You Say “Healthcare,” I Just Shake My Head and Cry

I have no “craving” to return to the issue of smoking on hospital properties and it seems a lost cause but I will. Let’s just consider it a “bad habit.”

I was on hospital property myself yesterday. When I left the architectural brilliance and heat of the building itself I noticed a gentleman in his 70’s hunched over in a wheelchair. He appeared to weigh something near his age and seemed somewhat compromised. I imagine his struggles are profound even within hospital but he was attempting to smoke in the wind and cold about 40 feet from the hospital entrance.

It has been minus “21 Forever” here in Ontario and yesterday was no exception. No exception seems to be part of the problem. This man was breaking hospital rules and even the old rule of not smoking within 60 feet of a hospital entrance. I don’t imagine he had a rebellious heart or complete disregard for rules, I think he may have been unable to make it off hospital grounds and the temperature itself may have been a further hurdle. If my ears nearly freezing are evidence of anything his wheelchair wheels may have been frozen.

There needs to be more communication between agencies in the region. When the Health Unit and police agencies issue a cold weather advisory and warn people to stay inside it may be prudent to apply this information to hospital staff and patients. It may even be important to ensure that 70 pound patients in wheelchairs have a safe and suitable place to smoke. Maybe the blankets were being laundered but this gentleman was under dressed for what I barely endured with half the exposure. This individual is unlikely to quit smoking in his 70’s or in his proximity to illness. It may be a bad habit or a long time pleasure.

We can all be proud of moving in the direction of a “Smoke Free Ontario” but my grandfather shouldn’t be run over in the process. He wasn’t my grandfather or I would have brought him home from the illusion of healthcare he was enduring. He is however someone’s grandfather, “bully for you.” I hope some idiot or at least the compassionate committees who have brought us this far find satisfaction in such an individual being tortured in the guise of health and healthcare. If you think smokers are going to hell it is no less sinful to expose them to anything similar here on earth. Perhaps we should pray on this.

I wanted to take a photo of this poor gentleman but I did not want to remove my gloves which he was without. I also respect patient confidentiality and it would have been a blurry shot as he was shaking so hard. Oh well, the rightless wretch will soon be dead and we will not be so uncomfortable in our conscienceless ideals. The grandchildren who attend his funeral will no doubt find peace that his last days were dignified and comfortable. They will hopefully find comfort that he was “exposed” to the most advanced and compassionate healthcare available.

I’m not saying hospitals are being heartless but providing a wheelchair becomes ironic and disingenuous when a 70 year old patient is allowed to suffer from exposure and near frostbite. I was in the same elements for a shorter duration and in an appropriate winter coat and I couldn’t wait until I reached my frozen car. This gentleman was under dressed and unable to access proper shelter or even stamp his feet to provide a sense of warmth.

I don’t know how we get around ridiculous rules but I would suggest those who are making them spend 6 minutes in a wheelchair, in a jacket, in minus 20 degree weather. It may provide enough exposure to uncover enough empathy to enable true compassion if not sense.

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.

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.