What is remarkable is that it wasn’t considered that remarkable: Two simultaneous murder trials in Victoria this week, both keying on the defendant’s mental health.
In one courtroom, Cory Barry stood charged in the death of 15-year-old Justin Wendland, stabbed while waiting for a bus in front of the Times Colonist building in 2010. That case continues.
Just down the hall, 21-year-old Alex Conte was found not criminally responsible for killing and dismembering his mother in Sooke last January.
Victoria’s Dr. Shabehram Lohrasbe can’t comment on those particular trials — but as a forensic psychiatrist who has been involved in more than 400 homicide cases, he can talk in general about the insanity of the way in which the system deals with mental disorders. Sick people are spun through a revolving door, or can’t get treatment until it’s too late.
It wasn’t always so. People used to be treated in mental hospitals. Coquitlam’s Riverview alone held 4,700 people at a time when B.C.’s population was half what it is today.
Then came deinstitutionalization. If the reasons seemed valid — activists wanted to free people who had been abandoned in Dickensian warehouses, and governments were eager to shed the cost — lost was the argument for treating some people in the safe, structured confines of a hospital.
“We in B.C., in Canada, in the West have moved away from providing asylum in the good sense of the word,” Lohrasbe says.
Today, those in desperate want of hospital care can’t get it. A generation ago, mentally ill people needed advocates to free them from institutions.
“Now they need advocates to get in.”
In the 1980s, when Lohrasbe worked at what is now the Forensic Psychiatric Hospital — the 190-bed Coquitlam institution for what we used to call the criminally insane — a general practitioner could phone and say he had a patient who was in danger of acting on psychotic symptoms, and Lohrasbe would bring the patient in to stabilize his mental state. “It was never measured in days, always weeks.”
No longer. Now admission takes a court order, and the courts don’t deal with someone until a crime has been committed — too late. A physician with a patient fighting demons has nowhere to send him for the kind of care he needs.
So those afflicted with serious mental disorders are left to wander the street, lonely and isolated, often turning to self-medication. “Mentally ill people are prime prey for the drug trade.”
While the great majority of mentally ill people are no more prone to violence than anyone else, adding street drugs changes the equation. Back when the institutions were being closed, no one foresaw the tsunami of street drugs and mental disorders that would, in combination, overwhelm the multi-billion-dollar health and justice systems, which devote a lot of energy to spinning a relatively small number of messed-up people through that revolving door: street to court to prison, the latter being the closest thing some have to a home, a place where people will talk to them.
Compounding the issue, says Lohrasbe, has been the War on Drugs. “Everyone knows it’s a failure, but no one has the gumption to set it aside and start in a fresh place.”
No one has the gumption to do much of anything. We seem to have resigned ourselves to being a society that, having once abandoned people in institutions, now abandons them to the street or to family members who love but are occasionally incapable of caring for them.
When something goes sideways our reaction is to either second guess front-line workers doing an impossible job or shake our heads at acts of violent insanity that we accept as inevitable.
Lohrasbe believes prevention is possible, and knows where to start: “What we want for people with major mental illness is safe accommodation with tight supervision, particularly when it comes to drug use.” Can’t treat someone who is intoxicated.
No one wants Dickensian institutions; sick people need care — asylum — not punishment. And we all need to stop taking for granted the consequences of inadequately treated mental illness.
© Copyright 2013