NEGLECTED SUB-GROUP NEEDS REAL HELP

With reference to Dr. Anthony Barale's letter "VIHA failing addicted,
mentally ill," I note the compassion that Barale feels for the people
that he has to deal with every day. It is not only the Vancouver
Island Health Authority that is failing these people, but it is
society in general.

As physicians we get to see close-up the results of social policy. We
are not armchair quarterbacks. We see the pain, we hear the grief and
look on helplessly at the results. Yet we are the last to be consulted
on how to deal with the situation.

I have long felt that the current situation with the panhandlers and
street people is due to an unhappy combination of naivete and
duplicity. Let me explain.

Sincerely well-meaning, but ill-informed, advocacy groups propose that
the mentally ill not be confined in institutions but be returned to
live a normal and full life in the community.

(It is my opinion that One Flew over the Cuckoo's Nest has done almost
irreparable damage to the attitude to the care and treatment of mental
illness. If ever there was a case for censorship!)

Administrators of all levels willingly comply with this advocacy in
order to appear "humane" and "progressive" -- while really ducking
their financial responsibility.

Without tangible support the mentally ill are vulnerable in society.
They are susceptible to malnutrition and illness. They are exposed to
the unscrupulous. They are particularly vulnerable to highly
organized, highly motivated drug dealers; then one has the addiction
problem on top of the mental illness.

"Go get a job" is not an option for many of these unfortunate
individuals. Not every street person is mentally ill, I agree -- but
the vast majority are. It is not fair that the vast majority should
suffer for the few.

If we become a more caring society, it will be argued that the welfare
system will be abused. It will. There is not a scheme in our society
that is not abused to some extent. How many ultra wealthy people pay
no income tax by abusing Revenue Canada loopholes? The mayor of an
Interior municipality was found guilty of flagrant abuse of his
expense account. Because of potential abuse tax breaks and expense
accounts should not be abolished entirely, and nor should the welfare
be stripped below a sustainable level.

I have a good memory. I feel that a section of British Columbia
society suffered dearly from the draconian cuts of 2001 -- cuts that
were deemed necessary to avoid financial disaster, at the same time as
provincial income tax was cut by 25 per cent. Signing bonuses and big
smiles are not wiping this from my memory.

Looking at the abject suffering and misery of the street people around
my office, and the addicts shooting up in the car park are daily reminders.

As a society let us provide supportive and caring homes for these
unfortunate people. Stop blaming them. Let us be realistic in
providing sheltered occupation for the mentally ill and disabled
(reintroduce Goodwill? Re-open and expand the Garth Homer sheltered
workshops?)

I suggest that drug addiction should be treated as a medical
condition, and that there should be a ready availability of
detoxification and rehabilitation facilities for this disabling killer
illness.

Is this essay "too touchy, too feely?" Am I unrealistic? Am I naive?
I, of course, say "no." I see these problems up close every day -- but
not as closely as my colleagues in the Archie Courtnall Centre.

The current policy of contempt and neglect has shown itself not to
work. Let us try another approach. Put pressure on elected officials,
demand accountability from administration, and follow Barale's idea of
community fundraising.