Comic: If physical diseases were treated like mental illness
BC Mental Health Act (1996)
Vancouver Sun, (2012).
- 1850: First reported case of insanity in B.C.
- 1872: Victoria Asylum opens.
- 1873: The Insane Asylum Act is introduced. It specified that a person deemed a “lunatic” should be committed to an insane asylum upon certificates issued by two doctors who examined the patient in the presence of each other.
- 1878: Asylum for the Insane opens in New Westminster.
- 1900: The principal causes of insanity are thought to be genetic, intemperance, syphilis and masturbation.
- 1913: The Hospital for the Mind opens, housing 340 male patients. The name was later changed to Essondale and then Riverview Hospital.
- 1954: The first psychiatric drug, chlorpromazine, used at Riverview in 1954.It replaced shock treatment therapy for severe depression and lobotomies for schizophrenia, mania and psychotic disorders.
- The use of anti-psychotic and tranquillizing drugs transformed patient therapy theories, allowing patients and doctors to realize the mental illness was not untreatable.
- 1955: Riverview reaches peak population of 4,726 patients and about 2,200 staff.
- 1965: A new B.C. Mental Health Act encouraged locally operated mental health services, which led to the downsizing of Riverview and the transfer of patients closer to their home communities.
- 1997: The 190-bed Forensic Psychiatric Hospital was built on the remaining Colony Farm land. It houses people in conflict with the law who at one time were deemed criminally insane, but the term has been changed to “not guilty by reason of a mental disorder.”
- 2002: It was decided Riverview would eventually be phased out in favour of community-based psychiatric treatment.
- July 2012: Riverview to close. Dr. Soma Ganesan, who spent a decade as the lead physician at Riverview and now is head of psychiatry at Vancouver General Hospital, suggested one building at Riverview be preserved as mental health museum.
© Copyright (c) The Vancouver Sun.
Mental health cuts disturb doctors
Vancouver Sun, (2013).
As members of the Department of Psychiatry at Lions Gate Hospital, we are responsible for servicing the needs of those with serious mental disorders.
Our in-patient and community mental health services assist thousands of active patients every year. Anyone picking up a newspaper will find tragic reports of the mentally ill assaulting people, committing suicide, and clogging our prisons and hospitals.
This is why we were very shocked to be informed Vancouver Coastal Health (VCH), which manages Lions Gate Hospital, plans to cut $500,000 from the budget for community mental health on the North Shore.
This is a significant proportion of our budget and will result in staff layoffs and fewer services to the very patients who are causing such concerns.
These cuts will result in longer length of stay for patients in hospital, as well as make the integration of these patients back into the community much more difficult.
Longer lengths of stay on the in-patient unit will also unfortunately lead to a congestion of psychiatric patients in our emergency department.
The irony is not lost that mental health is moving to the Hope Centre next year, a multimillion-dollar building largely supported by private and community donations. It makes no sense that we will be moving into this multimillion-dollar building and yet be cutting positions.
The undersigned strongly urge that VCH reconsider these cuts in view of the damage it will inflict on the most vulnerable of society.
Thomas W. Barnett, MD
Allan Burgmann, MD
And seven colleagues at the Department of Psychiatry at Lions Gate Hospital
© Copyright (c) The Vancouver Sun
Drugs and lack of safe housing part of Vancouver's mental health crisis: experts (BC)
Luk, V. (2013). Montreal Gazette.
VANCOUVER - A man wielding a knife threatens to kill passersby, another man says he'll burn down an apartment building and kill everyone inside, and a third man is taken to hospital after trying to throw himself off a bridge for the second time in one night.
The incidents happened within one week last month, and Vancouver Police say they're part of the shocking statistics that show a dramatic spike in such scenarios over three years involving the mentally ill and their subsequent contact with law enforcement and the city's hospitals.
Police say 21 per cent of their calls involve someone who is mentally ill, and apprehensions under the Mental Health Act have risen 16 per cent between 2010 and 2012.
Rising drug use and a lack of safe housing are major factors in the problem that is overwhelming limited resources, experts say.
St. Paul's Hospital, which sees most of Vancouver's psychiatric emergencies because of its proximity to the impoverished Downtown Eastside, has seen a 43-per-cent increase in people with severe mental health issues during the past three years, police say.
A recent review of the hospital's emergency department suggests that increased use of amphetamines, such as crystal meth and ecstasy, may help explain the increase in mental health patients.
"There is this interesting trend towards what appears to be increased drug-related (emergency room) visits, and drug-related psychosis," said Dr. Eric Grafstein, regional head of emergency medicine with Vancouver Coastal Health and Providence Health Care.
Grafstein said the St. Paul's emergency room saw about 4,700 patients with mental health-related complaints last year, up 1,500 visits from three years earlier.
But forensic psychiatrist Shabehram Lohrasbe believes the gradual closure over the last two decades of Riverview Hospital, a mental health facility in suburban Vancouver, plus the simultaneous "explosion of drug use" could have created the perfect storm.
"The mentally disordered are prime targets for the drug trade," he said.
"We dump these people on the streets, but even if they're provided housing, they're still very vulnerable to predators particularly within the drug trade. So the constant battle is not only to keep them on their prescribed medications, but to keep them away from drugs."
Lohrasbe said health officials probably did not anticipate deinstitutionalization followed by increased drug use when the government decided to close down Riverview in favour of community-based care.
At a roundtable discussion on mental health and addictions last month, the City of Vancouver estimated about 70 per cent of the city's homeless or single-room occupancy residents are seriously addicted and/or seriously mentally ill. Many also have brain injuries due to physical trauma, medical causes, or drugs.
A 100-bed facility in Burnaby currently offers treatment to people who are both mentally ill and suffer from substance abuse.
However, an affiliated pilot project that provided supportive housing for people with mental health, addiction, and chronic diseases was shut down last year.
The program operated out of Riverview Hospital, which closed down at the same time.
"Riverview has been in the process of closing for over 20 years," he said.
"If there was a specialized facility on Riverview grounds for this population it would be beneficial, but I don't think the closure of Riverview had anything to do with (the increase in the number of incidents involving people with mental illnesses). Most of the people who left Riverview in the last 10 years went to purpose-built new facilities that were appropriate for their needs."
A three-year, cross-Canada supportive housing program called At Home/Chez-Soi, funded by the federal government, had housed homeless people with mental illnesses and addiction, but it also ended last March.
"The most important thing when managing seriously mentally ill people is safe, secure housing," Lohrasbe said. "If you can guarantee that, everything else follows."
A five-point plan announced by Vancouver's mayor and the police chief includes calls for an additional 300 long-term, mental-health treatment beds, the establishment of a crisis centre, and more housing facilities to help the mentally ill.
Video: B.C. mental health system failing teens, watchdog says
CBC News (2013).
In many cases, youth who were receiving mental health care were shunted off to shelters, emergency rooms or even jail.
"A young person described it as falling off a cliff. All of a sudden you're 16 and there's no treatment bed, there's no support [because] you're an adult," she said.
Instead, families are faced with a fragmented and under-resourced system that can be confusing and traumatic, Turpel-Lafond said.
Her report on youth mental health in the province found serious shortcomings and poor communication in a mental health system she described as a patchwork of services that was inconsistent from region to region.
The report says promises from a 2003 report to improve the mental health system for children have gone unfulfilled.
She wants to see the creation of a Minister of State for Youth Mental Health, responsible for building a three-year plan to create coherent mental health programs for teens.
Health Minister Margaret McDiarmid says such a plan will have to be discussed after the election, but she agrees that health care for mental illness needs to be seamless.
"There's a particularly vulnerable population that have two transitions: an age transition and a between ministries transition that we are not managing well enough today and we need to address that," McDiarmid said.
In the meantime she says 2,000 GPs in B.C. have received extra training to deal with mental health in their practices.
Video: What happens when a killer is found not criminally responsible?16x9.
“I was standing right here and I hit the floor,” recalls Carol de Delley. “I went out the door and just screamed ‘No”!”
De Delley’s son, 22-year-old Timothy McLean, was killed in 2008 aboard a Greyhound bus just outside Winnipeg, Man.
In 2009 a court ruled Vince Li, the 40-year-old Edmonton man charged with the brutal slaying and decapitation, Not Criminally Responsible (NCR), meaning he was in a psychotic state at the time of the murder. Li, who has schizophrenia, was remanded to the Selkirk Mental Health Centre and is under the care of a psychiatrist.
Lori Triano-Antidormi also lost her son to a killer found NCR. Sixteen years ago her two-year-old son, Zachary, was stabbed 10 times by neighbour Lucia Piovesan, in Hamilton, Ont. Like Li, she has schizophrenia and is housed in a mental health facility receiving treatment.
“People think about punishment, right. And that these people need to be punished. But they don’t commit the crime out of ill intent. They commit it out of an ill mind,” says Triano-Antidormi.
Video: ‘Improv is a safe space’: Laughs help treat mental health issues (NS)
Wong, J. (2013). Global News.
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