Brain-injured street people require compulsory treatment

Pivot Legal Society is calling on the B.C. government to stop its proposed expansion of forced mental health and addictions treatment.

image: STAT News

Compulsory treatment must proceed.

I sympathize with the legal society but the reality is that the number of street people that are brain-injured is unprecedented.

Brain Injury Canada has identified that reality. There is a growing prevalence of brain injury due to substance abuse.

“Opioid overdoses can have catastrophic results, including brain injury,” says Brain Injury Canada’s website.  “The effects of the brain injury will change them as well. It’s a scary experience that can be hard to put into words or share with others and can have a huge impact on mental health and wellbeing for both the person with a brain injury and you as a friend/family member.”

Under B.C.’s Mental Health Act, a person can be detained in a psychiatric facility if a physician deems it necessary for their own health and safety and for the safety of others.

When the act was constituted in 1965, no one could have imagined the growing number of British Columbians who would be brain damaged because of the toxic brew of drugs now available.

B.C. Premier David Eby says the province needs to expand the availability of “involuntary care” and to update the Mental Health Act to provide clearer options for intervention.

Under section 28 of the Mental Health Act, police have the authority to bring a person to a hospital to be assessed by a doctor if the police have reason to believe that the person who is suffering from a mental illness is likely to cause harm themselves or others if not treated.

Pivot Legal Society argues that compulsory care is an outdated approach that is harmful, degrading and often discriminatory.

I agree that compulsory care can be discriminatory.  In 2021, I wrote about “A.H.,” a First Nations woman, who was wrongfully detained for almost a year under the Mental Health Act. In a court case between A.H. and the Fraser Health Authority, the Supreme Court of B.C. learned that A.H. had been held against her will and that she was not even found to be mentally ill. She would still be detained if lawyers had not presented her case pro bono.

But the issue has moved from indiscriminate use of the act to the political arena. Now the safety of citizens and business owners has become paramount.  

Kamloops’ Reid Hamer-Jackson was swept into the mayor’s chair over such safety concerns.

Hamer-Jackson campaigned on establishing a recovery centre outside of the city centre and said transportation should be provided so that the homeless could be returned to their home communities. (One-half of Kamloops homeless have lived here longer than six years or are from Kamloops).

B.C.’s premier understands the impact of drug-induced brain injury.

“For every person that fatally overdoses, there are at least three people that are seriously brain injured,” Eby told The Globe and Mail. “And until you’re sufficiently brain-injured to the point of permanent long-term care, then people are being really spat out from the emergency room back into the community. So it’s cruel and it’s a miserable existence.”

The compassionate thing to do is force brain injured street people into treatment.

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Turn on, tune in, heal yourself

When I first tried psychedelics in the 1970s, I wasn’t trying to heal myself. I was curious to find out how psychedelics, including LSD and “magic” mushrooms, could alter my consciousness.

image: New Scientist

My trip into hallucinogenic world of psychedelics wasn’t as studious as Aldous Huxley’s. He took notes as he journeyed into a state of altered perception. In his book, The Doors of Perception, he says:

“Half an hour after swallowing the drug I became aware of a slow dance of golden lights . . .”

That’s pretty much the way my experience went. It wasn’t always a joy ride –not something you tried casually. It required commitment and was truly a “trip.” Once you stepped onto that path, more like a conveyor belt, there was no turning back at for many hours.

“Turn on, tune in, drop out” was a phrase first popularized by Timothy Leary in 1966. He was a promoter of psychedelics as part of the hippy counterculture. Leary borrowed the phrase from the Canadian media guru, Marshall McLuhan.

Regrettably, after psychedelics became “recreational drugs,” they were made illegal. That’s when serious investigation into the medicinal applications of that family of drugs stopped.

One of those early studies in the 1950s was at the Saskatchewan Mental Hospital in Weyburn. That’s when the term “psychedelic” was first coined.   Saskatchewan was home to some of the most important psychedelic research in the world at the time. Treating patients with a single dose of psychedelic was seen as an attractive, cost-effective approach. It fit with the goals of a new, publicly funded health-care system started by Saskatchewan’s new premier, Tommy Douglas. The treatment was aimed at restoring health and autonomy to patients who had long been confined to asylums.

Since then, the prohibition of drugs has been a disaster. Instead of limiting drug use, making them illegal under the criminal code has increased the use of unregulated, contaminated and dangerous street drugs. This is especially true of synthetic opioids such as Fentanyl.

The trouble with opioids is that they are addictive with ever-increasing doses.

Now that the hippy era just a nostalgic memory and acid trips are no longer in vogue, the medical uses of psychedelics are being investigated again.

Health Canada has only approved psilocybin treatment for people in palliative care. The Vancouver Island based company, Numinus Wellness, is one of many who are looking go beyond that to the treatment of mental illness, addiction and trauma. Dr. Evan Wood, chief medical officer at Numinus says:

“With one in five Canadians currently grappling with debilitating mental-health conditions, we can’t afford not to look at psilocybin seriously (Globe and Mail, Sept. 4, 2021).”

The pandemic has further increased the incidence of mental illness.

The difference between using opioids versus psychedelics is that one or two treatments of psychedelics can completely change your view of reality.

“A session with psilocybin seems to disrupt this network,” adds Wood, “reset it and decrease its activity, thus alleviating the symptoms. The changes it appears to be bringing about with people are really profound. It gets at the root of what’s driving people to these mental disorders. Instead of giving them chemicals that numb those feelings, these treatments help you put that trauma behind you.”

We are being tested by smoke, fire, heat and disease

As we emerge from the pandemic, Kamloopsians expect that summer, especially this summer, will be liberating.

image: Globe and Mail

After being cooped up all winter, carefully  cloistering ourselves and observing ceremonial cleansing, we look forward to being outside, basking in the glory of Kamloops’ legendary heat.

But this summer, the heat is oppressive. And like the pandemic, the smoke keeps us indoors. Now all we want to do is seek the refuge of an air conditioned shelter.

It all tests our resiliency and takes its toll on our psyche.

Instead of being rewarded for our good hygiene in fighting the pandemic, we are stuck inside as thick smoke from wildfires that blanket the city.

When you’re choking on smoke and your eyes are watering, it’s bad for your physical health to be outside. And it’s bad for your mental health to be inside.

We imagined that the “new normal” will be adjusting to a world in which most people are vaccinated and COVID-19 is just another bug in the cast of flu characters.

But our new normal will have to include hotter summers, wildfires and smoke. The areas burned will become even greater.

The area burned by wildfires in Canada has doubled since the early 1970s, says Dr. Mike Flannigan, research chair for fire science at Thompson Rivers University.

And it’s only going to get worse, says Flannigan, – it’s just a matter of how much worse. Modest predictive modelling suggests the area burned in Canada will double again by the end of the century; more aggressive modelling predicts an increase by 11 times.

We are getting familiar with the measurement of the smoke hazard –just how bad is it? The hazard is measured by the weight of smoke particles in a certain volume of air; specifically, the weight of PM2.5 particles in micrograms per cubic metre.

What makes the PM2.5 particles so potent is that they can affect every organ in the body, not just the lungs.

Sarah Henderson, scientific director in environmental health services at the B.C. Centre for Disease Control, says that the particles are dangerous long before you can smell and taste the smoke. At levels of only 30 micrograms per cubic metre, adverse reactions begin:

“When it looks really bad, people think it is really bad,” she said. “But it becomes unhealthy long before it looks terrible. The immunological response ends up causing inflammation, and that inflammation is systemic.”

Concerned about the smoke hazard, I recently installed an air sensor, made by Purple Air, in my house. While the weekly average reading has been nine micrograms per cubic metre, which is safe, sometimes it peaks at over 50.

George Bonanno, a clinical psychologist at Columbia University, has studied people’s resiliency in the aftermath of hurricanes, terrorist attacks, life-threatening injuries and epidemics such as the 2003 SARS outbreak.

Bonanno’s research shows three common psychological responses to hardship. Two thirds of people are resilient and maintain relatively stable psychological and physical health. About 25 percent struggle temporarily with psychopathology such as depression or post-traumatic stress disorder and then recover. And 10 percent suffer lasting psychological distress.

We are being tested on a number of fronts. Physical and mental illnesses are not a sign of weakness –they provide an occasion for everyone to rise to the challenge, to draw closer together and support those in need.

BC Housing should value their friends in Kamloops City Council

City councillors support public housing but the recent announcement by the B.C. government took them by surprise. In a press release, BC Housing said that they had purchased the Fortune Motel on Kamloops North Shore.

Fortune Motel, image: Agoda

BC Housing is a crown corporation that finances subsidized housing for low income families.

“What the hell is this?” was a common reaction at City Hall, Councillor Dale Bass told me. The lack of communication represented a “disconnect of our relationship” with the provincial government.

While staff at City hall were apparently aware of the purchase, councillors were not Bass said.

Consultation is needed because Council has plans for the North Shore and BC Housing’s purchases may not fit. Of course, consultation would have to be done in confidentiality since real estate purchases are sensitive.

In a press release, Attorney General and Housing Minister David Eby said that BC Housing and the City of Kamloops will work together to determine a permanent plan for the property. That’s a fine thing to say but just when did BC Housing plan to start working together?

It’s Councillors who take the flak from the public over public housing. Some citizens are “genuinely afraid” of homeless people, Bass said.

Kamloops homeless are often characterized by the actions of “street people” who sometimes appear menacing.

Encounters with mentally ill people can be frightening. A friend of mine was approached by a stranger, apparently in a psychotic state, as she shopped in a thrift store on Tranquille. “You’re going to fucking die, bitch,” he shouted angrily. The verbal assault left her shaken.   

Mental health of homeless people is a problem and it’s exacerbated by their lack of secure shelter. While mentally ill people are more likely to injure themselves than others, that’s little comfort to those are accosted by the unstable mentally ill.

Street people are also blamed for an increase in crime. Yet the perception doesn’t always match reality.

Kamloops RCMP Supt. Syd Lecky told City Council on June 11, 2021, that crime was actually down in some parts of the city compared to last year. Property crime was down in North Kamloops by eight per cent, the same in Valleyview, and up 11 per cent in Westsyde.

But last year was unusual because of the pandemic, Lecky added, and that property crime was up everywhere from 1019.

Homeless people represent a fragile sector of our population.

In a survey done by BC Housing of Merritt’s homeless in 2020, one-quarter reported a brain injury and 70 per cent had two or more health concerns. Seventy-eight per cent suffered from addiction.

In a survey done in Kamloops in June, 2018, one-half of respondents first experienced homelessness as youths. Probably, as in Merritt’s case, many were formerly in foster care.

The profile of homeless people is one of addiction compounded by desperation, mental and physical health. They are often youths thrown out on the streets with few life-skills.

Kamloops doesn’t need a big-stick approach by BC Housing to get affordable housing in Kamloops. Not like that other Interior city, Penticton, where City Council is taking the province to court over a dispute involving BC Housing’s locations.

Kamloopsians sensibly realize that you can’t complain about homeless people on the street while also complaining that they are being housed.

Bubble families emerge from pandemic

Provinces are allowing the expansion of family units to include friends and family. The selection of who’s in and who is out is tricky.

image: Money Crashers

B.C.’s provincial health officer, Dr. Bonnie Henry, said last week: “I believe that we are at a point where we can increase our social contact, and we can have more people in our close circle of family and friends.”

Singles can pair off with another single or with a couple and socialize exclusively with them.

Families can also pair off with other families. But it has to be done carefully. As soon as you add others to your circle, you add all the people which they are connected to which amplifies the risk.

Before you extend your bubble family, sometimes called a cohort family, you need to check with them to ensure that their degree of virus avoidance matches yours. It would be a mistake to extend your circle to a family just because they’re “cool” as Professor Lucia O’Sullivan found out.

O’Sullivan wasted no time inviting her “best friend family” to join forces after New Brunswick allowed bubbling. The families lived nearby, traveled together, spent Christmas Eve together and have children of a similar age (Globe and Mail, May 2, 2020).”

“Saturday morning,” said O’Sullivan, “I was gardening and I thought, uh oh, I better contact them and see. I felt rushed because I thought everyone’s going to ask them. They’re like the coolest family in town. It’s like asking someone to the prom: Were they already taken?”

It turned out that they were taken. Instead, the “best friend family” had bubbled up into a group of eight: two husbands, two wives and four kids.  O’Sullivan’s parents paired up with her sister. Her best friend family’s parents decided not to break their quarantine. Bubbling can leave you feeling left out.

Bubbling requires commitment, like going steady or being in a monogamous relationship. For instance, the chances of contracting a sexually transmitted disease is extremely low in a monogamous relationship, but increases sharply if one or both partners cheat.

You can’t play the field. Dr. Henry says: “What you can’t do is see two people one night and four different people the next.”

Bubbling reduces the isolation of singles. Daycare and work-time access improve.

An Edmonton couple, both who work and have a two-year old, bubbled with another working couple with two-year old forming a makeshift family of six.  They care for the children on alternate days: While one parent goes for walks, or does arts and crafts with the kids, the other three parents can work a full shift uninterrupted. They rotate a biweekly grocery run, one person shopping for both families. As a courtesy, they text message each other whenever anyone leaves the house for errands, a walk or a drive.

Mental health improves with socialization. Some sense of normalcy returns to these crazy times.

However, what legacy will remain once the pandemic is over. Will you remain close to those in your bubble?  Will those not included feel slighted or shunned?

And how will you feel about the “others’” outside your circle? The stain of disease is deeply engrained in the human psyche. If they didn’t meet your standards of hygiene, can they ever be trusted?