Can you *believe* this guy? (AGGGHHH!!!)

Graeme Bacque (gbacque@arcos.org)
Sat, 13 Jun 1998 04:49:06 -0400


Saturday, June 13, 1998  The Financial Post

What's Right

It is no kindness to treat mental illness as a civil rights issue

Psychiatry is a form of treatment, not a punishment

                                               By DAVID FRUM=20
                                               The Financial Post=20
              How upset should we be that Torontonians are being pushed in
front of subway trains by mentally disturbed people?

             The answer of the Mike Harris government seems to be: not very.=
=20

              In the last three months of 1997 and the first three months
of 1998, six people were assaulted in this way on the Toronto transit
system; one of them, 23-year-old Charlene Minkowski, was killed. (Another
of them was my wife who escaped without injury.) In all six cases, the
culprits had long histories of mental illness. The uproar touched off by
these horrific incidents prodded the Harris government to assign
Scarborough Centre MPP Dan Newman to chair an inquiry into the province's
mental health system and come up with some recommendations. The report --
plus $40 million of funding for mental health projects --was unveiled last
week. After reading it, one can only wonder: why did the government bother?=
=20

		We're all familiar with the tendency of political documents to go in for
meaningless generalities. But even by the flabby standards of government,
the Newman report stands out for its unwillingness to offer detailed
analysis of the problem or specific recommendations for reform. You hear a
lot of bureaucratic bafflegab about the need for better "integration and
co-ordination" of services. What you don't hear is any reconsideration of
the dogmas and doctrines that have brought us to a point where the
sidewalks of Toronto are camping grounds for so-called homeless people who
are in most cases seriously mentally ill; or where subway riders keep their
backs pressed to the wall lest they be shoved by someone in the grip of a
delusion.=20

 		And sad to say, Newman's evasiveness appears not to be accidental. Since
the early 1970s, mental health has become a bloody ideological
battleground. On the one side stand most doctors and the families of the
mentally ill. They know mental illness is a real thing. They know it can
transform a person into a danger to society and a constant menace to
himself. They know mentally ill people are often not the best judges of
their own best interests. It is no kindness to listen to someone who tells
you he wants to sleep on a

cardboard box underneath the Gardiner Expressway in January. Call this
side of the debate the medical approach to mental illness. For the past
quarter-century, it's been losing.=20

 		On the other side stands what might be called the social work approach.
Its supporters think about mental illness not as a health issue -- and
certainly not as a public safety issue -- but as a civil rights issue. They
want us to think of mental health institutions as the equivalent of prisons
and they believe disturbed people should be given psychiatric treatment
over their objections only if the government can prove beyond all
reasonable doubt they constitute a direct and immediate danger to those
around them. As far as those
who take the social work point of view are concerned, government's most
important responsibility to the mentally ill is to protect their right to
refuse treatment. Beyond that, it's all a matter of money: handing out free
housing, welfare and other benefits.  Those who see mental illness as a
medical problem believe you measure our society's concern for the mentally
ill not only by the money we spend, but by our willingness to take
protective action -- both for the sake of the mentally ill and for the sake
of the society around them. Letting someone afflicted with schizophrenia
freeze to death on a January sidewalk is a strange way to show respect for
his rights.=20

		But this is what we in Ontario and most of the rest of Canada have done,
and this what we are likely to go on doing. For vague as it is, the Newman
report gives every indication the Harris government has been just as
completely captured by the advocates of the social work approach as the Bob
Rae government before it. When listing the principles that should guide
mental health legislation, the Newman report lists public safety third --
behind "co-ordinating and integrating benefits" and "guaranteeing access to
services." And repeatedly it refers to those afflicted by mental illness as
"consumer/survivors" -- the signature term of the most extreme advocates of
the social work approach, who regard psychiatry not as a form of treatment,
but as a punishment.  Newman has now passed the job to Health Minister
Elizabeth Witmer. Let's hope she does better.=20
=20
David Frum is an author and columnist.=20
 =20

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--
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Graeme Bacque
<http://web.arcos.org/gbacque>
(#2226799 on ICQ)
++Question and challenge *all* human 'authority'++
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