For the past two weeks, members of Families supporting Adults with Mental Illness in Alberta (FAMI-Alberta) have been watching the debate on Bill 17, the Mental Health Amendment Act.
We’ve been watching as if lives depend on it. Because they do.
The Mental Health Act (the Act) is the main piece of legislation in Alberta that deals with the assessment, treatment and rights of people with a serious mental disorder (illness) in certain situations. The Act describes how a person with a mental disorder can be apprehended, detained and/or given treatment in a hospital or in the community under specified conditions. It also explains people’s rights in these circumstances. Bill 17 was introduced largely to address the JH v. AHS court ruling in July 2019 that determined that parts of the Act dealing with involuntary admission and treatment are unconstitutional.
Illnesses like schizophrenia and related psychotic disorders attack the brain – the organ we use to interpret sensory input and make choices about our actions. When the brain isn’t working properly, it can be impossible to interpret reality and make rational choices. Half of those with a psychotic illness have a symptom known as anosognosia, which prevents them from recognizing their illness. Many of those with an untreated psychotic illness will be victimized and exploited, 5 to 10% will die by suicide (often attributed to delays in receiving treatment); and a smaller percentage are likely to engage in violent acts.
The comments by MLAs in the legislature reflect the varied responses of society at large. Some acknowledge how mental illness has impacted their families or social circles. Others seem to struggle with what to think or say about mental illness. And some comments reflect an unconscious bias or uncomfortableness that exists within most people when it comes to speaking about mental illness. This implicit bias leads to trivializing mental illness, distancing oneself from it, and avoidance of dealing with it directly.
Please note we’re not blaming or shaming; we simply hope this is a teachable moment that could lead to more awareness, and possibly raise the level of the debate to be more considerate of those to whom the Act applies.
We trust our elected officials want to make a positive impact, and we applaud that. We also want to emphasize that this must not become a partisan issue. Anyone using this debate to take cheap shots at the other side is exploiting those living with mental illness for their own purposes. This debate must stay focused on those living with mental illness, and how the Act can help improve their mental health while protecting their rights. Mental illness doesn’t discriminate. It can happen to anyone.
Some may find it more comfortable to talk about legalities than the gritty reality faced by those living with mental illness. That’s a natural reaction. However, getting out of one’s comfort zone to help vulnerable Albertans is what we expect of our leaders. Restricting the debate to a fine point of legality is ignoring the reality of tens of thousands of Albertans who need psychiatric help.
Without early and effective treatment, those living with a serious mental illness are more likely to be unemployed, require social assistance and have a much reduced quality of life. They are also more likely to need further interventions – meaning more, and more lengthy, involuntary hospitalizations. Ironically, this means their rights are infringed more often and for longer periods of time than if they were treated properly in the first place.
Most families will tell you it’s highly unusual for someone to be kept in hospital longer than necessary. On the contrary, it’s very difficult to get even the most obviously psychotic, even suicidal, individuals into care. Once admitted, they’re commonly discharged before they’re ready – and with limited community supports they’re apt to end up homeless, back in hospital, or worse.
Last year we asked family members what they thought would have happened to their loved one if involuntary treatment wasn’t available. Here are some typical responses:
- “He would have killed himself or me.”
- “Our daughter would not be alive.”
- “He would have hurt someone and would still be not treated.”
- “He would have stayed in intense pain and worry through paranoia. Because of treatment, he is now safe.”
- “He’d still be on the streets or dead by now.”
We’ve also asked those who had been treated involuntarily and achieved some level of recovery. They replied that while it was a horribly upsetting experience at the time, they’re grateful it happened. As family members, we want our loved ones to retain their rights as well as get treated for their illness. What we don’t want is for them to die with their rights on.
Here are some suggestions that might be considered while debating Bill 17:
- Make the Review Panel process less confrontational and more therapeutic. Our court systems have incorporated healing circles, restorative justice, and other means. Some creative solutions could go a long way here.
- Question the role of police in mental health care, which leads to criminalizing mental illness. While there may be times when police are needed, there are other options in most cases.
- Take a holistic look at the way mental illness is treated. More effective use of resources could result not just in better outcomes for those with mental illness, it could ultimately save money by eliminating the revolving door syndrome and reducing repeat hospitalizations.
Please contact us if you want to discuss these and other suggestions. We are families who live with and support those living with serious mentally illness. We’re ready to help inform and enlighten.
We implore you, as our elected representatives: look around and think about who this law is meant to protect. Ask them, and those who care for them, what they need. Then, speak up about how the law can better help them.
Countless lives are depending on it.