MENTALLY ILL ADDICTS FIGHT DUAL DEMONS

Desperate Sufferers On The Downtown Eastside Say They Are Society's
'Throw-Away People'

Lisa McNally has haunted blue eyes peeking out from her dishevelled
hair. Her hands continually fidget, she crosses and uncrosses her legs
anxiously. A large sore is healing under her nose.

She's a few days into detox trying to kick her heroin habit. Again.
She's tried dozens of times. It's a tough road. Going through
withdrawal is hell.

But McNally, 45, is also struggling with another inner demon: She was
diagnosed as bipolar when she was a teenager. Her mental illness has
not been treated, she says, since she came to live in the squalor of
the Downtown Eastside six years ago.

"I use dope mostly not to feel anything. At first it works and then
the drugs make it worse," the friendly, articulate woman says.

There are everyday consequences to living in a cockroach-infested room
and turning tricks to support a drug habit, without intervention for a
mental illness.

"The depression parts of it: We get very suicidal. Then the manic
parts: You spend everything you have," she says quietly.

"I used to attempt suicide at least once a year, usually with pills,
and I'd often end up in the hospital."

The last time she says she saw a psychiatrist to discuss her mental
illness was 10 years ago, during a period of her life when she was
clean and sober. A Downtown Eastside walk-in clinic has given her a
prescription for drugs to fight depression, but she's had no
professionals assess what medications she needs to balance out the
bipolar symptoms, she says.

She has played some role, she admits, in her slip through the cracks
in the medical system because she knows which medical ailment is her
priority.

"If you're in active addiction, your main concern at that point is
getting drugs. So the other stuff goes on the back burner."

She's a few days clean as she speaks to The Sun inside a detox centre,
and appears earnest about seeking help now. But she also argues there
are few services out there to deal with both her mental illness and
her addiction.

"It [the system] is incapable of dealing with anything. We're just
throw-away people. We don't matter at all. We don't feel like anyone
gives a s--- about us."

The Sun spoke to several women in the Downtown Eastside who are dual
diagnosed, and they all echoed McNally's concerns.

They complained of being turned away by crammed hospitals; being told
to get clean before attending mental health clinics, and being told to
get off medical prescriptions before attending treatment for illegal
drugs.

A frank report released by Vancouver police earlier this month, which
said officers have been forced to become front-line mental health
workers, argued there is a "prevalence" of dual-diagnosed people in
the city and "a disturbing lack of available resources" to help them.

And if police are the front-line workers, then St. Paul's Hospital is
the "default social safety net," said veteran emergency room nurse
Jane McCall.

"Our department is overwhelmed with people who are dual diagnosed,"
she said. "The system has failed them."

St. Paul's has secure psychiatric beds, but there aren't nearly enough
to meet the demand.

"We discharge a lot of people from here that are not medically all
that great, they're not in great shape, and we discharge them to
shelters all the time. It's an outrageous situation," she said.

McCall argued there are few resources in the community to treat both
issues these people are struggling with, noting it isn't realistic for
mental health clinics to ask patients to be clean before attending
sessions.

"The reason people with mental illness use drugs is to treat their
unresolved symptoms: It's to treat the voices in their heads, it's to
treat their paranoia, it's to treat their depression.

"To a great extent, the only way to get people into treatment in
Vancouver is to get them arrested and charged. Then the court orders
it," McCall said, echoing a startling fact revealed in the police report.

There are success stories of people who kick their drug habits, but
without money, proper housing, and support services they often slip
back into their addictions, McCall said.

McNally knows that all too well.

A few years ago she went through detox and recovery, but went back to
the Downtown Eastside -- where there is cheap housing, food kitchens
and outreach services -- because she had "nowhere else to go."

"The problem is a lot of the help is right here. This is the worst
place we can be. The drugs are in your face 24/7," she said, calling
for government-run treatment and mental health centres in other areas.

In addition to being bipolar and addicted, McNally says she is
HIV-positive, was abused as a child, was involved in the survival sex
trade, and spent a year living on the streets before finding a hotel
room "infested with cockroaches and mice."

The mother of three grown children said she was clean for several
years until about six years ago.

She relapsed, she said, after going through a nasty breakup and
custody fight with her ex-partner -- but would like to get healthy
again.

"It's been awful. You wake up every day and you wonder how you're
going to make it. It's a vicious cycle," McNally said, weeping. "I'm
just hoping so badly I can stay clean this time."