Involuntary treatment, insufficient support: Riverview patterns continue post-closure
It’s been more than a decade since the Riverview Hospital closed its doors for good and one thing is clear: The pattern of treatment, discharge, and insufficient post-hospitalization care continues throughout the province.
In fact, patient advocates warn that B.C. involuntarily detains more patients now under the Mental Health Act at various facilities than were treated at Riverview during its peak patient population of 4,700 residents.
The cycle began in the late 1980s, when the New Democrat government of the time adopted medical advice that urged a life lived in community rather than institutions for those with mental illness, but those with first-hand knowledge say it happened far too quickly and led to the establishment of a homeless population in Vancouver’s Downtown Eastside.
“Back in 1989 and the early 1990s, suddenly the orders were given from Victoria to downsize Riverview as much as possible and they actually gave the hospital quotas on the numbers of patients to discharge to the community,” said Dr. John Higenbottam, who was clinical vice president of Riverview at the time.
“It didn’t matter what their needs were, basically (the government said), ‘Get’em out.’”
Veteran CTV News journalist Mike McCardell filed hundreds of stories on Riverview Hospital and the many patients who were victimized by predatory drug dealers in the Downtown Eastside, where they could afford to live in cheap rooming houses.
“It was a pipeline (from Riverview) … people left, there was nowhere else to go, so they got on a bus and came down here,” he said, emphasizing the provincial government had promised adequate housing and support that didn’t materialize.
“Drug dealers would say, ‘Here, I’ll give you this pill that’ll make you feel really good,’ and I saw that happen hundreds of times.”
FORCED TREATMENT AND TRAUMA RESPONSE
In light of the growing encampment in the Downtown Eastside and stranger attacks, there’s been public discussion about using the old Riverview lands and possibly some of the buildings to treat the large number of people showing signs of serious mental illness and drug addiction.
But an advocacy group for patients is raising the alarm that thousands of people are already undergoing forced treatment under B.C.’s Mental Health Act at more than 70 institutions and hospital departments across the province, a practice that’s nearly doubled in the past 15 years while street homelessness has continued to escalate.
“We never stopped involuntarily treating or detaining people simply because of Riverview’s closure in 2012,” said Laura Johnston, legal director for Health Justice.
“In fact, we detain and involuntarily treat far more people now than we ever did at the height of Riverview’s institutional population.”
In its own “Pathway to Health” report, the Ministry of Mental Health and Addiction acknowledges “B.C. has the country’s highest rate of hospitalization due to mental illness and substance use.”
Johnston points to the long waits and considerable expense for mental health or addictions treatment – unless someone is in crisis – as a paradox, since people often can’t get care until they’re ill enough to need hospitalization – and possibly commitment under the act – which leads to a dangerous cycle that could be fuelling B.C.’s statistics.
“People who have had those experiences of involuntary treatment can carry that trauma and harm with them,” she explained. “So, if they need help again or if they feel like they might want to reach out and get support – instead they might be so afraid of being made involuntary and being in involuntarily treatment again that they avoid contact with health and social services, and we sometimes see really strong alienation from health-care services.”
DOCUMENTED ONGOING FAILURES OF SUPPORT
Reports to government in 1994 found “transition issues around discharge planning” at Riverview, and a 1991 report warned that “adequate facilities have not been provided in the province’s communities, hospital care is fragmented and there is a lack of psychiatrists and clinical psychologists.” Despite this, when the BC Liberals took power, post-hospitalization supports for psychiatric patients did not improve.
“They didn’t have the housing, didn’t have the social supports, didn’t have all the kinds of things people would need to enact recovery and to live their lives,” said Marina Morrow, a York University professor who studied B.C.’s mental health landscape in her years teaching at Simon Fraser University.
“That’s been a consistent gap across all of the decades.”
Higenbottam agreed, noting that the medical community has agreed since the 1950s that institutionalization is not a long-term solution for the mentally ill, those struggling with substance use, and especially those with both, since there are still too few treatment facilities for those with concurrent disorders.
“You have to have the housing because the hospital is just a node, really, on going back to the community, and that’s how it should be,” he said in an interview on the UBC campus, where he’s a clinical associate professor of psychiatry.
“It might be a longer-term node at a specialized Riverview-type of facility because these are complex care people, but there needs to be a path to go back to the community – and they need to be supported there.”
CTVNews.ca Top Stories
Western University researchers unlock potential 'cure' for ALS
New research out of London, Ont.'s Western University is shedding light on a potential cure for ALS, in which the targeting of the interaction between two proteins can halt or fully reverse the disease's progression.
What Michael Cohen said on the stand in Trump hush money case
The star prosecution witness in Donald Trump's hush money trial took the stand Monday with testimony that could help shape the outcome of the first criminal case against an American president.
Collapsed Baltimore bridge span comes down with a boom after crews set off chain of explosives
Crews conducted a controlled demolition Monday to break down the largest remaining span of the collapsed Francis Scott Key Bridge in Baltimore.
Police release 3D images of young child found in an Ontario river two years ago
Police have released a three-dimensional image of a young child whose remains were discovered in the Grand River in Dunnville, Ont. almost two years ago.
Kamala Harris drops F-bomb during White House live-stream
U.S. Vice-President Kamala Harris used a profanity on Monday while offering advice to young Asian Americans, Native Hawaiians and Pacific Islanders about how to break through barriers.
Behind the barricades: How protesters spend their first days in a new encampment
Students in Montreal describe life in a newly erected encampment in Montreal as a whirlwind of preparations, from facing rain and a potential police crackdown to setting up a space for the exchange of ideas.
Security video caught admitted serial killer disposing of bodies in Winnipeg garbage bins
Security video caught admitted serial killer Jeremy Skibicki on multiple late-night outings, disposing of body parts in nearby garbage bins and dumpsters in the middle of the night.
Next 48 hours will be 'extremely challenging' for B.C. wildfire crews near Fort Nelson: officials
A wildfire burning dangerously close to Fort Nelson, B.C., has grown to more than 50 square kilometres, and officials are warning that the blaze's behaviour is expected to become more volatile over the next 48 hours.
Southern Ont. man charged with attempted murder in Timmins shooting
One of two men wanted for attempted murder in Timmins has been arrested, while a warrant has been issued for a second suspect, who fled police on foot.