Western Standard - August 05, 2022


Morgan says it's time to destigmatize & expand use of our mental institutions

Topics
deinstitutionalization failure
Mentioned
DeinstLee Gold
Kelly Malmberg on Ottawa's pressures on agricultural producers Mark Milke of the Aristotle Foundation how the right has to stop acting like the left

Episode Stats


Length

5 minutes

Words per minute

203.08

Word count

1,142

Sentence count

76


Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

In the wake of recent mass shootings and the release of individuals with serious mental disorders into the public, the question is, should they be placed in secure mental health facilities? Or should they stay on the streets, where they are a danger to themselves and others?

Transcript

Transcript generated with Whisper (turbo).
Topics generated with Qwen2.5-3B-Instruct.
Hosts, guests, and mentioned names generated with spaCy (en_core_web_sm), reconciled against Wikidata.
00:00:00.000 Recently, we had a man go out on a rampage with a hammer in Calgary, and he caused hundreds of thousands of dollars in damage to the Calgary Peace Bridge.
00:00:07.200 Then last week, another guy broke into Calgary City Hall and did extensive damage to the building as he lit fires.
00:00:13.280 He couldn't be immediately restrained because he was carrying a large knife, and he got injured when police arrested him.
00:00:20.020 And the City Hall is still closed now due to the water and fire damage.
00:00:23.400 In Montreal, last Tuesday and Wednesday, even worse, three people were shot and killed in what appeared to be random killings.
00:00:28.720 A suspect was located on Thursday, yesterday, in a motel, and he was shot and killed by police as they tried to apprehend him.
00:00:34.920 Now, the common denominator in all three of these incidents is that all three of the perpetrators were known by authorities to have serious mental disorders, but they'd been released into the public anyway.
00:00:44.460 With the tragic incident in Montreal, the killer had been released from a mental institution last March, despite the psychiatrist at the hearing saying he presented a significant risk to public safety due to his mental state.
00:00:55.060 They knew he was dangerous.
00:00:55.980 So if an expert felt this man was dangerous, why was he released?
00:00:59.680 Well, it's because of a policy trend, essentially, over decades called deinstitutionalization.
00:01:04.700 That's a big mouthful, that one.
00:01:06.300 And that movement came to a head at the end of the 20th century.
00:01:09.460 The rationale was it was inhumane to keep people incarcerated for mental health disorders, and that with proper community supports and medication, they can be safely and productively living freely within the public.
00:01:19.300 And in most cases, actually, this is true.
00:01:21.820 In many cases, though, it's wrong.
00:01:23.440 And the price of failed community integration can be pretty high, as we've seen.
00:01:27.460 The push to keep people out of long-term mental health facilities is understandable.
00:01:30.780 Nobody likes to think of incarcerating somebody for a disease which is no fault of their own.
00:01:35.000 Just because a person can't be faulted for their mental illness, no, doesn't mean they don't present a hazard sometimes to themselves or the others around them if they are under control.
00:01:43.400 I mean, mental institutions used to be horrible places where patients were warehoused under terrible conditions.
00:01:48.400 They were often abused, and they were subject to experiments, even.
00:01:51.360 In the 20th century, that did change, though.
00:01:53.260 And in the developed world, institutions were reformed to become more treatment-oriented and with efforts to improve the standard of living for patients.
00:02:00.900 When the deinstitutionalization movement took hold, though, and I blame kind of the one flew over the cuckoo's nest.
00:02:06.740 It really started in the 70s and so on, people having this thought of how terrible it is to be in a mental institution.
00:02:11.420 The goal of reformation of the institutions, though, changed.
00:02:15.260 It went to one of elimination.
00:02:17.280 And that movement was successful in that the populations of institutions have dropped, and many have even closed.
00:02:22.660 In the long term, though, it's becoming evident that the movement's been a failure.
00:02:25.640 Many people found themselves on the streets that really don't belong there.
00:02:28.980 We have a terrible homelessness and opioid addiction epidemic, and it's killing thousands right now.
00:02:33.760 The solution to that crisis is going to be complicated and multifaceted.
00:02:37.300 One important facet of that puzzle, though, is the number of homeless and addicted people with serious mental health disorders that never should have been on the street in the first place.
00:02:45.300 In a proper institution, medication can be supervised and regulated for patients.
00:02:49.580 In a street setting, many people with serious mental disorders are self-medicating with products they get from predatory street dealers.
00:02:55.140 And this compounds the person's problems as they now have an untreated mental illness and an addiction to feed.
00:02:59.720 Let's quit pretending the homeless person shambling around, pushing a shopping cart while talking to themselves, just needs a new apartment or a job.
00:03:06.580 We won't hesitate to put a person who's physically injured in the hospital.
00:03:09.780 We've got to stop being so squeamish about putting people with mental health disorders into proper care facilities as well.
00:03:15.220 And yes, the difference is the person with a mental illness might lose personal choice, and I'm talking about secured facilities, but we don't have to like the necessity to accept it.
00:03:24.000 Harm mitigation.
00:03:24.920 It's a popular concept these days when it comes to addictions.
00:03:26.920 Well, that term should be applied to people with mental health disorders as well, and the means of mitigation will be institutionalization for a lot of them.
00:03:34.220 Existing mental health facilities are already overwhelmed.
00:03:37.160 Conventional hospitals have mental health wings, but they're full, and they don't provide good or comfortable long-term care.
00:03:42.520 They're meant to be transitional, and patients are often discharged, not because they're healthy again, but because the space and resources are needed.
00:03:49.320 Many people with mental health challenges have been housed in senior citizen care facilities as well,
00:03:53.260 because the units housing residents with dementia are secured, and there's nowhere else to put people.
00:03:57.800 This is unfair to the seniors, the staff, and of course the people with the mental health illnesses.
00:04:01.800 And finally, many of those with serious mental health issues end up in our prison system.
00:04:05.880 They're often abused there, and they don't get the treatment they need.
00:04:08.840 Let's accept that a number of people with mental illnesses just can't be treated, at least not at this time,
00:04:13.260 and must be secured within an institution indefinitely.
00:04:16.660 The facility doesn't need to be a place of punishment or harsh living.
00:04:19.940 Facilities should be well-funded and comfortable as possible while allowing visits with loved ones,
00:04:23.680 and as much supervised public interaction as safely possible.
00:04:27.220 I'm sure many families who have lost members to the streets because of mental illness challenges
00:04:30.620 would have preferred it if the family member had been secured in a facility rather than exposed to the elements and lost on the streets.
00:04:37.200 If patients truly can be stabilized and eased into society, that's the best outcome.
00:04:40.700 It has to be accepted, though, that many can't or won't stick to their medication or they're untreatable,
00:04:45.320 and they're going to have to remain insecure.
00:04:48.600 Deinstitutionalization.
00:04:50.680 Deinstitutionalization.
00:04:51.220 It's a big one.
00:04:51.860 It's a well-meaning but naive and failed policy.
00:04:55.380 It's time to tackle the issue of serious mental illness with a mixture of harsh realism and compassion.
00:05:00.180 And that means expanding the capacity of our long-term secured mental health facilities
00:05:03.460 and accepting they'll always be needed for the sake of patients and society as a whole.
00:05:08.000 Well, that's what I wanted to talk about today when we're seeing so many of these terrible outcomes lately.
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00:05:14.880 DeinstLee Gold facebook
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