I see the woman with the pretty eyes every night – but we never speak. She endlessly puts on lipstick – over and over she smears the bright colors on. She smiles into any mirror she can find, laughing and telling secrets to the bright-eyed girl within. Her own image is the only confidant I have witnessed her indulging. She looks past me and I know she doesn’t see me. I am the ghost in her real world – my words cannot touch her, my own smile slips away transparent in the blinding light of her internal revelations.
I see the man with the blue mittens and tangled grey beard each night. He throws up his fists at invisible predators, and shouts at the sky as if hoping some omniscient deity would like to take up his arguments. He pushes a phone book across the room for hours with quiet intensity, and drapes his shoelaces across his dinner plate. Mumbling, sometimes singing to himself, he asks me several times a night what I think about cardboard, or sometimes cheese, always forgetting my answer. He seems deeply engrossed, vacationing in a private mental resort– we stand apart from one another in a frozen vignette separated by a gulf of mental illness that I feel helpless to span.
I am not a doctor, nurse or counselor. I am not a psychiatric specialist, or even a mental health association volunteer. I am merely a support person helping the homeless to find a warm place to rest, perhaps something to eat or on a tough night, offering a sympathetic ear. Yet I can guarantee and assure you, I can tell you with 100 percent certainty that my blue-mitted gentleman and pretty-eyed friend are in desperate need of mental health care. My wish for them is a cleaner safer environment, and of someone to help administer care and medications that will help free them from the traps their own minds have surely become.
Michael Kirby, Chair of the Mental Health Commission of Canada, says 25 to 50% of homeless people have a mental illness. The DI shelters over 1200 people every night, and at a very conservative estimate, around 300 people (25%) suffer from profound mental illness and another 10 to 20% mild to profound mental illness. They all require the same thing, care beyond the level we are able to provide at the DI.
Historically, although staff could plainly identify those in desperate need of mental health care, the rigors of the mental health care act limited what could be done to help these individuals. With the new Mental Health Act guidelines, hope for more appropriate levels of care is possible.
James Galloway
In 2004, Martin Ostopovich, a diagnosed paranoid schizophrenic, killed RCMP Officer James Galloway in Spruce Grove Alberta. A former Alberta Hospital patient, Ostopovich had been released against the attending psychiatrists recommendations. Due to definitions in the mental health act the hospital could not continue his treatment without his consent. Even though professionals felt he could potentially harm someone, they could not prove, (as was necessary under the old MH legislation) that the patient was a direct danger to himself or others and thus keep him confined. Shortly after his release, Ostopovich killed Officer Galloway and a public outcry for an inquiry into the cause of the crime arose. This inquiry would eventually result in recommended changes to the Mental Health Act (MH Act) that widen the criteria for which a patient may be involuntarily admitted or held for mental health treatment. Changes that could have saved the life of Officer Galloway had they been in affect five years ago. Changes that do have the potential for better care for our clients with mental health issues.
Care givers no longer have to prove the patient is a direct danger of bringing ‘harm to themselves or to others’. They can now request assessment or continued care within a psychiatric facility if the individual is seen to “suffer substantial mental or physical deterioration or serious physical impairment.” This means we don’t need to wait for harm to happen, we can bring forward to mental health caregivers more of the people whom we believe need assessment. We no longer must stand by helpless as someone deteriorates – we have a stronger mechanism to engineer better living – to span the gap between us.
On the heels of this legislative change however, The government has stated that it will close 246 beds at Alberta Hospital (our central provincial MH hospital). Rather than receive specialized mental health care in a central location, patients will be sent to local (non MH) hospitals in “community care settings.” Regardless of the provincial government’s assurances to ensure ‘appropriate care’, the unanswered question remains: In an already strained and overburdened system, how will downloading mental health care to communities improve access and delivery of service?
Sadly, as happened in the 1990’s with the closure of mental health facilities across the province, it’s probable the DI will see more clients with severe mental health disabilities with no where else to go. It is a Catch-22. More latitude to ensure clients receive more appropriate MH care. Few specialized MH beds and staff to care for them.
Fundamentally, the legislative changes allow us to better care for the ones we care about. It is, in the end, at least some small consolation to know that from something as sad as the loss of life at the hands of someone suffering with a MH disease, that some hope, no matter its girth, has been garnered.
So why should YOU care about these changes? Perhaps you are not affected by homelessness or work in a shelter. Perhaps you feel this issue is but a byline in the newspaper. Stop. One in five adult Canadians (21.3 percent) will suffer a mental disorder in their lifetime. This figure translates into 4.5 million people – one of them might be your best friend, partner, son or daughter – one of them might even be you. It’s a wonderful feeling to know you are being empowered to help those you love and care for – and that’s one thing here at the DI we know LOTS about!
I really hope this legislation is effective. And sure, it’s a fine line and all, but down here we really see it up close. And it becomes so hard to help people in certain stages of their illnesses.
When I worked nights, some nights I would need to spend almost all my staffing resources managing one client. It’s really not the best situation. But when no one else will take them, what do you do? You manage.
Anyway, great article, Ginny! And I really hope the legislation helps to change things. I feel your pain.