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Ontario Can Be a Mean Place if You Have a Mental Illness

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Ontario's record in improving services for those with mental illness and, in particular, those with the most serious of illnesses is totally reprehensible. So, imagine my surprise when I read an article by Toronto Star columnist Carol Goar who wrote glowingly about Liberal MPP Kevin Flynn and his crusading for mental health.

I have no doubt about his commitment but he is part of a ruling party that has none, based on its record. Flynn chaired the all party Select Committee on Mental Health and Addictions that issued an excellent report in 2010. Problem is that it has been a mostly ignored report.

That report had 22 very specific recommendations and the headline on my letter to the editor of the Star about the Goar column read "Excellent Report Had Little Impact." I decided to question my own Liberal MPP who is also in cabinet on why so little has been done and we got into an email exchange. His initial comment was that the committee recommendations were rolled into a subsequent report issued a year later called Open Minds Healthy Minds.

His responses to my emails were so Kafkesque that a friend likened talking to a politician as trying to swim in jello. My MPP said he is personally in favour of improvements as he sits on the board of a local mental health agency and he encouraged me to advocate as well. My reply was that the agency has no power to set government policy or to allocate funds and nor do I. The cabinet does and he is in the cabinet so... His reply to that was to congratulate me for my advocacy and to encourage me to continue.

Like I can personally bring about changes when the government refuses to.

My Star letter pointed out that the original committee recommended that Ontario investigate and change the Mental Health Act pertaining to involuntary admission and treatment. In fact, the committee cited how impressed they were with how this issue is handled in British Columbia, Norway and The Netherlands. Recommendation 21 and never done.

The committee recommended that Ontario re-evalute its Personal Health Protection Act. That Act prevents health care officials from revealing information to families about their adult children and, as a result, families cannot help prevent further deterioration and to minimize the risk of serious physical or psychological harm. Again the committee was impressed with how well British Columbia accomplished this. That is recommendation 22 and again, nothing has been done.

Since that report was shelved for the new one a year later, we should look at what this new report recommends and what has been accomplished. But first, the Select Committee Report of 2010 was actually initiated to replace an earlier report that the Liberal government inherited when they first took power from the Tories in 2003. Called the Time Is Now, that report was co-chaired by former federal cabinet minister Michael Wilson who called the Ontario mental health system something that was based on 30 years of neglect. The incoming Liberals assured all that they would study the report and take action.

They did not, as my first Huffington Post blog in 2011 pointed out. Interestingly, the Time is Now report has been removed from the government website.

As for the latest report, it sets out quite a few very vague, pie in the sky goals with no explanation of how they are going to be achieved and that reflect a lack of understanding of serious mental illness. The very first is that they plan to reduce the prevalence of mental health and addictions in Ontario and reduce suicides. When science does not know what causes these illnesses how is it then possible to prevent them? Inoculations prevent diseases like polio and good sanitary practices prevent cholera but how do you prevent autism or schizophrenia? I guess the government could prevent Post Traumatic Stress Disorder if it were able to prevent any of its citizens from ever suffering from severe trauma.

In order to accomplish all it sets out to do, the government is to:

  • Develop common performance measures with clear accountabilities;
  • Set up an Advisory Council;
  • Establish a task force to examine current Ontario legislation related to involuntary treatment and sharing of health information (e.g., Mental Health Act, Child and Family Services Act, Personal Health Information Protection Act). Note this is a carryover from the 2010 report;
  • Report to the citizens on their progress every two years (which should have been done in 2013.

No indication of any of these having been done is available on the the government website but I am told that the government is working with the Institute for Clinical Evaluative Services (ICES) to develop a scorecard and evaluation framework for the strategy. No advisory group, however, has been set up

And, if we consider autism as a mental illness which would be included in the deliberations for the Open Minds Healthy Minds report, then the government has totally failed. According to a report in the Toronto Star on March 7, 2014, Ontario is also failing those with autism. A not yet published government report dated December, 2013 that the Star was able to acquire found that "Parents spoke of confusion trying to navigate a convoluted system, lack of transparency about wait lists and how agencies make decisions about who is eligible for treatment and how long they get it," along with other problems.

Ontario has recently seen a number of inquests into police shootings involving people with serious mental illnesses and National Post columnist Christie Blatchford made some excellent points. She stated that:

"The critical thing these poor people had in common, it seems to me, was not that they were shot by police, but how ill-served they and their loving families were by the shambles of what passes as the mental health care system in this province."

And she is so right. Because of that column, a mother with a son with schizophrenia wrote to Blatchford privately and has given me permission to use her information. I'm not mentioning her name to protect the privacy of her son as requested but she is a freelance writer in Vancouver. Her son was in Toronto on at least two occasions when he received Ontario services for his illness.

She said:

"There is something very wrong with Ontario. My son was kicked out of psych emerg in 2011 (Toronto Western Hospital: "All he needs is a sandwich", the psych nurse told me, on long distance telephone to Vancouver. I was frantic.) When he finally and miraculously returned to B C, he spent the next 10 months in hospital, till they closed Riverview. He is doing OK at the moment, not great, but way better than Ontario. If he had stayed in Ontario I have no doubt in my mind that he would now be dead."

And

"Ten years ago, again in Toronto, my son was turfed out of hospital (St. Mikes) after a couple of weeks, at night, into freezing February winter, with no money, no friends or relatives at hand ... nothing. It was a terrifying scramble for us, 3,000 miles away, to try to get him into a hotel so he wouldn't freeze to death on the streets. Looks like nothing has changed."

She concluded with:

"Ontario, or at least Toronto, is indeed a very mean place to be, if you have a mental illness."

And no amount of government committees can change any of that if all they do is meet, listen and ignore.

Premier Kathleen Wynne seems like a nice lady -- a mother and a grandmother. I would not wish this on her but imagine if one of your grandkids developed schizophrenia, bipolar disorder, autism, would you be satisfied with the services they would get? Put yourself in those shoes, Wynne, and get off your butt and start to do something.

And, as for my MPP, don't knock on my door come next election looking for my vote.  

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