HIGHLIGHTING THE FAILURE TO DEAL WITH AN ACUTE HEALTH CRISIS

VICTORIA - This city has suddenly decided that it has a problem with
panhandlers, the homeless and drug addicts, mostly thanks to a U.S.
group that decided to take its convention somewhere else.

Too many panhandlers and tacky T-shirt shops, the Americans
complained. The decision cost the Empress Hotel $200,000. The Times
Colonist revealed all this 10 days ago, prompting a flood of letters
to the editor and brisk public debate.

And, most usefully, a damning review of the Vancouver Island Health
Authority's failure in the areas of addiction and mental illness from
its own clinical director of psychiatric services.

The authority has neither the resources nor the will to meet the
medical needs of people with addictions or mental illness, Dr.
Anthony Barale says. Its staff struggles to provide basic care with
"little support and the pitiful resources provided by VIHA." The
health authority's services would be inadequate "even by so-called
Third World standards," Barale said in a letter to the Times Colonist.

Barale is quitting what should have been his dream job, giving in to
"long-standing frustrations" with VIHA. He's based at the
two-year-old Archie Courtnall Centre, which was to represent a new
vision for dealing with mental illness. Instead of showing up in
emergency rooms that were ill-equipped to help them, people suffering
from a mental-health crisis were to go the centre. It was to provide
a calm, specialized response to their problems, helping them avoid
longer-term hospitalization.

The community backed the vision, which Barale helped developed. The
prominent Courtnall brothers, including former NHL stars Russ and
Geoff, led a $2.2-million fundraising campaign. The centre is named
for their father, who committed suicide after struggling with mental illness.

But it's gone wrong. The centre was expected to deal with a mix of
patients. Instead, Barale says, it's been swamped by people
struggling with addictions. The centre and its medical staff aren't
equipped to deal with the complicating issues of homelessness, hunger
and disease. But there's nowhere else for the people to go.

The centre had reserved beds for people who just needed a day or two
of care to stabilize their mental illness. Those beds have been given
over to addicts needing a place to detox. It would be immoral to turn
them away when there is no other help, Barale says. The region has
seven detox beds, treatment is scarce and supported housing for
people recovering pretty much non-existent.

None of this is a surprise. The difference is that the criticism is
coming from inside.

And none of these problems is limited to the Island. Resources for
both mental health and addictions are inadequate in every part of the
province. When health authorities set their budgets, the mentally ill
and the addicted can never compete for spending priority with the
push for more knee operations or seniors' beds.

The result is more mentally ill and addicted people living on the
streets, panhandling or just getting in the way.

The attention being paid to the issue here is welcome. Maybe it will
even bring change. But there's something bizarre about the fact that
it took the loss of $200,000 in convention revenue to get peoples' attention.

If we were the kind of society we profess to be, surely the presence
on our streets of more and more sick, skinny people, with abscessed
arms and empty eyes, would have suggested something needed to done.

Even if we didn't much care about the people, the $200,000 in lost
convention revenue is nothing compared to the costs of untreated
addiction and mental illness every week. Health care, policing,
emergency social services, harm to communities and businesses -- the
toll is enormous.

Those are the costs of the health authority's failure to deliver
adequate mental health and addiction services, with the consent of
municipal and provincial politicians.

Barale says the community better start fundraising and planning how
to deliver the services on its own.

"VIHA," he says, "has no real will and no real resources to do so."

Footnote: In last week's column I said B.C. had a junior minister for
mental health and addictions and challenged readers to name the
minister and one initiative he or she had promoted. It was,
inadvertently, a trick question. The job vanished after the 2005
election. Addictions and mental health now have no champion, not even
an ineffectual one.