LUCIA COSTA
<Contributor>
Mental Health “talk” is everywhere. A few weeks ago Bell launched its “Let’s talk” campaign; this exemplifies just one of many of these campaigns aimed at leveraging awareness and, as the Mental Health Commission cliché goes, have mental health come “out of the shadows.” Philanthropists have been stepping up too. Years ago, no rich donor would dare bestow a substantial offering towards a psychiatric cause – it was an embarrassment. These days it’s different; generous donations are forthcoming and are rewarded with prestigious plaques adorning the sides of newly redeveloped buildings.
The future promises more of these initiatives and they will definitely target universities and colleges as the emerging problems in post-secondary mental health reach a crisis point (apparently, according to Maclean’s). Also emergent is the public personal disclosure speeches for audiences hungry to understand the mind of the mad consuming every salacious detail with the most compassionate of gazes. These public testimonials, though different in small ways, follow the same overall trajectory: a descent into madness with the subsequent rise to recovery, all thanks to medication. Biology is the problem; drugs are the answer. Rarely do these disclosures stray from that archetype.
There are also the relentless stigma-busting projects. Has any lawyer ever taken “stigma” to court? Why the fixation on stigma as opposed to discrimination? Usually we need to identify an individual or organisation that will be accused, no? In whose interest is this stigma-busting? There is evidence that stigma campaigns aimed at illness recognition are not effective unless they include attention to amelioration of structural problems.
While I don’t aim to rain on anyone’s parade, awareness campaign, or use of psychiatric services, I would like to reflect on what these campaigns and personal disclosure stories do and don’t do. While the upshot of such campaigns may be that more people have access to information (mostly biomedical) in order to improve their quality of life (though if you are on ODSP there is not much improvement), these campaigns and personal disclosure spectacles raise nothing of the state of advocacy for persons with psychiatric disabilities. Here is one example: presently, the advocacy available in hospitals in psychiatric facilities is minimal. Historically, the Psychiatric Patient Advocate Office (PPAO) has provided rights advice and advocacy to hospital clients, but in the summer of 2011 the Liberal government announced a proposal to divest the services of the PPAO. As a result of protest by many organisations, lawyers, and individuals, the divestment was halted. While this was good news, the fact of the matter is that this government has no interest in supporting a rights agenda for persons in the mental health sector. While advocates provide rights advice as required under the Mental Health Act, their broad-based advocacy has been considerably diminished if not extinguished. Previously the PPAO took a strong lead in advocacy with the police, in inquests, and other related rights issues. However, presently, we are unclear about whether there is even legal counsel readily available at head office for assistance to the advocates providing rights advice across 10 major mental health facilities. In 2008, the Coroner’s Jury at the inquest into Jeffery James’ death in restraints recommended that the PPAO create a model of governance allowing for sufficient institutional independence, and that a governing board consist of a majority of persons who were patients or ex-patients. This has never been implemented.
In December 2012, the Globe and Mail published an article critiquing the failure of a psychiatric hospital to notify the Ontario Review Board of a restriction of liberty of a client who had been in seclusion for two months. And apparently all psychiatric hospitals were reportedly leaving it to their discretion to determine the interpretation of section 672.56 of the Criminal Code. This is but one example that was fortunately able to garner some media attention – there are many more that don’t.
In other news, current Ministry of Health’s regional Local Health Integrated Networks (LHIN) are reforming all services in the mental health sector in an attempt to cut costs. Community agencies have been merging in order to survive the changes. All hospitals will receive no budget increases in the next fiscal year. Essential programs are being cut such as recreation services, and popular treatment modalities. Patients are being transitioned haphazardly into community supports that are non-existent, often for organisational convenience or organisational restructuring as directed by the push to move “bed blockers” out and get new people in, especially the ones who have potentially been lingering in jail for a number of weeks.
These are the personal stories you won’t see at campaign parties or at philanthropic ribbon cutting ceremonies. And these are the stories that need to be heard and need to be included in strong legal reform and legal aid modernisation agendas.
Yes, let’s talk.
The Kitty Lundy Memorial Lecture has sponsored a wide-ranging series of lectures and events over the years which has enriched academic and cultural life on the York Campus. They are all open to the public, and alumni from every part of the University are encouraged to attend. This year’s lecture on March Thursday 28th 2013 focuses on “Mobilising Mental Health Advocacy”. Guest Speakers include activist and author Pat Capponi and Barbara Hall, Chief Commissioner, Ontario Human Rights Commission.
For more event details please visit: http://www.yorku.ca/laps/lundy/.
Lucia Costa is an LLM student at Osgoode.