The Mental Health Crisis in Ontario: An Open Letter to Premier Doug Ford, Minister Christine Elliott, Solicitor General Sylvia Jones, Prime Minister Justin Trudeau and Minister Ginette Petitpas-Taylor – August 8, 2019
We live in a country that is amongst the top in the world to live in. I am proud to be a Canadian. And yet as I write this letter, I am absolutely disgusted by the state of our healthcare system.
We are in a crisis. Our system is broken.
Allow me to tell you a story about a friend of mine – we will call him Mr. P. This story starts just 3 weeks ago. Buckle up.
Mr. P was diagnosed as Bipolar a number of years ago and after a lengthy and destructive manic episode, was committed for treatment just 3 or 4 years ago. This history of mental illness is well documented. Not his first rodeo. Since that episode, life has been pretty low key and normal. Until 3 weeks ago.
At the beginning of July, Mr. P started to act a little out of the ordinary. He was a little more irritable, forgetful, had great difficulty sleeping. While on a mini-vacay with a friend, Mr. P really started acting strangely. He started telling tall tales and began making very strange plans. On Monday, July 15th…exactly 3 weeks ago…friends of Mr. P identified that indeed something was very wrong – there was little doubt amongst us that he was in a manic state. He, of course, adamantly denied it and insisted nothing was wrong – he was just overtired and suffering from insomnia – but we knew it was more.
The next morning, with some urging, Mr. P agrees to go to Hospital #1. Friends who were with him explained his history and his behaviours. Doctors had him speak with a crisis councillor. He is given a low dose, 50mg, of an anti-psychotic called Seroquel to help him sleep and is released. A follow up appointment is made with his GP for 2 days later where he is given an RX for 400mg of Seroquel in the hopes that his manic state could be broken with that dose.
In his mania, Mr. P gets into an altercation on the same day, July 18th, and is arrested by Police Force #1. Police speak to Mr. P’s friends who explain the mental health situation and he is taken back to Hospital #1 by Police Force #1. Hospital #1 keeps him overnight but releases him in the morning. Mr. P then decides that Hospital #1 is not equipped to help him – so he makes arrangements to get a ride to Hospital #2 – a one hour drive from his home.
Mr. P arrives at Hospital #2 with no money, no medication, no family or friends. They release him with an RX for Seroquel, but no means to be able to fill it.
At this point, Mr. P’s delusions are worsening. He is sporadically messaging his friends at home but is making less and less sense. July 21st he went back to Hospital #2 desperate for help and chose to leave when he felt as though he wasn’t being treated fairly.
Remember, he is now manic, homeless and desperate with not a penny to his name. Thankfully he has found a shelter that was willing to house him for the night…but he is still penniless. If you’ve been following along, you can probably guess what happens next. Yup, arrested for stealing by Police Force #2.
So, we are just one week into this manic episode at this point and Mr. P is in far worse shape now than he was when this story began. 5 hospital visits, 2 police altercations and he’s still not properly medicated. In fact, his delusions are far worse and he is becoming more and more of a victim to his own disease and is falling through the cracks in a very broken system.
Police Force #2 takes him back to Hospital #2 and keeps in contact with his friends back home who have all sent emails outlining the mania they have experienced and begging for him to be given the help that he needs – at this point, he is a danger to himself and he needs to be kept safe and medicated.
While awaiting a psych evaluation, Mr. P becomes extremely agitated. His delusions have him convinced that he is being held hostage by the police and he has plans to sue everyone. He is now violent, uncooperative and disruptive – all uncharacteristic of a medicated and healthy Mr. P. He is admitted into Hospital #2 and a decision is made on July 25th to transfer him to a mental health facility, which we will call Hospital #3, as an involuntary patient. It is confirmed that he will receive treatment and will likely be at this facility for 2 weeks.
At the 72- hour mark, despite having been moved the night prior to the intensive care section of the hospital for extreme delusion and depression, Mr. P was made ‘Voluntary’ and immediately checked himself out of the facility with no medication and no money. It is now July 28th.
For the next 48-hours, he is finding shelters to sleep at and is begging for money from everyone he can find. He is just trying to survive. He tells a close friend that he is desperate for cash to fill an RX and the friend sends him some cash. Of course, this is a lie and instead he uses the cash to buy a bus ticket – we think he was trying to get back to his hometown, but instead ends up in another town…another hour in the opposite direction.
He finds a coffee shop there to take shelter and thankfully a concerned customer called police to let them know that they thought he posed an immediate threat to himself. Cue Police Force #3 who arrive and start asking questions. Mr. P is making no sense but was able to share contact information with some of his close friends. Police Force #3 listens to concerns and agree that he is in danger to himself – so on July 31st, Mr, P is brought to Hospital #4. Calls to nurses and doctors explaining the last two weeks results in Hospital #4 admitting Mr. P on a Form 1 and they start a medication and treatment regimen that includes visits from the psychiatrist on staff. FINALLY, PROGRESS!!
Nope. Just 48 hours later, Mr. P is discharged from Hospital #4. Same story – no money, no meds, no place to go.
Any guesses where Mr. P is now?
If we follow the events, he could be in a shelter or in an altercation with Police Force #4 or trying to get help from Hospital #5. But instead, one of the people in his village of friends, out of pure frustration with the system, has brought Mr. P into his home – he is not a trained mental health worker, nor is he a healthcare professional, nor is he equipped in any way to deal with a person in this mental state…but he is a friend who at this point knows that he can do better for Mr. P than the system has done.
Now imagine a system that worked properly. A system where Mr. P would have been treated at Hospital #1 on Visit #1. A system where Mr. P never would have required the services from the staff at Hospitals #2, #3 or #4. A system where Mr. P would have never had a run in with Police Forces #1, #2 or #3. The emotional impact that would have had on Mr. P and the people around him would be immeasurable. And if that emotional human piece doesn’t pull at your heart strings, think about the financial impact to the tax payers in Ontario. Can you fathom what this last 3 weeks of chaos have cost? Now compare it to my scenario where the system worked on visit #1.
According to stats on www.camh.ca, mental illness is a leading cause of disability in the country and prevents nearly 500,000 employed Canadians from attending work each week. The economic burden of mental illness in Canada is estimated to be $51 BILLION Per YEAR – The costs to society and to humanity is immense.
I’m thankful for corporations like Bell who are doing their part to bring awareness to the mental health crisis with their #BellLetsTalk Campaign – I truly believe that this campaign is helping to #EndTheStigma.
But do you know what will really end the stigma? ACTION.
If Mr. P entered the hospital with a knife sticking out of his body, would he have been released? What if his heart had stopped beating? Or was profusely vomiting blood? Would he have been sent home? Then WHY is it socially acceptable to send him home in crisis? Just because you can’t see it? Does Mr. P deserve less than?
Enough with the Buzzwords. It is time for the Province of Ontario to be the leader in Canada – to be the ones who DEMAND better.