In case you were wondering: A surfeit of social realities to explain (a bit) about how we got here

Image by Taken from Pixabay

I haven't worked as a full-time journalist for almost 20 years now, but people still pay me to go find things out. I have a habit of finding way more information than the person who hired me wanted, the curse of a curious nature. 

Here's some of the surplus I've accumulated recently from some of that work, all of it related to the multiple layers of social crises we're seeing emerging in virtually every BC community. I drive along 900-block Pandora Street sometimes and am at a loss to grasp just what the hell is happening to us, but when I consider all the snippets of social tragedy below, it makes a very, very sad kind of sense. 

For instance:

We shut down institutions and never really replaced them with much

Riverview Hospital used to be BC’s largest mental institution, housing 4,300 people at its peak in the 1950s. But by the early 1990s, locking up people deemed "mentally disordered" for indefinite periods of time, with or without their consent, had fallen from favour. Riverview had been scaled back to 1,000 beds, and plans to replace institutional care with community care were in their final stages.

But from the start, the political motivations for closing Riverview were as much about cost savings as they were about philosophical shifts in how best to support people with mental illness. Between 1994 and 1998, spending on in-hospital psychiatric units was cut almost in half, and spending on community services for mental health was reduced as well, despite years of political promises to the contrary. 

Riverview was permanently closed in 2012. The long-abandoned promise of community services to replace what Riverview once provided isn't even talked about anymore. We are not going to return to the days of huge institutions, and that's a good thing, but there must be some middle ground between that and the modern-day reality of abandoning people with lifelong psychiatric health issues to figure out a hard life on their own. 

As for BC hospitals' psychiatric units, people pass through them so quickly nowadays that their mental health crisis doesn't even have a chance to stabilize. People used to stay an average 36 days in BC psych units before being discharged, but that fell to 15 days a number of years ago, and 14 days now. Psychiatric admissions between 2005 and 2017 increased 29 per cent, with no increase in beds[3].

People with developmental disabilities used to have to live in large institutions in BC as well back in the day. But deinstitutionalization happened for them around the same time as Riverview was being phased out. 

That population did seem to get better community care for a number of years after institutions like Tranquille, Glendale and Woodlands closed. But over time, the safety net has frayed substantially for them, too. It's not uncommon now to see people with developmental disabilities among the homeless. 

That is such a devastating ending for all the families who fought so hard in the 1960s-70s for the right for their children not to be locked away in institutions. Be careful what you wish for.

We are drowning in poisoned drugs

BC has always had lots and lots of illicit drugs. But what we've got going on in 2023 looks nothing like the relatively straight-forward drug scene of years past. With fentanyl, carfentanil, benzodiazapines and all kinds of other weird additives stirred into the mix now, people are getting sick in entirely new ways, and the death toll from toxic drugs is staggering. 

Since BC declared a public emergency in 2016, there have been 13,000 deaths from toxic drugs in the province, and no end in sight. Annual toxic drug deaths have increased almost ten-fold in the decade from 2012 to 2022, from 270 to 2,342.

For those who overdose on an opiate, prescription drugs like naloxone can save lives when injected immediately after an otherwise-fatal overdose. But people revived after an overdose are at high risk of having incurred a brain injury during the minutes when their brain was not receiving oxygen, and suddenly, a crisis of brain injury among people brought back to life after an overdose is emerging as a new (and almost completely unserved) concern.

Our governments quit building affordable housing

We all know there's a housing crisis going on. The increasing use of housing as an investment is often cited as a primary driver.  But as stats from BC's rental scene make clear, an equally big issue is that nobody has kept up with population growth. 

BC's population grew 34 per cent in the last 30 years. But in that same period, we've added exactly 6,000 more rental units. Our population grew by a third, while the number of rental units increased by a mere five per cent (from 114,129 units to 120,472[4].)

Equally problematic: Rents that are just so far beyond so many people's ability to afford. 

Average rents have increased 250 per cent in the last three decades. But the shelter allowance for those on income assistance was frozen at $375/month for the last 15 years up until this year’s increase to $500 (which still gets you nothing in any urban area). 

Given all of that, it's no surprise that the Lower Mainland's 2023 homeless count noted a 32 per cent rise in homelessness since 2020, with almost 70 per cent homeless for more than a year. We have created a permanent homeless class. 

We do jail differently now, mostly by accident

Even 15 years ago when the social crisis wasn't quite so obvious, people with mental illness or substance use disorders made up the majority of BC inmates, at 61 per cent. But now, it's almost like jail is the new psych hospital. Three-quarters of inmates now have a diagnosis of mental illness, substance use disorder or both. 

They and their fellow inmates churn through the system with unprecedented speed. The median length of stay in a provincial jail these days is 12 days. Almost a third of inmates across Canada are released from jail into homelessness. 

Provincial jail is where you do your time if your sentence is "two years less a day." But the majority of inmates in BC jails don't even have a sentence yet - they're in remand, where a person is held while awaiting trial if bail doesn't work out. People in remand units now account for 67 per cent of inmates in BC jails[7], up 15 per cent from a decade ago and slowly on the rise since the 1980s.

So we have recreated the institution part of Riverview by turning our jails into de facto psych units, but minus the psychiatric services and supports. Things that make you go hmmm.

We're still so far from doing right by Indigenous people

Indigenous people are over-represented in virtually every measure that matters for social wellness, health, safety and well-being. This is particularly true in terms of our jails.

Indigenous people account for six per cent of BC’s population, but make up more than a third of people in custody in the province[8]. In 2020-21, the incarceration rate for Indigenous people in BC was 22 in 100,000, compared to 2.3 for non-Indigenous British Columbians. 

A staggering 90 per cent of Indigenous people in provincial custody have been diagnosed with a mental health or substance use disorder[9]. Grimmer still: A Statistics Canada study released this year found that in the years 2019-21, almost one in 10 Indigenous men in Canada between the ages of 25-34 experienced incarceration[10]. 

We're returning to the days of poverty for some seniors, only this time they're homeless too

More than a fifth of people identified as living homeless in the 2023 Greater Vancouver Homeless Count are ages 55 and up. Nearly half of them became unhoused for the first time after turning 55. People age hard once homeless; those who are chronically homeless have life spans 20 years shorter than the rest of us.

Even comparatively comfortable BC seniors are struggling. BC Seniors Advocate Isobel Mackenzie noted in her 2023 "It's Time To Act" report that seniors in privately run, publicly subsidized assisted-living units are having a hard time keeping up with the array of additional costs that housing operators now charge for every little service, not to mention rent increases of up to 15 per cent a year at some facilities. 

And here's a strange trend: Even though BC's senior population is expected to increase to 25 per cent from 19 per cent over the next 15 years, the number of assisted living units per 1,000 population has fallen 15 per cent in the last five years in the province.

Is that because people don't want to live like that and they're finding other options, or because somebody has quit building that type of housing because they can make more money doing other things? Tune in 15 years from now to find out.

***

Ah, feels so much better to get those unused stats off my chest. I should wrap this up with some pithy conclusion, or a ringing call to action to fix this by doing a, b and c. But seriously, is it even possible to wish for a fix anymore? We are so profoundly late to the game. 

---

[1] https://www.publicsafety.gc.ca/lbrr/archives/cnmcs-plcng/cn28441-eng.pdf

[2] BC Ombudsperson report Committed to Change

[3] BC Schizophrenia Society and BC Psychiatric Association joint report

[4] https://www03.cmhc-schl.gc.ca/hmip-pimh/en/TableMapChart/Table?TableId=2.1.31.3&GeographyId=2410&GeographyTypeId=3&DisplayAs=Table&GeograghyName=Vancouver

[5] https://globalnews.ca/news/10030845/vancouver-homeless-seniors/#:~:text=%E2%80%9CWe're%20already%20in%20crisis,32%20per%20cent%20from%202020

[6] https://www.cbc.ca/news/canada/british-columbia/prison-mental-health-sfu-study-1.6271915

[7] https://www150.statcan.gc.ca/n1/pub/85-002-x/2017001/article/14691-eng.htm

[8] https://www2.gov.bc.ca/gov/content/justice/criminal-justice/corrections/reducing-reoffending/indigenous#:~:text=Indigenous%20people%20are%20nearly%206,and%2027%25%20in%20the%20community.

[9] https://www.oag.bc.ca/sites/default/files/publications/reports/BCOAG-Mental-Health-Substance-Use-Services-Corrections-Report-February-2023.pdf

[10] https://www150.statcan.gc.ca/n1/pub/85-002-x/2023001/article/00004-eng.htm

The upside of mental illness - creative brilliance

Nice to see mental illness finally getting some good press. The latest news is of a genetic link between creativity and mental illnesses, which seems to confirm once and for all what many other studies over the decades have also found.
From the Oracle of Delphi to the great creative talents of today, this thing we call mental illness has been enriching our communities for a very long time.
These days, it’s popular to wish for all mental illnesses to be treated and cured. But we’d be a poorer society in so many ways were we ever to achieve that questionable goal. Think of all the beautiful words, paintings, music and design we’d have missed out on over the centuries were it not for the brilliant work of creative people with mental illness.
I met a young busker and his friend on the Inner Harbour a couple weeks back, and have been struggling with how to write up their very interesting story without falling into one of those man-with-schizophrenia-overcomes-disability tales.
Because the thing about mental illness is that it’s not all about trying to “overcome” it. As science is now confirming, illnesses like depression, bipolar disorder and schizophrenia are linked to creative brilliance. And what’s intriguing about the story of Jordan Blaikie and his pal Ross Johnson is that their mental illnesses are in fact what brought them together in the first place, which has turned out to be a very positive thing.
Blaikie is 30 and Johnson is 29. Both have lived with mental illness for all of their adult lives and then some, having been diagnosed when they were teenagers.
They certainly know the negative aspects of living with mental illness, not the least of which has been an inability for the two men to find and keep a decent job. They’ve had to get by on disability cheques for the most part, supplemented with part-time work at pizza joints and the like. (“It’s a lot more fun to go busking,” notes Blaikie.)
Over the years they’ve been on medication, off medication and everything in between, and are all too aware of the challenges faced by people living with chronic and persistent mental illness.
Still, if they’d never experienced a mental-health crisis, they’d never have met. They met because they were housemates in 2007 at the Seven Oaks psychiatric facility, and struck up the conversation that ultimately led them to their new business venture: Tricky Magic Productions.
Blaikie had worked off and on as a street magician for three years before he met Johnson, having inherited his sister’s old magic tricks after she lost interest. Johnson had ideas for how Blaikie could extend his busking season by performing indoors in the winter months at seniors’ centres and community events.
And so far, so good. Blaikie took his magic show to 25 venues over the winter. More recently, the pair has branched into “casino nights” at some of the seniors’ facilities, having discovered the joys of dealing blackjack and Texas Hold ‘Em for delighted residents gambling for Thrifty Foods coupons.
It’s on to bigger and better things this fall. Johnson has booked the theatre at Eric Martin Institute for a variety show Oct. 10. The show will be a fundraiser for the Friends of Music Society, an organization that works on bridging the gaps between musicians with mental illness and those without it. The headliner will be Blaikie, of course - “The Great Jordano.”
“I’m hoping to have nine performers that night - we’re calling it ‘Monty Pylon’s Family Circus,’ “ says Johnson. “Most of us have disabilities, but not all of us. Anyway, it’s about the ability, not the disability.”
Blaikie dreams of becoming a cruise-ship magician. Johnson lists six Vancouver Island theatres he wants to do shows at one day. Mental illness will undoubtedly complicate things for the men, because it generally does. But maybe it’s also the thing that helps make Blaikie a confident and charming magician, and Johnson a sweetly enthusiastic pitch man.
Think of the creative gifts that mental illness has given us over the centuries. Would Ernest Hemingway and Virginia Woolf have set pen to paper in such compelling fashion if not for their mental illnesses? Would Van Gogh have painted with such passion and insight? Or Beethoven written with the same power?
Call it a sickness if you must, but the truth is that the world is a much better place for having people with mental illness in it. I wish my young busker friends a lifetime of shining in the dark.

Life can be lonely for people with mental illness
Jan. 4, 2008



I have a layman’s understanding at best about mental illness as a medical condition, but years of experience in how it plays out in real life.
You meet a lot of people living with mental illness when you work in the media. Those in the throes of an acute stage of illness often think their only hope is to get their story out there. So I’ve had many conversations with people carrying that label, and made a lot of shifts in my thinking as a result.
The more I’ve seen of mental illness, the less certain I am of what it is. But I do know it’s a damn difficult thing to live with, particularly in a world with little time for anyone who can’t keep up. It can also mean a life of terrible loneliness.
I’ve had a dear friend for about six years now who has been a remarkable tutor for me, including waiting patiently for probably the first two years of our acquaintanceship while I worked my way clear of defining her only by her illness.
With five decades of personal experience with the local mental-health system, she’s also a fount of knowledge, having lived through the gamut - from the locked-up, drugged-up days through to the group hugs of the 1970s, then on into the lean, mean 1990s and beyond. Her stories captivate me.
You’ll hear people tossing around that line about how we’re all one paycheque away from homelessness, but that really is true for people with major mental illness. However much effort they put into being well, it’s never going to be easy, and many will struggle for a lifetime to find the love and friendships that sustain the rest of us.
Worse still, anyone with serious and chronic illness has no choice but to rely on governmen to help keep their head above water. That’s a risky proposition at the best of times, but especially challenging in a period when governments are eager to shirk the responsibilities of caring for people.
Well over half of the people living on Victoria’s streets are mentally ill, and thousands more are living so close to the streets that one more bad break is all it’s going to take. My friend was in that latter group once and still would be were it not for all the hard-won things in her life that keep her well - good housing, good care, good friends.
But it’s a tough life just the same. Just ask Sharon Johnston, another woman with bipolar disorder who recently vented to me over a cup of coffee.
Like my friend, Johnston has an affordable place to live thanks to a mental-health rent subsidy. But the subsidy is slowly being whittled down - from $270 a month once upon a time to $225 now, and soon to $200. Those are big changes for someone on a disability cheque, and she’s scared and angry about them.
On and off a laundry list of medications through her 20-plus years of mental illness, she’s frustrated at not being able to afford the nutritional supplements she’d rather be taking. She’s worn out from counting every dime.
But Johnston’s real complaint on this day is not so much about shrinking subsidies and medical merry-go-rounds, but about a community that just won’t let her in. She feels it most poignantly at times like Christmas, when her acquaintances retreat into the comfort of their own families and she’s reminded of how very alone she really is.
“I may be warm and comfortable in a restaurant right now, but in society I’ve been homeless and out in the cold just the same,” says Johnston, 45.
We all need to feel connected, and for people with mental illness I think that is often the critical difference between who falls to the streets and who doesn’t. But a sense of self-worth - of purpose - is also vital.
For my friend, it comes through art, which has helped her through some of the most chaotic periods of her life. It feeds her soul even when everything else is going sideways.
Johnston uses music to manage, having played trombone for many years and studied music at university. “At this time of year, I always make sure I’ve got my guitar and trombone close at hand,” she says.
On this particular day, Johnston is angry at the world, but acknowledges that’s part of her illness. She knows her intensity tends to scare people away, which in turn just leaves her feeling even more isolated and angry.
She’s working on a gentler persona. “I’m telling myself that the trombone doesn’t always have to play double forte,” she jokes. “It can also play quietly and sensitively.”
She’s grateful for the Friends of Music, a non-profit that brings together people with mental illness to make music, and for friends at church. One of them gave her a necklace of tiny Christmas lights, which she shows me with pride. But she desperately wants friendships that extend beyond “a quick hi-bye” at the Sunday morning service.
“I do have some good people in my life, but they go away. I need people who could take me out for coffee now and then, or just pass some time,” says Johnston. “I feel like I always have to be working so hard just to stay happy.”

More cuts to mental-health supports betray the lie of "community care"
Aug. 31, 2007

These are the first words I’ve written about the closure of Laurel House. Given that it’s closing for good in three weeks, that’s pretty late to be taking up the cause.
The problem was that I had a job in the non-profit sector up until very recently, which made it difficult to go shooting my mouth off about decisions being made by another non-profit.
In fact, I caught an earful a couple months ago just for sending an unhappy e-mail to other non-profits letting them know that Laurel House was closing and our community would be losing yet another resource for people with chronic mental illness. I learned the hard way that I’d have to keep my own counsel on the subject for the time being.
Me and my 800 words aren’t going to change a thing at this late date. But a lament for Laurel House is in order just the same.
If you’ve read the flurry of letters in the paper these past few weeks, you have the gist of the story. A beloved drop-in program in a Fernwood house that supports a couple hundred people with chronic mental illness is to be shut down and replaced with new, short-term programs focusing on “rehabilitation.”
It’s good news for people with lower levels of mental illness, who could go a long way with a little rehab help.
But for the people whose illnesses are more profound – the ones who loved Laurel House because it was the only place where they felt accepted for who they were – the closure is devastating. They don’t need a rehab program. They need a place to go where somebody isn’t always trying to “fix” them.
On the surface, the Capital Mental Health Association appears to have made an independent decision to close Laurel House. But I can’t shake the suspicion that the move has less to do with the will of the CMHA as it does with trying to hold onto almost half a million dollars in annual program funding from the Vancouver Island Health Authority.
Non-profits have to bend themselves into all kinds of uncomfortable positions when it comes to maintaining funding. Perhaps the CMHA risked losing the entire $500,000 unless they scrapped Laurel House in favour of more rehab-focused programs.
Whatever the real story, I find the association’s public position on the issue pretty unpalatable. In response to a fairly scathing opinion piece in the Times-Colonist last week written by one of several health-care professionals opposed to the closure, CMHA board president Karla Wagner wrote a letter to the editor noting that some clients were just coming for the cheap lunch anyway.
“They are understandably upset that the lunch will no longer be served, but in its place will be expanded nutritional guidance and a community kitchen to achieve economies of scale,” wrote Wagner.
“We will be teaching people to fish, rather than giving them fish.”
Oh, please. I’m all for the concept of giving people a hand up instead of a handout, but sometimes a person just needs someone to give them a damn fish – or at the very least, a friendly face to sit beside while they eat it. “It’s lonely sitting in a bachelor apartment,” noted one Laurel House regular.
And when you’re barely scratching by on an $800 monthly disability cheque, what’s so wrong about appreciating a one-dollar lunch? Have we no compassion left for chronically ill people who may never be able to get out there and land a paid job?
I’ve got a good friend who has relied on the kind folks of Laurel House for more than 20 years. Some days, she’s plain worn out from trying to “better” herself from an illness that will be with her for the rest of her life.
She must have done a dozen programs in the six years I’ve known her, some of which have admittedly been very helpful in stabilizing her illness. But Laurel House was the gentle background noise to all those programs – the place where she knew she was always welcome, free to pursue the painting and sculpture that makes her happy, and able to make her own choices around what she’d do that day.
Neither she nor any of the Laurel House regulars were asked about the changes that are now underway. They were just called to a meeting one day and told how it was going to be. Apparently drop-ins for the mentally ill are out of step with modern psychiatric theory - these days, it’s all about short-term, work-focused programs.
That the new programs will be run by an occupational therapist rather than the psychiatric nurse who headed up Laurel House says it all. God knows what will happen to the poor souls who just don’t have it in them to rehabilitate themselves any further.
Once upon a time when B.C.’s largest psychiatric hospital was being emptied in favour of a new kind of “community care,” we vowed we’d take care of the thousands of British Columbians who were ousted from Riverview. The closure of Laurel House is just the latest in a long string of betrayals of that promise.