Monday, September 16, 2024

Lock 'em up: Everything old is new again

Image by Gerd Altmann from Pixabay

And just like that, institutionalization is back. 

My head is in a whirl. After untold hours of my early journalism career spent documenting the hard-won battle to banish BC's bad old institutions rife with abuse and civil-liberties violations, the former executive director of the BC Civil Liberties Association is now the premier of the province and pitching involuntary care like it's a fresh new idea whose time has come. 

“This announcement is the beginning of a new phase of our response to the addiction crisis," said Premier David Eby in a statement released yesterday in which government outlined how British Columbians could now be held against their will for mental illness, drug use or brain injury if they are making their communities feel "unsafe."

"We’re going to respond to people struggling like any family member would. We are taking action to get them the care they need to keep them safe, and in doing so, keep our communities safe, too," said Eby. 

If it was possible to believe that a return to institutionalization would actually play out that way, maybe it wouldn't feel so damn sad to have us rolling the clock back 50 years. History tells us otherwise, however. The stories of suffering that journalists all heard in those years leading up to the closure of BC's big institutions were absolute heart-wrenchers.

The whole reason we abandoned institutionalization back in the 1980s is because it's a horrible idea that doesn't work, except as a means to shield "normal" people from realities they'd rather not have to think about. 

Like what happens to people with severe mental illness when they don't get help and support. Or, in this latest incarnation of "secure care" (aka imprisonment), the tremendous damage a product can have on its customers in a market totally controlled by the sellers/manufacturers and abandoned by the regulators.

Instead of trying to fix any of that, it appears we're just going to lock people up again so we don't have to see our policy failures in their shattered faces.

As researcher Gillian Kolla noted in The Tyee last week, B.C. is jumping to institutionalization without even trying to see how things might go if we actually had spaces in voluntary, trauma-informed, evidence-based treatment programs for all the people who are desperate for such services. Research and experiences all over the world - much of it right here in BC - have demonstrated time and again that institutionalization does not make people well, and in fact puts them at risk of even more harm.

Sure, temporary secure care might have a role in helping to manage some aspects of the social crisis unfolding in all of our communities. But it's meant to be a last resort, after all other attempts to help a person have failed. Please don't let anyone tell you that the people we're seeing spilling out onto our streets have had every social intervention provided to them already. That is so very far from the truth.

Our current social crises are in fact a result of decades of social needs gone unmet. We haven't even begun to try hard to help people with mental illness, substance disorders and brain injuries. Virtually all of the services we've got are patchwork, disorganized, uncoordinated, short-term and often unevaluated. BC doesn't even have an overarching social policy.

We have orchestrated a disaster with our indifference - and now we're going to "fix it" by finding new ways to hold people against their will? Not a chance. 

As Kolla also pointed out, BC does have the power right now to hold people against their will under the Mental Health Act. If someone is deemed a danger to themselves or others, they can be held. (And that definition includes threats and anti-social behaviour, as my uncle Joseph McCorkell found out back in the 1990s when he fought his own incarceration in the years before Riverview Psychiatric Hospital was fully phased out.)

How low will be the bar be for this new initiative? No details yet, but I'm going to take a wild guess that people who are impoverished, traumatized, unable to maintain paid work and with a lifetime of struggle and hardship will be the first ones in. Interesting as well that these new secure facilities are mostly going to be sited at prisons, not hospitals. 

To see brain injury thrown into the mix this time out just adds to the wrongness. Someone suffers a serious injury that causes behavioural changes that unravels a life, and our government decides the best course of action is to make it really hard for them to get any help, and then lock them up indefinitely when they inevitably fail to recover. 

As soon as I read that Vancouver story earlier this month about one person getting their hand severed by a stranger with a machete in a mental-health crisis and another person dying, I knew where this was going, especially mere weeks before a provincial election. 

Eby has been hinting at a return to institutionalization since 2022, when he was angling to replace John Horgan. BC Conservative leader John Rustad has made institutionalization part of his party's platform.  I suspect both will get plenty of support from the electorate for their positions, because everyone I know is sickened and fed up with the social disasters unfolding on their city streets. 

But the answer to the tragedies we're seeing in the hearts of our communities is not to lock people up. Where is the announcement of preventive measures to slow the flow of people onto our streets? Where are the services that would catch people early in their crisis? Why are we embracing the harshest "solution" first? 

I wonder if I will live long enough to be throwing out a bitter "I told you so" in 15 or 20 years when we are back to trying to undo the damage of this deeply sad return to institutionalization. People, we are making a mistake.