To Heal a Hurting Mind
Globe and Mail - February 9, 2008
Written by Robert Matas
VANCOUVER — Ellen and Allan have all the advantages that you would expect to find in a well-educated, financially comfortable family. They know their way around the medical system. They know influential people. They have the financial resources to arrange whatever is needed for their mentally ill, drug-addicted son.
But it is not enough.
They cannot persuade their 31-year old son — who was diagnosed with schizophrenia at 29 — to accept the available medical care. They could not find appropriate housing anywhere except in Vancouver's Downtown Eastside.
Ellen is a family physician with 30 years of experience. Allan designs computer systems. In an interview this week, they talked about how helpless and horrified they felt when they heard that police were having almost daily contact with their son. But they could not stop the downward spiral that led to a hotel in the city's skid row district three months ago.
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Five years ago, Ellen fought the involuntary admission of one of her patients to a mental-health institution. Now, she would not.
"Having someone [with mental illness] in your family changes one's way of thinking," she said as she recounted her son's descent into the Downtown Eastside. "I thought I knew about it until I lived in a family with someone [with mental illness]."
A report released earlier this week by the Vancouver Police Department says police are spending an inordinate amount of time dealing with the mentally ill. The report recommends an urgent response centre for the mentally ill as an alternative to jail or hospital.
The report echoed concerns that have reverberated through many cities that have mentally ill people living on the streets. Several large institutions for the mentally ill were closed in the 1980s after the development of drugs that could control symptoms if taken properly.
After the report's release, B.C. Health Minister George Abbott announced support for a new secure treatment facility for 100 to 150 mentally ill people. The new centre would be "an incremental addition" to the services now available, he said later in an interview.
Mr. Abbott said the government is not contemplating changes to make it easier for police to pick mentally ill people off the streets. Currently, the test for an involuntary admission to a mental institution is whether a person poses an immediate danger to themselves or others. The government would welcome a debate over possible changes, but does not intend to initiate the discussions, he said.
"It's a very difficult question associated with attempting to rebalance the rights of those who are mentally ill with those of their families," Mr. Abbott said.
At his home, Allan shows off photos of his son during happier days in cap and gown on graduation day, in a military outfit, with family members.
Before he became ill, he did everything right, his father said. He did well in school. He went into the military with the ambition of becoming an air force pilot. But then something in his mid-20s happened. It was described as depression. A few years later, doctors in Montreal and Vancouver diagnosed his son with schizophrenia.
Allan's son does not accept the diagnosis. (His name is not used in this article to protect his privacy). He said in a separate interview that he has a history of using heroin and cocaine, but he does not have a mental illness. He attributed his hallucinations and paranoia to cocaine binges. "I feel when I am not on drugs, I am fine," he said.
He also cautioned against accepting what his parents say about him. "I do not want that to be my story," he said. "t is a one-side interpretation of what's the bigger picture."
His parents say his lack of insight into his illness is a huge obstacle to getting proper care. The family realized that something was wrong during a phone call in January, 2006, when their son was living in Montreal.
He told Ellen he was responsible for his father's death and should kill himself. Allan was alive. Allan went to Montreal and took his son to the hospital. The doctor released him. In the following days, his son's condition worsened. Ellen coached Allan on the magic words that would have their son admitted to a hospital — Allan told the hospital his son was going to kill himself. He was admitted immediately.
A week later, he was released to return with his father to Vancouver. Allan and Ellen set their son up in a basement suite in their home. "We thought we could help protect him with our love and our knowledge," Ellen said, "but he got worse and worse at home."
His parents could not ensure he ate well. They could not keep the place clean. His pets — a chinchilla, a bird and large fish in an aquarium — attracted flies and strong odours. Their son would not let them into the suite to clean up. He stopped taking his medication and became increasingly paranoid.
"We were watching him crumble in front of our eyes and we felt helpless," Ellen said.
Eight months after moving back to Vancouver, he called police, saying people were after him. He was taken to hospital covered in self-inflicted injuries. He was kept in the hospital for 10 days, until the medication sedated him. Medical staff decided he was no longer a danger to himself or others.
Their son still did not believe he was mentally ill. His parents did not believe he was healthy. Two weeks later, he was readmitted to a locked ward. But he talked his way off the ward the next week.
Allan and Ellen decided they could not care for their son, a crack addict schizophrenic, at home. Allan rented an apartment for him and arranged for a care worker to visit him regularly.
On his own, their son's drug use escalated. He had a $300-a-day diet of cocaine and heroin, financed by pawning everything he had, reselling food his parents bought for him, and draining thousands of dollars from family bank accounts.
Ellen and Allan felt like they were watching him die. When he was evicted 10 months later, his parents thought he might do better in his own place.
Allan bought a condominium for his son. "It was total hell," Ellen said.
Their son let prostitutes and drug addicts stay in the condo in exchange for drugs. His neighbours were afraid to go into the building. Police came almost every day.
Two months after their son moved in, Ellen and Allan decided they had to try something else. Neither rental accommodations nor ownership offered their son security. They found a spot at the Regal Place Hotel, a single-room occupancy hotel in the Downtown Eastside.
Allan is frustrated with the mental-health system that allows his son to decide he does not need help. "The pendulum has swung too far," Allan says.
"Mentally ill people who are unable to make decisions, unable to keep themselves clean and feed themselves, have been given the right to make decisions about medical care," he said.
"But when should society intervene?"
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