Dear Mr. MacKay, I was surprised that when I spoke to you at the Canadian Alliance On Mental Illness and Mental Health Gala that you did not inquire into my access-ability requirements.

I feel terrible. The Honourable Minister of Justice Peter MacKay is leaving his post. He’s been urinating on the Charter for a while now and I was wondering how long he could keep it up. I guess he’s finally petered out which I’m sure is a relief. Maybe not to the prime minster who is nothing more than Reform without Peter.

If I thought Peter MacKay would resign I would have written to him sooner. I only wanted to invite him to my home but he has taken it as the gauntlet being thrown. I hate to say it but for someone so athletic looking I would have thought Peter had more game. I did admonish him which may have been unwelcoming but having no regard for a segment of society who are in conflict as a direct result of a mental illness is not a slight I can pretend to ignore.

I actually thought Peter may have visited me so he resigning is quite a shock. Does anyone know how long cucumber sandwiches last? I guess someone should step aside. We are allowing serious human rights violations to be inflicted on the mentally ill. When I looked into my crystal ball/stainless steel toilet sink combination I saw more orange than justice ministers resigning at my feet. I wasn’t even aware that it was an injustice to be psychotic in the confines of solitary confinement.

I did not mean to scare Peter MacKay into resigning. I only wanted to point out his mistake in the hope of pointing out more mistakes. It would have simply been tea with a detainee but in a way he has done the right thing by stepping down. I feel somewhat responsible but he made his own mistakes. I would have reasoned with him and found a way around all of this but some crown attorneys see only one scenario. It can be overlooked as a job description for a crown attorney but when you continue on that path as a Justice Minister you become a knob. Peter MacKay became a thing Stephen Harper turned to key up for election. When it comes to justice and sadly Peter MacKay this government always did what looked good and seldom what was good.

I’m not an optimist but I have dreams. I will be awake at night imagining the course of withdrawing my extended hand to the prime minister. Possibly he too will not see me coming. I certainly did not see this coming. I don’t know who to aim for next but this is sure a lot of fun. Good bye Peter.


May 12, 2015

Dear Mr. MacKay,

I was surprised that when I spoke to you at the Canadian Alliance On Mental Illness and Mental Health Gala that you did not inquire into my access-ability requirements. Some disabilities are invisible and I assumed at such an event you would have been more careful. I mentioned to you that I had lived in solitary confinement and that I was found Not Criminally Responsible on Account of a Mental Disorder. But you handed me a business card without asking if I had any requirements of assistance. It would have been most helpful to have you contact me.

As one of few who speak about the issue of Not Criminally Responsible having experienced it as living flesh I am dismayed that my voice has not been heard by this government. I submitted a Brief to this government regarding Bill C-54 which post prorogue became Bill C-14. I spoke with government employees and tried to access my own Member of Parliament but I was never asked if I had any accessibility requirements. I’m somewhat uncomfortable with sharing my medical information with a receptionist and I had to enlist assistance from individuals not employed by the government in attempting to communicate with the government.

I am pleased you are coming to London and will take you up on your offer to see me. I would like the opportunity to show you that solitary confinement can damage an individual. Mental illness in the correctional system is a complicated issue. I understand corrections is not your portfolio but in reading your statement on solitary confinement and thanks to your offer to speak with me I’m sure you could understand and convey to those better versed what you will learn.

Since language is no more than incomplete shorthand I will be able to convey more in person. As such I would like to invite you to my home. I am slightly agoraphobic and it would be helpful to have access to my writings to impart on you what I know. I have firsthand knowledge of corrections and the forensic system from the position of inmate and patient while living with serious and persistent mental illness. I know you believe that there are no adverse effects to Administrative Segregation but I have proof. Some of this evidence is within me, some of it is written and some of it is in how I live.

Please contact me at your earliest convenience to set up a meeting.

Kind regards,
Brett Charles Batten

Attorney-General MacKay wants us to believe solitary confinement doesn’t exist in Canada because he calls it ‘administrative segregation’. BS!

The use of solitary confinement and acceptable standards for the treatment of mental health in corrections is a form of torture as it exacerbates and often deteriorates the mental health of a segment of society that is marginalized, compromised, and vulnerable to abuse and in many cases clearly disabled. Solitary confinement deteriorates the mental wellness of anyone.

The use of solitary confinement can inflict permanent psychological injury. To use it on individuals with mental illness is more harmful, depending on their symptoms. ‘Administrative segregation’ denies a person the psychological benefits of movement, and visual or auditory stimulation. The need for human contact and interaction is fractured at best. Seeing a hand or face through a food slot may worsen symptoms. It is also internally disorienting to be exposed to 24 hour light. The use of light in various forms can be used to torture an individual. To my knowledge there is no medical literature supporting the use of constant light to treat or rehabilitate mental illness of any sort or severity.

When I was in solitary confinement I lost the sense of time in part due to 24 hour light. For me 15 minutes was exactly the same as 2 hours which was identical to 12 seconds. What reality was I to build without the cornerstone of time? At times I confused night with day. The denial of a sense of day or night affected my sleep which worsened my condition. Sleep interacts with several neurotransmitters which also have an effect on memory, emotions, moods and appetite. Solitary confinement causes a disruption in circadian rhythms and affects dopamine which is linked to schizophrenia and serotonin which is linked to depression, anger, OCD, sleep disturbances and many other emotional and physical disturbances.

To place someone in solitary confinement who is struggling with reality is like taking the half dead goldfish out of the bowl to revive it.

This government would not allow corrections to worsen the physical health of an inmate but we allow them to worsen the mental health of inmates. Mental health in corrections or around the corner is a health issue. Being involved in the justice system does not in any way mean the government or any individual has the right to withhold proper and humane health care. Mental health is health care. If I suffered a severe physical illness the image of correctional surgeons would seem alarming.

Even in corrections the necessaries of life are a societal standard. The Correctional Service of Canada (CSC) Commissioner’s Policy Objective Regarding Health Services is:

1. To ensure that inmates have access to essential medical, dental and mental health services in keeping with generally accepted community practices. Inmates with severe mental illness are subjected to ‘administrative segregation’ so why do we not see it used as an “accepted community practice?”

It is incumbent on government; a duty, to provide the necessaries of life including mental health care, as inmates are in conditions which make them incapable. The duty to provide the necessaries of life is essential when an inmate is further incapacitated by illness. This government has not and is not performing their duty. Instead they are openly presenting a systemic institutionalization of stigma through laws and services. Under the charter these are acts of discrimination. The government is legally bound to provide the necessaries of life; treatment, to any inmate who is in need of what we refer to as mental health services but which under the charter must be acted upon as though it is and can only be recognized as health care. To continue with the use of solitary confinement and the denial of mental health care is negligence.

When an inmate is incarcerated, health care becomes the responsibility of the government. Individuals in jails and prisons are neutered of any capability to seek out or enlist assistance. In dealing with individuals with mental health concerns, availing oneself of health care is often not within the capabilities of the inmate as symptoms often further reduce an inmate’s ability to vocalize and enlist assistance. If an individual is incapable of insight into their illness they are also incapable of being proactive with regards to their health. It then becomes imperative for the authorities to institute conditions and opportunities to address the needs of the inmate.

Attorney-General Peter MacKay says inmates in ‘administrative segregation’ do not suffer adverse effects and that segregation in Canadian prisons is “different from and not analogous to the concept of ‘solitary confinement’ referred to in many foreign jurisdictions and should not be confused with it.”

Solitary confinement in Canada is not dirt floors or cockroaches but the dimensions and duration of confinement is essentially identical. Inmates are given food and sanitation but their toilet is table and chair. Inmates are checked regularly but there is virtually no human contact. People who have no mental illness to contend with would find segregation alarming in a matter of days if not hours but politicians speak of it like it’s a fable or fallacy.

I know that solitary confinement has many similarities regardless of latitude and longitude. It is the prolonged exposure to a small chamber often with constant light and essentially no human contact. Peter MacKay wants Canadians to believe solitary confinement doesn’t exist in Canada because the conservatives and corrections call it ‘administrative segregation’. You can paint a Toyota a hundred colours but it’s still a Toyota. It is a ridiculous ruse and epitomizes the fact that the conservatives have no “concept” of solitary confinement.

Peter MacKay uses the same distorted logic in telling Canadians ‘administrative segregation’ is not analogous or in no way comparable to solitary confinement. The United Nations refutes this notion. The United Nations defines solitary confinement as any incarceration method that restricts inmates to a cell for 22 hours a day or more “without meaningful human contact.” Canada falls into this definition easily but for some reason the government wishes to make their own parameters and use silly name games to camouflage their use of these measures. Is it a bad thing to follow the United Nations in promoting human rights or would we rather the conservatives make up our definitions? Are we a nation of conscience?

I would ask Attorney General MacKay how many solitary confinement cells he has seen in “foreign jurisdictions” and how many he has seen in Canada. What is the Dishonourable Peter MacKay’s firsthand knowledge of solitary confinement?

With regard to these “foreign jurisdictions” my first question is what are the differences? My second question is does the Canadian government consider solitary confinement as a form of torture in these “foreign jurisdictions” or is it simply foreign ‘administrative segregation’? My third question is which elements of solitary confinement in these jurisdictions are considered a form of torture and of these elements how many exist in ‘administrative segregation’ in Canada?

I can only laugh if Peter MacKay has never seen ‘administrative segregation’. I wonder if he has heard the door close behind him. Has he spent an hour there? Peter MacKay is a manipulative liar and I will call it to his face. We are all talking about the same place but the conservatives have named a bathroom Bermuda and we’re supposed to swim in the spin. Inmates refer to it as the Hole or the Digger. Corrections call it ‘administrative segregation’ and therefore conservatives tell us solitary confinement doesn’t exist in Canada. We are exposing persons with identifiable medical conditions to this contradiction of terminology. We should ask the inhabitants if it is anything but hell.

I will simply state that the conditions of ‘administrative segregation’ in Canada contains elements of torture and further that these conditions are imposed on individuals with symptoms of mental illness and in many cases for that reason alone. This policy and practice is discrimination.

We see photos of Peter MacKay and the Teflon Toupee in combat zones. It would be a great photo op with the pair of them near a solitary confinement cell. Maybe they could step on the throat of someone with an identifiable illness as they croon to the base of their vote who are excited by tough on crime policies regardless of human rights.

As far as non-existent “adverse effects” I mainly speak from personal experience but in comparison to the Attorney General Peter MacKay it is at least experience. Peter’s mother is a psychologist. Possibly she could draw him a picture of what dissociation and PTSD are. I went into solitary confinement with neither. I had never experienced them in my life. When I came out it took two years before I stopped staring. If that means nothing to Peter MacKay and his conservative agenda the shame is his mother’s.

Distancing oneself or ones government from the truth that they are not providing services in health care is understandable. I think quite simply this government wishes most not to have to compensate those who have been exposed to this form of torture. Like the residential schools they owe an apology. (Other than those in the conservative government who have spoken up against it.) It confounds me why a government would use conditions even remotely similar to what is clearly torture in other nations on individuals with a health condition or disability. I am ashamed of my nation.

As I write this, individuals with mental illness are in solitary confinement in Canada. The use of solitary confinement as an acceptable standard for the treatment of mental health is a form of torture, exacerbates mental illness and often causes a deterioration of the mental health of a segment of society that is under the care of our government. This shame doesn’t disappear with terminology. Tomato, tomahto.

Ignoring inflation it cost $550 000 dollars to deal with my mental illness institutionally.

I read an article in the London Free Press regarding policing and mental health. In a survey Londoners were asked :

“What do you think is the most important crime-related or policing problem facing the community and London police?”

Mental illness replaced downtown safety/bar issues in the top five. Why do Londoners believe that mental health is a police concern? If physical health is not a police concern why is mental health? If diabetics deserve doctors from start to finish why wouldn’t people with mental illness? If we are ever going to view mental illness differently we need to insist on medical interventions rather than law enforcement interventions. Part of the problem is the widespread perception that mental illness is synonymous with dangerousness.

Less than 3% of violence is attributable to mental illness in the absence of substance abuse. If ever we notice someone we suspect as hearing voices or disoriented in their thoughts or actions or somewhat delusional we might cross the street. The truth is that on both sides of the street 97% of our vulnerability to violence comes from the people who have no mental illness. People with mental illness are more often the victims of crime than the perpetrator.

When we allow law enforcement to administer to a health concern it is little wonder that the health concern becomes stigmatized, related to crime and associated with violence. If the police escorted diabetics to the hospital we would all have similar impressions about diabetes. Consider what we visualize, assume, think, feel and understand about mental illness. Now imagine having similar perceptions for a cancer patient. It would be unfair to the diabetic person or the individual with cancer but for the mentally ill it is as it would be for others with other illnesses; a barrier to treatment and a difficulty of rehabilitation.

Five years of my life have been spent under 24 hour care 7 days a week in an institution. Ignoring inflation it cost $550 000 dollars to deal with my mental illness institutionally. If a tenth of that money was used for comprehensive treatment in my youth, I might not be writing this.

A mental health clinician paid $60 000 dollars per year could have treated me for one hour a day for 70 years.
If we continue to fund and access policing and correctional measures to deal with mental illness we will forever feed the wrong end of the cow.

We do not fight cancer by building more cemeteries.(King)

When I first started living in the community after the forensic hospital I saw a psychologist once a week, a specialized therapist once a week and my psychiatrist at least once a month. Those supports were needed initially and they would have been expensive but it was nowhere near the near $350 dollars a day it cost to keep me in an institution. People can be monitored and treated in their own homes.

I could simply say an ounce of prevention is worth a pound of cure but people might miss the point.

We leave mental illness unanswered and instead we deliver services mainly in times of crisis. Figure out the cost of an ambulance, two police officers and a truck or two of firefighters to respond to a suicide call and with any luck deliver that person to an emergency room and possibly a psychiatric unit for an indefinite period.

Now figure out how much it would cost for a therapist to prevent it in the first place.

If the financial realization is not enough for you consider letting heart disease progress to the point where invasive measures were necessary. With every other illness we prescribe the greatest amount of medicine at the beginning because to let any illness worsen is more devastating, difficult and expensive to treat. The social costs are immeasurable.

If you were ask a child how she feels about her father finding the best treatment for his heart she would likely answer the same for helping her father with schizophrenia. The best medicine at the beginning is not rocket science.

We are stupid to continue as we do but we are wrong and inhumane to do nothing.

Ontario Provincial Police (OPP) Mental Health Strategy, Ect.

I don’t often advocate for the police. They have unions and each other so I don’t view them as disadvantaged or marginalized. They are not on my radar so to speak 🙂 I usually defend those who are unable to stand up for themselves or who do not have the opportunities and advantages that I do.

In my recent encounter with Ontario Provincial Police officers I have softened and expanded some of my views. Few of us have the honour or opportunity to share a meal with the police and their humanity is nourishment itself. I don’t want to disappoint those who find me a refreshing prick with a pen but I have a few points for us all to consider.

Most people do not know that since I was a child, I dreamed of being employed in law enforcement. I know of few better examples of irony. I also have several friends from my youth who are police officers. I can name at least seven who I played high school football with. I am fairly outspoken regarding tragedies that involve mental health but do not think I would not be as upset to hear of an officer falling in the line of duty.

Many of us have an uninformed sense of what the police are like. They are the brutes who give us speeding tickets. I agree that it is an annoying pastime of theirs but they are attempting to keep their families safe as well as yours. We do not blame the baker for making us fat.

Like everyone I am influenced by the media. With the media preoccupation with the sensational we are force fed and filled with any and many officer mistakes. To make an analogy it is no different than hearing that the Toronto Maple Leafs have actually won a game and concluding that they are having a great season.

I tried digging up some real numbers to provide some perspective and fairness. There are over 26 thousand police officers in Ontario. The few we hear about as having fallen short in their duties would be statistically minute and invisible on almost any graph.

I was aware that police officers are trained and informed that a person with a knife can be lethal at a range of 15 to 20 feet. I might be spatially disabled under such conditions. Officers are trained to use lethal force in these instances. I will still argue that a greater distance should be maintained where possible and appropriate but it is comprehensible that such situations do not always work out. I would imagine that any officer who had to make a lethal decision would be haunted by such and it is understandable why officers also suffer from Post Traumatic Stress Disorder.

I have argued against the use of Tasers on mentally ill individuals as they are often disabled and it is a health condition. We need to guard against Tasers being used too often but in speaking with an officer I see their value. An individual with a knife who charges at a distance of 20 feet will still reach the officer even when shot with a gun. This is a no win situation. The Taser if successful will stop that same individual in their tracks. I would rather have to deal with psychological and temporary agony than find myself and or someone trying to help me in a coffin. I have a family as do they. The consequences of the lethal use of a firearm are far reaching.

We can point out that 92% of officer fatalities are committed with a firearm or that police homicides occur 23% of the time involving robberies and 3% occur apprehending psychiatric patients but I’m not sure those numbers would make me feel better if I was faced with a knife and I am unlikely to call on statistics or probabilities when I see that knife waved in my proximity. Any weapon is problematic.

I could only find numbers from Vancouver but they may still be relevant. One third of all police calls involve people with mental health issues. Let’s assume that the Ontario Provincial Police are dealing with similar numbers. I think the police have been put in a place and are being called on to remedy issues that are not theirs to own. Mental health is increasingly involving agencies that were never meant to be mental health service providers; police and corrections.

We can scream and shout at them both but the solution doesn’t entirely lay with altering what they do. We need a number other than 911 to call and we need to prevent and protect individuals from entering the justice system as a result of their addictions and mental health issues. Thirty percent of individuals come into contact with the police in their first experience trying to access mental health care. We don’t change the diaper when an infant needs to be burped.

There are agencies better suited to serve the mental health needs of Ontarians. These organizations and agencies need to be better coordinated, better funded and more accessible. To keep things as they are is monumentally more expensive fiscally and socially. We will have less need to call 911 if mental health care can be obtained prior to crisis. The police will always have a place and we need to be grateful for that. It is an unenviable position and a difficult duty. It is unfair to the police and Ontarians to make police an automatic selection for mental health issues.

I am showing my support to the Ontario Provincial Police not because I now know several more outstanding officers but because I deeply desire better outcomes for Ontarians. I will still point out problems and they may be the target of my often sharp and ill timed sense of humour but in the case of the Ontario Provincial Police and specifically the Elgin County Detachment I see compassion, promise and an active engagement in improving the mental health outcomes of Ontarians. Is the Ontario Provincial Police Mental Health Strategy perfect? Possibly not but I am inspired and I believe community stakeholders can co-operate and implement something of an improvement.

The quarterback doesn’t throw the ball because he is incompetent or incapable of making headway; he knows the receiver stands the best chance of the most advancement. Community stakeholders are the wide receivers. We have been calling the police for help with mental health matters for decades. Community stakeholders are now being called on. I believe they can handle the pass.

We Can Find A Limp In Anyone But Especially When We Use Our Own Gait As A Measure

I was checking out Twitter and clicked on a link to:

“6 Things That I Have Noticed About People Who Change and Recover From Mental Illness.”

I was excited by the prospect of change and recovery. After I battled with the Pop-Up screens where Barry Pearman was flogging his free book, the wind was knocked out of me. Barry’s first life changing “great stride” was:

1) They make their bed every morning.

Just before I was about to flush my anti-psychotics, mood stabilizers and anti-depressants down the toilet I thought about it for a minute. I started to wonder how many individuals Barry Pearman has seen change and recover. My next question was what the hell is Barry doing in all these bedrooms? Is he a sleuth or a slut?

According to Barry I shouldn’t “drift into the day” but like the Navy Seals who are renowned therapists in his world, I should start my day with “a drilled in positive habit.” I have had suicidal months and been immobilized by depression. It was not a matter of preferring to stay in bed; I in fact could barely get out. Had I owned a bedpan I would have used it. I have also been psychotic and my bed was as likely to have been a magic carpet as anything I would tidy and tuck.

Dear Barry,

If you are going to speak about mental illness please consider the vast array of degrees and diagnoses. What you consider positive may be worlds away from what I value or consider positive. I don’t make my bed for the same reason I do not do the zippers up on my pants when I fold and put them in the drawer. It is to me slightly illogical, a waste of my time and a pointless make work project. When I do not pull my sheets up and tuck them in each morning it enables me to refrain from pulling them back out each evening. You say illness I say efficiency.

I’m sure you’re sure I am destined to a state of illness but I personally look back at my life and see that I have “changed” my mental illness and I have enjoyed prolonged periods of recovery. Obviously this has nothing to do with making my bed.

I am as illiterate as you but in my estimation recovery is not always a destination. Further, it is my belief that recovery is a highly personalized process that can be different for each of us. I can look at another person with mental illness and “should” on them but their habits and efficacies can still qualify them as recovering or recovered. Some individuals with or without mental illness are comfortable to leave mustard on their shirts. We can find a limp in anyone but especially when we use our own gait as a measure. If any measure is to be used it must originate mainly in the individual. If an individual with or without mental illness is able to find meaning and arrive at whatever points of personal satisfaction they set out for themselves they are in no small way thriving. Is it “change” or recovery? I cannot answer that and neither “should” you.

Kind regards,
Brett

Since my neck was not in a noose (though he had no way of knowing) he didn’t know who to call or what to do.

Some names have been changed or omitted to protect the idiotic.

As some of my readers will be aware I was not in a good place mentally last week. One of the individuals who reached out to me asked around for some assistance for me. I ended up with a number to a local agency who provides a Crisis Response Line. I am feeling somewhat better and it is counterintuitive for me to reach out as assistance has not always been so.

I called the Crisis Line and ended up speaking to Barney. I explained my recent difficulties and was inquiring about what services I could access. I wasn’t crying which seemed to confuse Barney. I asked if he was a counselor and he explained he had some training but was not a counselor. He searched for some numbers and suggested next time I should call the Distress Line. “Oh, so who would I end up speaking with if I called the Distress Line?” ”ME” was his answer. What the hell? I wanted to reach out and shake his head for him. Firstly, when I am unwell I might not have the insight into whether I am in crisis or distress. They are literally and figuratively the same damn area code. Further, what is logical or logistical to his mandate and procedures are irrelevant to someone in crisis or distress. I would never tell Barney what to do but I would recommend suggesting the value in reaching out rather than suggesting what he values.

I told Barney some of my story and he could have easily engaged me. He was given several paragraphs to build a conversation. I was silent a few times which were long and awkward and I could sense Barney’s discomfort. The only input he made into the conversation was to inform me “we are here to listen not make you feel better.” What the hell? They might as well use an answering machine if all they do is listen. Wouldn’t a few well placed questions uncover the extent of my crisis or distress?

This gentleman knew and found out nothing about me including my name. What supports do you presently have? Do you have a family physician? Are you able to access services? Do you live alone? Are you in a safe environment? Have you ever been suicidal? Are you able to care for yourself? Are you on any medications? Are you having any disturbances of thought? Are you experiencing hallucinations?

If we are going to train these individuals to refrain from attempting to alleviate difficulties or offer advice we should definitely train them not to make assumptions about the degree of crisis or distress an individual may or may not be experiencing. The consequences could be tragic. I was safe and possibly he interpreted me as healthy. I can baffle you with brilliance in full blown psychosis. People don’t call these numbers to order ice cream. I realize he was not a professional which is a problem in itself. There are often not answers or solutions but being an ear doesn’t do much good when I need a comforting voice.

Barney was uncomfortable that I was waiting for him to speak as I believe that was his training. I can tell when someone is directing me to end a conversation and I believe that since my neck was not in a noose (though he had no way of knowing) he didn’t know who to call or what to do. What is your phone number? I will pass on your contact information to a colleague who is aware of community supports.

Barney was mainly giving me information about support groups which I have an aversion to. My mental health is private and some of the things I struggle with are best not spit out in a circle of chairs. Some of these groups are simply the blind leading the blind. I don’t need Darlene’s insight; she’s a damn basket case though I’m sure she knows what is good for me.

I almost feel like jumping off a bridge but I’m going to hunt down Barney first to time the fall. I am not personally upset but I am seriously alarmed for my community. If I call 911 for a physical crisis they do not say “were here to listen until the ambulance arrives.” After determining the severity of the situation they offer immediate and useful first aid information where appropriate. Further, highly trained individuals follow up on the call.

I understand budget constraints. I believe in the value of peer support and volunteers make the world go round but Barney might not be the best person for someone in crisis or distress. My first impression of him is that he probably has difficulty in a drive-through. We would be alarmed if any or even initial acute contact regarding physical health was taking place under the direction of volunteers with a crash course in health care. What’s good for the goose is good for the gander.

Unfortunately, these well meaning but overbearing boardroom bureaucrats fail to fathom the positives and pleasures of smoking.

I had a friend put a bee in my bonnet. It could be argued that it was always there but I shall defer a degree of credit to him. The issue is hospitals making smoking illegal for psychiatric patients.

My health or lack thereof is still “my” health. When we crowd individuals with serious and persistent mental illness off hospital grounds to smoke the message is, “we want to make you healthy and we refuse to enable non-healthy behaviours.” It appears to be an admirable avenue but it is still a slippery slope. If non-smoking initiatives are embraced it enables preventing patients from any behaviour including ingesting pizza and pop.

Obesity is as problematic as smoking. Will it be next or can we continue to consume chocolate? A serious and widespread side effect of some psychiatric medications is weight gain. If it is prescribed by a psychiatrist there seems to be no dilemma but if I thrive on soda pop it is unacceptable. I knew individuals who were policed for their pop consumption. The one individual I recall most was allowed to drool uncontrollably but liquid running in the other direction was monitored and measured.

If your argument is that second hand soda doesn’t affect others I would have you stand at the side of a highway or avenue and measure the cocktail of car exhaust you breathe in. When I first arrived at the forensic hospital in St. Thomas we had smoking rooms with cushioned chairs and TV’s. I quit for a period and don’t recall any smoke in the hallways. The smoke was contained in a humane way using air exchangers. The smoking rooms were closed while I was there but the asbestos and lead paint didn’t seem problematic.

Unfortunately, these well meaning but overbearing boardroom bureaucrats fail to fathom the positives and pleasures of smoking. We can all relate to the benefits of joining friends for a beer or meal and smoking is no different. Should relative health supersede happiness and free will? Even the executioner has the mercy to offer the beneficiary of bullets a cigarette as a last wish. Smoking is unhealthy and slightly disgusting but for a depressed patient it may offer four minutes of pleasure. It can be a reminder of normalcy and freedom in a situation of caregiver custody.

There are more productive pleasures but who doesn’t choke on other people’s ideas of what they should be doing with their Loonies, lungs or legs? Autonomy must be complete and absolute wherever possible and practical or else patients are essentially prisoners.

I was in Stratford Jail when the province issued a smoking ban in those institutions. I remember a notice in Admitting and Discharge:

“The jail will be smoke free as of November 22nd. We suggest you either quit smoking or stay out of jail.”

Hospitalization is not a choice or a poor decision. To deny a patient a pleasure they are likely addicted to on the street is punitive, cruel and misguided. If you choose not to smoke I admire you but don’t deny me the dignity of my own decisions. Don’t put me in the cold and rain on the side of the highway in the guise of care or because of your self-righteous beliefs and behaviours. Others are not stupid or wrong they simply have other priorities, likes and habits.

To deny an individual dependent on tobacco as a coping pleasure is nothing more than institutional primacy which places patients beneath the institution.