Vancouver hospitals predict 2015 will see emergency mental-health visits surpass 10,000

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      Vancouver is experiencing a crisis in mental-health care that continues unchecked. That’s the conclusion Vision Vancouver councillor Kerry Jang draws from data covering 2009 to the end of June 2015, which show emergency mental-health and substance-misuse hospital visits have increased every year and are on track to hit a record high come December.

      “We clearly need more long-term mental-health care,” Jang said in a phone interview. “We know that there are so many people in the Downtown Eastside who don’t see or have any contact with mental-health professionals at all. So the emergency ward is very much becoming primary care. That is something that has to change.”

      Jang was responding to information provided at the Straight’s request by Providence Health Care, which operates St. Paul’s Hospital, and Vancouver Coastal Health, which runs Vancouver General Hospital. The statistics show that during the first six months of this year, the two hospitals together saw 5,110 people experiencing a mental-health crisis admitted and 3,703 visits for substance-misuse problems such as a drug overdose. The comparable numbers for 2014 are 4,895 mental-health emergencies and 2,830 cases of substance-misuse issues.

      By the end of 2015, these numbers are projected to surpass 10,220 mental-health emergencies and 6,146 substance-misuse incidents. Taken together, that translates to an increase of 76 percent compared to 2009.

      Over the last five years, the Vancouver Police Department has observed a similar rise in the number of apprehensions its officers make under the B.C. Mental Health Act. In 2014, officers detained 3,010 people under Section 28 of the act, which allows police to take into custody an individual deemed mentally unfit and a threat to themselves or others. That’s up from 2,278 in 2009. During the first six months of 2015, the VPD made 1,510 Section 28 apprehensions.

      Jang, who sits on the Mayor’s Task Force on Mental Health and Addictions, said what’s needed to reverse these trends is greater involvement by the province. He reiterated a call for more long-term-care beds that Mayor Gregor Robertson has made repeatedly since declaring a “mental-health crisis” in September 2013.

      The B.C. Ministry of Health declined to make a representative available for an interview.

      In recent years, the province has allocated money for mental-health-care infrastructure. For example, in January 2015, it announced that an addition to VGH will open in 2017 as the largest facility for mental-health and addiction services in British Columbia. However, the city has said what’s required to address the problem in Vancouver is 300 “long-term and secure mental health treatment beds” and, in September 2014, warned that the province was falling short of that number by 250. (The province has made small numbers of new beds available—nine at St. Paul’s Hospital, for example, and 14 on the Riverview grounds in Coquitlam. But the majority of funding is going to replacing outdated facilities.)

      Mark Levy is the medical manager of the VGH psychiatric-assessment unit. He told the Straight the statistics match what he’s observed on the ground.

      “It does put a strain on resources,” Levy said in a phone interview. “There really hasn’t been an increase in in-patient beds to any significant degree. We do run into situations where we are in a crisis mode and we have to accommodate patients that are in the emergency room.”

      Levy emphasized the numbers make clear there is a problem. But he also said they include good news, explaining that they’re at least partly the result of changing attitudes and a shift away from the justice system in favour of health care.

      “People who might have been taken to cells in the past are seen by an arresting officer as suffering from a mental-health issue,” Levy said. “Now, rather than charge them—as long as it’s not a serious offence—they will bring them to hospital.”

      He suggested the next step should be making more mental-health care available in communities where people live, so they receive treatment before their mental health declines to a point where they end up in an emergency room.

      “These are chronic problems,” Levy said. “Are people best treated in a hospital or should we try to do whatever we can to help them deal with their problems while they are residing in the community?”

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      7 Comments

      Pete Quily

      Aug 19, 2015 at 5:08pm

      Jang is right. We clearly DO need more long term mental health care. AND we need more early mental health diagnosis. By our government and citizens ignoring children, teens and adults with mental health conditions, they sometimes:

      1. Develop other mental health conditions on top of their first one. ie have ADHD, get's ignored, add on depression or anxiety disorders or eating disorders, etc

      2. Self medicate their undiagnosed and untreated and likely stigmatized mental health conditions with booze, drugs, and/or food further damaging their mental and physical health.

      3. Worsen their mental health condition or conditions, making them more costly and harder to treat.

      ALL of these not only cause suffering to the person with the mental health condition and their families but are very, very expensive for BC citizens.

      For example, 20-30% of addicts and alcoholics have ADHD, 21-45% of prisoners in jail have ADHD 15 clinical studies show. Yet BC liberals closed the only adult adhd clinic in BC and very few doctors are properly trained on diagnosing ADHD.

      See my post on the socio economic costs of ADHD which is very expensive to ignore. And it's only one MH condition.

      http://bcadhd.com/socio-economic-costs-adhd-expensive-ignore-us/

      Well...

      Aug 19, 2015 at 7:11pm

      People on welfare in BC (and even on disability) are not paid enough to eat, so this shouldn't surprise anyone who doesn't have a medieval view of mental illness. Malnutrition is pretty much universal, the way it is kept out of the stats is that most studies on nutrients in the west recruit from a non-morbid population. What should be _completely standard kit_ for anyone who comes in with a mental health complaint is comprehensive nutritional testing. It's not even standard to _ask_ the person "so, have you been eating anything other than white bread and cheese sandwiches for the last six months?"

      For someone on welfare to get enough, say, zinc, from whole foods, as opposed to from a fortified breakfast cereal is nearly impossible.

      What we have in the general population as well as vulnerable populations is not a mental health crisis but a nutrition crisis. If mental illness is, as the witch-doctors say, largely genetic, why is there such variability in onset? Why is there no real genetic testing for it? What's more likely, that nobody will express a healthy phenotype if under-nourished or that some people are just born bad, even tho things like schizophrenia tend to have their onset _after_ people are on their own, making bad choices in terms of food. Why is it that some people can use all the drugs they like, not go nuts, some people use substances and go nuts? Sure, there are probably some genetic factors, but I bet nutrition is a big one. And until we address that, these problems are only going to increase.

      Anyone who wants, try living in $906 for six months, which is what a disabled person gets. That includes food, shelter, clothing, shaving kit, soap, cough medicine, etc. etc. Does anyone here think that after living in such a way one wouldn't suffer from some sort of mental health issue? Even if only from not having enough money to socialize---socialization is a big part of mental health, but people on social assistance have no money to socialize with. All of these bike lanes being put in, disabled people subsidize them through the property taxes they pay to their landlords. They don't even get enough for a shit-bike, let alone a nice one.

      Oily bird

      Aug 19, 2015 at 8:58pm

      Good post Pete. I also wonder how much poverty causes people to develop mental health issues. Also these are not just government issues but also a society issue. Is modern life making people ill? I think so. I honestly think big cities are not natural communities to live in. People are still learning to live in large communities where they don't know everyone but it is more natural to live in small communities where you know everyone but also look after everyone. In a small community can mental health issues be dealt with more sympathetically with an understanding of the different needs of individuals. How do you get a community to be understanding and sympathetic enough to care for each other without becoming a community of distrust and bigotry? I wish I knew the answers to this but I don't think hospitals are always the answer.

      True fighter

      Aug 20, 2015 at 3:24pm

      I believe first off that mental health is that, HEALTH and the provincial govt and cities should care for it's residents (PAY FOR IT), surely more people are dying due to suicide than to bike accidents, but Mayor Gregor where really is your heart?, if I can work hard to get somewhere with the province, so can you all powerful one....certainly it is a crisis and how did we get here since 2009, I'll let you in on the little or rather 250 acre secret, "closing down river view", that is what happened, and just shipping all these poor people out into the streets like they mean nothing and they don't need help, these people can't live in small or big communities in BC, it has become WAY too expensive and if you are reading this BC ministry of health, since you give yourselves raises how about one for the most very vulnerable and displaced people in society , the disabled and/or mentally ill?...how about a 400- 500 dollar increase or do people of Vancouver want them to simply go away due to high costs and them unable to survive?, please these are PEOPLE, kind people, smart people, worthy people, people who need HEALTH CARE not be a health scare....please help them before it is too late for many. Please go to my website and support RIVERVIEW being rebuilt and used again for it's main purpose (mental health & keep the trees) and not sold to the highest (or in BC, the lowest) bidder- greedy and rich developers! These people are suffering now....not later....first step increase disability wage and make it harder for immigrants to go on, I see it all the time, them doing a dance when they get a cheque, make it more money but harder to get on, more testing and such not just if your "blue".... disabilities are for REAL and largely invisible , heck I am disabled and I can't even get hired, I want to work for crying out loud and because of stigma or lack of skills, I can't get a job and I have a degree and diploma! ....what about others who have NO skills, I like seeing the people employed by some out there, congrats to you, giving a human, esp the disabled a chance to survive and be independent.

      ....to support river view and ultimately mental wellness go to:
      (we need a centre just like cancer got a centre- a place to call home when needed)

      riverviewisnotforsaledotwordpressdotcom

      Let's Rebuild, spend $ and make it healthy. Mental health is EVERYONE's issue!

      True fighter

      Aug 20, 2015 at 8:20pm

      So ironic, I used to date an emergency doctor from St. Paul's and he did coke.
      it hits us all.....

      Anonymous

      Aug 21, 2015 at 9:48am

      True fighter Thumbs up

      Tony K

      Aug 23, 2015 at 11:34am

      Not only would I freak out if left alone, hungry and homeless, I would definitely wish for a reprieve. And in this city, there is a choice to either get high, or eat well for a week and go to a quite natural setting. I'm all for opening riverview, but what about helping families and people on there own with living expenses and a chance to buy real, nutritious food.
      Why do people in this city seem so focused on munching on vegan burittos while others can hardly make a decent breakfast.