The B.C. government recently rejected the recommendation of the Union of B.C. Municipalities to re-instate Riverview Hospital. Our government has made the right decision.
Recent debate has revealed a number of important issues that have reframed questions about Riverview, and the premier has correctly commented that we need to deal with a new set of problems.
Surprisingly, the idea of reopening Riverview appeared to garner a good deal of public support. However, we question the idea that reopening the hospital would have solved complex problems such as homelessness, poverty or the lack of 24-hour community-based treatment for people with mental illness or substance-use problems, as many comments suggested.
Reopening Riverview would not be a compassionate solution to homelessness or poverty. The truly compassionate solution would be to take an honest look at how we treat people with severe mental illness and substance-use problems and change our course of action.聽
For starters, we should ensure that people who have disabilities can afford basic costs of living. Poverty can cause a great deal of stress, which can, in turn, worsen symptoms of mental illness and substance problems. If we make it easier for people with disabilities to make ends meet, we will have less demand on our mental-health care system. The 91原创 Mental Health Association has been urging the government to increase the disability benefit and index it to cost-of-living increases. This would mean that even low-income people with mental illness could be elevated out of poverty.
聽Additionally, we need to address the lack of affordable, safe and supportive housing. Many British Columbians with mental illnesses or substance problems cannot find suitable housing. They can be found on the street, under bridges and in shelters.
In the short term, we suggest that the government implement a rental-assistance program for people who have low incomes and mental illness. A longer-term goal would be to invest in building a variety of housing across the province with varying levels of mental-health treatment and supports. This would allow people at all stages of recovery to live in, and contribute to, their communities.
There are significant gaps in our community mental-health-care system. For example, most community mental-health services operate during business hours. It is important that we create programs that are available to respond to situations that arise at any time of the day.
We also need to ensure that people experiencing distress from mental illness can receive care where they can鈥檛 be turned away. We should not rely on our police departments, emergency rooms and family members to provide this type of care on their own.
Some will argue that we need to provide an institutional setting to care for people who have severe symptoms.
We don鈥檛 deny that there are people on the street, experiencing profound distress, without resources. However, people in institutional care eventually leave institutions, often returning to ill-equipped and under-resourced communities. International research has found that patients with severe mental illness do better in community-based settings when provided with the right supports. We need to provide our communities with the supports to ensure that patients can leave facilities, and that when they do there are places for them to live and experience recovery.
In short, a broad continuum of community-based supports is the foundation of responsive mental health care 鈥� this is the compassionate solution. It allows people with differing levels of need to access supports and live fulfilling lives within their communities, not hidden away in institutions.
Places like Riverview are expensive. We estimate that operating 300 long-term secure beds would cost at least $45 million a year. That would be money not available for solutions that could potentially help thousands.
Rather than asking our government to reopen Riverview, we should be asking it to invest in programs that ensure that people with mental illness and substance-use problems can live in dignity in our communities, and that a robust system of appropriate and timely mental health care is available for all British Columbians in their communities.
聽Bev Gutray is CEO of the B.C. Division of the 91原创 Mental Health Association, and Marina Morrow is associate professor and director at the Centre for the Study of Gender, Social Inequities and Mental Health, faculty of health sciences, Simon Fraser University.聽
