Vancouver mayor's first report on mental health and addiction identifies priorities for addressing a crisis

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      The city has published its first report on mental health and addiction nearly one year to the day that Mayor Gregor Robertson stood beside Vancouver police chief Jim Chu to ask higher levels of government for support in addressing those issues.

      Robertson used the report’s publication to reiterate calls for assistance.

      “Untreated mental illness and addictions continues to be an issue that our City confronts, whether it’s through our social services, policing, or schools,” he said, quoted in a media release. “Through the work of the Task Force, the City is committed to mobilizing the support of stakeholders and senior levels of government to address the challenge of mental illness and addictions, and help our most vulnerable residents get the support they need.”

      The document released this morning (September 10) summarizes work conducted by the Mayor’s Task Force on Mental Health and Addictions since it was formed in September 2013. It then identifies 23 “priority actions” divided into six categories that together comprise a strategy for how the province and regional institutions should work together to better address mental-health care needs.

      Those priorities are: working together and addressing service gaps, a peer-informed system, de-stigmatization, focusing on youth, focusing on wellness for aboriginal peoples, and enhancing addictions knowledge.

      The report states that through phase one of the task force’s work, there was a strong consensus around identifying those areas as priorities.

      “Phase 2 will include implementing short-term actions, further scoping of actions, the assignment of key leaders, and implementation strategies, with a report back to Mayor and Council next summer,” the report reads.

      The document also provides an update on four recommendations that the mayor, police, and Vancouver Coastal Health outlined in a September 2013 letter to Premier Christy Clark.

      It was suggested that support for mentally ill individuals be increased through Assertive Community Treatment (ACT) teams, which provide psychiatric care to people living in communities. The province responded by providing funding for an additional two ACT teams (bringing the total operating in Vancouver up to five) and by funding an Inner-City Youth Intensive Care Management Team.

      The province also acted on a recommendation that it create an enhanced form of urgent care in Vancouver. There is now a nine-bed acute behavioral stabilization unit at St. Paul’s Hospital, and an Assertive Outreach Team was established to manage individuals’ transitions from a hospital to a community.

      The province has not acted on a recommendation that it add 300 beds for long-term psychiatric care for patients experiencing more complicated mental-health challenges.

      Also left unaddressed was a suggestion that the province increase staffing at supportive housing sites to accommodate patients with severe addictions and mental health issues.

      In November 2013, the provincial government responded to the mayor and police chief’s initial call for help by making $26 million of new funding available for mental-health and addiction services. The province also produced its own “120-day” plan designed to address patients with complex mental-health needs.

      The mayor’s report highlights statistics that Robertson and Chu have reiterated publicly on several occasions.

      It notes that from 2009 to 2013, Vancouver General Hospital and St. Paul’s Hospital together registered a 43-percent increase in emergency mental-health visits, and that in 2013, the VPD reported an 18-percent increase over the previous year in apprehensions made under the Mental Health Act.

      According to the report, Vancouver is home to an estimated 2,000 SRO tenants who are “severely ill” and receiving no care for mental-health issues or problems related to addiction. In addition, roughly two-thirds of the city’s homeless population is identified as requiring mental health and addiction support that those individuals are not receiving.

      Chasing a crisis
      Through September 2014 the Straight ran a series of articles exploring how Vancouver cares for the severely mentally ill.
      Part one: Vancouver police still seeking help to prevent a mental-health crisis
      Part two: Amid a mental-health crisis, Vancouver care providers revisit the debate on institutionalization
      Part three: Vancouver service providers fail to get ahead of a mental-health crisis
      Part four: B.C. prisons lock mentally-ill offenders in isolation

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      Won't Work

      Sep 10, 2014 at 3:02pm

      The gap is inpatient care with adequate diet. I've seen what the people in the DTES eat---unless they are _exceptionally_ wily and spend almost all of their time dedicated to food procurement (which is difficult to do when you're abusing drugs on the daily), they will subsist on a diet consisting mostly of carbohydrate. Even if they spend lots of time procuring food, most of what they procure will be other sorts of carbohydrates---potatoes are better than white bread, but one cannot live on a diet of potatoes alone. And that is only helpful if the poor dear has a place to cook. Many of them don't.

      Combine this inadequate diet with a bunch of well-meaning (but prob. deranged) "healthcare"/"activist"/"community planner" types trying to tell these people that science has determined that their mental health problems have a genetic basis, that there is nothing environmental about mental illness---we've known this to be, at least generally, false since the discovery of B vitamins; there is a well-documented psychosis that comes about if people are deficient. It also tends to involve dermatological problems. Funny how most of those malnourished street drugs addicts are crazy and have bad skin. I'm _sure_ it has nothing to do with their diet lacking in essential nutrients, it must be some sort of original sin or stain on their genetic material!

      Add to that the inter-generational effects of bad diet---many of these people likely grew up eating the same white bread, potato chips and candy diet. This could inhibit their ability to learn things like math, which is necessary for a healthy diet. Add to that the impact of disorders like FAS.

      "Mental health issues" are the symptom of a much wider crisis, not the cause. The cause is a lack of inpatient care for those who need it, and a general acceptance of genetics as the cause, and pharmacy as the solution to the "crisis." Put someone in a "stabilization" bed, give him three squares a day, then let him loose into an environment where he won't get three squares, watch his symptoms return and tell him it's because he's genetically defective and that he'll need to take these pills the rest of his life, not so much so that he'll feel better but so that he won't generate so many problems for everyone else? Disgusting.


      Sep 11, 2014 at 10:17am

      <- seems legit

      There's a big Venn diagram overlapping with poor diet, mental illness, substance abuse, domestic violence, child abuse and neglect, lack of education, criminality, and religiosity. Basically, the things that successful people do, don't get done by chronic clients of The System.

      The why of it is historically interesting if you're into the whole "blame colonialism" scene but "Won't Work" is talking about addressing proximal, immediate causes of suffering, in this case malnutrition.

      It's not a sexy big giant human rights landmark like "you stole our land, MFs!" but, I dunno, it seems more achievable and productive for community leaders to encourage a focus on the small things, like lunch. And after lunch, cooking class and parenting support group. And then teen basketball, and so on. The mundanities that get junior to want to do well in school.


      Sep 11, 2014 at 11:43pm

      Ah...a blank is probably about what most of these posts amounts to... I was just saying that I kind of like what Won't Work said. I like the idea of relatively straightforward help. Food aid (I would include teaching how to cook, buy vegetables, plan diets, acquire utensils and so on) is as practical as it gets and the benefits are pretty big.

      But another part of what doesn't work, IMO, is well meaning outsiders giving tips. Nobody thanks you for pointing out that their house is not in order.

      The well meaning insiders are the ones who can give useful advise. And they are, by the effects, not giving very useful advise. Encouraging poor people to be angry at the government because of treaties, unceded terrority, the capitalist system, the real estate market in Vancouver (to name a few, you can add your own) for example, does not strike me as a very good way to encourage the government to cough up more dough for things of immediate value, such as parenting class, safe places for women transitioning out of domestic violence situations, high school completion, birth control, job shadowing, microloans, and whatever else integrates populations that are technically and morally NOT at war with each other.

      Sid Chow Tan

      Sep 12, 2014 at 12:55am

      Decent housing. Nutritious food. Good friends.

      Curious Aboriginal

      Sep 17, 2014 at 1:41pm

      Odd photo choice, no?