and the Laurel House saga continues…
Laurel House is safe. It seems. For now.
Six months of closed-door negotiations between the Capital Mental Health Association, Vancouver Island Health Authority, and Laurel House users who staged a sit-in last September ended with a verbal commitment from VIHA that, “Laurel house will not be closed in the foreseeable future,” says Laurel House user-negotiator Kathleen Sumilas.
“It’s absolutely awesome,” she adds, noting that the sudden last minute agreement after six weeks of utter silence from VIHA “was quite unexpected.”
However, as of Focus’ press time, VIHA had provided no details in writing, and had pledged only that the users would be “consulted” about what Laurel House programming would look like. In light of VIHA and CMHA’s past poor record of conducting and respecting consultations, does it cause her concern? Worry? “Yes…” Sumilas responds slowly. “Yes, it does…”
Regardless of the outcome, however, one astonishing fact emerged during the process, with repercussions far beyond this individual issue.
From the beginning, the closure of Laurel House, a comfortable home used by people diagnosed with mental illnesses for socializing, meal sharing and learning crafts and skills, was immensely controversial. This was because no users of mental health services were ever consulted. However, it has now emerged that VIHA decision-makers didn’t even consult their own psychiatrists or case managers, either. And VIHA psychiatrists have been irate.
This became clear in February when Dr. Andre Masters raised Laurel House at the monthly meeting of VIHA’s South Island psychiatrists. Masters is a Victoria Mental Health Centre psychiatrist who treats some Laurel House members, publicly supports Laurel House, and has participated in the negotiations.
With negotiations stalling, Masters proposed advising VIHA management to extend the negotiating period three months.
VIHA’s psychiatrists passed the motion unanimously.
Then, Masters was surprised by what else got said at the meeting, and afterwards.
Some psychiatrists said they felt VIHA had mishandled the Laurel House situation, says Masters, while others expressed how upset they were with VIHA management generally.
“It opened the can of worms,” says Masters. “I was surprised how much they were festering with their anger.”
The issue, according to Masters, is that VIHA management has been frequently bypassing its psychiatrists during mental health programming decisions.
“There’s supposed to be an administrative manager-psychiatrist team in every area,” says Masters. “Well, too many decisions are being made by the administrative managers without proper consultation with the psychiatrists.”
And that’s not just budget discussions; the psychiatrists are often ignored “on clinical issues” that directly affect patients’ wellbeing, too, says Masters.
He doesn’t want to speak for specific individuals, but Masters’ assessment of the collective message is clear: “Many psychiatrists are just fed up with the whole thing.”
Masters claims this same frustration is widespread amongst nurses and case managers, too. The public is in the dark, however, due to employee fears for jobs and VIHA contracts restricting rights to speak publicly.
As a VIHA contractor, Masters doesn’t have the same restrictions. Also, at 71 and semi-retired, he says he’s more drawn to defending his clients needs than tolerating this objectionable situation.
“They’re gagged,” says Masters. “I’m not.”
VIHA suffers from an ever-expanding, top-down “pathological bureaucracy”, he argues, which is increasingly out of touch with front line realities.
“I worked in Regina for 27 years,” says Masters, a former health district head of psychiatry. “There was nothing like this. People tended to work together. Here, no, it doesn’t happen. Not as much as it should.”
Indeed, as the deadline approached for saving Laurel House with nothing but silence emerging from VIHA, Masters suggested the negotiations were likely just a “smokescreen” to quiet the public outrage, and that this lack of proper consultations was “symptomatic of a malaise that occurs throughout VIHA.”
Though Laurel House apparently dodged that bullet, all of this raises serious questions about other community-based mental health programming changes; the most significant recent one being VIHA’s decision to attack homelessness with costly psychiatric Assertive Community Treatment programs.
While the successes of ACT in Ontario are frequently touted, it’s rarely mentioned that there, ACT works with people who have homes, and then functions entirely through the use of court orders, lifestyle constraints and forced treatment, effectively becoming a system of mobile padded handcuffs. Can that truly help Victoria’s homeless?
In Masters’ opinion, we’ve grossly overestimated the percentage of mentally ill homeless, anyway. Through his work and personal time spent downtown, Masters says he knows the street people who are actually seriously mentally ill.
“They’re a fraction of the problem,” he asserts. “A small fraction.” Instead, Masters accuses governments of opportunistically “blaming” the mentally ill, to excuse their own poor policies with regard to housing, unemployment, welfare, crime and addiction.
Which raises the question: Were the psychiatrists, nurses and case managers who actually work with street people and the mentally ill in Victoria ever consulted about ACT? The VIHA representatives involved in the city-organized homelessness initiative were managers.
In any case, what VIHA’s psychiatrists have definitely shown support for isn’t ACT. At their mid-March meeting, they unanimously advised VIHA management to commit to continuing voluntary, community-based mental health social programs before the Laurel House negotiations ended.
Was this a turning point? And could VIHA’s turnaround mean management is starting to truly listen to both its psychiatrists and program clients?
“Time will tell,” answers Sumilas, before returning to basking in the glory of at least this one battle won. “I’m feeling wonderful. But it all feels very surreal as well.”