Written for Daily Hive Urbanized by Jack Middleton, who is the president of the BC Schizophrenia Society Board and director of policy at Sedgwick Strategies in Vancouver.
On October 19, 2024, British Columbians will go to the polls, but the parties running in that race are developing their platforms now.
A question politicos and campaigners like to ask when developing their platforms is, “What is the ballot question?” In October, the question seems to be “Who do British Columbians trust most to do something about housing costs, the economy, crime, drug use, poverty, and an overloaded healthcare system?”
A question that likely won’t be on the ballot, but should be, is mental illness. Which party is doing something to support those with mental illness and their families?
Mental illnesses like schizophrenia and psychosis are taboo subjects, often swept under the rug and ignored. But mental illness is a key part of the puzzle to ballot questions like crime, poverty, and healthcare. This is why the winning party must have a strong policy on mental illness.
It is important to understand that mental illness is common. Over 90,000 people in BC are living with schizophrenia and more than 150,000 are living with psychotic disorders. You likely know someone with a mental illness or someone who has a person with mental illness in their family. This can be frightening because mental illness causes serious and severe changes to the lives of everyone involved. Mental illnesses like schizophrenia are not curable but they are treatable. With the right medication and support, people can live good and fulfilling lives.
The knock-on impacts of untreated mental illness are some of the core issues being debated. This is demonstrated daily on the Downtown Eastside. There are many challenges facing this area and the people who live there, and many of them are rooted in mental illness; a 2024 study estimated that 67% of homeless people live with a mental health disorder.
Street violence is another major issue and one that was hotly debated during the Vancouver mayoral elections two years ago. Although people living with severe mental illnesses are no more violent than others, untreated mental illness can unfortunately lead to violence.
Untreated mental illness places a greater burden on the province’s healthcare system and results in increased costs, both directly and in the worsening health outcomes for people who become unhoused or turn to substance use. There are also significant health and economic impacts on families and communities.
A plan championed by three organizations — BC Schizophrenia Society, BC Psychiatric Association and Pathways — has been put forward to all parties ahead of the election. It offers three recommendations for parties to build platforms that take real action on mental illness.
First, they can ensure their platform supports treatment that includes medication. Many people living with schizophrenia and other psychotic disorders suffer from anosognosia, a neurological symptom that is characterized by a complete lack of insight into one’s illness. As a result, these patients will reject voluntary treatment.
Providing safe, timely, and effective treatment that protects people when they are most vulnerable sometimes requires the judicious use of involuntary treatment under the Mental Health Act. Such treatment must be administered with the respect and dignity of the patients in mind. The legal and medical procedures defined in the Mental Health Act must be available to people with mental illness in these cases.
Second, election promises need to include care that is available, accessible, and affordable everywhere in BC. Community services need to include psychiatrists and others to provide early and continuing treatment. Hospitals need to have sufficient beds that are adequately staffed. Ongoing support following discharge is critical for providing wraparound care that includes supportive housing, rehabilitation, and comprehensive community support. Point-of-care testing for clozapine should be available in local pharmacies and care homes to ensure medications can be administered in the community.
Lastly, treatment should include collaborative engagement with patients and their families. It’s a simple fact that outcomes for people with mental illness improve when families are involved. Any and all solutions that facilitate involvement are welcome and will make a lasting impact.
While the election may feel far away, the parties running in it are crafting their messages now. On October 19, please consider the significance of mental illness in all of our lives, and the parties who have presented thoughtful solutions as a path to helping with some of the biggest challenges our province is facing.