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Editorial: Mental health costs offloaded

Psychiatric care and other treatment for mental illness are expensive, but failing to provide that treatment is proving to be even more costly, and police departments are picking up an unfair share of the burden.

Psychiatric care and other treatment for mental illness are expensive, but failing to provide that treatment is proving to be even more costly, and police departments are picking up an unfair share of the burden.

Over the past five years, capital regional police departments have seen mental-health-related calls rise substantially. Victoria’s police department has seen a 356 per cent increase in “disturbed person” calls, and Chief Frank Elsner says that on some nights, most, if not all, officers are tied up with mental-health calls. For other departments, the increase is not as great, but all are finding their resources strained by the increased workload.

Police officers are the front line when it comes to dealing with disturbed people who are a threat to themselves or others. Crime, addictions and mental illness are often tangled up in each other, and it’s appropriate for the police to be involved initially.

But too often, it’s a catch-and-release situation, as psychiatric facilities and specialists are in short supply. As reporter Katie DeRosa noted in her coverage of the issue in Sunday’s Times Colonist: “People arrested under the Mental Health Act are often bounced among police cells, hospitals, overcrowded drop-in centres and then right back to the streets, a rotating door with few long-term solutions.”

In the past, people with mental illnesses, particularly those who were a threat to public safety or themselves, were confined in mental hospitals. Those institutions had a grim reputation, often deserved, as gloomy warehouses where people were abused or neglected. More enlightened practices developed as the focus turned to treatment, rather then mere confinement. Community-based care began to replace institutionalization. B.C.’s Riverview Hospital in the Lower Mainland, which once housed nearly 5,000 patients, was gradually dismantled.

That was a positive step for many people who found new lives under community care. It was definitely a step forward for the B.C. government — in 1994-95, the operating cost for psychiatric hospital in the province was $424 million. By the 1998-99 fiscal year, it had dropped to $234 million.

But in that same time, funding for community psychiatric care also dropped by $8 million — the savings realized from closing Riverview were not passed on to community care.

“Although many patients benefit from community integration, some may experience negative effects,” wrote Alison Read in a 2012 paper published in the University of B.C. Medical Journal. “Funds saved by this trend have not been allocated to provide necessary supports to mentally ill people in the community. Due to a deficiency in mental-health resources, this population is at risk for homelessness, drug abuse, incarceration in jail and suicide.”

It falls to police departments to pick up many of the pieces resulting from that underfunding.

The closing of Riverview is not to blame for every instance in which mental illness encounters the justice system in Greater Victoria, but it represents the trend wherein the province saves money and entities such as police departments bear the burden.

The region has initiated some effective programs, including Island Health’s Assertive Community Outreach Team, in which police officers, social workers, mental-health workers and nurses work together to provide co-ordinated services to the most vulnerable people living with mental-health disorders. Such teams help steer people away from drugs and harmful behaviour toward building constructive lives.

The province should be putting more resources into such programs, as well as into more psychiatric beds, to ease the load for police and ensure the mentally ill get treatment that helps, instead of a process that merely takes them off the street temporarily.