A level one room at the Burnaby Center for Mental health and Addictions November 10, 2009.
British Columbia's dedicated centre for the most troubled of mentally ill drug addicts failed in its mission to admit, treat and quickly discharge those severely afflicted patients, says a review obtained by The Globe and Mail.
The 102-page evaluation, obtained through a Freedom of Information request, looked at the Burnaby Centre for Mental Health and Addiction, which was started with great fanfare three years ago as a way to treat those from Vancouver's Downtown Eastside whom the rest of the system had neglected.
The biggest problem the evaluating team identified was the inability to ensure that people with the worst problems were the first admitted to the 100-bed facility, which costs $14-million a year to run. "Services offered need to be focused and geared towards intervention for those clients with complex and severe concurrent disorders," was the main recommendation from the outside evaluation team, Raymond Chabot Grant Thornton.
The centre, run by Vancouver's regional health authority, Vancouver Coastal Health, ended up keeping its patients far longer than originally planned, according to the evaluation of its second year of operation from April of 2009 through March of 2010.
One patient was at the centre for 672 days – a stay that cost $280,991. About 40 per cent of people admitted stayed longer than seven months. As a result, waiting times for new patients were four months or more. The evaluation team also observed that the record-keeping was so incomplete that it was hard to tell what kind of progress patients were making. And it recommended the centre do more to keep illegal drugs out of the facility.
In spite of that, there was no suggestion that the centre be closed.
"There was general consensus on the fact that there is a need for specialized services for the target clientele," said the review's authors, who consulted with health authorities, the Burnaby RCMP, BC Housing, the advocacy group Coast Mental Health, and others to get their assessments.
Jeff Coleman, the vice-president of regional health for Vancouver Coastal Health, said he didn't disagree with anything in the review. But he said the centre has already changed its admissions process to make sure it is taking the most needy patients, as well as making other changes.
However, he said, the centre still has a problem with moving people out of the facility because there is no place for half of them – the most severe cases – to go.
The Burnaby centre grew out of a widely publicized Vancouver police report that said officers were being turned into de-facto mental-health workers because of the numbers of people with severe psychiatric problems on the streets.
In February of 2008, a couple of weeks after the report came out, former B.C. premier Gordon Campbell announced that the province would create a specialized facility for the kind of people police said were taking up much of their time: those with a complex tangle of mental-health and drug-addiction problems, compounded by severe health conditions and homelessness. The centre opened at the end of June, and some of its problems, the evaluation indicates, are the result of the province rushing it into existence.
About 10 per cent of the centre's clients move on to independent living. Another 40 per cent can be moved to special apartments run by the health authorities where people get support from nurses, social workers and other specialists.
Half of the people who have come to the centre need permanent residential care and there are few places available, Mr. Coleman said. That's because the province is closing down Riverview, its last big centralized mental-health institution, but hasn't yet transferred the money for those beds to local health authorities, he said.
People who work with the mentally ill and drug-addicted in Vancouver's Downtown Eastside say they're not surprised by the evaluation.
"We had some of our people get in to the centre when it first opened, but then they were full after that," said Karen O'Shannacery from the Lookout Emergency Aid Society. "The biggest issue is there's very little turnover. We have people on the waiting list but when they would get in, who knows?"
Special to The Globe and Mail
Frances Bula