Fighting the Tax Man for the Disabled – A Review of An Accidental Advocate

By Marvin Ross

Lembi Buchanan’s book is described by Dr David Goldbloom, professor of psychiatry at the University of Toronto as “an Erin Brokovitch style memoir”. In his Foreword, Murray Rankin who got to know Lembi when he was a Member of Parliament from Victoria and National Revenue critic in the House of Commons said:

Lembi’s memoir is a David and Goliath account of what a single, determined “accidental advocate” can achieve. While it is inspiring at that level, it is also a deeply personal story about the challenges of living with a person with bipolar disorder. Her love shines through as brightly as her tenacity.

Lembi set out to advocate for tax fairness for Canadians with disabilities over 20 years ago thinking that it would be an easy task. What she found was that “common sense and practical solutions do not prevail in government” What she encountered was “an obstructionist bureaucracy obsessed with balancing the budget, even when it meant denying a modest tax credit to the very people who need it the most. In order to achieve its goals, our government was systematically breaking the law and getting away with it.”

Canada has a disability tax credit which enables those with significant disabilities and their families to get some tax breaks to help make their lives easier. But, qualifying is no easy task. Over the years, the criteria have changed making it, at times, more difficult to qualify. Many doctors have even refused to fill out the necessary forms claiming that it would be senseless as their patient will be refused anyway.

The medical certificate that Lembi received from her husband’s psychiatrist was one of the subjects in her Tax Court case Buchanan VS the Queen, 2001. Not only did she win but she also successfully fought off an appeal by the Government. In that case, her husband’s psychiatrist appeared as a witness for the Crown and did not impress the judge. Her Honour, Judge Campbell stated that “To go on to state in writing that most of his patients will not qualify for the credit based on the information he provides is clear and blatant bias, and for this reason I conclude that he misapprehended his responsibilities in completing the form when he stepped into the shoes of judge and jury. In doing so he not only misinterpreted his role but misinterpreted the relevant sections of the Act as well.”

Today, doctors who refuse to fill out the tax form can be sanctioned by their regulatory college in Ontario at least.

Lembi has been fighting for over 20 years and is still fighting today with allies from a number of Canadian health groups. Her husband and her adult children are highly supportive of her efforts which were recognized when she was awarded with the Meritorious Service Medal for her contributions to Canada in 2016 by then Governor General David Johnston.

Aside from demonstrating that it is possible for a private individual to fight the government bureaucracy, this book is also a love story and an excellent description of the impact of bipolar disorder.

It was just before Christmas in 1972 when Lembi and Jim found themselves stuck at LaGuardia in New York waiting for the same flight to Toronto to visit family. Lembi admits to approaching the “very good looking, dressed impeccably in a Bill Blass suit, peach coloured shirt and a nice matching silk tie” man waiting for the flight in a standing room only crowd. They moved to the bar while they waited and when the flight was cancelled, they headed off to the Port Authority Bus Terminal to catch a Greyhound to Toronto together. That was the beginning of a relationship that has endured despite the ups and downs of Jim’s bipolar disorder that often threatened to sabotage their happiness.

The book is a must read on many levels and an inspiration to all. For more information, check out the book website at https://anaccidentaladvocate.ca/

An Accidental Advocate, Lembi Buchanan, Beresford Press, ISBN 978-1738947621 Distributed by Ingram and available from your favourite bookstore.

On Gender Dysphoria

By Dr David Laing Dawson

My field, broadly speaking to include psychologists and therapists of all stripes, has an unfortunate history of taking our patients’ anxieties and conflicts, usually stemming from that complex broth of nature, nurture, our intricate first 24 years of brain development, and our human awareness of self, and inventing a disease, or at least a defined and categorized “disorder”.

Part of this arises, I think, from our persistent failure to appreciate the extent to which our own presence, our words, our interpersonal exchanges and negotiations, affect the other’s perception of reality and memory.

Another part arises from our both professional and human need to categorize and label. Our patients share this need or wish. They often want a diagnosis. And then, of course, a role is played by insurance companies, our wish to have medical legitimacy, and big pharma.

In my professional lifetime we invented multiple personality disorder, and then satanic ritual child abuse. In the first instance we transformed a legitimate, entertaining literary conceit, into a medical reality. For the second, a naive psychiatrist followed his patient down a rabbit hole of fanciful experiences of cinematic child abuse and wrote a popular book about it. Both concepts flourished, and damaged hundreds of lives before being debunked and diminished in size and scope.

Yet both linger on. The first in treatment programs for “dissociation disorders”, and the second in the search for an early trauma that would explain all of today’s anomie.

Beyond the damage these inventions have caused in and of themselves, they also undermine public understanding and empathy for actual neurological and mental illnesses. Beyond schizophrenia being persistently presented as a form of multiple personality by cinema and press, the very existence of invented fictitious diseases dilutes our concern for real diseases.

We can’t be human without being conflicted. Conflicted in our wants, desires, impressions, even our perceptions. Anxiety, stress, puzzlement, confusion are all necessary experiences in the evolution of our self awareness.

In today’s popular culture there seems to be a strong belief in a journey to find oneself, one’s true self, as if this homunculus existed already, and awaits to be found hiding somewhere among the bushes of our seeking. Whereas, more realistically, the self we settle for is an amalgam, sometimes a compromise, between our genetic directives and the stew of interpersonal and social imperatives surrounding and feeding us during our complicated brain development. To find that self, the adolescent brain really has only two basic modes of responding: reject/oppose or accept and imitate.

And today, of course, much of that interpersonal and social stew in which we simmer is virtual, distorted by social media algorithms, and often fictional. At a time when fact and scientifically established reality is readily available to all of us, we are bombarded with equal quantities of bull shit.

Which leads me to a topic fraught with land mines. Gender dysphoria, binary, non-binary, and identity.

Now, before I go there, I have to say I have had a broad range of experiences with patients with “gender dysphoria”, from the extremes of a trans woman long post hormone treatment and surgery, now concluding it was all a mistake (“I should have been treated for obsession”), to a very smart, but socially very awkward young man, becoming a trans woman much happier and more successful than “she” was as a man (so far), and a young woman deciding she not only did not identify as female or male, she also did not “identify” as human. To say nothing of young men (always on the autistic spectrum) who are disgusted with their penises, to young women who have concluded, by experience, that it would be much safer to be a man.

This discourse could go in many directions but I would like to focus on the aspect implied by the opening paragraphs. We live in a time when we have cast out many rules and rituals and not found replacements, when the social stew in which our sense of self (in harmony or conflict with our natures) develops, is, well, out-of-control, wild and uncontained, and often now overwhelmed with the fantasies of social media. Dysphoria of all kinds is bound to increase. And, indeed, it has. Youth mental health is in the news every day, along with endless discussions of the effects of social media.

So here is the question: Given all the above, might we health professionals be making matters worse by reifying this particular dysphoria, gender dysphoria, into a diagnosis (disorder, syndrome, disease)? The numbers of children and youth diagnosed with this “disorder” is increasing at the same pace we once watched “multiple personality” and “satanic ritual child abuse” increase. The people who received these latter two “diagnoses” were of course troubled, dysphoric, but the whole business of several named personalities residing within one brain was an invention, complete nonsense, as was the whole notion that there were cadres of parents abusing and sacrificing children on Satan’s alter. As is the notion that a “person” can be born in the wrong body.

Supportive Housing or Supportive Housing – Which Would You Prefer?

By Marvin Ross

I suspect that it is universally recognized that supportive housing is necessary and crucial for many with serious mental illnesses. When I think of supportive housing I think of a clean, decent place to live for vulnerable people at an affordable cost which includes qualified support staff present to supervise, monitor and to ensure safety. And, of course, legislated standards and inspections.

Unfortunately, that is not often always the case. I’ve written a few times about a local supportive housing organization that is considered to be the largest in Ontario. You can see my diatribes about them here in the Pitfalls of Supportive Housing Part I and Part II Since I wrote those, there have been more disasters with that agency exposed by the Hamilton Spectator.

Unfortunately, the Spectator has those articles behind its paywall but the first one is by reporter Susan Clairmont on October 6, 2022. She describes the death of one resident, Michael Miller, whose body was not discovered for at least a week. He was actually found a day earlier by a staff member who checked on him, saw him lying in bed, seemed unaware of the smell and assumed he was asleep.

Bear in mind that Ms Clairmont points out that “There are nurses, psychiatric social-support workers, addiction experts and housing specialist working at Parkdale” (the name of that particular building) yet no one noticed the man’s absence. His body was so badly decomposed that his identity had to be confirmed by DNA and no cause of death could be determined but there was no sign of drugs in his system.

That article points out opportunities to have seen Michael and to have noticed that he was missing:

• He was often in and out of the front door
• Did anyone notice that he did not pick up his dinner which is provided at that residence?
• Did anyone ever do apartment checks on residents?

Michael’s disappearance was only noticed when he did not attend a medical appointment with another agency and they had the police do a wellness check. Police reported “that the smell was horrendous”. Michael was the second person who had died without being noticed at Indwell although in the previous case, the resident had been murdered. My posts linked above discuss that.

Then there was a third undiscovered body reported to the Spectator writer.

On November 9, 2022, Ms Clairmont reports on another death that went unnoticed for three days. This one took place between the murder and Michael Miller’s death. Eric Green had been first diagnosed with schizophrenia when in jail and had been on hard drugs in the past but he had been clean for five years according to his mother.

Unfortunately, drugs are readily available at this particular Indwell building which came out at the murder trial and Eric was lured back in. In her coverage of the murder, Susan Clairmont stated that “Security cameras inside Parkdale captured hours of video of both dealers hanging out in apartments on Michel’s floor (the murder victim), going in and out of units at all hours. The trial heard they were selling drugs and collecting debt.”

Eric’s mother said he begged her to get him out of that building but his only other choices were a shelter or the street. After his not being seen for a few days, staff called police and his body was found. An autopsy revealed that he died from an overdose of meth laced with fentanyl. The coroner stated that “there were issues with purple heroin in the complex.”

One of the suggestions Eric’s mother made to Indwell is that they set up dry floors for those who do not want to be around drugs or alcohol. She does not believe any of her suggestions were accepted.

Indwell has been a registered charity since 1984 and, to give credit where it is due, they are excellent when it comes to acquiring old properties and renovating the building into very attractive apartments. They have a number of buildings in Hamilton and in Haldimand-Norfolk, London, Peel Region, Waterloo, St Thomas and Oxford. They fail miserably, in my opinion, at running them. According to Revenue Canada, their total revenue is $65.6 million with slightly over $52 million coming from governments. Total compensation to staff comes to almost $10 million for 227 full time and 110 part-time staff. Eight staff earn between $80,000 to $119,999 per year while two earn between $120,000 and $159,999 per year.

Disclosure – my son lived in the building described above, was one of Michael Miller’s friends and lived across the hall from the man who was murdered. He now lives in another Indwell building.

In contrast to Indwell, let me describe another supportive housing group in the same city which, I confess, I just learned about from the Spectator. Options for Independent Living and Development is a small organization with residents who have “Down syndrome, schizophrenia, a variety of learning challenges and other conditions that make it helpful for them to have a special place, and if they are different in many respects, they have at least this in common here … and that is each other, as friends.”

The residents can be busy all day and involved with various activities that are available for them such as bowling, crafts, learning and at an activity centre. Day trips are arranged to various venues like the Ontario Science Centre, theatrical musicals and the butterfly conservatory.

Total revenue for this organization is just under $500,000 and they only have one full time and seven part time employees. I don’t have full details on how many clients they service but I intend to explore this organization in greater detail. The praise for it in the Spectator is intriguing and to be trusted as I know the writer. (He has written favourably about me so I know he can be trusted)

The message from this blog is that we need better rules for what constitutes supportive housing, standards that must be adhered to and inspections to ensure that is happening including evaluations of efficacy. Long term care facilities have standards and inspections so we don’t put granny into places that are substandard. What is good for grandma and grandpa should be the same for the mentally ill and others with chronic problems who need care and support.

Unfortunately, there are many long term care facilities that are substandard. These are mainly the ones which are privately run.

Pride Month and Schizophrenia Advocacy

By Marvin Ross

It’s Pride Month and the LGBTQ+ community and AIDS activists can teach schizophrenia advocates how to do it. There are commonalities between the two groups. Gays hid in the closet for years while many families are still embarrassed by the illness their loved ones have and don’t say anything to people. More of us need to come out of the closets and fight. When we do, we often find people who have schizophrenia or other serious mental illnesses in their families. It is doubly important for us to do that because the LGBTQ+ folks have the mental capacity to fight their battles when our relatives do not.

Just look at what has been accomplished by them in a few years. Not only are cops not raiding bath houses but police chiefs and right wing politicians are proudly marching in Pride parades (unless they are Republicans in the US). The Pride flag flies over many public buildings including police stations. There are some exceptions of course and in Ontario, the York Region Catholic School Board has voted to not fly the flag. At one of the debates held by their council, police had to be called to deal with the opposition but they eventually went ahead and refused. Now, there are calls to the government to force them to fly the flag.

A relief pitcher for the Toronto Blue Jays posted an anti-gay video on-line and was forced to apologize to the public and to his teammates. The Toronto Star editorialized that he be traded and when he came in to pitch shortly later, fans booed.

Very few defend those with schizophrenia. A number of years ago, I went to a Billy Crystal one man show and he told the audience how his mother worked as a bookkeeper in a psychiatric facility and charged schizophrenics for both their identities. I complained and the theatre passed my complaint on to him (or they said they would). Then I heard a radio DJ on Valentine’s Day make up a stupid poem about a schizophrenic and his two identities. I complained again.

As for AIDS, it has gone from a sure death sentence to a manageable chronic illness in a very short time. I’m not sure if this had anything to do with it but I was at an AIDS medical conference in the late 90’s and was surprised to see that half the delegates were AIDS activists. They were arguing and pressing the docs and researchers to do more and providing commentary on the studies presented. Maybe its time that we started showing up at psychiatric meetings.

We need to up our game considerably although I recognize that many families are exhausted. I know I am. Some of it was done, at least where I am, when the Schizophrenia Society of Ontario had an active chapter in Hamilton, Ontario. We had regular monthly meetings with interesting speakers that were well attended, we put on an annual mental health fair where most of the agencies had booths and explained to the public what they did, a well attended Annual General Meeting and banquet with a speaker from the local health system and an annual golf tournament sponsored by the NHL Old Timers.

The golf tournament raised a considerable amount of money and enabled the chapter to explain schizophrenia to the golfers before the first hole. One determined mother stood in the hot sun and would not let anyone tee off until she had explained the disease to them and given them literature.

We once met with the hospital president and his senior staff to demand greater accountability in the post hospitalization residences they were in charge of. I still remember one vice president ask in exasperation if they were supposed to house the people at the Hilton.

It all died when the central provincial office exerted its legal authority to take over the chapter and the other well functioning ones. Today, schizophrenia is not in the name of the provincial organization which holds yoga sessions. Over 20 years ago, they were central to lobbying for community treatment orders to be implemented in Ontario and they were successful.

Time to get back to active advocating across the country.