Former Canadian government official says streets, prisons "asylums of the 21st century" for people with mental illnesses

From Canwest News Service:

Former Liberal senator Michael Kirby is lashing out at this country for the way it has cared for its mentally ill.

Kirby says health officials closed insane asylums across the country after deciding that institutionalizing or ``warehousing'' people was the wrong approach - promising instead to create community-based beds for the mentally ill.

The problem, he said this week, is that those community beds didn't materialize.

``They closed the institutional beds, but were very slow on opening community beds,'' said Kirby, now the head of the Mental Health Commission of Canada.

``I'm embarrassed to say this as a Canadian, but we have really made the streets and the prisons the asylums of the 21st century.''

Kirby says he's dedicated to fighting the homelessness that plagues the mentally ill and eradicating the stigma around such illness.

It's a stigma, he said, that wasn't helped when a mentally ill man attacked and decapitated another passenger on a Greyhound bus in Manitoba last summer.

Vincent Li's gruesome attack on Tim McLean in front of horrified witnesses made international headlines.

Kirby said the potential for violence is about the same whether you have a mental illness or not - but the stereotype is quite different.

``When you have a story like that, particularly one that was that gruesome, it stays in people's minds and reinforces the negative view that a lot of people have,'' Kirby says. ``I think that it perpetuates the stigma.''

Many Canadians are personally affected by mental illness. Kirby is no exception. For years, as he advocated on behalf of his sister who suffered from severe depression, he said, he got a first-hand look at the gaps in the mental- health system.

He heard hundreds of stories about the system's failures when he chaired a Senate committee that produced the first national report on mental illness, Out of the Shadows at Last.

A year after the 2006 report was released, the federal government created the Mental Health Commission of Canada to address the state of mental-health care.

When people were institutionalized, Kirby says, those with mental illness at least got three meals a day and a roof over their heads.

Today, across the nation, there's a lack of affordable, supportive housing for those who are mentally ill.

One in five Canadians experiences some form of mental or emotional health problem every year. Two-thirds will not seek treatment because they fear they will be labelled and viewed as dangerous, studies have suggested.

Stigma is an age-old problem, Kirby says; it goes back centuries to when the medical profession severed the head from the body.

``There was perceived to be no connection between the two,'' he says. ``That's of course where all of the current evidence is showing they were wrong. The wonderful thing about Aboriginal Canadians and Aboriginals around the world is that they've known for centuries that you couldn't treat just the physical without treating the mental. You have to treat the person as a whole.''

Jayne Whyte, a 61-year-old Saskatchewan woman, has battled the stigma surrounding mental illness for years. Whyte remembers being chastised by her mother in 1967 because she spoke about her mental illness during a phone call.

``I said, `I've been to the psychiatrist and he says I'm schizophrenic,' ''Whyte recalls.

``My mother said, `We're on a party line in rural Saskatchewan!' They talked about their gall bladders and sciatica on the party line, but they didn't talk at that time about cancer, and I think that mental health is in that same place. People are so scared about it that they don't talk about it.''

Whyte believes it's easier to be open about her mental illness than to try to conceal it. ``But I certainly understand why people do,'' she says.

``I remember coming out of a grocery store, and just before the screen door slammed I heard one clerk say to the other, 'She doesn't look crazy.' That's where the stigma comes from - people look at you differently.''

Dr. Mansfield Mela, a Saskatoon forensic psychiatrist, said some mentally disordered patients face a double stigma - they are in trouble with the law and they are mentally ill. He, like many in the judicial system, describes the court as a revolving door for the mentally ill.

Without community supports, some people with mental disorders stop taking their medications and discontinue their treatment. If they act out, that can land them in trouble with the law and since there are not enough treatment facilities, they end up in jail. When they are released, the cycle begins again.

The mentally ill shouldn't be involved with the judicial system in the first place, Kirby says.

``When it comes to housing and everything else, prison is the last stop,'' he said. ``It's the one place they have to give you housing. We and other countries have been pretty slack . . . That is why dealing with this is a pivotal issue for us.''

Canada's only mental health courts are in Toronto and Ottawa. Every year 2, 500 people appear in the Toronto court and more than 2,000 in the Ottawa court.

Canada is the only G8 nation that doesn't have a strategy for addressing mental illness. To remedy that, the mental health commission is working on a strategy that focuses on specific groups of Canadians, including children, youths, seniors and aboriginal, Inuit and Metis people, as well as people with mental illness involved in the criminal justice system.

The process is being done in two stages.

``The first stage is to determine, what should a revised mental health system look like? Where are we, where would we like to go? The second question is, how do we get there?'' Kirby says.

For three months, beginning in February, the mental health strategy team travelled to 13 Canadian communities to get feedback on the draft document, called Toward Recovery and Well-Being.

By summer's end, Kirby expects the commission will embark on the second stage and expects the final strategy to be released in 2011.