By Marvin Ross

Many families are hesitant and even afraid to mention that they have an offspring with a serious mental illness and I have no idea why. Do they think it reflects negatively on them? Maybe, I don’t know but it doesn’t. I should add a caveat to this though. There are some cases where, because of the ill family member, it is best not to say anything until the ill person has greater acceptance.

I should also mention that my criticism of families is not another example of family blaming. Many families try but are bashed by hostility, tokenism, anger, and mocking as one mother explained. And then the seriousness of mental illness is trivialized by all those who refer to it as a mental health issue or challenge rather than a serious illness.

To quote Dr David Goldbloom in an essay he wrote when he retired recently from clinical practice at the Centre of Addiction and Mental Health in Toronto:

“Work with people who are sick. They don’t have “mental health issues” just like people with cancer don’t have “cell proliferation issues”. Don’t live in the land of euphemism. 
 
Call things what they are.”

Until we do that, we will never take mental illness seriously. 

A number of years ago, I was invited to give a talk to a class of college students about schizophrenia and its development. They were training to work in schools. The instructor wanted them to be able to recognize the early symptoms which was commendable as the instructor had a son with schizophrenia. However, before I began, I was told not to reveal that fact to the class. Another person who was the treasurer of a family group of people with members with schizophrenia claimed not to be able to sign checks. That person had a government job and feared that signing checks would result in the government discovering they had a relative with schizophrenia.

I’m not naive and I do know that stigma does exist but so what? If families cower in fear, nothing will improve because who knows better what is needed than us. A number of years ago, I covered a Grand Rounds presentation at the local medical school by a noted psychiatrist. He began by asking the doctors and medical students in the audience how many had a personal experience with mental illness. A few tentative hands went up and he responded by saying that most of you are liars. Most people know someone with a mental illness.

That’s something that I’ve seen first hand. Just about everyone has a friend or relative with a similar problem. Mental illness isn’t the only medical problem that’s faced some form of stigma. There was a time not that long ago when no one talked about cancer but, over time, that changed. If you or a family member do develop cancer, there may be some who shun you for fear of catching it themselves but they are becoming even more rare.

In the facebook group for the town I live in, someone mentioned a particular spot where males with schizophrenia hung out. Some might have been homeless and others might have been from the residences for people with mental illness in town. Numerous people mentioned how they would go by with coupons for MacDonalds and Tim Hortons. No fear, No stigma. Just compassion.

The one group that has made the most progress in being accepted is the gay community. Once a few brave souls started to come out of the closet, acceptance accelerated. HIV and AIDS were hardly spoken of when it first started appearing. Victims were highly stigmatized but thanks to incredible advocacy on the part of the gay community, it went from a guaranteed death sentence to a manageable chronic condition.

The community did not leave the research to a few academics but demanded more research and action. The one AIDS conference I attended as a writer in the late 1990’s was full of advocates critiquing the research and demanding better. Fast forward to 2023 and the size and spread of Pride parades involving politicians who probably would not have gone near one 20 years ago has grown. A 2019 report on Pride Week in Toronto found that it created 4827 jobs and added $347 million to Ontario’s GDP. There were over 1.7 million visitors. Now, you can’t watch a TV series without the likelihood of there being a Lesbian couple raising a child together. A ho hum bit in the plot.

As proof of the need for families to get out of the closet and make a noise is the search for Andrew Bryenton that I wrote about last week.

Getting back to my main example, Andrew’s mother Marlene in Charlottetown put out on her facebook page details of Andrew and that he needed to be taken to hospital. Andrew is in Toronto, and had been taken to hospital when his mother got a Form 2 to have police take him for an assessment. The hospital discharged him back to homelessness with nothing after 72 hours claiming he was fine despite what his PEI psychiatrist reported.

Toronto is no longer the small friendly provincial city it was when I grew up there but a large, bustling place with gridlock and people rushing about to make ends meet or to make a fortune. But, the city surprised me in its compassion and concern for Andrew – one homeless, disheveled soul with a serious mental illness among all the others like him who remain anonymous.

People all over Toronto have been contacting Marlene with pictures of him and descriptions. At times he is talking to himself and has been seen crying. Many are giving him food, water, and money. He was found sleeping in the sun in a park on a very hot day so an ambulance was called but he refused help. There is nothing paramedics or the police can do without a legal form sworn in the courts to have him taken to the hospital which Marlene was trying to get. That is an exercise in itself and I’ll talk about that later.

A report on his mother’s attempts in the media quoted a street nurse saying “there are some significant ethical dilemmas that come with sharing photos and videos, as well as his personal information, without consent on social media.” Well, if the mom does not do that, no one would find him.

She added she hoped that this man gets the help he needs, but he also has the right to privacy and the agency to decide how he wants to live his life, as long as he’s not at risk of or harming himself or others. One symptom of serious mental illnesses is the inability of the person to recognize that they are ill called anosognosia. I really doubt that Andrew, as a former bank official, would want to be wandering and sleeping in the streets if he was of sound mind.

People with Alzheimer’s often wander off and get lost but we do not assume that is their choice. Police search for them and return them home or to the hospital without the family having to chase down a Justice of the Peace and demonstrate the need to do that.

On Tuesday night, Andrew was spotted walking on a busy highway in the north west of Toronto during a heavy rainstorm. Neither the Ontario Provincial Police nor the Peel Regional Police who were notified were able to spot him but he was later seen at the airport.

Then, on August 16, Marlene wrote:

“The lady that saw Andrew at the airport last night happened to be around and hopped in her car when she discovered Andrew was in Etobicoke. ANDREW’S GUARDIAN ANGEL FOUND HIM AGAIN!

She followed him and notified me. An RCMP officer was in the area and came to relieve her.

By August 17 after a week’s effort, Marlene was finally able to get a justice to sign a form 2 so that police could take Andrew to hospital. He was then spotted on the morning of August 18 and police took him to St Joseph’s Hospital and he has been admitted. Advocates locally who have been helping Marlene were also able to contact the Ontario Minister of Health and the Associate Minister of Mental Health and Addictions and they both are in talks with PEI to try to arrange a medical transfer.

It seems there is a provision under the Mental Health Act whereby the Minister of Health can issue an order to have Andrew medically transferred home to P.E.I.

This Kafkaesque adventure to obtain a signed committal for a hospital evaluation will be the subject of my next blog. But, all this is what it takes to try to get one mentally ill person off the streets and into hospital. We all want a solution to the homeless situation in Canada but it is estimated that about 30-35% of them have a mental illness so the process is complicated and more complicated than it should be given the failure of the various mental health acts.

Hopefully, Andrew will get the help he needs thanks to his mother’s efforts in putting out a public appeal for help and to the kindness of nameless citizens in a big mostly unfriendly city who came out to help. And I would be remiss in not mentioning the compassionate help from members of the police service who almost always show kindness and understanding to those with mental illness.