We need compassionate P3s for the Downtown Eastside
By Trish Walsh and Michael Krausz, Special to the Sun
When we consider public-private partnerships (P3s) in British Columbia, we usually think of rapid transit lines, bridges and economic infrastructure.
We don't normally associate P3s with things like drug addiction and mental illness on the Downtown Eastside. But we should.
Similarly, when we consider private involvement in health care, we usually think user fees or for-profit clinics. We don't normally associate private health care investment with helping the most vulnerable in society. But we should.
Corporate social responsibility is not something new to Vancouver. In fact, you could argue our business community has led the way. There are many examples of compassionate public-private-partnerships happening in B.C. now -- particularly related to construction of social housing.
Over the past three years, Vancouver has witnessed a historic scaling up of housing supply to meet our urgent homelessness need. For addiction we need to see the same scaling up of resources to meet demand. System capacity is severely lacking and another compassionate P3 should be part of the solution.
In a recent Vancouver Sun column, Stephen Hume suggested the homelessness catastrophe in Vancouver stems not so much from the recent cold temperatures as from the collective enduring coldness of Vancouver citizens. This opinion represents a challenge to all of us -- individuals, businesses and government.
One year ago in the speech from the throne, the provincial government promised to complete a new 10-year mental health plan to meet the needs of our neighbours with complex physical, mental and addiction care needs. Today, the 10-year plan is one of the many important priorities being considered for next week's budget.
If the provincial government delivers on a comprehensive mental health plan and a research agenda focused on the growing number of people diagnosed with concurrent disorders, Vancouver's private sector should step up to the plate, too.
In addition to proving Hume wrong, we can complete a compassionate P3 that will change our city forever and set an example for the world when it lands here a year from now.
Among other things, a properly funded 10-year strategy can expand clinical research and continue the development of innovative treatment models for the most vulnerable in the Downtown Eastside and across the province.
The plan should also include the creation of an International Centre of Excellence in Addiction and Concurrent Disorders -- as proposed by top researchers at the University of British Columbia.
The UBC centre would facilitate innovate applied research trials and follow-up on the recently completed North American Opiate Medication Initiative (NAOMI) that found promising results with substitution treatment and heroin maintenance.
It would also provide a valuable outlet for the private sector to make direct contributions to effective, cutting-edge treatment solutions.
Given the economic crisis, governments are rightfully taking a harder look at bottom lines and considering innovation. It is a time for considering strategic options based on best practices and changing approaches that are not working. The status quo is not an option.
Addiction and mental illness are the leading cause of combined disability and death among Canadian women. Youth suffering from addiction and mental illnesses face high risks of early disintegration as development problems are often not recognized at an early stage.
A recent national health report concluded that mental health and behavioral disorders were responsible for 52 per cent of hospital stays among homeless people. The most common type of mental health problem recorded for homeless patients in Canada was substance abuse (54 per cent.)
A 2005 survey of 1700 homeless in Vancouver found 49 per cent having an addiction and 23 per cent reported having mental illness.
At St. Paul's Hospital there has been a 30-per-cent increase in the number of patients entering the emergency room with a mental illness over the past year. The average patient spends 48 hours in the emergency room -- and 27 per cent of them are readmitted within a month.
Simon Fraser University research-ers have estimated that the average B.C. homeless adult with severe addiction and/or mental illness costs the public system more than $55,000 a year. Provision of adequate housing and supports is estimated to reduce this cost to $37,000 -- for an annual "cost avoidance" of about $211 million.
And it was one year ago that Vancouver police released a study that reported 49 per cent of their emergency service calls in the Downtown Eastside involved people with mental illness or drug addiction.
The bottom line is if our society does not make the investments required to help people with concurrent disorders then we will pay a price for another generation.
And while we can measure the financial cost of inaction to government and society, we will never really be able to calculate the personal toll on families and human souls.
Trish Walsh is executive director of the Inner Change Foundation, a non-profit society focused on promoting innovative drug treatment research --including substitution treatment for chronic addicts. Dr. Michael Krausz is the UBC/Providence Health Care leadership chair in addiction research.
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