“If a person has a mental health diagnosis then we have to refer to mental health,” says Sheila Adcock. “And that’s where it comes into a snag.”
The program coordinator for Career Development Services (CDS) in downtown Trail offers insight to the organization's place in helping individuals with ongoing mental health conditions, substance use issues or a combination of both.
Adcock is quick to point out there is no “they.” Individuals caught in the maelstrom are not homeless and the majority requiring medical intervention and community outreach are locals – not out-of-towners.
She's often heard comments, “they” are sending people here, because of the lower cost of living compared to the coast.
The Ministry of Social Development is not in the business of sending people anywhere, Adcock added.
“There is no big 'they' shipping people here in the dark of the night with a bus pulling up.
“The individuals we are hearing about are not homeless – they are mentally ill and in need of help.”
Community sectors approached the Trail Times this year, voicing concerns about what many perceive as a growing number of homeless, mentally ill and addicted individuals relocating to the city. Mostly, people share that they are troubled by newcomers with serious mental illnesses, who are not being adequately managed by community outreach.
Seeking facts along with narrative, the Trail Times talked with community services, city officials and contacted Interior Health, asking for details of the role each entity plays in managing those with ongoing afflictions.
The focus of last week’s first report in a three-part series, was a perspective from the Downtown Trail Business Group. They are the first to collectively go on record with city officials.
By writing a letter to Trail council, the group effectively opened a much needed discussion about the city’s most vulnerable, falling through the cracks. Notably, the group works downtown and a few call the inner city, home. First hand accounts of daily goings-on was the sensible place to start the conversation.
This second report centres around CDS programs and where those resources fit into the bigger picture of caring for those requiring progressive medical treatment.
“I hear the same thing you do,” said Adcock. “Homeless people are on the street, but they are not homeless, they are mentally ill.”
CDS' mandate is to support individuals who are homeless, at risk of being homeless or have barriers to obtaining and/or maintaining housing. Many of those referred to the program, called the Getting to Home project, have mental health and substance use problems.
Of the 243 individuals assisted through CDS, Adcock says 70 per cent disclosed their medical condition. However, only up to seven percent had relocated from other communities.
“The rest have lived in the Greater Trail area for more than two years,” Adcock clarified. “And many have family in the area.”
Outreach workers access various community resources to help individuals maintain their housing and they keep in touch with their clients – but the buck stops there.
Services for ongoing support are available through Community Living BC (CLBC)– but only if that individual has a diagnosis of Fetal Alcohol Spectrum Disorder, Autism Spectrum Disorder or another developmental disability.
Those with psychiatric illnesses must have an open file with mental health.
“If the individual does not meet the criteria for CLBC Outreach Support but does have mental health and substance use issues then we would contact mental health to see about accessing those services,” Adcock reiterated. “If the individual does not have an existing open file then we are told they are not eligible for outreach services.”
CDS has an open door policy, whether it be a cup of coffee, use of a phone, or help filling out ministry forms. But workers' hands are tied when dealing with more complex issues, and the situation can be frustrating.
“We had an individual pounding holes in our walls and freaking out,” said Adcock. “We tried to get him help but he didn't have an open file. We don't care, he's taking fists to the wall – this guy needed support.”
With Kootenay Boundary Regional Hospital being the only West Kootenay facility offering acute and long term psychiatric services, it's a given that people from outlying areas relocate to Trail for ongoing medical care.
“There are a lot of people that end up here because of the psychiatric unit,” she explained. “And there are many that are recommended to live here from, for example, Midway, Rock Creek or Beaverdell. It makes sense for them to stay because they are needing ongoing support – especially if it someone experiencing their first (psychiatric) break.”
That isn't always the case. She described two situations when patients were released from hospital and instead of being housed in Trail, were sent home to family elsewhere in the province.
“Absolutely we've had people come here from other communities,” she said. “But we had a person from Cranbrook who came here to get medical treatment and was told he might as well look for a place.”
All his support systems and family were in Cranbrook, Adock said, so through CDS's small pot of emergency funding, the person was bused back home for community care.
Another example she gave was a very ill person discharged from KBRH, who didn't want to live in Trail.
His family resided in Victoria. They wanted their son home and planned to admit him to a safe facility on the coast.
“It made no sense to house him here,” said Adcock. “So we bought him a plane ticket and his family met him. That's where our emergency funding goes, under the homeless project.”
Regardless of who stays or leaves, continuity of care within the Trail community is key.
Creating Caring Communities is an initiative Adcock is involved with. Its mandate is to identify all resources under one umbrella and identify low barrier services.
“We just developed a map of all the services in all the communities that identifies where a person can go to get help without all these barriers,” she said. “(Presently) the individual has to walk through a set of doors, fill out an application, and have a doctor sign it.”
When a person is unwell, completing an application, lengthy forms, and scheduling appointments, is too overwhelming a task, Adcock maintains.
Therein lies part of the problem of how people remain unchecked in the community.
“These guys on the streets are very visibly ill,” she added. “They aren't going to go through the process on their own. And if the individual doesn't follow up for a next appointment because they are unwell – then the file is closed.”
The final part of the series will highlight Interior Health services and its response to concerns in our community.