LETTER: System ‘heartless and costly’ to society

Every week we see a news item about the homeless — here in our own town, in Vancouver and, well, just about everywhere.

Every week we see a news item about the homeless — here in our own town, in Vancouver and, well, just about everywhere.

A couple of weeks ago the Vancouver Sun ran a letter to their editors from a distinguished doctor, researcher and former cabinet minister, Dr. Pat McGeer, and his wife. His point was that much of the homelessness was caused by inadequate care and supervision of some mentally ill who took to the streets (and often illicit street drugs) brought about by the closing of traditional mental health hospitals.

I agree, and I feel that situation has its roots in two issues which, like many new social initiatives, began in the US where “studies”   postulated that with the development of psychotropic drugs and the provision of community care such as mental health boarding homes and the supervision of care by local mental health clinics care could better be taken rather than in huge mental institutions such as Essondale near Coquitlam.

A third part of the program was the establishment of psychiatric facilities in community hospitals — such as the Eric Martin Institute (attached to the Royal Jubilee Hospital in Victoria, and the special wing at the Kootenay Boundary Regional Hospital in Trail.)

In addition, facilities were maintained in Riverview for patients too seriously ill to get by in the community, the criminally insane and what were termed psychogeriatric patients (mostly with senile dementia or Alzheimer’s).

Fundamental to these programs was the appropriate administration of psychotropic drugs.

It doesn’t take a genius to see that the key governmental motive was to save most of the capital sunk into asylums such as Essondale as well as their huge operating costs. Millions would be saved!

But there were several flies in the ointment: first, the community facilities such as mental health boarding homes were either inadequate to the task and the whole program was underfunded once the large institutions were closed.

Second the patients often did not take the prescribed medications. Third, failing adequate medication and supervision they often took to the street where they were prime prey to drug pushers of a different kind with a different, illegal motive.

Some of these people could not tolerate the prescribed medications, others refused to take them.

I personally know one man with a bipolar condition, now deceased, who did not take his medication because he liked being in a high where he felt omnipotent!

While mental health patients are not the only homeless persons (some others like being on the street) I think it is time to rethink and go back in part to some of the old ideas that asylums were just that: they were places where mental health patients could find a safe asylum from people who did not care for them, who often connived to commit family for financial and other motives, and least of all “treatment” as it then existed.

Perhaps we could find a way for those facilities to be used without the prison-like regime and the shame that they and their families felt for being branded as insane or lunatics.

It is clear that the present system is not working because, in effect, the patients have been cast out either by their government’s programs or their own actions.

It is time for government and the experts to come up with a plan that isn’t just about “saving money.”

The present system is even more heartless and costly to society, human dignity and the patients. Their problem is not just homelessness, but not being adequately cared for.

Maurice A. Rhodes, Nelson


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