Our national anthem says its all.
Our country is ‘The True North strong and free’ – and that applies to all Canadians.
People are free to live wherever they choose and free to make their own choices, medical and otherwise.
“People are allowed to live at risk,” says Cheryl Whittleton from Interior Health. “Gone are the days when you could tie somebody up, lock them up, and throw away the key. Mental health patients have rights and we treat everyone with respect and dignity.”
Her words introduce the third report of a three-part series in what began as a conversation about mental health patients and a frustrating disconnect between hospital care and community outreach in Trail.
Whether it’s in a coffee shop, on city streets or overheard in a salon, concerns are being voiced about what’s perceived 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.
“I think it’s important to note that there is a regional in-patient psych unit at Kootenay Boundary Regional Hospital (KBRH),” explained Whittleton, Kootenay Boundary’s community integrated health services administrator. “Folks from the whole region are transferred there for the acute phase (of treatment).”
When patients are discharged from the Daly Pavilion, most return to their home community because that’s where the family support is as well as other medical services, she added.
“If they chose to stay in Trail, then that is their choice.”
She says Trail has the same number of community clients as other regional municipalities, and those outlying areas do have mental health outreach services in place.
“We do have outreach all the way to Rock Creek, and we have services in Nakusp, New Denver, Salmo, and a contractor in Kaslo,” Whittleton explained.
“And we are very fortunate because the psychiatrists who live in Kootenay Boundary and support the Daly Pavilion also travel to our rural communities to make sure mental health clients are seen in their home community.”
Nurses including a nurse practitioner, social workers, life skills resources and outreach support, work together as a team in Nelson and Trail, Whittleton continued. “Sometimes mental health clients can’t find a GP for a number of reasons, so we have a full time nurse practitioner they can come and see. She specifically looks after people with mental health issues.”
Unless a person is having an acute psychiatric break and a threat to him/herself or others, intervention cannot be forced on anyone.
“If they are having an acute episode, it’s important wherever they are, that people call 9-1-1,” said Whittleton. “Then the police can take them, and take them to the hospital to have an acute assessment.”
Another critical IH resource is the urgent response team.
Two mental health nurses based out of KBRH are available seven days a week, during the day, to respond to calls from the community, says Lynn Miller, manager of acute and tertiary services, mental and substance abuse.
Generally, those calls come from IH community mental health staff or local police.
“These nurses would also support mental health patients in the emergency department in accessing services and supports that may help them avoid an admission to hospital,” Miller clarified. “This is part of broader funding from our community mental health portfolio.”
Yes, people are brought to Trail for regional inpatient psychiatric care, says Miller.
“But we do not relocate individuals to Trail based on mental health services here. As is the case with other regional services offered at KBRH, patients receive service and would return to their own communities,” she said. “If an individual elects to move to Trail on their own and needs mental health services, our priority would be to make sure they have access to those services.”
That means referrals to mental health are made upon discharge and resources are available if a patient opts to access the services. If not, that is their choice.
“If people chose not to come then they are allowed to make that decision for themselves,” said Whittleton. “And if they are not deemed to be a danger to themselves and others then they cannot be committed under the Mental Health Act. They are allowed to make their own choices and rights need to be respected.”
So there it is. Acute and community mental health services are available in the Trail community. But the latter will only work if a person willingly partakes in ongoing treatment – everyone has the right of free will.
The series has come full circle, and returns to the perspective of the Downtown Trail Business Group (DTBG).
By writing a letter to Trail council, the DTBG effectively opened a much-needed discussion about the city’s most vulnerable, falling through the cracks.
The group works downtown and some even call the inner city, home. First hand accounts of daily goings-on and the 24/7 problems they deal with, started the conversation.
Factually, police are on call around the clock and day time IH staff are available to respond to calls of concern from the community. But no one can be forced into ongoing medical care.
That brings the report to the second in the series. The focus was Career Development Services (CDS), and how the organization fits into the bigger picture of engaging those requiring progressive medical treatment.
Therein lies one key component in Trail that can help a person’s road to recovery, regardless the affliction.
Getting to Home, which hosts its annual Coins for Change fundraiser today, is managed through CDS. The program, a joint venture between the service and the Skills Centre, helps people living with mental health problems and illnesses find and/or maintain housing.
Trail council addressed the resource in council this week and agreed to grant the program $15,000 and possibly another $5,000 in 2016.
Safe housing is the first step in helping people with mental health problems, according to the Mental Health Commission of Canada, an organization that spent $110 million researching the connection between managing mental illness and housing. ( The ‘At Home/Chez Soi’ study can be viewed at mentalhealthcommission.ca)
A house is not just a home, the commission avers, it’s a catalyst for recovery.
Early findings reveal some participants are reconnecting with family and have a sense of safety and hope for the future. Some are even working, volunteering and going back to school.
So this report gives final words to Coun. Sandy Santori, who spoke during Trail council’s discussion about funding the homelessness program.
“The message should be clear that no task force, no bodies out there, nor would we ever have the resources, to eliminate this issue,” he said. “But what we can do, is support it.”