abandoned promise of community services to replace what Riverview once provided isn't even talked about anymore. We are not going to return to the days of huge institutions, and that's a good thing, but there must be some middle ground between that and the modern-day reality of abandoning people with lifelong psychiatric health issues to figure out a hard life on their own. 

As for BC hospitals' psychiatric units, people pass through them so quickly nowadays that their mental health crisis doesn't even have a chance to stabilize. People used to stay an average 36 days in BC psych units before being discharged, but that fell to 15 days a number of years ago, and 14 days now. Psychiatric admissions between 2005 and 2017 increased 29 per cent, with no increase in beds[3].

People with developmental disabilities used to have to live in large institutions in BC as well back in the day. But deinstitutionalization happened for them around the same time as Riverview was being phased out. 

That population did seem to get better community care for a number of years after institutions like Tranquille, Glendale and Woodlands closed. But over time, the safety net has frayed substantially for them, too. It's not uncommon now to see people with developmental disabilities among the homeless. 

That is such a devastating ending for all the families who fought so hard in the 1960s-70s for the right for their children not to be locked away in institutions. Be careful what you wish for.

We are drowning in poisoned drugs

BC has always had lots and lots of illicit drugs. But what we've got going on in 2023 looks nothing like the relatively straight-forward drug scene of years past. With fentanyl, carfentanil, benzodiazapines and all kinds of other weird additives stirred into the mix now, people are getting sick in entirely new ways, and the death toll from toxic drugs is staggering. 

Since BC declared a public emergency in 2016, there have been 13,000 deaths from toxic drugs in the province, and no end in sight. Annual toxic drug deaths have increased almost ten-fold in the decade from 2012 to 2022, from 270 to 2,342.

For those who overdose on an opiate, prescription drugs like naloxone can save lives when injected immediately after an otherwise-fatal overdose. But people revived after an overdose are at high risk of having incurred a brain injury during the minutes when their brain was not receiving oxygen, and suddenly, a crisis of brain injury among people brought back to life after an overdose is emerging as a new (and almost completely unserved) concern.

Our governments quit building affordable housing

We all know there's a housing crisis going on. The increasing use of housing as an investment is often cited as a primary driver.  But as stats from BC's rental scene make clear, an equally big issue is that nobody has kept up with population growth. 

BC's population grew 34 per cent in the last 30 years. But in that same period, we've added exactly 6,000 more rental units. Our population grew by a third, while the number of rental units increased by a mere five per cent (from 114,129 units to 120,472[4].)

Equally problematic: Rents that are just so far beyond so many people's ability to afford. 

Average rents have increased 250 per cent in the last three decades. But the shelter allowance for those on income assistance was frozen at $375/month for the last 15 years up until this year’s increase to $500 (which still gets you nothing in any urban area). 

Given all of that, it's no surprise that the Lower Mainland's 2023 homeless count noted a 32 per cent rise in homelessness since 2020, with almost 70 per cent homeless for more than a year. We have created a permanent homeless class. 

We do jail differently now, mostly by accident

Even 15 years ago when the social crisis wasn't quite so obvious, people with mental illness or substance use disorders made up the majority of BC inmates, at 61 per cent. But now, it's almost like jail is the new psych hospital. Three-quarters of inmates now have a diagnosis of mental illness, substance use disorder or both. 

They and their fellow inmates churn through the system with unprecedented speed. The median length of stay in a provincial jail these days is 12 days. Almost a third of inmates across Canada are released from jail into homelessness

Provincial jail is where you do your time if your sentence is "two years less a day." But the majority of inmates in BC jails don't even have a sentence yet - they're in remand, where a person is held while awaiting trial if bail doesn't work out. People in remand units now account for 67 per cent of inmates in BC jails[7], up 15 per cent from a decade ago and slowly on the rise since the 1980s.

So we have recreated the institution part of Riverview by turning our jails into de facto psych units, but minus the psychiatric services and supports. Things that make you go hmmm.

We're still so far from doing right by Indigenous people

Indigenous people are over-represented in virtually every measure that matters for social wellness, health, safety and well-being. This is particularly true in terms of our jails.

Indigenous people account for six per cent of BC’s population, but make up more than a third of people in custody in the province[8]. In 2020-21, the incarceration rate for Indigenous people in BC was 22 in 100,000, compared to 2.3 for non-Indigenous British Columbians. 

A staggering 90 per cent of Indigenous people in provincial custody have been diagnosed with a mental health or substance use disorder[9]. Grimmer still: A Statistics Canada study released this year found that in the years 2019-21, almost one in 10 Indigenous men in Canada between the ages of 25-34 experienced incarceration[10]

We're returning to the days of poverty for some seniors, only this time they're homeless too

More than a fifth of people identified as living homeless in the 2023 Greater Vancouver Homeless Count are ages 55 and up. Nearly half of them became unhoused for the first time after turning 55. People age hard once homeless; those who are chronically homeless have life spans 20 years shorter than the rest of us.

Even comparatively comfortable BC seniors are struggling. BC Seniors Advocate Isobel Mackenzie noted in her 2023 "It's Time To Act" report that seniors in privately run, publicly subsidized assisted-living units are having a hard time keeping up with the array of additional costs that housing operators now charge for every little service, not to mention rent increases of up to 15 per cent a year at some facilities. 

And here's a strange trend: Even though BC's senior population is expected to increase to 25 per cent from 19 per cent over the next 15 years, the number of assisted living units per 1,000 population has fallen 15 per cent in the last five years in the province.

Is that because people don't want to live like that and they're finding other options, or because somebody has quit building that type of housing because they can make more money doing other things? Tune in 15 years from now to find out.

***

Ah, feels so much better to get those unused stats off my chest. I should wrap this up with some pithy conclusion, or a ringing call to action to fix this by doing a, b and c. But seriously, is it even possible to wish for a fix anymore? We are so profoundly late to the game. 



[1] https://www.publicsafety.gc.ca/lbrr/archives/cnmcs-plcng/cn28441-eng.pdf

[2] BC Ombudsperson report Committed to Change

[3] BC Schizophrenia Society and BC Psychiatric Association joint report

[4] https://www03.cmhc-schl.gc.ca/hmip-pimh/en/TableMapChart/Table?TableId=2.1.31.3&GeographyId=2410&GeographyTypeId=3&DisplayAs=Table&GeograghyName=Vancouver

[5] https://globalnews.ca/news/10030845/vancouver-homeless-seniors/#:~:text=%E2%80%9CWe're%20already%20in%20crisis,32%20per%20cent%20from%202020

[6] https://www.cbc.ca/news/canada/british-columbia/prison-mental-health-sfu-study-1.6271915

[8] https://www2.gov.bc.ca/gov/content/justice/criminal-justice/corrections/reducing-reoffending/indigenous#:~:text=Indigenous%20people%20are%20nearly%206,and%2027%25%20in%20the%20community.

[9] https://www.oag.bc.ca/sites/default/files/publications/reports/BCOAG-Mental-Health-Substance-Use-Services-Corrections-Report-February-2023.pdf


Wednesday, December 21, 2022

When a rock meets a hard place


Francesco Villi was an angry man who settled his differences violently. The fights he got into with his Toronto strata council were obviously like fire to the powder keg for a man like him. 

And then last Sunday he just knocked on their condo doors and shot three of them dead, along with two of their spouses. What an awful, crazy thing. 

Whenever these kinds of unthinkable events happen, it seems a natural instinct to question what could have been done differently. 

Why wasn't something done about Villi back when he was an abusive husband and father? Shouldn't somebody have done something about his mental health? Shouldn't somebody have stopped him from getting a gun? Could anything have been done to divert the rage he felt toward the strata council?

Valid questions. Unfortunately, the shoulda/woulda/coulda questions don't mean much once the horrible deed is done and five innocent people are dead. 

Short of a government initiative to attach a good Samaritan to watch over each of us for all of our lives in case we start to go off the rails, we'll rarely know until it's too late that somebody in our midst was on track to explode. 

Media reports in coming days will doubtlessly carry news about the many warning signs from Villi's life. But who exactly do we expect should have even been adding up those warning signs, let alone acting on them? 

The question of whether anything could have been done about Villi's escalating battles with his strata council, however - that one's got potential for reflection. In the event of a rock meeting a hard place, are there measures that could come into play before one or the other is smashed to bits?

Quasi-judicial system are exactly the kind of structures that attract, trap and ignite a person like Villi. I don't know how to characterize his kind of mental unwellness, but I saw so much of it in my journalism years related to courts, child custody, divorce, property disputes and bylaw breaches. 

There is a type of Angry Man who absolutely loses his mind when caught up in disputes like that. The outcome can be horrific.

There is no excuse for Villi's actions. But in the interest of not having any more strata council volunteers gunned down by raging residents, this might be a good time to scrutinize the history of the fight between Villa and his strata council. Was there a point where it became excruciatingly clear that this was shaping up to be a battle to the death?

The people who sought me out as a journalist - the ones who turned to media as part of their escalation - had not yet reached the point of murder. But I could always hear the dangerous obsession in their voice as they related their stories. 

They believed themselves to have been gravely wronged and repeatedly ignored (and in many cases, there were elements of that along the way). And now, they were pretty much on fire. 

Our quasi-judicial systems don't do well with grey. They're designed to create winners and losers, and to shut people out entirely once they have run through the processes available to them. For a particular type of Angry Man, that point seems to mark where the escalation really begins. 

Systems have to be fair, of course. Millions of Canadians co-exist peacefully with their strata councils. But any system in which one group's wishes dominates another runs the risk of a dispute moving into dangerous new territory. Having a red-alert clause and an alternative strategy before things get even uglier just seem like useful concepts.

Fathers killing their children; students killing their teachers; employees killing their bosses; tenants killing their landlords - virtually all of those terrible events generally have long back-stories of things going wrong between an increasingly angry person and systems where nobody ever steps back. They're often characterized as random acts of violence, but are rarely as random as they look.

Villi was clearly a disturbed man. He locked horns with systems that don't see their role as having to differentiate between the regular angry people and the seriously disturbed ones, and five people died. A person looking for a war met a system built to resist, and a terrible thing happened.

Wednesday, July 30, 2014

Lest we forget: A tally of police shootings and taser deaths of Canadians with severe mental illness

     I am haunted by the 2013 police shooting death of Sammy Yatim, and the words of Toronto Police Chief Bill Blair this month that the recommendations that came out of the investigation of the 18-year-old's death won't be "left to gather dust." If only we could believe that.
     Blair has said versions of that before, in past years when Toronto police killed some other person with mental illness. The case of Sammy Yatim was particularly tragic, what with him being a young man alone on an empty streetcar when he was first shot nine times by the police and then tasered as he lay dying on the floor.  (See the enhanced YouTube video of his death taken by a passerby here.)
    But he's hardly the only sad story.
     One night last week I went looking for every archived news story I could find on fatal police shootings of people with mental illness, and found at least 36 such shootings in Canada since 1988.
     And at least half of the 21 known deaths of Canadians after being tasered by police have also involved people with mental illness. (Must be careful with the wording here, as Taser International continues to assert that tasers don't kill people, just tasers when combined with cocaine use or that new-fangled thing we call "excited delirium," which I imagine we would all experience when about to be shot or tasered by police).
    There's nothing wrong with the recommendations issued in the wake of Yatim's death.  But when you go back through most of the news coverage of those other 36 shootings, you will note a striking similarity. And yet, ill people who desperately need help continue to be killed instead.
     While the Yatim case is a clear exception, I don't mean to lay all the blame at the door of police officers. They've got tough jobs at the best of times, and our country's decision in the 1980s to cut loose people with serious mental illness is clearly the root of much of the problem. We have left police to manage those with severe and chronic illnesses, which has to be just about as nutty of a societal approach as any you'd see.
     But here we are, with no sign that we're serious as a society about doing anything to correct that terrible decision. And people  - well, men, more specifically, as only one death has involved a woman - continue to die at the hands of police instead of receiving the medical and community help they so urgently need. A man gets shot, an angst-ridden community who briefly cares wrings its hands, a report is issued recommending this, that and the other, and soon enough it's all forgotten until the next shooting. In fact, another man with mental illness has already been killed by Montreal police in the year since Sammy Yatim died.
     There is power in speaking a name. So here they are, by name, to be remembered as those whose deaths once led to similar recommendations as those for teenager Sammy Yatim. Some were implemented, others weren't. And the country rolled on, each shooting treated like a surprising one-off instead of the latest indicator of a disastrously failed mental-health system.
    Lest we forget.

Fatally shot by police:
2014 – Alain Magloire, Montreal
2013 – Michael McIsaac, Durham
2013 – Sammy Yatim, Toronto
2013 – Steve Mesic, Hamilton
2012 - Farshad Mohammadi, Montreal
2012 - Michael Eligon, Toronto
2011- Mario Hamel, Toronto
2010 – Reyal Jardine, Toronto
2010 - Sylvia Klbingaitis, Toronto (sole woman)
2007 – Paul Boyd, Vancouver
2009 – Jeff Hughes, Vancouver
2008  - Byron Debassige, Toronto
2007 – Unnamed man, Vancouver
2004 – Martin Ostopovich, Spruce Grove 
2004 – Joe Pagnotta, Langford
2004 – O’Brien Christopher-Reid, Toronto
2004  - Magencia Camaso, Saanich
2004 – Antonio Bellon, Toronto
2003 – Unnamed man, Vancouver
2000 = Darryl Power, Newfoundland
2000 – Norman Reid, Newfoundland
1997 – Edmund Yu, Toronto
2000 - Frank Hutterer, Ottawa 
2000 - Otto Vass, Vancouver
1999 – Unnamed man, Langley
1999 - Unnamed man, Vancouver
1997 – Thomas Alcorn, Vancouver
1997 – Unnamed man, Vancouver
1996 – Charles Albert Wilson, Vancouver
1996 – Wayne Williams, Toronto
1996 – Tommy Barnett, Toronto
1994 – Albert Moses, Toronto
1992 – Dominic Sabatino, Toronto
1988 – Lester Donaldson, Toronto

Fatally tasered and confirmed to have a mental illness:
2013 – Donald Menard, Montreal
2010 – Aron Firman, Collingwood, Ont
2007 – Howard Hyde, Nova Scotia
2007 – Claudio Castagnetta, Quebec City
2006 – Jason Doan, Red Deer
2005 – Kevin Geldart, Moncton
2005 – Alesandro Fiacco, Edmonton
2004 – Samuel Truscott, Kingston
2004 – Ronald Perry, Edmonton
2004 – Roman Andreichikov, Vancouver
2004 – Robert Bagnell, Vancouver (opinions divided as to whether he had mental health issues)

Monday, August 17, 2009

The upside of mental illness - creative brilliance

Nice to see mental illness finally getting some good press. The latest news is of a genetic link between creativity and mental illnesses, which seems to confirm once and for all what many other studies over the decades have also found.
From the Oracle of Delphi to the great creative talents of today, this thing we call mental illness has been enriching our communities for a very long time.
These days, it’s popular to wish for all mental illnesses to be treated and cured. But we’d be a poorer society in so many ways were we ever to achieve that questionable goal. Think of all the beautiful words, paintings, music and design we’d have missed out on over the centuries were it not for the brilliant work of creative people with mental illness.
I met a young busker and his friend on the Inner Harbour a couple weeks back, and have been struggling with how to write up their very interesting story without falling into one of those man-with-schizophrenia-overcomes-disability tales.
Because the thing about mental illness is that it’s not all about trying to “overcome” it. As science is now confirming, illnesses like depression, bipolar disorder and schizophrenia are linked to creative brilliance. And what’s intriguing about the story of Jordan Blaikie and his pal Ross Johnson is that their mental illnesses are in fact what brought them together in the first place, which has turned out to be a very positive thing.
Blaikie is 30 and Johnson is 29. Both have lived with mental illness for all of their adult lives and then some, having been diagnosed when they were teenagers.
They certainly know the negative aspects of living with mental illness, not the least of which has been an inability for the two men to find and keep a decent job. They’ve had to get by on disability cheques for the most part, supplemented with part-time work at pizza joints and the like. (“It’s a lot more fun to go busking,” notes Blaikie.)
Over the years they’ve been on medication, off medication and everything in between, and are all too aware of the challenges faced by people living with chronic and persistent mental illness.
Still, if they’d never experienced a mental-health crisis, they’d never have met. They met because they were housemates in 2007 at the Seven Oaks psychiatric facility, and struck up the conversation that ultimately led them to their new business venture: Tricky Magic Productions.
Blaikie had worked off and on as a street magician for three years before he met Johnson, having inherited his sister’s old magic tricks after she lost interest. Johnson had ideas for how Blaikie could extend his busking season by performing indoors in the winter months at seniors’ centres and community events.
And so far, so good. Blaikie took his magic show to 25 venues over the winter. More recently, the pair has branched into “casino nights” at some of the seniors’ facilities, having discovered the joys of dealing blackjack and Texas Hold ‘Em for delighted residents gambling for Thrifty Foods coupons.
It’s on to bigger and better things this fall. Johnson has booked the theatre at Eric Martin Institute for a variety show Oct. 10. The show will be a fundraiser for the Friends of Music Society, an organization that works on bridging the gaps between musicians with mental illness and those without it. The headliner will be Blaikie, of course - “The Great Jordano.”
“I’m hoping to have nine performers that night - we’re calling it ‘Monty Pylon’s Family Circus,’ “ says Johnson. “Most of us have disabilities, but not all of us. Anyway, it’s about the ability, not the disability.”
Blaikie dreams of becoming a cruise-ship magician. Johnson lists six Vancouver Island theatres he wants to do shows at one day. Mental illness will undoubtedly complicate things for the men, because it generally does. But maybe it’s also the thing that helps make Blaikie a confident and charming magician, and Johnson a sweetly enthusiastic pitch man.
Think of the creative gifts that mental illness has given us over the centuries. Would Ernest Hemingway and Virginia Woolf have set pen to paper in such compelling fashion if not for their mental illnesses? Would Van Gogh have painted with such passion and insight? Or Beethoven written with the same power?
Call it a sickness if you must, but the truth is that the world is a much better place for having people with mental illness in it. I wish my young busker friends a lifetime of shining in the dark.