I had a meeting with the Minister of Justice and Attorney General Peter MacKay

I was sitting at an elegant table in the elegant Shaw Centre in Ottawa. We were gathered for the Canadian Alliance on Mental Illness and Mental Health Champions of Mental Health Awards. The Parliament Buildings were to my right as was my beautiful wife and I was simply minding my own business. A senator who didn’t look anything like Mike Duffy came round the table and gave me his business card. I smiled and gave him mine.

I noticed the Minister of Justice Peter MacKay schmoozing and posing for photographs like some redundant rock star. He seemed pleased with himself. Without warning I rose to my feet and went and stood behind him as he was speaking to a groupie. I glanced back at my wife and she had the same worried look on her face as the day I proposed to her. I gave her a wink and she started shoving dinner rolls in her purse in case we were turfed before the taters.

“Hi Mr. MacKay, my name is Brett Batten and I’m an advocate. I don’t know if you’ve ever met anyone who has lived in solitary confinement but I have spent some time there.” “In fact I have” was his response. I wondered if they too were wearing a suit and tie at the time but my immediate thought was to recall ‘Bobby the Bullshitter’ who lived around the corner when I was seven. “We’re going to Disneyland.” “I’ve been to Disneyland twelve times.” I detoured the exasperation and mentioned that I would like to discuss the issue of solitary confinement with him sometime.

“Well, that’s the portfolio of Public Safety and my portfolio is Justice.” I wasn’t sure who thought who was stupid. “I understand that but as the Attorney General you have made statements regarding solitary confinement which are misleading.” “I don’t believe I have, what did I say?” I looked around for a second as I thought we were suddenly in the House of Commons. “You said Administrative Segregation was not similar to solitary confinement in other countries.” “Well, solitary confinement in Sarajevo is different from what we find in Canada.” “Well, we are not talking about dirt floors but the dimensions and more are quite the same sir. The United Nations defines solitary confinement as any incarceration that confines a person to a cell for 22 hours a day or more without human contact.” “Well I don’t always agree with the United Nations.” (Especially when it contradicts ‘the agenda’.) “Solitary confinement is used for sex offenders to ensure their safety.” “It is predominantly used for individuals with mental illness; it is a default response to a health issue.” For someone who didn’t say anything about solitary confinement Peter seemed to hit on all the points he made in his official statement.

I decided to give him the benefit of my doubt and asked who I could speak to about the issue. “You can talk to me” and he handed me his business card asking for mine. “Where are you from?” “London!” “I’m going to be in London in a week or two, maybe we can meet.”

“I was found Not Criminally Responsible and was the individual Champion of Mental Health here last year. Pretty much in that order.” He looked surprised and at the time I wasn’t sure at which. Maybe for a minute he thought ‘Wow, I could have actually spoken to someone found Not Criminally Responsible before I shoved the Not Criminally Responsible Reform Act through Parliament.’ Nothing may come of this but at least Peter MacKay can say he shook the hand of someone found Not Criminally Responsible. Good on him!

It all sounds hopeful with him coming to London for Tea and Crumpets but like the rest of the electorate I expect his political promise to be broken. It was a formal event and I’m sure he was trying to appease me but I did drive all night to get home and vacuum in case he visits. He has my business card so I hope he enjoys my Blog.

As a public service Peter MacKay’s phone number is (613) 992-4621. Just tell him Brett gave you his number.

P.S. Please don’t call me at home, I’m expecting an important call.

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.

RE: Vincent Li and Tim McLean. Compassion isn’t a dart we throw it is a net we cast.

I spent the weekend battling on Twitter. I don’t often Tweet but there was much ignorance I felt compelled to refute. Vincent Li who was found Not Criminally Responsible for a very disturbing and tragic incident is in the process of being granted a progression of freedoms in his treatment and rehabilitation. It needs to be clarified that these measures will themselves be measured and monitored. It is also important to understand that Mr. Li has been assessed by several psychiatrists who are in agreement as to the status of his mental health. Most importantly the individuals who contribute information and make decisions on that information have and always will ensure that public safety is paramount. Paramount.

I am not an expert in law or medicine. I have some information about each but my specialty is what it means and feels like to be caught between the two. If you want the definition of psychosis you can ask a doctor. If you want to know what the experience is like, you can ask me. If you want to know the intricacies of Not Criminally Responsible ask a lawyer who specializes in such. If you want to know how those processes affect an individual, you can ask me. I don’t consider myself an expert by any stretch but few know what I know. My journey is far removed from what most experience and I believe that is where my use is found.

Unfortunately, people with opinions often have no desire to hear from someone who actually knows something, as it interferes with their ignorance. Opinions have value but when their basis is ignorance they become water balloons without water; completely ineffective and they go nowhere.

I heard the voices that are incensed and incredulous over the appearance of the case. In my estimation most of these individuals are using headlines for a measure and as a basis of knowledge from which to form and progress their opinions. If a person looks only at the atrocity they can only make basic conclusions.

The severity of the offence is not the indicator of recidivism. If a person stabs another twice they are not twice as likely to re-offend as the person who stabs once. It is an asinine assumption and a distortion of logic. The brutality of the offence for which an individual is found Not Criminally Responsible has no bearing on their prognosis or recovery. The absence of blood in no way determines the effectiveness of medications and the presence of blood in no way determines the efficacy of treatment and rehabilitation.

Tim McLean who is the deceased in this case is clearly a victim. He was simply a passenger on a bus. However, there is more than one victim. We have to consider the families and friends connected to all involved. We have to consider witnesses and first responders. We have to consider communities. We also need to consider Vincent Li himself. Mr. Li is a victim of a mental disorder and a victim of public backlash, stigma and hatred. He no more asked for this event than anyone involved. To be a monster to a nation as a result of an illness is a weight that must also be measured. Mr. Li did not choose his illness and he is quite likely near the front of the line of individuals who would wish the event never occurred.

People confuse psychosis with psychopathy. They are two vastly different states and it is unfortunate they are phonetically similar. It is the same as confusing dentistry with dysentery. Psychosis and hallucinations are Axis 1 disorders while psychopathy is Axis 2. Twitter was awash with words like psycho and I would direct those people to the internet to actually find out the meanings and intricacies of mental disorders. Knowledge is power and slang is pathetic and painful.

I was disappointed to uncover the extent of hatred and intolerance that exists in Canada. People seem to embrace the biblical “eye for an eye” mentality all the while ignoring the New Testament and specifically the red letters attributed to Christ. I guess it is easier to cast stones. Possibly people gain a sense of self righteousness and can forget their own faults. An “eye for an eye” does not bring peace or restore the order of the universe. The universe is unfair and unjust. Just ask a child with a distended belly in a third world nation. People seem to believe the world is just and they become quite worked up trying to make it so through mental manoeuvrings. An “eye for an eye” leaves two people blind and it only expands suffering. It is rather imbecilic to think that suffering can relieve suffering. It is also a little sadistic to find peace in anyone’s pain.

Many individuals seem to think that Vincent Li may be better but Tim McLean is still dead. My sympathies go out to all involved but Tim McLean will be dead no matter what happens to Vincent Li. There is no logic in that argument or revelation and nothing that is done will alter what happened to those involved.

People were flying off the handle saying maybe Mr. Li’s psychiatrist who assessed him should have him as a neighbour. The fact is Mr. Li was assessed by several psychiatrists who came to the same conclusions. The general public and even Members of Parliament like Shelly Glover think they should be the ones assessing and that their opinions which originate from newspapers or less are the only assessment tool needed. We need to allow those who are trained and knowledgeable care for the community and Mr. Li. Despite the brutality of the offence Mr. Li is considered low risk and has been assessed and is being monitored. Few of us could say the same thing about our neighbours. No one is immune to mental illness and it does not discriminate. To an extent we are all capable of atrocity if we become ill to the point Mr. Li was. If you disagree please point me in the direction of the magic water you swallow to prevent mental illness.

I was called a douche, a jerk, a scumbag, a murderer advocate and was told to go hang myself. All were desperate and illogical attempts to overcome the disparity of being confronted by someone found Not Criminally Responsible and who is intelligent, logical and able to disseminate information, form relatively sound opinions and coherently craft them into Tweets. I got a little saucy myself but being the Not Criminally Responsible individual in these arguments I tempered my responses. I came to the somewhat biased opinion that I would rather have me as a neighbour than these scary and somewhat unstable twits. I have been tested and proven not to be a psychopath or sociopath but these individuals cannot claim the same. I don’t much care what they Tweet from their parent’s basement but I am concerned that they interact with others in person and that they are probably allowed to obtain firearms and most terrifying; can vote.

I came to the edge of being insulting and was uneasy with where I found myself. I am one of only a few who to a degree represent individuals who have been found Not Criminally Responsible. I do so not always out of desire but more so out of duty. There are many days I wish to be more ordinary and forget what is past. I realize though that my abilities, experiences and gifts are meant to be shared. I have near total recall of most of my psychosis and as much as it is a curse to remember all of that, it is somewhat rare and it would be a loss not to explain and share with others in an attempt for us all to understand each other. I don’t have fame or popularity to promote my causes. I am involved in the unsavory aspects of mental health: Not Criminally Responsible, the Canadian Criminal Code, Board of Review hearings, courts, police and corrections. Possibly I could let some of this slide if Clara Hughes jumped in but she’s busy on her bike.

I told one individual to “say Hi to everyone on his paper route.” I felt bad that I might be misinterpreted. I have every regard for individuals who support or supplement their income from delivering periodicals. Unfortunately, the 140 characters allocated by Twitter did not allow me to explain my meaning. When I was growing up teenagers delivered newspapers and I was implying that this individual was a child in his thoughts and arguments.

I think it is fair and acceptable that I get a little saucy. I don’t believe that since I was found Not Criminally Responsible that I need to portray something meek and gentle. I am and we all are many things. Part of my point is that I am no different from anyone and I posses characteristics that many and most humans posses. In a way being sarcastic and cheeky is an exercise in illustrating my ordinariness. I grew up with three brothers so I was born and bred to stand up for myself. For years I was unable to do this as I was in jail or hospital. If I had no voice I would be skinnier than I am. I traded barbs with my brothers as an exercise of intellect and debate and it was an ingrained and somewhat socially conditioned form of love. We did not hug each other though we do now. Instead we insulted each other as a form of attention and we found affection, comradery and even respect in its often humourous arms.

The one individual who seemed quite engaged in trying to enrage me gave up when I asked him his real name. He was calling me “champ” in some attempt to belittle me and I told him “my name is Brett and I do not hide.” My full name is attached to my Twitter account. This child was Tweeting from behind his mother’s skirt and when I said to “step up or shut up” he implied that I was threatening him. I reassured him and told him he couldn’t “hide and speak” and that I simply wanted to know if he “was a mouthpiece or a man.” He did not give his name which confirmed he was in fact just a mouthpiece. He was a noise originating from the area of the head but not the brain necessarily.

People were arguing that if Mr. Li misses a dose of his medications he will buy a bus ticket and repeat his actions in some form. Medications are important but only a fraction of the treatment and rehabilitation Not Criminally Responsible individuals receive. Further, these individuals are monitored and know themselves the importance of their medications and the other aspects of their treatment and recovery. In the case of Mr. Li there are a series of supports in place and extended that were not present at the time of the offence.

People think Mr. Li should be locked up forever and worse. Punitive measures do not alter the cause of the offence when the cause is mental illness. Treatment and rehabilitation of the individual with the illness is not only humane and progressive, it is the only successful and logical approach. Mr. Anonymity was trying to argue that all criminals should be medicated and why was Mr. Li so special? Firstly, Mr. Li is not a criminal and secondly they have not discovered medications for greed, stupidity and evil. As you might conclude it was draining attempting to inform such moronity. If I had to do it again I might just walk away as many of these individuals used their opinions as a shield to information. However, some of what I was saying was getting out there and their deflection did not mean I did not reach anyone. I am also pleased that there is a lasting public record of their stupidity. Maybe eventual embarrassment will guide them towards a book.

People were using the grief of those involved as a basis and argument for their hatred, ingrained ignorance and intolerance of people and circumstances they have little basis of knowledge in. People think they are being sensitive to victims and compassionate but compassion isn’t a dart we throw it is a net we cast.

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 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.

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.