"Safe" Injection and "Reduced" Harm good for society? Don't think so

[RangerRay]

I wish we would recognize that “community living” has been a complete failure. The mental institutions should have been made more humane, not shut down.

 

[mariomike]

The mental institutions should have been made more humane, not shut down.

Nothing new about deinstitutionalization in Toronto, from what I saw.

And, from what I have read, since then, the rest of Canada.

The policy began in the 1960s with the closure of psychiatric hospital beds — it was to be the first part of a plan to move people into the community. Over the next 20 years, more than 80 percent of the beds across Canada were closed, along with entire psychiatric hospitals.

September 9, 2022

Deinstitutionalization is one of our biggest public policy failures. Here’s how we can reverse it.​

Canadians need to accept that our one-size-fits-all shelter system does not work

The dismantling of Canada's mental health system played a key role in creating today’s crisis that sees more than 235,000 people living on our streets annually,

Deinstitutionalization is one of our biggest public policy failures. Here's how we can reverse it. | Broadview Magazine

Canadians need to accept that our one-size-fits-all shelter system does not work

broadview.org

The problem, however, was that the second phase of the plan — community supports and housing for those patients — never materialized. Thousands were moved out of hospitals. Many ended up on the streets.

 

[ArmyRick]

You haven’t lost a family member to overdose, have you?

I have. My cousin Lisa was half white-first nation, she suffered from drug addictions her whole life (she was born and her mom was high at the time). It was down right horrible to watch and she died at age 43. I still don't agree with these wish washy solutions that achieve nothing or in my view, make the problem worse.

 

[brihard]

I have. My cousin Lisa was half white-first nation, she suffered from drug addictions her whole life (she was born and her mom was high at the time). It was down right horrible to watch and she died at age 43. I still don't agree with these wish washy solutions that achieve nothing or in my view, make the problem worse.

I was replying specifically to the “Darwin” comment, not speaking specifically in favour of any specific policy or approach. It simply sucks when you see discussions on this stuff slide away from the fact that we’re still talking about human being with families and friends.

Drug overdoses killed my brother in law, and a friend from my regiment who was having a difficult time after some deployments. I try to remember what’s at stake in these conversations.

 

[YZT580]

And how much treatment are addicts getting for their addictions in jail compared to how much is needed there, right (happy to hear from corrections folks on this)? Then again, throwing more people in jail is something that can be done relatively quickly, easily and visibly, whereas other solutions may be less concrete and (to the right demographic) sexy.

Found this as a meme-ish explanation of how rooting out addiction and its destructive side effects (individual and societal) is so hard ...
View attachment 78947

at least in Ontario, no knowledge of elsewhere, there is little or no treatment for addicts in our jails when they are first arrested. Because of the concept of presumed innocence no remedial efforts are made until after conviction. With the reduced sentencing and only serving a small portion of sentenced time in jail there is no time for an effective programme of help.

 

[Colin Parkinson]

With our always limited resources, I would focus on young addicts and kids at risk, making sure they go through detox and have ex-addicts helping then change their lifestyle, that will help reduce the number of addicts.

 

[SeaKingTacco]

With our always limited resources, I would focus on young addicts and kids at risk, making sure they go through detox and have ex-addicts helping then change their lifestyle, that will help reduce the number of addicts.

I am sure you meant it, but addiction usually means underlying emotional or mental health issues that also need treatment.

 

[YZT580]

I am sure you meant it, but addiction usually means underlying emotional or mental health issues that also need treatment.

amazingly enough, time spent with an X addict can often have more impact than all the psychologist sessions at 200 an hour. Try anything that works

 

[Halifax Tar]

I was replying specifically to the “Darwin” comment, not speaking specifically in favour of any specific policy or approach. It simply sucks when you see discussions on this stuff slide away from the fact that we’re still talking about human being with families and friends.

Drug overdoses killed my brother in law, and a friend from my regiment who was having a difficult time after some deployments. I try to remember what’s at stake in these conversations.

You do understand that we can't save everyone, right ? And you do understand there comes a time when we're just wasting resources and time ?

I get that that is a harsh thing to say but it's the truth.

 

[SeaKingTacco]

amazingly enough, time spent with an X addict can often have more impact than all the psychologist sessions at 200 an hour. Try anything that works

$200/hr? That is a bargain.

 

[The Bread Guy]

I wish we would recognize that “community living” has been a complete failure. The mental institutions should have been made more humane, not shut down.

... Create a secure space, for them and the public, where they can get the help they need, and get them off the streets at the same time.

Perfect example of the pendulum swinging too far (as was done with hospitals vs. home care in the past).

I'm sure not everyone in institutional care needed that level of support, but in the day, it was convenient from a centralized solution viewpoint. In swinging almost completely away from that model - ESPECIALLY without doing enough to get enough support set up in the community beforehand - the baby was thrown out with the bath water.

Not everyone fighting addiction needs institutional support, but not everyone can manage with only community-based support, either. The struggle is to find the right mix AND to make sure all bits of the spectrum are properly resourced.

 

[brihard]

You do understand that we can't save everyone, right ? And you do understand there comes a time when we're just wasting resources and time ?

I get that that is a harsh thing to say but it's the truth.

I had no idea. All the dead bodies I’ve attended have promptly gotten up and happily skipped away.

 

[OldSolduer]

I am sure you meant it, but addiction usually means underlying emotional or mental health issues that also need treatment.

Bingo. That’s part of it.

 

[RangerRay]

at least in Ontario, no knowledge of elsewhere, there is little or no treatment for addicts in our jails when they are first arrested. Because of the concept of presumed innocence no remedial efforts are made until after conviction. With the reduced sentencing and only serving a small portion of sentenced time in jail there is no time for an effective programme of help.

Someone with more intimate knowledge of our correctional systems can probably correct me, but my understanding is that there are no rehabilitation programs in provincial jails because inmates are there for at max 2 years less a day and provinces are stingey in providing funding for those programs. It’s not until someone does serious time in Club Fed that they get access to good programs. By then, it’s too late for many.

 

[Kirkhill]

Respectfully mental health is a lot more than addiction.

There are "clinical" addicts who are guinea pigs for the psychiatric community and there are those who need care that have never touched a drug stronger than aspirin.

I agree entirely with those that say the sanatoriums should have been improved not removed.

The fundamental problem....

a sincere conviction that insanity could easily be cured.

The general demise of provincial psychiatric hospitals in Canada (until 2006)

medcraveonline.com

Addiction and insanity are both chronic ailments with no cure. Just like TB used to be a chronic ailment with no cure. In both cases the solution was the sanatorium. I think it still is.

Forget the treatments... those come and go like any other passing fads. The key element was the sanatorium as a home. From 1836...

In New Brunswick which has the distinction of having had the first provincial asylum, the 1836 Report of the Commissioners had as a central theme the moral treatment of the insane.

This treatment approach originating in the UK by the Tukes and Philippe Pine in France had a buoyant view of man and a sincere conviction that insanity could easily be cured. The consideration given to the location of a site, the floor plan, and the provision of amusements, occupation and religious worship was all intended to put these ideals into practice. One of the initial concerns in New Brunswick and similar to reports in other provinces was the avoidance of populated urban areas and the preference for a quiet, pastoral, semi-secluded countryside for solely treatment concerns.

The commissioners of the asylum were advised by a Mr. Lee that:

It should not be too near a large city, or within half a mile of any street which is, or will likely become, a populous part of the Town. The location should be so elevated as to command a full view of the surrounding country, it should be in a region where the scenery is varied and delightful; a navigable river bearing on its basin the varieties of water craft, public roads thronged with the evidences if life and business. These objects will afford diversions and interest; excite conversation, and supply constant proofs that they are in a world of hope, and among beings who are engaged in the everyday business of life and everything about the establishment should give evidence of care and comfort.

The total population was never planned to exceed 200 patients. The original idea was one of a relatively small institution operated on a personal family group concept with the medical superintendent as the central figure.

 

[Halifax Tar]

I had no idea. All the dead bodies I’ve attended have promptly gotten up and happily skipped away.

I get that man I really do, and I wasn't trying to be flippant. But I can see how that could be the perception. I have no doubt you have to deal with this and clean up the messes at a ridiculous volume.

My point is purely resource based. And at some point we have to take a long hard look and see if the juice is worth the squeeze.

I can honestly think a lots of other things our outrageous level of taxation could be better redirected towards. To me this is a problem for charity, unless we decide to go back to and reopen institutions.

 

[Bruce Monkhouse]

Someone with more intimate knowledge of our correctional systems can probably correct me, but my understanding is that there are no rehabilitation programs in provincial jails because inmates are there for at max 2 years less a day and provinces are stingey in providing funding for those programs. It’s not until someone does serious time in Club Fed that they get access to good programs. By then, it’s too late for many.

I will correct you. The province of Ontario has one of the best inmate treatment programs in the world. The Ontario Correctional Institute has received accolades from around the world.
Did my last 16 years there, didn't want to go but it's where the paid move was as opposed to paying to move myself, but within a couple weeks I knew I wanted to stay.

Worked most of my time on the assessment unit where we'd decide if one was a suitable candidate or not. House meetings, inspections, tons of book work, using first names for staff, alternative dispute resolution rooms,.etc.

They got way more treatment then ANY hospital psych ward I've ever been in. (Been in lots guarding 30 day assessments all the while thinking how pathetic this is compared to OCI)

Catch is,...they have to apply to come there and even with tons of rec and outside time, restaurant quality food, couch visits, et al it was still hard to find inmates who wanted to do treatment.
Most are happy the way they are, they can't say it though, goes against "the code".

I remember an inmate at Guelph jail having to go PC because he gave an interview to the local paper about how nice it was on C-4 unit. (Kitchen, beef centre, and fish plant) The latter 2 where they made very good money while incarcerated.

 

[brihard]

I get that man I really do, and I wasn't trying to be flippant. But I can see how that could be the perception. I have no doubt you have to deal with this and clean up the messes at a ridiculous volume.

My point is purely resource based. And at some point we have to take a long hard look and see if the juice is worth the squeeze.

I can honestly think a lots of other things our outrageous level of taxation could be better redirected towards. To me this is a problem for charity, unless we decide to go back to and reopen institutions.

Just to be clear and not come across as claiming anything untrue, I’m not doing first response stuff on the road anymore so this isn’t something I’m currently immersed in. The fentanyl crisis was just picking up when I moved into something different, but it’s continued to have impacts on my life and family through people lost.

I’m obviously well aware of how under-resourced ‘the system’ writ large is. It’s bad. I’m just not comfortable writing off the human cost of that deficit as simply natural selection taking its course.

 

[YZT580]

$200/hr? That is a bargain.

i was guessing

 

[mariomike]

All the dead bodies I’ve attended have promptly gotten up and happily skipped away.

As long as they walk...