Opinion: Acknowledging the elephant on the Island — psychiatric emergency services need independent review

Opinion: Acknowledging the elephant on the Island — psychiatric emergency services need independent review
Courtesy Lisa Fawkes
Glen Fawkes is shown.

After continual efforts to seek help at emergency services across Vancouver Island, Glen William Fawkes — a son, brother, uncle, husband, father, and friend — took his own life on Oct. 10, 2020.

Like so many of those struggling with mental illness, Glen was raked over the rigid spars of an unforgiving mental health system.

What began as a seemingly innocuous mental health struggle soon became a malignant ordeal. When initial interventions proved ineffective at treating insomnia and anxiety in spring of 2020, Glen slid into a near-paralyzing paranoia with persistent panic attacks and demonic delusions.

In September of 2020, Glen was admitted to Royal Jubilee’s Psychiatric Emergency Services (PES). Within 36 hours he was released and neither he nor the wider Fawkes family received outpatient support. Instead, Glen was told to “take back his autonomy.”

He did: 19 days later he ended his life.

Unfortunately, dramatic stories about abhorrent service at Island PES units have become a recurring theme. A recent Facebook page, created by advocates Ella Hale and Emma Epp, has helped to disseminate and publicize many of these patient experiences. Entitled “PES: A Pathetic Excuse for Support,” the platform has illuminated explosive allegations of sustained emotional manipulation, abuse, bias, discrimmination and maltreatment at PES units across Vancouver Island.

Yet these stories and the festering discontent that accompanies them should not come as a surprise: the writing was on the wall.

READ MORE: External review needed for Vancouver Island’s psychiatric services, patients say

According to Vancouver Island Health Authority’s internal performance measures, hospital readmission rates for mental health patients — a metric that the province uses to assess the effectiveness of services — were “significantly outside [the] acceptable range” in 2020.

Then there is the 2019 Ombudsman report on the legal conduct of provincial health authorities. The investigation found “significant levels of non-compliance” with the Mental Health Act as well as the Canadian Charter of Rights of Freedoms. B.C. health authorities, including Island Health, were observed continually breaching procedural obligations and patients rights enshrined in the law.

Finally, there is the administrative situation. In a scathing 2018 review, the University of Victoria’s School of Public Administration revealed the inner workings of a conflictual, hostile, and mistrusting work environment within the lower Island’s mental health and substance use services.

In short, VIHA’s mental health system fails to meet provincial service standards, diverges from the law and is riddled with internal animosity — all of which surely contribute to fortifying the bitterness and resentment currently boiling amongst PES service users. It is difficult to manage psychiatric emergencies in institutional disarray.

Yet critical reproach of these issues is unlikely to trigger transformation in the current political environment.

In her 2019 visit to Canada, Ms. Catalina Devandas-Aguilar — the United Nations’ Special Rapporteur on the rights of persons with disabilities — emphasized the “lack of independent monitoring of mental health facilities” in Canada and urged provinces and territories to do more to “establish independent monitoring mechanisms.”

B.C. has yet to implement an independent monitoring body, and as the 2019 Ombudsman report outlines, options for patients to seek legal redress in cases of procedural misconduct are abysmal.

This environment allows health authorities to maintain a suboptimal status quo with exceptional impunity. If VIHA doesn’t want to refashion PES or doesn’t have the capacity to do so, it won’t.

For its part, the provincial government has acknowledged the delicate state of mental health and established a whole ministry around the matter. However, as Rob Shaw eloquently articulated in the Orca, the ‘Ministry of air’ is virtually handcuffed by its own, narrow political mandate, leaving suicide, mental illness and substance use to continue unabated in an institutionally fractured system.

Without ministerial support or an obliged health authority, clearly the time has come for a wholly independent review of Island PES facilities. Only with this legitimized, external scrutiny will the accountability of these public institutions be upheld.

For me, I sincerely hope that 2022 won’t be the first ‘fatherless’ Father’s Day for those young adults and children who are currently watching their dads confront not only a mental illness but also grapple with a cold, callous and chaotic emergency support system.

Kyle Fawkes is a mental health advocate and the son of Glen Fawkes.

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