Mad justice

>> On the eve of Mental Health Week experts look for solutions

by CRAIG SEGAL

Richard Tock, a 48-year-old schizophrenic with electric blue eyes buried deep in his worn-out face, spent 20 years in and out of prison. He was often better off behind bars, he says, since it meant he got three square meals a day and a clean bed to sleep on. Even though it meant being treated like a regular prisoner, being cut off from his medication and having his nose broken three times.

Tock describes Quebec prisons the way the rest of us describe youth hostels. At Parthenais, they had good food, but he had no appetite so they fed him Pablum in the infirmary. At Archambault he lived in a small room with a mattress on the floor. At Cowansville they put him in segregation. At St. Vincent they put him in the hole for three months and cut him off from his medication and tobacco. "My hand became my puppet," Tock recalls. "I'd yell at it and hit it. The doctor thought it was because I was doing drugs, I guess."

Falling through the cracks

With Mental Health Week just days away, experts are outraged so many people like Tock are still not receiving proper treatment. "They're not meant to be in prison," says Isabelle Leduc in her crowded office at the St. James Drop-In Centre on the corner of Ste-Catherine and City Councillors. "They're often in prison because they've messed up. And they mess up because they don't have the support they need in the community.

"I am discouraged and revolted by the way people are just falling into the cracks all the time. It's nonsense."

One reason so many mentally ill people end up in prison is because doctors are confused about whether they are allowed to treat patients against their will. In a contentious opinion piece published in La Presse last November, syndicated columnist Dr. Kenneth Walker, a 77-year-old Ob/Gyne, wrote that "our ridiculous laws" allow people suffering from schizophrenia "to walk freely in the streets." The article implied that a high percentage of violence in Canadian society is attributable to people with mental illness and that the only solution is medication and institutionalization.

The article pissed many people off, including Barbara Everett, chief executive officer of the Ontario Division of the Canadian Mental Health Association. In a letter to Walker, Everett claims that only "three per cent of violent criminal acts are committed by people with mental illness." And, she says, the current legislation does allow doctors to treat patients when they are incapable or unwilling to give consent. "They have the right to refuse services that aren't suited for them," adds Leduc. "Big deal! It's a consequence of a lack of appropriate services."

Out on the streets

The main reason so many mentally ill people get themselves into trouble with the law, experts argue, is because they never got the help they were promised after they were kicked out of hospitals in the mid-1990s. The Louis-H. Lafontaine Psychiatric Hospital on Hochelaga Street alone had 6,000 live-in patients in 1960. Today they have under 700.

"Everyone was okay with the idea of deinstitutionalization as long as we helped patients to reintegrate into society," says Jacques Duval, of the Montreal branch of the Canadian Mental Health Association. "But there was no investment in community resources."

The St. James Drop-In Centre's coordinator couldn't agree more. She says the chronically underfunded centre is a lifeline for the 60 men and women who use it every day. At the St. James, people with mental health problems get a square meal, a safe space where they can sleep on couches without being interrupted, board games and a free phone to call their doctors and social workers. Leduc regulates medication for a dozen or so regulars out of Tupperware containers in a locked file cabinet. She and her staff also manage people's finances, organize appointments with doctors and CLSCs, shower people, distribute clean clothes and even organize group trips.

But more than drop-in centres, Leduc says, mentally ill people need to be reintegrated into society. "There's no miracle cure. But I think there should be certain types of housing structures adapted to different types of needs. They need to have their primary needs taken care of so they can use their time to volunteer or work, rather than wander the streets and get themselves in trouble."

Tock agrees. While he was staying at a transition home, Tock learned to look after himself for the first time in his life. "I learned to do my laundry every week, my cooking. It helped me with my routines. That's what it's really good for. If you're shut up in a hospital you get you pill, your bed. That's it."

"These places help us look more presentable," Tock adds. "We want to live amongst you. Maybe we can't work as much as you do. Maybe we can't have a car. But we want to be accepted as a human beings."