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B.C.'s mentally ill are lost in the wake of record-high surpluses as the Provincial Government's health care system sinks. Authorities seem woefully ill-equipped to bring forth sensible strategies to cope with even the most obvious, tragic outcomes such as homelessness.

With a serious mental illness striking 1 in 5 Canadians, this neglect demonstrates a shameful disregard for the health and welfare of citizens.

Untreated mental illnesses not only devastate the health and social welfare of individuals, with time, the circle of victims expand to include family, friends, coworkers, employers and the community at large. The costs are high as children loose their parents, brothers loose their sisters and the taxpayer picks up the tab.

Mental illness is recognized by those on the front-lines of community outreach as a leading cause of substance-abuse and homelessness. The BC Partners for Mental Health and Addictions Information, a project funded by the BC Provincial Health Services Authority, admits to the dire situation facing B.C.'s victims of mental health disorders: "People with concurrent disorders—the combination of a mental illness and substance use disorder (sometimes called ‘dual diagnosis')—often fall through the cracks in the province's health care system.”

A national survey in the US reveals that “between 50-75% of people with a substance use disorder are affected by a mental illness and between 20-50% of people with mental illness also have a substance use disorder.”

The strongest argument supporting why such "dual-diagnoses" exist is that individuals with untreated mental illness will begin to self-medicate with drugs or alcohol. Such that an otherwise contributing member of society can eventually fall victim to substance-abuse while seeking relief of the early symptoms of the disease through progressive substance-use. This starts a vicious cycle as the substance-use oftentimes acts as a trigger to the underlying mental illness, which causes the victim to seek further relief through self-medication. Research concludes that in a case of a dual-diagnosis, the underlying mental illnesses exists up to ten years prior to the surfacing of substance abuse -persons with an untreated mental illness are very likely to self-medicate, eventually becoming substance abusers.

Treatment Roadblocks

Why then does mental illness go untreated?

“Mental health services may refuse treatment to a person with an active drug or alcohol addiction, while addiction professionals may believe that a person cannot recover from problem substance use until the mental disorder is treated. As a result, people with concurrent disorders are sometimes bounced back and forth between both mental health and addiction services or they may be refused treatment by each of them."

"Although Greater Vancouver has a small concurrent disorders program, it is not equipped to serve the growing number of people with these illnesses in Vancouver, let alone in the rest of the province. Concurrent disorders are much more widespread than many people realize. For example, it is generally estimated that around half of people with an addiction or mental illness will also have the other."

According to the Public Health Agency of Canada, "The stigma attached to mental illnesses presents a serious barrier not only to diagnosis and treatment but also to acceptance in the community."

"The serious stigma and discrimination attached to mental illnesses are among the most tragic realities facing people with mental illness in Canada. Arising from superstition, lack of knowledge and empathy, old belief systems, and a tendency to fear and exclude people who are perceived as different, stigma and discrimination have existed throughout history. They result in stereotyping, fear, embarrassment, anger and avoidance behaviours. They force people to remain quiet about their mental illnesses, often causing them to delay seeking health care, avoid following through with recommended treatment, and avoid sharing their concerns with family, friends, co-workers, employers, health service providers and others in the community."

The Missing Link

Since part of the disorder oftentimes entails lack of recognition that a problem exists, it follows logically that if suffers were thinking clearly, they would not need help. This leaves many alone to fend for themselves while the illness, neglect, self-medication and destruction continues.

Whatever the reason, what we are doing now is simply not effective as addiction continues to devastate lives all around us --been downtown lately?

The shortcomings of traditional 12-step programs have been offset thanks to modern work conducted in the treatment of a dual-diagnosis. Therapeutic techniques such as the transtheoretical model of change recognize that change occurs in stages. The therapy delivered must be appropriately match to the present phase of the patient's recovery.

The missing link between the individual and the care they deserve is intervention. We seem to be waiting for incompetent citizens to all of a sudden start exercise their civil liberties and sound judgments to make independent decisions for their own welfare. Again, if these citizens were thinking clearly then they wouldn't need help.

Reforms

British Columbia's Mental Health and Addictions Reform initiative provides the vision for a comprehensive, evidence-based continuum of mental health and addictions services in the province. As part of this reform in BC, the Ministry of Health formed best practices working groups that would build upon the vision and foundation provided by the Review of Best Practices Mental Health Reform (1997), prepared by the Health Systems Research Unit of the Clarke Institute of Psychiatry under the auspices of the Canadian Federal/Provincial/Territorial Advisory Network on Mental Health.

Seven reports titled BC's Mental Health Reform Best Practices were developed and published in February 2002. The reports reflect the efforts of 44 industry representatives who participated in the best practices working groups. Following literature reviews and consultation, they compiled services and strategies that produce positive health outcomes for individuals.

The following reports are available:

• Crisis Response/Emergency Services (PDF 4.5MB)

• Consumer Involvement and Initiatives (PDF 1.8MB)

• Housing (PDF 4.1MB)

• Inpatient/Outpatient Services (PDF 2.7MB)

• Psychosocial Rehabilitation and Recovery (PDF 2.6MB)

• Family Support and Involvement (PDF 1.5MB)

• Assertive Community Treatment (PDF 1.4MB)

http://www.healthservices.gov.bc.ca/mhd/bpelementsbc.html

Page 2 of each report has this disclaimer:

"

Important note

The principles of psychosocial rehabilitation form the philosophical
foundation for all best practices in mental health care. These principles
emphasize both consumer involvement in developing and realizing
personal care and life goals, and treatment and supports that help
consumers manage their symptoms and build on their strengths."

Sounds fair enough, but the choice of word consumer was conspicuous to me --Suddenly, we are no longer patients or even clients, we are consumers. If that's the case, I think a lot of people deserve a refund.

Harm Reduction

One good example that the road to hell truly is paved with good intentions is that of the safe-injection site --Any first year psychology student knows the difference between harm reduction and enabling. A harm reduction program that does not reduce harm is not a harm reduction program, it is a harm enabling program, a crutch for addicts to continue down the road to self-destruction. AIDS is now treatable, most addicts will not live long enough to worry about the long-term complications of AIDS.

The "Insite" program, brought to you by the good people of the Vancouver Coastal Health Authority is located at 139 E. Hastings. Hours are 10AM to 4AM 7-days per week open to the drug abusing public. If you're 17 years or older, check it out.. Free parking in rear, be sure to bring your own drugs though because they haven't figured out a way to tax heroine yet. But that's OK, because you can buy outside anyway.

Please be advised that in order to protect the drug use experience of all guests, and in accordance with WCB Regulations, Insite is a NON SMOKING shooting gallery -please refrain from smoking anytime during your trip.

Programs like Insite perpetuate a lifestyle of insanity: Those addicts will never achieve the level of intellectual competency necessary to think past their next hit thanks to the assistance of the Vancouver Coastal Health Authority and your tax dollars.

Prescription Drug Abuse

Prescription Drug Abuse. This one speaks more for the level of incompetence taxpayers endure from our officials than anything.

Not to advocate prohibition, after all, any substance can be abused; Drugs, alcohol and even food. It's just infinitely annoying to witness both common sense and existing laws routinely violated, particularly when done in a professional capacity.

Such is the case with many medical industry professionals that allow prescription drug abusers to renew prescriptions at multiple Doctor's offices and pharmacies. While the evidence on hand is only colloquial hearsay, not being aware of a study that has documented the phenomenon, however, the industry knows it happens every day.

In a technique know as 'Drug Diversion' legitimate drugs are used for illegitimate purposes. Here's how it works:

1) Fake pain.
2) Shop for a Doc
3) Forge or modify a prescription
4) Call in your own prescription

There are a couple of tricks involved. The first is the most difficult to stop, but is also the least significant in magnitude. The first problem is that any given prescription drug user can turn around and sell their medications. The deterrent to the buyer is the expense and the necessity to deal with a dealer which always carries the risk of getting caught. This combination of high cost plus risk and inconvenience works as a deterrent to many.

The second trick with prescription drug abuse is that patients can go Doctor shopping --looking for a Doctor that doesn't care enough to check their medical records to confirm that they have already been prescribed medications by others. If they complain loudly enough, some Doctors will write a prescription simply to get the abuser out of their hair. If the Doctor refuses, they will simply find another one. Oftentimes it comes down to how ethical and diligent the dispensing pharmacist is --the good ones, if they have any doubts about the patients legitimacy, will follow up with a call to the Doctor's office, or if they recognize that the patient as an all too frequent customer, they will simply refuse to dispense. The bad ones are more interested in the dispensing fees they earn and simply fill the prescription. For anonymity, abusers will use every trick in the book --they will go to every pharmacy in the area, hoping not to be recognized, or they will try to get someone they know submit/pick up the prescription on their behalf --unaware at the time, the author has been personally recruited for such a task.

Plugging the holes in the prescription drug industry could be done easily if their was the will to do so among health care providers. This by no means would completely stop prescription abuse, but at least it would make the access to those powerful drugs more difficult.

Take a look for example at the typical prescription that the Doctor hands you --does that look like even remotely like a secure document? No, not really...A $5 cheque with security features, watermarks, microprint and holograms would be scrutinized more by a bank teller then a prescription for ativan.

If standard operating procedures simply dictated the use of just a little due diligence in reviewing the patients prescription history, this problem would be solved and would close the door on another major enabling substance-abuse factor -ease of access.

Summary
Severe mental illnesses are more common than cancer, diabetes, or heart disease. A mental illness can strike anyone at any time. What if one day someone you love needs help?