Lots of politicians are lawyers. Some are community activists. Others hail from the labour movement or business. But Kerry Jang is the only B.C. politician who is also a professor of psychiatry, and he’s trying to put this expertise to good use as a member of Vancouver city council.
The most visible example came in the recent approval of a $500,000 council grant to the Mental Health Commission of Canada to convert the 102-unit Bosman Hotel into supportive housing for the mentally ill. It’s part of a four-year national research project to assess ways to help homeless people with high and moderate needs. The hotel on Howe Street will be used for about three years between 2010 and 2013 at a cost of nearly $8.2 million, with funding coming from the commission, the shelter portion of income allowance, the Streetohome Foundation, and the Vancouver Foundation.
Jang, who is a member of the UBC faculty of medicine, told the Georgia Straight in a phone interview that city staff worked closely with the commission and the Portland Hotel Society to win the support of the neighbours. “When they thought it was necessary, they called me in,” he quipped.
In 2008, SFU’s Centre for Applied Research in Mental Health and Addictions reported that there were approximately 19,500 adults in Vancouver in 2005 with severe addictions and/or mental illness. Of those, 1,800 were described as “absolutely homeless”. Another 2,280 were at risk of becoming homeless.
Many assume that all homeless people are mentally ill, but Jang said this is a mistaken impression. He noted that it’s unknown what percentage of homeless people actually meet the definition of mental illness as laid out in the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. “To be honest, the estimates are all over the place, and that’s what bothers me,” he said.
To address this information gap, two of his colleagues in the UBC psychiatry department, Bill Honer and Bill MacEwan, are conducting a study of the mental health of formerly homeless people who live in supportive-housing units. Jang said that these psychiatric assessments sometimes include magnetic resonance imaging (MRI), which creates detailed pictures of the brain. He revealed that preliminary results indicate there is less schizophrenia and much more brain trauma, fetal alcohol syndrome, and bipolar disorder among this population than the researchers initially expected. “So we’re kind of surprised by that,” Jang said.
Last January, council approved Jang’s motion to create a mental-health plan for Vancouver. In the preamble, he mentioned that the Vancouver Police Department reports that a third of its calls involve at least one person who is mentally ill. “Having a mental-health plan for Vancouver will outline the various roles of governments and capitalize on the strengths,” he said. “If we’re good at real estate, land use, and building use, then we should be harnessing this as opposed to doing it in an ad hoc way.”
A staff report in July estimated that the city spends $28 million per year responding both proactively and reactively to situations involving mental health and addictions. This includes everything from the cost of buying land designated for supportive housing to fire and rescue calls to civic-staff time dealing with addicted and mentally ill people.
Jang said staff have expressed concerns to council about possible provincial downloading of mental-health services and suggested that by defining the city’s role, this could be avoided. In the end, the city decided to focus its attention on building capacity rather than taking on the cost of delivering more health services, which are under provincial jurisdiction.
As the city opened more shelters, the expertise to address mental-health issues was being dispersed. “Some have lots of skill and experience,” Jang said. “Some have virtually none. As one guy put it, ”˜We had some workers who couldn’t tell when somebody was acting out if they were just being an asshole that day or if they were having some sort of psychotic break.’ They couldn’t distinguish between the two.”
To help address this, he said, the city is working with the Canadian Mental Health Association to educate emergency workers and other staff. When asked how the average person can determine if a person is psychotic, Jang advised examining what precipitated the behaviour. If there’s an underlying cause for a person’s anger, it’s less likely that he or she is psychotic.