As the mental health and addictions crisis continues to wreak havoc, a business leader in B.C.香蕉视频直播檚 capital city is calling for a rethink of the provincial mental health strategy 香蕉视频直播� even if that means pulling people off the street and putting them in care against their will.
香蕉视频直播淲e have to take a look at the idea of involuntary care for some of these people who are no longer in a position to be able to care for themselves or make the right decision,香蕉视频直播� said Bruce Williams, CEO of the Greater Victoria Chamber of Commerce, during a luncheon last month.
Experts say this presents difficult choices about self-determination and who pays for care, while those who have struggled with mental health, addiction and life on the street say meeting basic needs like housing will go much further to address these problems than involuntary care.
The Feb. 23 luncheon was arranged to allow chamber members an opportunity to ask B.C.香蕉视频直播檚 finance minister about the 2024 B.C. budget. Public safety was the first issue he brought up.
Finance Minister Katrine Conroy acknowledged it is a topic of conversation within government.
香蕉视频直播淲e have a number of thoughts on that from different experts, experts that say it doesn香蕉视频直播檛 work, and experts that say it does,香蕉视频直播� she said. 香蕉视频直播淵ou have to balance it all and make sure what you香蕉视频直播檙e doing is not harming the person; that you香蕉视频直播檙e actually helping them.香蕉视频直播�
Business leaders want 香蕉视频直播渙pen episodes of addiction and mental illness breakdowns香蕉视频直播� off the streets, Williams said.
香蕉视频直播淚t would make the streets safer for them, and for those of us who also work on those streets, and walk on the streets, and live in those neighbourhoods.香蕉视频直播�
Looking for examples elsewhere
While generating a fair amount of controversy, New York City instituted a policy in 2022 that allows police officers, firefighters, mental health clinicians and other designees to effectuate the 香蕉视频直播渞emoval of a person who appears to be mentally ill and displays an inability to meet basic living needs, even when no recent dangerous act has been observed.香蕉视频直播�
This is different than what is allowable in B.C. Other than family members and guardians, police are the only people with this authority, and can only detain a person under the Mental Health Act when an individual poses an immediate threat to themselves or others.
The other difference in B.C., according to the University of Victoria香蕉视频直播檚 Erica Woodin, is that places like New York have more resources for mental health care than B.C. does.
香蕉视频直播淣ew York City, in my understanding, is putting a good deal of resources into a greater number of psychiatric beds and community supports,香蕉视频直播� she told Black Press Media.
香蕉视频直播淩ight now, it香蕉视频直播檚 very difficult to even get care for people who are at risk of harm to themselves or others [in B.C.].香蕉视频直播�
Woodin is a psychology professor and has spent years studying Victoria香蕉视频直播檚 Assertive Community Treatment (ACT) teams, which work to treat people who have severe mental health issues and have been identified as a risk to themselves or others.
These teams, which include police, try to help with basic needs like housing and accessing medical care, as well as providing mental health treatment.
She contends that in the past half-century, the deconstruction of the old institutionalization system in Canada, which at one time included involuntary committals of those suffering with mental illness, was not replaced with adequate community supports.
This happened throughout the 1960s and 70s as new medications, such as powerful anti-psychotic drugs, allowed people with mental illness to recover and live in their communities.
But as time has gone on, the lack of actual services to provide mental health care for people, particularly those who have not been identified as a threat to themselves or others, has left a gaping hole in the system.
Falling through these gaps are people like Guy Felicella, who spent 20 years living on the streets of the Downtown Eastside in Vancouver dealing with addiction and mental health issues before finally getting the treatment he needed.
He said in an interview that undiagnosed learning disabilities and childhood trauma made recovering from addiction an almost impossible proposition 香蕉视频直播� especially without the money to pay for treatment.
香蕉视频直播淭rauma therapy is not covered under MSP,香蕉视频直播� he said.
香蕉视频直播淵ou just can香蕉视频直播檛 go walk into a trauma therapist and start talking to them.香蕉视频直播�
Felicella is a vocal advocate for addressing people香蕉视频直播檚 basic human needs, such as housing, then give them the choice and means to seek treatment. Until these needs are met, people will simply be scrambling to solve the daily struggle of how to get food and where to sleep, he said.
Without a place to go upon release from treatment, people simply end up back on the street, and either stop taking meds, start using again, or both.
Forcing treatment when people aren香蕉视频直播檛 ready will also have little success, he said.
香蕉视频直播淚t香蕉视频直播檚 more like turning the treatment industry into a prison industry,香蕉视频直播� Felicella said of involuntary care. 香蕉视频直播淎nd, that really wouldn香蕉视频直播檛 be a therapeutic environment for people to start healing from their pain and trauma.香蕉视频直播�
Some tricky questions
Figuring out how to get people into treatment who have not outrightly shown themselves to be a danger to themselves or others while also respecting people香蕉视频直播檚 right to self-determination presents some difficult choices, Woodin said.
香蕉视频直播淭here are layers of issues there that make these decisions really difficult.香蕉视频直播�
Part of this is the difficulty of determining when a person is actually able to make a decision for themselves, epecially if they have refused to take anti-psychotic medication and are experiencing psychosis or mania.
香蕉视频直播淭hat香蕉视频直播檚 the debate right now, too, is to what extent do you coerce individuals to take medication that they do not want to take,香蕉视频直播� Woodin said.
香蕉视频直播淭heir symptoms might be so severe that their judgment might be incapacitated香蕉视频直播�
If police or others do intervene, and the person is brought in for an evaluation, the question also remains of how that treatment is funded.
香蕉视频直播淚f we have no services for them after the evaluation, then we have put the individual through what can be a stressful and potentially traumatic situation,香蕉视频直播� Woodin said. 香蕉视频直播淏eing hospitalized against your will is not a pleasant experience for a lot of people.香蕉视频直播�
Woodin and her colleague, Catherine Costigan, have been studying whether a police presence on the ACT teams is helpful or harmful. So far, she said that police officers trained specifically for the team tend to be able to look at cases through a mental health lens, rather than a criminal lens.
These teams work with people who have already been deemed high-risk, and who are given the choice to either participate or return to a hospital setting. This means it is a 香蕉视频直播渃oercive香蕉视频直播� model for care, as people aren香蕉视频直播檛 really given a choice.
香蕉视频直播淐ould you use a coercive model like that for an individual who wasn香蕉视频直播檛 deemed to be at such high risk, but maybe still needed the supports?香蕉视频直播� Woodin asked. 香蕉视频直播淭hat香蕉视频直播檚 the tricky question.香蕉视频直播�
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