HELP INADEQUATE FOR THOSE FIGHTING TWIN MONSTERS

He is 17 years old. We'll call him Bob, because that's not his real
name.

Two years ago, Bob got into drugs -- crack, marijuana, booze, ecstasy,
LSD, the works. He dropped out of school, was soon spending days at a
time on the streets of Victoria. When given the choice, Bob moved into
foster care rather than quit drugs and stay at home.

It got worse. Just over a year ago, his mother says, Bob became
psychotic, delusional, paranoid and extremely frightened. Committed
under the Mental Health Act, he was placed in the Queen Alexandra
Hospital's Ledger House program. He developed Capgras syndrome, a
condition that left him believing his mother was an impostor who had
killed his real mother. He thought his brother was an impostor, too.
He contemplated harming others, including his mother.

The mother says a number of local treatment programs, including the
one at Ledger, did little for Bob, though medicines helped him become
less fearful and less delusional. His mother looked around for
options, but found B.C. has a dearth of facilities treating dual
diagnosis -- that is, both mental illness and addictions.

So she began looking elsewhere, found a Utah hospital that dealt with
dual diagnosis. Last August, B.C.'s Medical Services Plan paid to send
Bob there for assessment. The Utah doctors recommended long-term
residential care for Bob.

He ended up in Youth Care, a private, $480-a-day residential
teen-treatment facility in Utah. His mother was happy, says the
success rate, measured by a patient's abstinence from drugs and his
ability to work or go on to college, is high. She liked the mix of
services, including specialized education programming of the sort that
would allow Bob to finish high school. "He was getting incredible care
down there, the kind he needs." The province covered the cost.

But in October the government began to balk, saying the best course of
treatment for Bob was back in B.C., that he should be brought home. No
way, the mother said, there's nothing for him here. Armed with letters
from Youth Care and a Victoria psychiatrist who warned against
returning Bob to a "patchwork" of services with low-level supervision,
she fought the decision tooth and nail -- ultimately to no avail. Bob
returned to Victoria last week. The mother is beside herself. She
wants her son returned to Utah, wants -- ultimately -- to move with
him somewhere he can get a fresh start.

This is where these stories hit a wall. Confidentiality issues prevent
the government from commenting on individual cases directly. All it
can do is speak in general terms: "Care plans are dependent on the
needs of the individual," said the Health Ministry. "What is critical,
and what the professionals try to achieve every time, is a
comprehensive and co-ordinated approach to ensure the care plan best
meets the needs of the client."

Which is another way of saying that the government has its own health
professionals -- in the Health Ministry, the Children and Families
Ministry, the Vancouver Island Health Authority and elsewhere -- who
are doing their best to decide what is best for clients, and sometimes
those decisions clash with the desires of the clients' families.

What no one disputes is the difficulty in tackling the twin monsters
of mental illness and addiction. Dual diagnosis isn't rare. A VIHA
report estimates up to 70 per cent of people with substance abuse
disorders also have a mental health problem.

Don't expect the problem to become any less pervasive, not if drug and
alcohol use continue to climb. Between 1994 and 2004, the percentage
of Canadians who drink rose to 79 per cent from 72. Marijuana use
doubled from seven per cent to 14, cocaine and crack from less than
one per cent to almost two. Just over one per cent use LSD, meth, heroin.

The Health Ministry notes that B.C. has hired 321 additional child and
youth mental health specialists in the past four years, bringing the
total to 515. Work is beginning on a new 10-year strategic mental
health plan.

That's good, but means little today to Bob or his mother. Just pray
that somewhere, someone gives them the help they need.