“A psychiatric hospital for the severely mentally ill is a foundation. And if you don’t have that foundation, the building just collapses.”
–Barbara Kane
Dr. Barbara Kane is a psychiatrist who has spent much of her career in BC’s north treating people with severe mental illness and addictions. During that time, she’s witnessed and cared for people in such deep distress, they are harming themselves in ways the rest of us can only imagine.
She’s calling on the province to green light a secured psychiatric facility in Prince George to care for the people with intractable mental illness and addictions, whose most essential needs are not being met in our current healthcare system.
To the naysayers who worry that mandatory residential care is an infringement of people’s rights, Kane is empathetic but firm – some people need it. For their own sake and the safety of those around them.
“The involuntary care aspect is problematic for some people, but often these people, they don’t know that they’re ill. That’s part of mental illness.
“Some of the people can be managed in the community, but… there’s a subset of psychiatric patients that are severe. They don’t get better enough.”
Right now, those individuals bounce back and forth from the street, to the hospital, to supportive housing, to the street, to the hospital, round and round they go, getting worse instead of better.
In hospitals, they’re scaring other patients and injuring staff not trained or resourced to adequately care for them. The streets are dangerous, violent and chaotic. Supportive housing is unequipped to deal with the acute needs of a person in psychosis or trapped in deep addiction and mental illness.
Previously, regional hospitals could send patients requiring longer and more intense care to Riverview Hospital in Coquitlam. Ever since the province’s only such facility closed in 2012, patients who need long-term treatment have few options.
“Nowadays, those patients, we have nowhere to send them. So we’re getting all these really violent people that… we have to keep on our ward and our ward isn’t built for that kind of violence.”
Or they are released into the community where their around-the-clock health needs can’t be met.
“[Treatment centres] have got long waiting lists – I’ve had several patients die waiting to go somewhere,” Kane said.
She argues that a properly resourced pschiatric facility would be safer for the community and more humane for the individuals. They patients would be safe, medically cared for, have freedom of movement not possible in a general hospital and they would have much greater hope of improving their quality of life.
“A psychiatric hospital for the severely mentally ill is a foundation. And if you don’t have that foundation, the building just collapses. And it’s collapsing on the street. You can see that homelessness and the violence, and the violence in the hospitals.
“Because people don’t get better in two weeks with severe illnesses. They need long stays and we can’t do that right now, at least not very easily.”
The former department head of psychiatry at the University Hospital of Northern BC, Kane has been the medical lead for Northern Health’s mental health program since 2018. She says she understands the deficiencies of the institutionalization of mental health patients in facilities like BC’s old Riverview Hospital, but has come to believe that having a psychiatric hospital, based on today’s ethical standards, is foundational to a strong health care system and the safety of the public.
The whole system is breaking down without this essential backstop, she says.
These patients are disrupting hospital systems not designed to care for them, endangering staff and contributing to capacity and staffing issues. We can literally see the consequences of not having dedicated psychiatric facilities on our downtown streets, she said.
Podcast producer: Rob Shaw