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. 

Life sentence for victims of intimate partner violence

Sharing an opinion piece I wrote this week that was published today in the Times Colonist, sparked by the sentencing of a serial assaulter of women. 

Tyler Mark Denniston is going to jail. And on the one hand, that’s a win in the world of intimate partner violence, where 80 per cent of the crimes aren’t even reported to police and a conviction is far from certain.

But the impact of the Greater Victoria man’s beatings will be felt by the women he attacked for so much longer than he’ll be in jail. That’s not just about having to live with the trauma - it’s about brain injury. 

People experiencing intimate partner violence end up with a brain injury (IPV-BI) from that violence as frequently as 90 per cent of the time.  A majority of them, in fact, end up with multiple brain injuries, because intimate partner violence is rarely something that only happens once.

Denniston was given a four-year jail term this week for attacking his then-girlfriend in 2018 and 2019. But he has a history of major assaults of previous girlfriends before that, all of a type most associated with brain injury. He strangles his intimate partners. Hits them in the head. Smashes their heads into furniture.

One of his victims said in an impact statement at Denniston’s trial that since her abuse, she has become someone she doesn’t recognize. She has trouble falling asleep, has terrible nightmares when she does, and is experiencing periods of explosive anger, panic and suicidal thoughts.

Whether she knows it or not, that could be because she is now living with a brain injury on top of all the trauma she has endured.

But if she’s like the vast majority of victims of intimate partner violence, her brain injury will go undiagnosed and unsupported. IPV-BI is such a newly emerging concept that even victims themselves don’t think about whether they’ve incurred a brain injury. The impact of their untreated brain injury can put them at risk of losing their job, their housing, their kids and so much more, and they won’t even know why.

It seems unbelievable that a woman who is beaten by her partner violently enough to incur a brain injury could suddenly find herself on the precipice of profound poverty, homelessness, child-protection involvement and social isolation as a result of the assault. Surely services are there to support her, or she could move to the head of the line for housing and supports to keep her safe?

Unfortunately, there are no designated services at any level – in BC or Canada – specifically for people experiencing IPV-BI. While some bright spots are emerging within Island Health around piloting occupational therapy assessments as a means of helping victims get past diagnosis barriers, that work is in its earliest days.

More broadly, there are no guidelines for health professionals to follow to ascertain IPV-BI-caused injury. No overarching plan. No targeted funding. No consensus as to what should be done, or data being collected.

And if work on all of that got going tomorrow, there are other hurdles. Start with the fact that only one in five women beaten by their partners even report the assault to police, rendering most victims of IPV-BI completely invisible in our systems.

Add in the stigma, lack of witnesses and fear factor for the victim around doing anything that might spark a whole other assault, and it’s not surprising that the majority of women aren’t even going to visit the doctor about that hit to the head they took, or after they’ve regained consciousness from being strangled.

And even when they do seek medical attention, there are no provincially funded community services for them unless their concussion shows up on an MRI scan. Which is not often the case, because it’s an injury that doesn’t show up well on an MRI, and is much better diagnosed through its impact on a woman’s ability to function.

At any rate, unless a woman can pay for that assessment of her functioning, and the services she needs as a result of what’s discovered, she’s never going to get that support anyway. It was nice to see IPV-BI get some solid mentions last fall in the BC government’s Safe and Supported action plan against gender-based violence, but we are so badly overdue for some genuine action on this appalling state of affairs.

So yes, Tyler Mark Denniston is going to jail. But he’ll be out in not much more than a couple of years if he behaves himself, and his life will carry on pretty much the way it always has. His victims, on the other hand, have been handed a life sentence.

Jody Paterson is a lobbyist and advocate on the issue of intimate partner violence and brain injury on behalf of The Cridge Centre for the Family and the Board Voice Society of BC.