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.

Ontario Hospitals Need to Give Their Head a Shake

I wonder what goes through the minds of patients who are pushed off hospital property to smoke in the cold with the public driving by.

Am I to believe I am valued as a person when certain aspects of myself are banished? It is quite like making a child stand in a corner to contemplate their unacceptable behaviour. It becomes difficult to see the love and respect for patients when they are relegated to the road and rain coping as they know how and finding pleasure and escape in a cigarette. These individuals have serious and persistent mental illness and we are worried about them smoking? Privileged individuals are instituting their values on marginalized individuals. Some will never quit so I suggest we stop shaming them.

When I was a forensic patient I really didn’t want people knowing I was such. I found it humiliating having to ride in the “big white vans” because most people in St. Thomas knew where the “big white vans” were from. They were part of the community consciousness and on more than one occasion I heard the “big white vans” used as amusing putdowns.

Privacy is a premise of dignity. When I am placed beside the road like a pathetic pylon I eventually become recognizable to repetitive travelers and commuters. This scenario makes community integration difficult and it compromises patient safety. What if a prospective employer, landlord or lover recognizes me from standing beside the road five times a day? It makes what is already difficult more so. Will I find employment or a date if I am publicly exposed as belonging in a forensic hospital? Nobody deserves a scarlet letter let alone for an unhealthy habit. Are we compromising patient confidentiality by placing these individuals beside a public thoroughfare?

At the old forensic hospital a friend and I ordered a pizza on a summer’s evening. We decided to eat it at a picnic table in front of the hospital. We were well back from the highway but a car full of fools drove by yelling obscenities at us. Not all motorists are mature or well meaning. Some motorists barely know the meaning of a STOP sign but we expect they will comprehend and be sensitive to STIGMA? Forensic patients are prone to abuse and discrimination and placing them beside a road is nothing more than facilitation. Having these individuals within distance of garbage being hurled at them is dangerous and unfair. St. Thomas is fairly accepting of Southwest Centre for Forensic Mental Health Care but it only takes one.

When I become a fixture standing at the end of the lane leading to a forensic facility I become recognizable. If and when I am allowed to wander other avenues I am still recognizable. We might as well dip these smokers in orange dye to further accommodate their prospective discrimination. These individuals are already compromised and marginalized and I find it shameful that an organization with a mandate to assist them is in fact harming them.

Johnathan Sher”lock” of the London Free Press calls himself an “investigative bulldog” all the while missing even simple hospital signage.

“Health Care: Ministry wants more done to protect nurses, patients in psych ward” was the headline on the front page of the London Free Press yesterday.

I have been a mental health consumer for over 30 years and I have never been on a “psych ward”. Apparently writing at a grade six level isn’t enough for the London Free Press and they have reverted to making up their own words. Unfortunately, these words carry meaning for many.

I would like to ask Johnathan Sher”lock” or his exaggerating editor which hospital they have observed signage directing the public to the “psych ward”? If a hospital has enough sense to be sensitive and current the same should fall to any reporter. I would not fault a reader for such references but an award winning health reporter should be ashamed and admonished. Sher”lock’s” misconceptions and sensationalism unfortunately have an effect on the general public. There must be a scarcity of space in the London Free Press and words like psychiatric need to be pruned. We all know it is on purpose. Sher”lock” and his editors have made a cheap attempt at an attention grabbing headline and the casualty is everyone who has, will have or is on a mental health journey. The social impact and perpetuation of stigma are incalculable.

Do we refer to the ICU as the Intensive Care Ward? Is there such a thing as a Neonatal Ward? Governments, organizations and individuals spend an inordinate amount of time and money to combat stigma and we have Sher”lock” and the London Free Press printing phrases that all but dismantle those efforts. There’s an award for that right Sher”lock”?

Sher”lock” calls himself an “investigative bulldog” all the while missing even simple hospital signage. I have a dog and all I know is it is full of feces twice a day. Thankfully the London Free Press does not have an evening edition. Often people’s misconceptions are solidified by headlines. A headline is a means to grab attention but it should be factual and current. Sher”lock” the “investigative bulldog” has stopped at the hydrant of hype and drenched the psychiatric community in stigma.

Johnathan Sher”lock” of the London Free Press reports that “Ontario’s Labour Ministry has ordered London’s biggest hospital to do more to combat violence and overcrowding…”

When I was being admitted to a jail I was placed in solitary confinement because the jail was at capacity. One of the female guards said “a full jail is a happy jail.” This is, was and always will be an oxymoron. I have been in lock-down situations and stacked three men to a cell and if my experience counts for anything the Labour Ministry, London Health Sciences Centre, Johnathan Sher”lock” and the London Free Press only need to understand one thing. If you address overcrowding you have little need to address violence. They are near being mutually exclusive.

Unfortunately, I can speak to the issue of overcrowding, segregation and the suspension of privileges and personal privacy and freedoms. Each and all have an effect on any individual but they are amplified by symptoms and serious mental illness. If individuals with physical symptoms were exposed to a similar environment we would see similar behaviors. The violence occurring at London Health Sciences Centre is environmental more than mental. Psychiatric units under normal conditions are not a breeding ground for beatings.

If Johnathan Sher”lock” was truly an “investigative bulldog” he would have sniffed out reality. Possibly Sher”lock” could have sniffed out statistics surrounding violence in Alzheimer’s patients and individuals experiencing dementia. The psychiatric community holds no ownership on violence. Head trauma can also result in personality changes and problematic behaviour but we paint psychiatric patients with a brush we would not use on other individuals in society who are also vulnerable and compromised for fear that they might be tarnished.

Sher”lock” reports that the “Ontario Nurses’ Association this week accused the hospital and the Labour Ministry of sitting idle while attacks on nurses last year surged 20-fold..”

Firstly, I am saddened by this as my mother was a psychiatric nurse and during my journey I have met dozens of nurses who deserve safe working conditions for themselves and to accommodate the great work they do. My issue again falls to language. Sher”lock” has a legal background and the word attack does not appear in quotations so I can only assume legal relevancy flew out the door when they brought in sensationalism. People are not charged with “attack”, they are charged with assault. Call a spade a spade. Surely not all of these incidents were “attacks.” Any logical person would assume some of these incidents are a harmful or offensive contact with a person. I understand there have been severe incidents but to call them all attacks is stigmatizing and sensational. To use this language to invite change is one thing but to use it to sell a newspaper is prostituting language. Only an overzealous crown attorney or a defunct defence lawyer would refer to an assault as an attack. In a court of law inflammatory inferences are often objected to and sustained. A lawyer writing for a newspaper should also be reminded of their contempt.

Is it really community integration when we have ghettos?

As a citizen of London with severe and persistent mental illness I am alarmed by the death of David McPherson and the displacement of a group of individuals with mental health difficulties.

We are giving these individuals our best when they are in crisis but we care less when they are chronic. Many surgeries are discharged prior to what would be considered good health as are mental health patients. What would we think if 25 post surgeries were displaced from a dangerous and disgusting dwelling? We can be proud of how hospitalization for mental illness has been transformed here in London but when I share my mattress with mites before and after it will be like Alice falling through the rabbit hole. Hospitalization will be a bizarre episode in a stupor of squalor.

It needs to be asked why so many individuals with mental health concerns are housed together. Is it really community integration when we have ghettos? When affordability means shared toilets and prolonged periods where privacy is extinct these dwellings essentially become a third world hospital with fewer staff. It should also be asked how much longer these individuals would have been allowed to be unsafe, unsanitary and defiled of dignity had there not been a tragic fire? Solitude is a human need, safety, security and sanitation should be absolutes.

If we are astute enough to recognize that clean and pleasing environments facilitate healing in hospital, why do we not employ it for people who are healing in the community? It all becomes mute when individuals are endangered, denied dignity and are made to endure circumstances and confines that would lead many to mental health difficulties. Possibly we would not remove the revolving door of hospitalization but fewer would need hospitalization if basic human needs were met in the community.

Many fine people and agencies came into contact with this tragedy far before it never should have been. Individuals with severe and persistent mental illness do not ask to be in these circumstances they simply need our assistance. I’m fairly certain it is against the law to do otherwise.

London Elect: You’ll all look swell when you’re sworn in. Thankfully only the mayor will have to pull something over his swollen head.

I’m a little perturbed by our local politicians. Elected, incumbent and future. As I have stated earlier, I enjoy being alone and I am slightly agoraphobic. I like it out there but I am more at ease between my own walls. That being said or in fact re-said, I don’t often poke my head far from the perimeter of my property. For others it may seem odd but to someone who has spent a few days in cells of confinement, it is endless acres to stride and stretch about 200 feet by 75. I can run a marathon with such dimensions.

This is my present and most thought out excuse for not getting out to meet the candidates. It makes me wonder how many citizens with disabilities that make “getting out to meet the candidate” more difficult than my anxieties, were accommodated in some way?

I hope it happened. It must have. It did! My mistake. It must have been in the small print on the thousands of signs I saw posted about the city. My windows were rolled up when they were shouting and waving from street corners to tell me the number to call if you have political and or municipal concerns you want to share with a candidate but are somehow disadvantaged.

I’m sure the city has accessibility plans for people with disabilities but how many candidates had that as part of their mandate and operating platform?

It does seem a stretch to accommodate someone politically who has a disability. Sure, you’ll pick me up and almost cast my vote for me but what about what I think? What about my ideas? Disabled may be a political disadvantage but it is rarely an intellectual challenge that would preclude being listened to. I know a man who uses a computer to speak and his wit is unquestionable. Did anyone take the time to listen to him? He is a citizen of this city. We can make voting accessible for him but democracy is lopsided when a citizen does not have the opportunity to speak. Asking questions and making your ideas and feelings known is what gives flesh to bone. Maybe my vote won’t count. Maybe my candidate won’t win but if I should be able to voice my ideas and concerns.

It would be a double stretch to accommodate let alone seek out a community advocate. I don’t have enough cash to propel a politician but the sadness is that none of the candidates had enough cents to question my questionable self.

I know many first thoughts will be: “the vanity of this fool.” I won’t argue vanity (though my baldness is a statement in itself) but this fool has been fairly front and center in the London community when it comes to mental health. It wouldn’t be impossible to overlook me but it could be argued that not a single candidate paid much attention to the citizens of London who have or do suffer from serious and persistent mental illness. I think it’s safe to say none were sought out and queried as to how to best serve them on council.

Can this city influence, progress and promote better mental health for its citizens?

I’m a fool for this page so I shall step on my tongue as to how but possibly one of these politicians elect can make up for not considering people who are marginalized and stigmatized; in their political vision.

“It is a kind of cold and uncaring environment”

A 30 year old father has died at Elgin-Middlesex Detention Centre. On the surface it seems no correctional officer or administrator can be faulted because it was a suicide and because this particular inmate did not voice an intention or thoughts about suicide. Corrections sidestep the corpse and deny responsibility because protocol was followed. What if protocol in fact hastens or facilitates the death? Following the rules in this case could be considered the smoking gun.

According to London Lawyer Kevin Egan, who represents hundreds of London inmates “It is a kind of cold and uncaring environment.” I hope Kevin Egan didn’t have to research too many legal documents to come up with the understatement of the century.

Inmates are screened at admission about their mental health and suicidality. “Do you feel suicidal?” if answered in the affirmative will bring about a second strip search and the inmate is placed in solitary confinement or for those who like to justify its use, segregation. The inmate is given a tear proof gown and blanket to go with their toilet and 24 hour light.

For any inmate who is familiar with this system of sadism there is only one answer to the question. “No.” Inmates in solitary confinement because of suicidal ideation or behavior are checked on every 10 minutes. Interestingly, it takes about 5 minutes to die. In the case of this young man because he was segregated but not on suicide watch he would have only been checked every 20 minutes in comparison to the usual 30 minutes in the general population. This deviation points to the admission that solitary confinement creates a dangerous situation that needs increased supervision.

I realize Elgin-Middlesex Detention Center is understaffed and poorly designed but is it not possible for “cold and uncaring” correctional staff to ask an inmate if they are suicidal after intake? Surely, while under the arguably tortuous conditions of solitary confinement an inmate could be spoken to and asked if they are suicidal. Would any institution grind to a hault if such a protocol was implemented? It would require conscience and a degree of compassion but it may save a life.

To be placed in solitary confinement deteriorates mental wellness and exacerbates mental illness. This is where it becomes difficult for guards, administrators and healthcare staff to sidestep culpability. This particular inmate was taking prescribed psychiatric medication and was placed in an environment where whatever mental wellness he possessed was compromised. His mental health was compromised by the correctional system which did little proactive to prevent his eventual death.

There have been 16 coroner inquests into jail suicides since 2007 and the recommendations of better screening and monitoring of inmates has been ignored. This is not only a dereliction of duty but it is outwardly reckless and a foundation for legal culpability.

Slightly Medieval Misconceptions

There seems to be a public misconception perpetuated by the media that when an individual is brought before the courts anyone can make an attempt to use the “mental illness card” and seek a designation of Not Criminally Responsible On Account of a Mental Disorder (NCR). Firstly, when a lawyer seeks the designation of NCR it may be the prosecution or the defense and it is rarely at the direction of the accused. Secondly, it is not pursued for any individual with a mental disorder but only in those cases where there is a possibility that the mental disorder rendered the accused incapable of appreciating the nature and quality of the act or of knowing that it was wrong. There needs to be a causal relationship between psychiatric symptoms and the offence. To have a mental disorder itself does not automatically lead to a loss of reality.

A finding of NCR does not simply mean that the accused has a diagnosis but that the disorder removed a crucial element of a crime. In order to be convicted of a crime the prosecuting crown must prove that there was criminal conduct or a guilty act but also that there was a criminal state of mind or a guilty mind beyond a reasonable doubt.

In certain instances a mental disorder can render an individual incapable of appreciating that an act was wrong which can subsequently prove that their mind was not guilty. It is not a matter of being ignorant about a law it is a matter of being incapable.

Individuals who are found to be NCR are not innocent or guilty and are thereafter referred to as the accused. They are usually confined to a forensic hospital for treatment and rehabilitation for an indefinite period. Their progress or lack thereof is reviewed yearly by a Review Board and a disposition is decided by a panel after hearing evidence from the hospital, the crown, the accused and the victims. Restrictions may be removed or added depending on the evidence. Public safety is paramount and it follows that the least restrictive and least onerous conditions for the accused are put in place. Treatment and rehabilitation are important but they do not overshadow public safety.

There are instances where a finding of NCR could be pursued but some lawyers do not pursue it as it places their client in a position of indefinite custody. To act in the best interests of their client a finding of guilt is preferred as the freedom of their client is determinant. This is logical but serves no one as the underlying illness is sometimes ignored. From the perspective of public safety this is the less desirable option as treatment and rehabilitation reduce recidivism.

There is a misconception that to be found NCR is some form of getting off. In some instances NCR individuals gain community access sooner than if they were sentenced but the opposite is just as probable.

My interest in the Luka Magnotta case is that it provides me an opportunity to inform and educate. These high profile cases highlight the stigma and misconceptions that permeate our society. The attitudes that spring forth are of little consequence to me personally but I am alarmed because they affect all individuals who experience mental illness. NCR is not a club or union that seeks members. Like anyone I would prefer to see no NCR cases as I am acutely aware that there are victims on both sides.

The NCR provisions in the Canadian Criminal Code protect us all on many levels. They insure humane and progressive treatment of the accused and for anyone with insight who realizes they are not immune to mental illness it is a relief to know you would not be punished for an illness that rendered you incapable of appreciating the nature of a wrong. No one should be punished for events that are beyond their control. This is civilized and this is humane.

I personally believe that the defense in the Luka Magnotta case has a difficult task but my mind remains open to all possibilities and I will wait for more evidence. There appears to be evidence of knowledge of wrongfulness but even this could be explained in the light of a mental disorder. There can still exist an impaired ability to reason or appreciate. It has to be proven that Luka Magnotta had the ability to apply the knowledge that his actions were wrong. To form an opinion and tie the knot of the noose in the first week of a trial is unfair, dangerous, irresponsible, unjust and slightly medieval.