Homelessness and the Failure of Government

By Marvin Ross

Over the past few months, we’ve done a number of blogs on the problems of supportive housing using a Christian charity (Indwell) as the example and published some research on how it operates by Karen Allin in Mississauga. Karen has no personal involvement with serious mental illness but she was concerned when Indwell wanted to build near her. She found my blogs and that concerned her about their competence. At the public meeting she attended, some of Indwell’s own residents came and complained about the failures of that organization.

And then I heard from another resident at Indwell in a building in Hamilton with complaints from that place. She and Karen conducted their own survey of residents and the results were not pretty. Karen’s report with those results I published last week.

Thus far, no one in any position of authority has shown any interest in looking into this situation despite Indwell getting about $123 million in financing from all levels of government and I’m not the least bit surprised. What impressed me about Ms Allin’s original report on Indwell is this statement: “Imagine the joy a potential tenant feels when they are told there is space for them in an affordable, supportive, housing apartment. As highlighted in this report, that joy quickly turns to a nightmare for many “

It turned out to be a nightmare for my wife and I when our son got a place at Indwell. We initially expected that he would have a nice place to live where, if problems arose, they would be taken care of. Problems continually arose involving violence (one murder), assaults, drug trafficking, to name a few that were never resolved.

What is happening at Indwell is not unique. There are no enforceable standards or oversight from government on how the tenants are cared for or how the grants are administered. As one comment on the last post on this topic said “All organizations that house individuals with mental health problems, etc. need to be held accountable, with transparent reports, financial statements, tenant feedback, etc.” 

That is not generally done because those with serious mental illness are the “ass end” of our healthcare system. Nobody in authority seems to care which is why we have the mess on our streets that we do. As statistics have shown, a considerable majority of those living on the streets have untreated mental illnesses. We do hospitalize people for as short a period as possible and then kick them out to the street with little or no follow up, no living arrangements and little money. They either fend for themselves or the families help to the extent they can.

It wasn’t always like this.

My blogging partner, Dr Dawson, commented in a recent e-mail to me that from his experiences as psychiatrist in chief at the Hamilton Psychiatric Hospital “We were doing the right stuff in 1975 : family involved always, had one team member assigned to each community agency to maintain communication and resolve problems. Prioritized the seriously mentally ill. 1985 started  special team to help transition from hospital to community. I think I always naively assumed progress would continue.” This is a longer review of how much we’ve deteriorated from the 1980’s to today

And what it takes to get proper medical care for a child with a serious mental illness was outlined recently in this blog by Dr Richard O’Reilly In that blog, Dr O’Reilly was discussing what it took Marlene Bryenton of PEI to rescue her ill son from the streets of Toronto. He said “families are often exhausted due to the effort needed to look after someone with a severe mental illness: particularly the effort sometimes required to ensure that a loved one stays on treatment. Family caregivers repeatedly tell me that they feel shunned and defeated by the system.”

He added, “The story of Andrew Bryenton demonstrates what I have always believed – that the mental health system will not meet its duty to provide appropriate care and treatment to people with severe mental illness until family caregivers come together and force it to do so.” The problem is that family caregivers are too exhausted to do that.

I’m fortunate that I live in a city that has a psychiatric hospital and even has a dedicated psychiatric ER but it takes all of our energy to ensure adherence to good medical practices. The senior bureaucrats know me well. There was one time when our son needed to be seen by the ER so I took him. That is not as simple as it sounds for the local psych ER is (or was) out of a 1950’s film, the Snake Pit. At one point, it was so bad that the medical school pulled all its resident docs out of there because of violence. I’m told it is now much better.

In order to get emergency psychiatric care, the patient first has to be cleared medically. The reason for that is a man with schizophrenia had pneumonia and his family doc sent him to the ER and called ahead. But, the ER staff knew him to have schizophrenia so made him wait for psychiatry even though he told them he was physically ill and had been sent there by his family doc. When he couldn’t breathe, he was given a paper bag to breath into as they assumed he was having a panic attack.

He arrested and died on the waiting room floor.

Now, all psych patients must be cleared medically which is sensible but then you have to convince the ER doc you want psychiatry. So, I take my son in and he gets checked by medical, they find no problem and try to discharge him. I then had to get into a shouting match with the doc so that he would be referred and we waited. No one came and they called psych again and again.

Finally, I could not wait any longer and told them I was leaving and ensured that they were aware my son was waiting for psych. Next morning, I called ER psych and they had never heard of him and refused to tell me where he might be (confidentiality you know). The switchboard told me he was still in the medical ER. Fortunately, I knew the VP of mental health services and her secretary arranged a search party and my son was found on a chair in the hall of the ER. He sat there in a psychotic state all night and no one noticed or asked why he was there.

My mention of lawyers at a meeting with hospital bureaucrats gets a lot of apologies but why did I have to even do that?

That wasn’t the first time I went head to head with them and it wasn’t the last but it leaves you exhausted. If families don’t do that, our adult kids suffer but when we do, it wears us down.

Imagine if you had a family member with cancer or some other serious and/or chronic condition and you had to do that as well. They don’t have to do that and we shouldn’t have to do that either. These are illnesses not moral failures and there are good treatments and supports but we mostly don’t get good treatment or good supports.

And God knows that we all want to take back our streets and parks from all the homeless who congregate there. Our society let this happen and society can correct it if only we properly fund treatment, rehabilitation, proper supportive housing, meaningful activities for people. Most European countries can do that. Instead, we literally piss away funds to groups like Indwell and all the other similar places to do what?

As someone in BC commented on last weeks blog,” I blame the government. Here in B.C., we used to have many properly staffed, licensed care facilities. Then the Provincial government decided to pass the Assisted Living Act, which allowed for the privatization of care facilities that would no longer require regular supervision to operate. All political parties were united in agreeing to this fiasco, so all are equally guilty of the disastrous housing shortage that ensued for many poor people — especially the mentally ill & the elderly who require regular, ongoing properly supervised care and other supports to live safely & with dignity in the community.

If anyone wants to see what is called here “the show’,” come to Vancouver & take a stroll by Hastings & Main. It is truly heartbreaking”

Just last week, the associate minister of mental health, Ya’a ra Saks, a yoga teacher among other qualifications, announced $500 million to youth mental health – not illness but health. The press release stated that: “It is critical that youth have what they need to build a happy, healthy start in their adulthood. Mental health care is an essential part of ensuring every young Canadians can reach their full potential, and that helps Canada’s economy reach its full potential, too.”

So what are they going to do to make youth happy? They don’t say but what will make many people happy is if we provide the resources to help those with serious mental illness. Stay tuned for more on this latest effort in uselessness from our government. .