As someone who has always voted for the NDP, I am concerned about some of this government’s approaches to severe mental illnesses, writes the mother of a daughter living with schizophrenia. Getty Images / PNG
Joy MacPhail, in her recent opinion piece, makes clear how pleased she is with the new provincial plan to improve mental health and addiction services. She believes that this plan, called A Pathway to Hope, can help “improve the well-being of all citizens.”
As the mother of a daughter living with schizophrenia, I disagree. Many unmet needs of adults living with the most severe psychotic disorders are not addressed.
MacPhail focuses on the high rate of hospitalization as evidence of the failure of the current mental health system. It is disappointing that she doesn’t acknowledge the many people with untreated psychotic disorders whose suffering is very visible on the streets of cities and towns throughout the province. Lack of treatment for this population leads to homelessness, victimization, addictions and incarceration.
The article seems to argue that all mental illnesses arise from negative social factors. It is unclear if MacPhail knows that psychotic disorders like schizophrenia and bipolar disorder cannot be prevented. It is also unclear if she knows about anosognosia, the brain-based inability of many people in psychosis to understand that they are ill. This symptom leads people to reject treatment when they most need it.
It is good that increased funding will probably be used to expand B.C.’s too few Early Psychosis Intervention programs. These time-limited programs, unlike much of the rest of the mental health system, are known for educating clients and their families about the illnesses they are living with. I have seen how people who receive adequate psycho-education have a much better chance of understanding, accepting and learning to manage their illnesses.
Most people with schizophrenia can have their psychotic symptoms alleviated by anti-psychotic medications. However, there is widespread and ongoing disability in this population because psychotic disorders often involve significant cognitive losses. B.C.’s many influential anti-psychiatry/anti-medication activists should learn that these losses often appear before the use of any medications.
These cognitive losses include difficulties with concentration, short term and working memory, problem solving, judgement and social skills. These problems can make many of the tasks of daily living, including remembering to take medications and attend medical appointments, very difficult.
All clients and families need, but currently do not have, the chance to learn about these cognitive losses. As well, clients deserve access to the evidence-based cognitive remediation programs that exist in many other countries.
A coalition of representatives from the B.C. Schizophrenia Society, B.C.’s Early Psychosis Intervention programs, the B.C. Psychosis Program and B.C. Psychosocial Rehabilitation put on a sold-out conference in 2017 on Bringing Cognitive Remediation to British Columbia. This group has gone on to submit several proposals for training staff in implementing evidence-based cognitive remediation programs. So far, this government has chosen not to provide necessary funding.
As someone who has always voted for the NDP, I am concerned about some of this government’s approaches to severe mental illnesses. The recent recommendations from the B.C. Ombudsperson, for example, will embed the Community Legal Assistance Society in hospitals to provide advice to all involuntary inpatients. This is an organization fighting to abolish access to involuntary treatments.
Currently, nurses and social workers inform involuntary patients about their rights and about ways to access review panels to ensure that people are not receiving unnecessary treatments. Patients will soon receive advice and legal assistance from an organization that publicly doubts the value of anti-psychotic medications.
Hopefully, the NDP can be persuaded to better meet the needs of people with the most severe mental illnesses. Rather than spending millions of dollars on lawyers, the right kinds of services for this disadvantaged population could be implemented.
A lot of money is about to be spent on various mental wellness programs. Some of these funds should be used to improve mental illness literacy programs. Educating the public about psychotic disorders can increase their ability to help people access and stay engaged in essential services.
Susan Inman was an English and drama teacher at Windermere Secondary School for 24 years. She has a daughter living with schizophrenia.
The son of an elderly couple says he wants two major airlines to stop blaming each other and take responsibility for abandoning his parents in their wheelchairs for half-a-day, with no help to access food, water or a washroom.
Mohan Karki’s parents, who don’t speak English and require assistance to travel, were found almost 12 hours after being dropped off at a service counter at the Vancouver airport — just not by the airlines responsible for assisting them during their trip, WestJet and Cathay Pacific.
“We were thinking they were somewhere in the corner of the airport … not knowing where to go,” said Karki. “My parents told me, ‘We never left this place’ … 12 hours they were there. They tried to communicate with some other people, passersby, and nobody responded to them. Maybe they couldn’t understand what they were saying.”
On Feb. 23, Narayan and Chhaya Karki, aged 66 and 69, were on the final leg of a trip from their home in Kathmandu, Nepal to visit their son and his family in Edmonton, with a stopover in Vancouver.
Mohan Karki said Cathay Pacific told him it delivered his parents to the WestJet customer service counter at the airport, and WestJet was to transport the pair to the gate for their final flight to Edmonton.
When his parents failed to arrive, a worried Karki spent hours on the phone trying to track them down. They didn’t have a cellphone. “For about six or seven hours, I kept on calling both airlines, but they never found my parents,” he said.
Karki then called the RCMP. It took officers 20 minutes to find the couple, located just steps from the service counter.
The couple had placards with Karki’s name and phone number, in case of an emergency. No one responded when they tried to get help by holding them up, he said.
According to an Ontario-based advocate for people with disabilities, services for those who need assistance travelling are “unreliable and inconsistent” because airlines are allowed to set their own rules — instead of being told to meet specific standards.
“It is appalling treatment … the regulator should make it clear that [airlines] can’t pass the buck to each other,” said David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance.
Left at the wrong gate for 8 hours
Thanh Phan shares that frustration; the same thing happened to his 76-year-old mother at the same airport.
In August, Niem Thi Le, who has trouble walking and doesn’t speak English, was left in a wheelchair for eight hours after being dropped off at the wrong departure gate by WestJet.
Le was on her way home to Hanoi, Vietnam after visiting family in Victoria. WestJet was supposed to connect her with China Southern Airlines for her next flight.
“My mom told me that the wheelchair attendant just left her there without talking to anyone.… I was shocked … this is a human being,” Phan said.
An employee with another airline eventually noticed Le sitting alone, found someone who could speak Vietnamese and brought the woman to the China Southern Airlines counter.
That airline contacted Phan and suggested he call WestJet to find out what happened. He did, asking if someone could help his mother until he could get there himself.
“I said, ‘Could you please help her give her some food and drinks.’… They said, no, they didn’t do anything wrong and that’s not their business,” Phan said.
He called China Southern Airlines back and it agreed to help, bringing Le a hamburger and a drink.
‘They did not think it’s a serious problem’
Phan complained to customer service and WestJet apologized, saying it would review its internal process. But he said the airline never got back to him to explain what happened.
WestJet also told him travellers who don’t speak English shouldn’t be travelling alone, he said, though they offered him a $100 travel voucher.
“It’s very frustrating because they blame passengers, and they did not think that is a serious problem.”
WestJet ‘reaching out to the families involved’
Both Phan and Karki are still demanding an explanation from the airlines involved in their respective cases.
“We sincerely apologize for the stress and worry that these guests and their families experienced,” WestJet’s media relations manager Lauren Stewart wrote in an email to Go Public.
“The nature of these incidents is serious, and we are in touch with both airline partners involved to investigate and make enhancements to our processes to prevent this type of incident from happening again. We are also reaching out to the families involved.”
The airline says it provides mobility assistance to more than 900 guests per day.
Cathay Pacific told Go Public it was sorry to hear what happened to the Karkis, adding it followed “standard operating procedure” when it delivered the couple to WestJet staff and exchanged wheelchairs.
“The proper turnover to WestJet was made by our staff. Additionally, we are in the process of reviewing this situation with WestJet and we will apply learnings from this experience to future transitions between our airlines,” wrote Julie Jarratt, the airline’s communications director.
‘I dread entering Canadian airspace’
Lepofsky, who is blind, said he’s had his own problems travelling. “I dread entering Canadian airspace if I’m travelling alone … not because the service is always bad, but because it’s not reliably and consistently good.”
Airlines have a duty to accommodate passengers with disabilities under Canada’s human rights laws, he said. But when that doesn’t happen, it’s tough to figure out where to turn for help.
“There are multiple agencies involved,” Lepofsky said. “The Canadian Human Rights Commission, the Canadian Transportation Agency — and you could be kicked from one to the other, trying to figure out where you’re supposed to go.”
He added: “The Canadian Transportation Agency, where you’re often kicked to, does not, from the perspective of people with disabilities, have a good track record in this area.”
Proposed rules require airlines to take responsibility
The CTA says it’s aware some of the standards are out of date and a binding set of rules is needed. Until now, accessible transportation has been governed by mostly voluntary codes of practice.
“They need to make sure that passengers don’t fall between the cracks,” said Scott Streiner, chair and CEO of the Canadian Transportation Agency.
Under the CTA’s proposed rules, airlines would have to provide people who need assistance a place to wait, near personnel who can assist them and will “periodically inquire” about the person’s needs.
Airports would be responsible for providing assistance from curbside to check-in, while the airlines would be responsible from check-in to boarding.
Streiner said the proposed recommendations would have helped in both cases. The agency plans to have the final regulations published before summer and hopes to have the majority of requirements in place in about a year.
“Persons who require wheelchair assistance, including older Canadians, absolutely are covered by these regulations,” Streiner said. “We want to make sure that there’s no confusion about who’s providing assistance and that people aren’t left without assistance.”
As for Karki, he said that the next time his parents visit, he won’t leave them in the hands of the airlines. Instead, he’ll try to match their itinerary with other Nepali-speaking travellers.
After hearing from Go Public, WestJet called Karki last week, promising an explanation once it looks into what went wrong.
Phan said WestJet has yet to follow up with him, adding that his mother is now afraid to travel and will no longer come visit.
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