Brandon comes full circle on mental health support

Opinion

Thirty years ago, the goal of mental health reform in Brandon was apparently crystal clear.

The closure of the Brandon Mental Health Centre on the North Hill would remove a community stigma — an impediment to people who needed care.

Instead, patient care would be shifted out of the institution and into the community, where people could live their lives as normally and freely as possible, while being supported by a newly formed network of government supports.

And those supports would be there, with proper funding — we were told as much by the Progressive Conservative government that was responsible for implementing the recommendations of mental health professionals.

“A paradigm shift from institutional isolation and stigma to modern service delivery in the community simply made common sense for the 21st century and offered a far better probability of successful outcomes,” wrote former Tory health minister Jim McCrae in an op-ed to the Sun in 2005. “Before the reforms, people had to go to BMHC to get help. The numbers clearly indicate the majority of people needing help simply would not go to BMHC to get it. The stigma was too overwhelming and intimidating. So they just suffered alone — or victimized themselves and their families.”

More than 100 staffing positions from the BMHC were re-allocated to various parts of Westman, including the Parkland, McCrae announced in 1996.

The BMHC was finally mothballed in the late 1990s, and in its stead several other organizations have been responsible for the mental health of Brandon and western Manitoba, including the creation of 25 beds in the Centre for Adult Psychiatry at the Brandon Regional Health Centre, the Children and Adolescent Treatment Centre on 10th Street and the Centre for Geriatric Psychiatry.

Other programs offered through Prairie Mountain Health include an adult community mental health program, and a psychosocial rehabilitation program. And this is not a complete list.

Along with the closure of the BMHC, there was a belief that consolidating health services in the downtown area was an ideal move. It’s why the RHA leaders of the day decided that health services that were formerly housed at the provincial building on Ninth Street would be better suited to move into the Brandon Gallery shopping mall (now The Town Centre) where many of their patients resided.

However, downtown has continued to deteriorate, and there is a growing sentiment among residents and business owners in the area that consolidating all services downtown — instead of having the whole city shoulder the weight of need — has been largely to blame.

Even those who are responsible for providing social services downtown have uttered concerns about their well-being, and the well-being of their clients, because of the perceived dangers of operating in the area.

Perhaps the most damning repudiation to the current system of mental health care has come from the Brandon Police Service, which released a Downtown Public Safety Strategy summary report in September. The release of the report followed five public consultation meetings with downtown residents, community partners, business owners and BPS officers.

One of the actionable items was a call for the creation of a crisis response unit that will pair Brandon police officers with mental health professionals. This new unit is supposed to be operational as early as this month.

“I think it’ll be very beneficial to actually have trained professionals dealing with those mental health calls,” said Insp. Dana McCallum, who will be part of a new downtown safety steering committee. “And have the officer there for the safety side of things, but then … have the health worker that has the experience and knows how to guide them to the services they require.”

Having actual health professionals work with police in crisis moments is a good idea that would remove the need for officers to also moonlight as mental health experts.

It’s not the only suggestion that has come out of the report. The internal session with BPS staff uncovered “significant operational and systemic pressures contributing to perceptions of disorder downtown,” according to the report.

Police noted a lack of access to detox beds, mental health assessment beds and long-term stabilization options. Officers are also forced to discharge individuals into the downtown without “appropriate followup or housing.” And the public perception of crime, the report noted, is often reinforced by “visible disorder.”

“The entire region funnels into Brandon and then stops downtown,” reads one quote from the report. “We’re the end of the line for every gap.”

Among the other proposed actions — which include relocating and decentralizing social services to reduce over-concentration, increasing psychiatric staffing and nurse availability, and offering tax breaks for developers and landlords building micro-suites or income-based housing downtown — the police have suggested building a dedicated mental health hospital or recovery centre.

Like the one that was shuttered nearly 30 years ago?

While it’s true that those who created this community-based system could not have foreseen the rise in the number of people who would come to Brandon searching for housing and mental health supports, it must be said that the problems in the system were already known by local health-care professionals at the time. People like Dr. Derry Decter argued that the Filmon government was not properly funding the necessary supports in the wake of the closure of the BMHC.

“I am no fan of the institutionalization of people,” wrote Dr. Decter in a 2006 letter to the editor. “I went to BMHC precisely to help those who had suffered at the hands of the mental health system. But what came after was in many ways worse. People once cared for were abandoned, left to their own devices in a violent world of uncontrolled access to alcohol and drugs. How many people in my practice alone died unnecessarily? I can count six, without even bothering to look up a file.”

We have come full circle.

The Westwind Counselling and Eating Disorder Recovery Centre, which was created in 1998 by former staff from BMHC after its closure — and reimagined as an expensive private clinic — closed its doors in Brandon and moved all operations to Kelowna, B.C. In a 2020 report from the Sun, the counselling service had been charging its clientele upwards of $20,000 for a three-month stay at its Westman facility.

And currently, PMH is still seeking no less than four family physicians to join the Department of Psychiatry as the general practitioner responsible for psychiatric inpatients in the Centre for Adult Psychiatry, the Centre for Geriatric Psychiatry and the Child and Adolescent Treatment Centre.

It’s time to start asking some serious questions about how our mental health services are delivered in Brandon, and what can be done to improve the system.

In fact, it’s long past time.