In a four-part series Toward Peace of Mind: Mental Health in B.C., Globe B.C. explores the province’s evolving mental health system – the careful steps it is taking to modernize and the challenges met along the way. This is part one.
Exactly what the small piece of plastic was he can’t now remember, but held under his shirt that day some 15 years ago, Lyle Richardson had convinced the staff at a downtown Vancouver electronics store it was a loaded gun.
“I went in and held the plastic under my shirt and asked for all the money,” he recalled. It was an early morning in mid-September and he can remember the warmth of the sun. “The manager said to give it to [me], so they gave me the $600 that was in the till and I walked out.”
At the time, his motivation for the robbery was clear: The voices wanted him to fast, and to do so, he would have to get out from under the watchful gaze of the guardians who prepared his meals. Cancun seemed an ideal place to fast; to get there, he would need money.
About a year earlier, the New Westminster native was diagnosed with schizoaffective disorder, a combination of schizophrenia (typically characterized by delusions, hallucinations and breaks with reality) and dramatic mood swings. The milder symptoms of his adolescence had progressed into full-blown psychosis – a detour in Mr. Richardson’s road to adulthood that took him through B.C.’s mental health system.
His illness also brought him full-circle within the province’s criminal justice system, from being a robbery suspect, face-down and handcuffed on the streets of downtown Vancouver, to a speaker at the Justice Institute of B.C., where all municipal police officers in B.C. are trained and – as of this year – learn how to interact with the mentally ill.
The province has taken steps to advance its mental health system, investing in new facilities and launching a 10-year plan focused on preventing problems and on early intervention. However, mental health advocates point to lengthy waiting lists, gaps in care, and the alarming number of police service calls that involve people with mental illnesses as proof much is still to be done. The Canadian Mental Health Association (CMHA) in B.C. has launched a campaign to make mental health an issue in next month’s provincial election.
A price tag can be put on how mental illness affects the economy – about $51-billion annually in health care and lost productivity in Canada, with about $6.6-billion of that in B.C. – but the emotional cost is incalculable and widespread. About one in five Canadians will experience a mental illness.
While only 1 per cent of Canadians will have schizophrenia, Mr. Richardson’s story shows the strong hold a mental illness can have – and the complexities involved in treating it.
Throughout high school, the symptoms “weren’t too dramatic,” Mr. Richardson recalls: “One day, I would be sleeping on the desk, and the next day, I would be on an emotional high, cracking jokes a mile a minute.” The graduating class at New Westminster Secondary elected him valedictorian because they knew he would make them laugh.
Next came a year at Simon Fraser University. Through an entrepreneurs club, Mr. Richardson landed a job as a junior executive assistant at a large venture capital firm, a position that afforded the young man free hockey tickets and occasional use of his boss’s Ferrari. On the surface, life was great, but Mr. Richardson began feeling withdrawn. When he was let go from the job, he didn’t mind.
The voices started when he was 23 or 24, familiar tones that were innocuous at first and even encouraging. One, for instance, told him to make a list of all the things he wanted to do. Mr. Richardson made that list, although he can’t remember if he ever accomplished those goals.
Even now, as a 39-year-old fully aware of his condition, it is impossible for Mr. Richardson to differentiate the hallucinatory from the real. The voices of his illness are as real as the voice of the barista who makes his coffee, the clerk who bags his groceries. They are, perhaps, even more real: “They kind of talk to my heart,” he said. “They affect me quite deeply.” So when the voice of a woman he quietly admired from afar told him to fast, he did. His weight dropped and he began acting out of character.
Realizing something wasn’t right with their son, Mr. Richardson’s parents called a psychiatrist’s office, only to be told there was a waiting list of six months. For urgent care, the family was told to call police: Under section 28 of B.C.’s Mental Health Act, an officer can immediately take someone to a doctor for examination if the officer believes that person has a mental illness and could be a safety risk to self or others.
They were conflicted, Mr. Richardson remembers, but felt they didn’t have a choice. In 1996, police officers apprehended him and took him to Peace Arch Hospital, where he was diagnosed with schizoaffective disorder. He stayed in hospital three weeks – not even enough time for him to realize he had a mental illness that could be treated, he says now.
Hospitalizations followed at Royal Columbian, St. Paul’s and the University of B.C. He offset months-long bouts of depression with episodes of hypermania brought on deliberately by going off his medication. When his illness overwhelmed him, Mr. Richardson would do what he calls “silent screams,” – clenching his fists and “screaming” without making a sound.
“It’s kind of like asphyxiation; it’s like cutting off oxygen to your brain, so you get a peaceful feeling,” he explained of the coping mechanism. “I’d press down on my heart with my muscles … so that there’s no blood getting to my brain. And then I’d have a peaceful effect from that, kind of a lifting feeling from the depression, I guess.” Mr. Richardson estimates he did about 50,000 silent screams over the years.
At UBC Hospital, his fasting became so problematic he was taken to Riverview Hospital – an experience he likens to being in the movie One Flew Over the Cuckoo’s Nest.
“They had some good doctors there, but the buildings themselves were so archaic,” he said. “They were old and they had been painted a thousand times. It felt like, ‘I must be really out of my mind to be here.’ It wasn’t very encouraging.”
After a year and a half at Riverview, Mr. Richardson was moved to a group home on the recommendation of a social worker. Two days into that, fuelled by an almost spiritual need to fast, he went for a long walk into downtown Vancouver. He went into a department store and stole the small piece of plastic he used to rob the electronics store.
Mr. Richardson was found not criminally responsible for the robbery on account of mental disorder. He spent a night in a holding cell and was taken back to Riverview for six months.
In Vancouver, one-third of all calls to police involve at least one person with a mental illness, with the figure climbing to almost half in some parts of the city, according to a 2008 VPD report. The number of arrests made under Section 28 of the Mental Health Act has climbed steadily in recent years, reaching 2,636 in 2012.
For all the help Mr. Richardson has sought, his turning point came suddenly. His psychosis was growing stronger and his mania no longer fun. One day, he thought: “My psychiatrist has 11 years of training. Why don’t I take his advice?” He began taking his medication daily. The fasting ended with the allure of a steak dinner.
Today, Mr. Richardson speaks at high schools and the Justice Institute of B.C. Two or three times a month, he addresses a class of police recruits, telling of his own interactions with police and fielding questions. Instructor Linda Stewart calls his contribution “priceless.”
“He opens his life story to help first responders understand the effects of mental illness to better prepare them to take effective action in de-escalating a critical incident,” she said. “Awakening the police mindset to the fact that not all aberrant behaviour is criminally charged allows for the opportunity to apply techniques that will provide a better chance to resolve the incident in a way that is safer for both the subject and the police.”
Part-time work, including the public speaking position, has helped Mr. Richardson supplement a modest disability benefit while giving him a sense of purpose. At high schools, he revels in making students laugh with animated tales of his experiences – not unlike during his own time in high school.