Community Mental Health: Reinvesting in Psychiatric Institutions Isn’t the Answer

An editorial response to mental health and homelessness in our region:

The period of deinstitutionalization between 1960 and 1976 saw two thirds of all beds in Canada, 47,633, closed for the mentally ill. Over the next half century this public health policy would see more and more people released into the community without adequate supports to maintain their stability and wellness, often resulting in the experience of further illness and chronic homelessness. Adding to this policy, steeply increasing levels of poverty—the effect of cumulative trauma—and subsequent experience of addiction and its criminalization have lead us to the place we are at today.

Yes, “people are living in squalor” and yes, “we need to do things to help”, but psychiatric facilities and mental hospitals aren’t the answer. Clinical, medical, and psychiatric supports will always have a key role to play in the management of the lives of those most profoundly impacted by mental illness. And, there will always be a need to invest in an accessible, equitable, and efficient mental health serving system.

But the real work needs to take place in our communities where so many living with mental health challenges reside. Firstly, addressing stigma: 1 in 5 Canadians, 84,000 Victorians, live with or experience mental health challenges at any given time. Mental illness is ubiquitous. Secondly, people get better in communities where they are accepted, feel a sense of belonging, and find purpose. We need to petition our governments to invest in much more robust levels of community support in the form of housing teams, crisis support, and effective programming such as clubhouses. Thirdly, this is a far more cost effective strategy than building and staffing institutions, that could provide a far greater impact to the general health of our communities. A recent Social Return on Investment study has shown that 1 dollar invested in Richmond’s ‘Pathways’ clubhouse saves the community 14 dollars that would otherwise be spent on expensive and temporary emergency, medical, and police services.

Invest in your community’s mental health. That is the answer.

Chris Forester
Executive Director