Mental health services need new approach to be effective
By John Reynolds And Stephen Toope
Media reports of those suffering with mental illness and severe addiction in British Columbia, and the Downtown Eastside of Vancouver in particular, have reached a level that may convey a sense of hopelessness. The release of the Vancouver Police Department report Policing Vancouver's Mentally Ill: The Disturbing Truth, as well as reports regarding deteriorated conditions at the psychiatric ward at Vancouver General Hospital and patient access to illegal drugs, could lead one to conclude that this will continue to be a significant drain on our policing and health care resources. This sense of hopelessness serves only to support proposals that the best solution to deal with severe addiction is isolationist (Drug Addicts Should Be Sent to Isolated Work Camps, Vancouver Sun, Sept. 14), which is more reminiscent of the archaic notion of leper colonies than it is a reasonable treatment strategy.
There is no doubt that problems created by those suffering from mental illness and severe addictions are costly to society in both financial and human terms. Some estimate that approximately 55 per cent of Vancouver's Downtown Eastside population of 18,000 are suffering from severe addiction and mental illness. The VPD reports that on average one third of all police calls for service involve one or more persons apparently suffering from a mental health issue, and this is true for one of every two calls in the DTES. The police have become "society's de facto 24/7 mental health workers."
It is clear that we need a renewed approach. As a society, we simply cannot afford to give up on improving the effectiveness of treatment for those suffering from mental illness and severe addiction.
One group of researchers, health care workers and community service providers is brainstorming an integrated approach that we think policy-makers and community members should support.
There is an urgent need to integrate mental health and addiction treatment systems and remove the silo approach to services in the Downtown Eastside, and beyond. The formulation of a better co-ordinated provincial model could provide a much more efficient use of scarce resources in our health system, community services and policing departments.
Two local examples give us a blueprint: the BC Cancer Agency and the B.C. Centre for Excellence in HIV/ AIDS. In both cases, the integration of research, training and clinical services, combined with the provincial co-ordination these centres provide, greatly improved outcomes for those with cancer and HIV/AIDS in B.C. and elsewhere.
Applying this model to mental illness and severe addiction would help tie together continuing initiatives, existing capacities, and future programs through best practice development, direct coordination of research and clinical treatment, training, and continuous evaluation.
We already have the necessary components of such a model. Imagine if we were able to effectively tie these together: world-class research conducted at University of British Columbia and other institutions, non-profit foundations such as InnerChange Foundation, policing agencies such as the VPD, mental health and addiction services, health authorities and health care professionals, and provincial leadership via the Ministry of Health.
Bringing these all together via a new B.C. Centre for Excellence would permit economies of scale, shared learning and the ability to directly coordinate both research and clinical treatments.
Dr. Michael Krausz, the UBC/Providence Health Care LEEF Chair in Addiction Research has said, "To provide innovative and more effective treatment you need clinical research, to do world-class clinical research you need innovative treatment facilities, and to train the next generation of experts you need both."
The VPD said it well in its report: We owe it to our most vulnerable citizens "to keep working toward more responsive and effective models of care for the mentally ill and/or addicted in our society."
John Reynolds is a board member of InnerChange Foundation and Stephen Toope is president of the University of British Columbia.
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