Guest Blog – A Mother’s View on the State of Mental Health Care in Canada

By Marilyn Baker

It was 6:00 a.m. Vancouver time, February 2^nd, 2004. We had just gotten up when the phone rang.

“Who could be calling at this ungodly hour?” I wondered. The call display showed a 416 area code.

When I answered a woman’s voice on the other end said, “This is Dr. Goldstein. I’m a psychiatrist working at St. Michael’s Hospital emergency department in Toronto. Do you have a son, Matthew?”

My heart stopped. I sat down and said, “yes.” I was shaking.

This was the moment I had been dreading for more than a decade. I didn’t know what was coming next. I feared he was dead.

Aside from a brief visit at Christmas we hadn’t seen Matthew for more than a year. He had vanished and we didn’t know where he was.

The doctor was very good. She reassured us that he was alive, but not in good condition. He had been found unconscious in a hotel room and brought into hospital in an ambulance. She didn’t use the word suicide, but it became clear from her questions that she suspected he had tried to take his own life. She had many questions. Over the 45 minutes or so, I tried my best to answer them.

When we hung up, relief washed over me. Finally! I thought, someone – a doctor! – had discovered what we had known for years:

It was not our imagination. My son really was sick. There was something wrong with him. Specifically, there was something wrong with his brain.

But now, thankfully, he was going to get care. Treatment! Doctors and nurses were going to look after him and find out what was wrong and fix it. I laid my head on the kitchen table and wept.

Matt was admitted to the psychiatric ward in St Mike’s and seemed to be doing well. He liked the hospital and a nurse told me was he receiving Zyprexa, the brand name for a new anti-psychotic drug called Olanzapine.

Seventeen days later, the phone rang again. It was three in the afternoon, so six Toronto time. Matthew was being abruptly discharged into a freezing February night in Toronto. He had no place to stay, no friends or family nearby, no money, no identification, no nothing. He had no means to cope with the freezing cold February night.

I begged the charge nurse not to do this. Why at night? When banks were closed and hotels were probably filled. He had no money, He said everything was lost when he was admitted.

I shall never forget the charge nurse on duty. My pleas for help, for mercy, for time for me to find help for him, fell on cold deaf ears. He simply said No. No. No. Over and over again.

When I asked “Why?” he said that Matt did not have an Ontario health card so would not be allowed to go a halfway house. I tried to explain that he had applied for BC health card but he still didn’t have it. The application had been lost so we had re-applied. But the nurse was unmoved. Matthew was heartlessly discharged into a freezing February night in Toronto.

I was panicked and frantic. They were basically sentencing my son to freeze to death.

This was my rude introduction to the barbaric state of mental healthcare in Canada.

It was the night that I learned how to scramble to save my son’s life.

This was when I learned that our mental healthcare system is a cruel joke – a patchwork quilt of people not talking to other people.

All I knew then was that my son was about to be ejected into a freezing February night in Toronto, with no place to stay, no money and no identification.

Since that night, nothing has changed. In fact, it has gotten worse. In 2004 there were psychiatric hospitals. Today most are closed.

Matt was not some unlucky patient who just slipped through the cracks. They knew his illness and chose to discharge him, against all medical ethics. People with schizophrenia spectrum disorder don’t “slip through the cracks”. They slide down a large bottomless crevasse where they just disappear and won’t be made safe.

People with schizophrenia are the homeless living on our streets. They languish in our prisons. They wander the streets hallucinating, muttering to themselves, hoping against hope that someone somewhere will realize they are ill, even as they protest that they are not. Paranoid and delusional, they stab people, push strangers off subway platforms and try to behead them. They are shot by police and armed guards. Sometimes they are brutally beaten to death by police. They kill themselves when they finally realize that life is unbearable and no one gives a damn.

Mathew did survive that night. I desperately called hotels in downtown Toronto till I found one that agreed to take my credit card and let a strange man with no identity spend the night.

I wonder how many mentally ill people freeze to death in Toronto? There are probably statistics.

Matthew’s plight in February 2004 was just one of many mundane examples of how our mental “healthcare” system is failing Canadians with serious mental illness. His crisis is just one of thousands of real-life stories that happen every day of the week in caring compassionate Canada.

The phrase “the banality of evil” – written about the mind-numbing horrors of World War I – now has personal meaning for me.

No one is ever charged with negligence or failing to provide the necessities of life. These are just the mentally ill. They do not count.

The prime reason for writing this book is to raise public awareness about schizophrenia and to describe the many horrific ways that Canada fails people with this serious mental illness. The disturbing reality is that a century ago, before we knew much about schizophrenia, we treated patients much better. A hundred years ago there were asylums to take in and comfort those with dementia praecox (precocious madness), the early name given to the psychotic disorder that begins in late teens and which is now called schizophrenia.

But the situation became worse than mere ignorance. The old phrase, “nature abhors a vacuum,” coined millennia ago by Aristotle, holds true today with respect to public awareness of schizophrenia spectrum disorders (SSD). In the absence of factual information about SSD, misinformation and disinformation has rushed in to fill the void. Thus we end up not only undertreating SSDs but end up with activities that actually do harm through mistreatments and spreading of wrong information.

The lack of knowledge harmed my son because I didn’t know what to do to help him and made lots of mistakes. The reader hopefully can learn from my mistakes about what helps and what hurts!

Marilyn Baker lives in Vancouver and this is the preface to her book which is a work in progress.