Speaking notes for

OPSEU First Vice-President/Treasurer
Smokey Thomas

Press conference

November 18, 2002

Good afternoon.

My name is Smokey Thomas, and I am the First Vice-President/Treasurer of OPSEU. Before I was elected to this position I was, for more than 25 years, a registered practical nurse at Kingston Psychiatric Hospital.

I am very pleased to be here today to speak about our union’s latest effort to enhance the situation of people in Ontario with mental illness.

This is the launch of yet another union report on mental health: Reality, Ontario’s Mental Health System isn’t working.

In a little more than 100 pages we spell out a litany of pain, anguish and death caused by cuts to psychiatric services across the province.

We spoke with union members who work with the mentally ill in 20 workplaces across the province. Our members include social workers, registered nurses, maintenance workers, occupational therapists, psychometrists, psychologists, cooks and housekeeping attendants.

We knew it was bad. I personally know it is bad because I have worked in this field since 1975.

Our researcher worked with our members and also researched newspaper reports, recommendations of coroners’ inquests and a host of other reports on the state of psychiatric care in this province. From that she has distilled a succinct analysis of the situation facing people with mental problems today.

To put it simply, they are facing a crisis, no matter where they live in Ontario. Here are just a few “for instances”:

· In London and St. Thomas, patients can’t get into the psychiatric hospital even though the beds exist, because the hospital has frozen admissions despite a long waiting list. (Page 11)

· In Hamilton and Niagara, a schizophrenic tried to murder his father after he was released too soon, despite his mother’s protests that he wasn’t ready to come home. (Pages 13)

· Toronto, once “the jewel” in the system, has lost researchers in both mental illness and addictions through the combining of services for the two distinct areas of disorders. Seven people have died, three by suicide, while waiting for treatment. (starting on Page 71)

· In Whitby, lack of appropriate service means more patients are acting out in more violent ways. (Page 77)

· In Penetanguishene people show up, psychotic, at general hospitals and take emergency room beds because there are no beds to serve them in the psychiatric hospital. (Starting on Page 80)

· A front line worker in Kingston says, “We discharge to Tim Horton’s basically, or to the kind of home where, if the client gets sick, they’ll lock him up in a motel outside of town for two weeks.” (Page 85)

· In Ottawa, workers point to grinding poverty as the fate for the mentally ill outside of hospitals, and long waiting lists for treatment. One client waved a machete around because it was the only way he knew to get help immediately. (Page 92)

· In North Bay, staff point to burnout as they do their best to maintain people who are stuck in substandard living conditions. (Page 95)

· And in Thunder Bay an excellent supportive housing program is being closed down by the government. (Page 22)

Across the province the services for those with multiple problems are virtually non-existent.

Where has this latest crisis come from?

From the government’s so-called reform of mental health. Since 1998, the Ontario government has:

· Handed over six of 10 provincial psychiatric hospitals to the control of public hospitals that don’t have the expertise or interest in caring for the mentally ill;

· Through downsizing and divestment forced out hundreds of people who used to work with the mentally ill.

· Reduced beds in the current and former psychiatric hospitals;

· Privatized support services and clinical programs in our hospitals, such as psychiatric care for seniors.

Our psychiatric hospitals were the safety net for the mentally ill. The government in the last four years has removed this safety net.

What this means is that, for many people desperate for help, there is no facility that HAS to take them.

If they go to a general hospital with a psychiatric ward, the hospital can and does turn them away.

Our report refers to coroner's inquests and newspaper reports from across the province that tell the sad and horrific stories of the mentally ill who have been turned away from the emergency rooms of public hospitals. As one Hospital CEO quoted in our report says: the demand for psychiatric services far outstrips the supply.

And if the mentally ill person is lucky enough to actually get admitted into the public hospital, they’ll be discharged after only a two or three day stay. The hospital will stabilize them and then release them, whether the patient is well or not. This can lead to disastrous consequences.

Our report talks about a case in Hamilton earlier this year when a schizophrenic was released against his mother's wishes after a week-long stay in hospital. He returned home and stabbed his father with a screwdriver. The father later died from the assault.

People with money and connections can always find the treatment they need. People who have the double misfortunes of mental illness and poverty are at the mercy of the system we create.

In the area of mental illness, the people with the greatest needs and the most complex diagnoses are the hardest and most expensive to serve. These are the ones who get turned away from other treatments. These are the people who the provincial psychiatric hospitals always took in.

The government needs to learn the lessons from its dangerous dismantling of mental health services. For a start, it should implement the recommendations from our report.

Reality follows on that long history of concern over the neglect of the mentally ill.

Its first recommendation is essential.

1. The province must stop closing beds in the current and former Provincial Psychiatric Hospitals (PPHs) as there is an urgent and demonstrable need for those beds.

We need time to get the promised care in the community before we close any more beds for psychiatric patients. There have been too many suicides and too many other tragedies because people who desperately need help have been turned away.

There has to be a place for patients whose mental state makes them disruptive, even dangerous, to themselves and to others. That place is NOT the streets, NOT the jails, and NOT wards in general hospitals.

The rest of the recommendations flow down from that overwhelming priority:

2. The province must order an increase in the number of acute mental health beds in Ontario’s hospitals in order to eliminate waiting lists and prevent the practice of prematurely discharging patients from hospitals.

3. The province must order an increase in forensic beds in psychiatric hospitals to alleviate the wide-spread problem of the mentally ill being in our jails and correctional centres and eliminate waiting lists at hospitals.

4. The province must legislate and enforce standards of quality and care wherever services to the mentally ill are provided, including but not limited to housing, and establish an accountable provincial body to enforce the standards.

5. All general hospital emergency rooms must have skilled and qualified psychiatric staff on hand 24 hours a day, seven days a week.

6. The province must ensure that every psychiatric consumer has the right to publicly-funded and publicly-delivered mental health services. Support services in hospitals, such as laundry, dietary, housekeeping, security and maintenance are an integral part of publicly-funded health care and should not be contracted out.

7. The province must increase the income support that individuals receive from the Ontario Disability Support Program in order to more adequately and humanely meet the needs of the mentally ill.

8. The province must develop and implement publicly-funded and publicly-operated community supports for the mentally ill, including supportive housing for consumers who are discharged from hospitals.

9. The province must develop and implement social and vocational rehabilitation programming to meet the needs of the mentally ill and integrate it into the continuous care model.

10. The province must not allow the closure of beds, programs and services in the former and current Provincial Psychiatric Hospitals until their equivalent is available in the community.

11. Community agencies must not have the right to refuse consumers.

12. The province must study the impacts of the integration of addiction and mental health services at the Centre for Addiction and Mental Health in Toronto before undertaking any further integration of addiction and mental health services.

The government has set up nine regional mental health task forces which will be making recommendations to the government by the end of December.

From what we have heard, the task forces will recommend more bed closures and more dismantling of the psychiatric programs for in-patients and outpatients provided by our hospitals. If this happens, the crisis we are outlining today will get much worse.

I urge you to read Reality. I urge you to tell the stories that are in there. Pass them on. We’re trying to light a fire under the government. We want attention, care and compassion for a group of extremely vulnerable citizens.

Their voices are lost in the wilderness. They are lost in incoherence, lost on the streets, lost in shelters and jails. They are sick and need care and treatment.

If we claim to be a humane society, how can we not listen? How can we not respond?

I thank you for your attention and interest.

Open it up for questions and answers.