At the end of an eventful year for mental-health care in Vancouver, stakeholders say more should be done to address problems before they reach a crisis point.

“There has been an expansion of things like housing and assertive outreach,” said Darrell Burnham, CEO of Coast Mental Health. “The question is whether that is enough. I’m not sure if it’s enough, but it’s not bad.”

Burnham said in 2015 he wants to see more cooperation between service providers.

“We’re not working from one file, and so the same client has a new experience every time they get to a new provider,” he explained. “We need to figure out a way to support someone’s privacy but also have a more consistent approach to some people who have complex issues.”

Jonny Morris, director of public policy with the Canadian Mental Health Association’s B.C. division, praised the Vancouver Police Department for calling attention to mental-health issues. He noted the province answered those calls with new and enhanced services. Where Morris said there is room for improvement is in addressing issues as they develop.

“We would definitely like to see more attention on what communities can do to prevent people from becoming more ill,” he said. “Getting ahead of the problem.”

Through 2014, VPD chief Jim Chu coordinated with Mayor Gregor Robertson to call attention to what they described as a “mental-health crisis”.

Partly in response, in March the province unveiled a nine-bed emergency psychiatric unit at St. Paul’s Hospital. It also increased the number of “assertive community treatment” (ACT) teams deployed to provide care where people live. More recently, on December 17, Health Minister Terry Lake announced 14 new long-term beds at the Riverview grounds in Coquitlam. The latter became available in addition to a relocation of 26 beds from the Burnaby Centre for Mental Health and Addiction.

Speaking at Riverview, a complex that once housed more than 5,000 patients before a long process of deinstitutionalization was completed in 2012, Lake emphasized that developments at the mostly abandoned site do not mark a return to an outdated mode of care for the mentally ill.

“Eventually, when we’ve settled on the longer-term plan, we will move from 100 beds—that we have at Burnaby at the moment—to a total of 163 beds. But it will be a continuum of care,” he said. “If people are looking for a simple solution, to take 2,000 people and put them behind walls again, that’s not going to happen.”

In 2013, the province spent $1.8 billion on mental-health care. According to Lake, that amounts to a 60-percent increase over spending in 2001.

Sue Hammell is the Opposition critic for mental health and addiction and NDP MLA for Surrey–Green Timbers. In a telephone interview, she noted that the addition of nine and then 14 beds is far below the number that Chu and Robertson say is required: 300.

“I don’t think anyone—even the minister—thinks that we are doing enough,” Hammell said. “We are spending a lot of money on mental health, make no mistake. We’re just spending it in the wrong way.”

She argued that, too often, people with a severe mental illness connect with service providers too late.

Hammell said this is evident in the number of calls to police that involve a mental-health component, a statistic that the VPD says reached a five-year high in 2014. She also noted the proportion of people in B.C. Corrections facilities who struggle with mental illness—at least 56 percent, according to a December 18 Ministry of Justice report.

“If you have pneumonia, you don’t wait until you are almost dying before you get care,” Hammell said.

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