While schizophrenia support may not come to mind as a topic for election campaign fodder, if Jack Middleton, board president of the BC Schizophrenia Society, has his way, it will be on the lips of aspiring political leaders in the provincial election campaign this fall.
Schizophrenia impacts one in 55 people, according to the society.
It is a challenging mental disorder that can include hallucinations, delusions, and disordered thinking.
“The likelihood that you know somebody, that we all know somebody, who has [schizophrenia] is quite high," said Middleton.
While there are a lot of negative depictions of schizophrenia, with treatment and continued support, those living with it can and do go on to have bright and fulfilling lives, he said.
What does the society want to hear?
Involuntary care
In terms of issues around mental illness, the non-profit society is looking to hear politicians support involuntary treatment under the Mental Health Act.
"We're not calling for it to be different; we're calling for it to be maintained," Middleton said.
"Involuntary treatment is a tough question for a lot of people, but in the case of mental illness, where somebody is a threat to themselves or to others, it's a life-saving tool," he added.
In a news release, the society notes some people living with schizophrenia and other psychotic disorders suffer from anosognosia, which means they have a complete lack of insight into their own illness.
NDP candidate Jen Ford
West Vancouver-Sea to Sky NDP candidate Jen Ford said she supports the continued use of involuntary care.
“Experiencing symptoms of psychosis, including schizophrenia, can be scary and isolating, and we believe that people need access to supports and services—sometimes voluntary, sometimes not—to keep themselves and others safe,” she said in a written statement to The Squamish Chief. “I know that the use of involuntary care under the current provisions of the Mental Health Act is critical to many people suffering from schizophrenia as they may not understand that they need treatment, and I am supportive of maintaining this function of the act.”
BC Green Party candidate Jeremy Valeriote
BC Green Party candidate Jeremy Valeriote said he is concerned about involuntary treatment.
“Given the disproportionate use on Black, Indigenous, and people of colour; women; the unhoused; and people with substance-use disorders, these measures should be used sparingly, with close monitoring and reporting,” he said.
“Schizophrenia is a mental illness which requires better public understanding and compassion, not least because it affects many more people than we might imagine. We need a spectrum of care—from medication to psychosocial support, including housing and cognitive remediation—that are affordable and accessible for all who need it on an ongoing basis. We would hope to see this addressed in a full Mental Health Act review.”
'Available and affordable'
The BC Schizophrenia Society says policies need to be implemented to ensure care is available and affordable everywhere in B.C.
"Community services need to include psychiatrists to provide early and continuing care, and hospitals need to have sufficient beds and staff," reads the society's release.
Middleton said that, especially in rural areas of the province, treatment for mental illness can be hours away, making it inaccessible for some.
The society also advocates for point-of-care testing to allow patients to access clozapine, which Middleton described as "a very effective drug," to treat schizophrenia, but it requires frequent blood tests to stay on it.
"And that blood testing in the past has been done at hospitals only. And so you can see the issue there,” he said. “If you're driving for hours to get your blood tested, that's challenging in that not everybody has access to a car, and not everybody has the ability to do that. And it reduces the likelihood somebody's going to stay on it."
The society recommends setting up pharmacies, care homes, or clinics to perform point-of-care testing.
A home for all
The society also argues care for those with mental illness must continue after discharge.
This care includes having access to supportive housing, rehabilitation, and "comprehensive" community support. "If they don't have things like affordable housing, they don't have their family around them ... people tend to not continue their treatments, and they continue to decline," Middleton said.
The society notes treatment also needs to include engagement with patients and their loved ones, but unfortunately, that does not seem to always be the case.
"You see political parties right now talking about homelessness and violence, addiction and all of these kinds of things. Well, mental illness isn't to blame for all of it … [but], I think if we can address some of the base causes, it could be a better province for everyone," he said.
Middleton noted mental illness is a disease, and it's something not everyone has.
"Mental health is something that we all have," he said.
"Just being able to draw awareness to the fact that it's not necessarily being talked about in public in these ways. We could do more to talk about untreated mental illness and schizophrenia."
He said more than anything, the society wants there to be more discussion around mental illness, including schizophrenia. "We're open to all solutions," he said.
"Everything that we've put in our call to action for government isn't going to cure schizophrenia; it's not going to solve everyone's problems, but we should seek to make people's lives better, I think," he said.
There’s really no excuse to avoid public funding’
Valeriote said he strongly supports the” longstanding position” of the BC Greens that mental health should be “properly integrated” into the public health-care system.
“So that affordability and availability are not a barrier to getting the supports people need,” he said.
“Just as they do in primary care, early intervention and preventative strategies in mental health reduce the likelihood of illness and a lot of pain and trauma. However, psychologists are not covered under MSP, and patients struggle to get access to psychiatric services. For schizophrenia, there are just three psychiatrists in the entire northeast of B.C. There is abundant evidence that tackling mental health reduces overall health costs, so there’s really no excuse to avoid public funding.”
Valeriote also said he understands from experience how vital ongoing care and family support are.
“Working with the Squamish Youth Council over the past few years, I learned how important it is to empower our young people with mental-health insight, tools and treatment so that they’re not burdened with suffering into adulthood,” he said.
“Furthermore, the BC Greens—alongside B.C. parliamentary committees and others—have long called for a full public review of the Mental Health Act, because it reinforces archaic and stigmatizing stereotypes, and in any case, the province routinely fails to comply with the Act.”
He said while he understands clozapine is effective, “it is a high-barrier medicine, and we should be investing in finding new alternatives”
‘Always looking for ways to improve care’
Ford pointed to NDP Premier David Eby’s actions to improve care for the growing population of people with overlapping mental health and addiction challenges like schizophrenia and brain injuries from toxic drug poisonings.
“He has appointed Dr. Daniel Vigo as B.C.'s chief scientific advisor for psychiatry, toxic drugs and concurrent disorders,” she said. “People with such conditions often face extreme challenges that impact their ability to make decisions about self-care and accessing services, and Dr. Vigo is working to improve care and outcomes for this group of people.”
She also pointed to the government’s expansion of early psychosis intervention programs in health authorities across B.C., including funding the hiring of up to 100 specialists.
“There are now more than 50 locations where young people aged 13 to 30 can get assessed and connected to this type of care. I agree that wraparound supports for people receiving these services, including resources after they complete their program, is important to help keep them on track to better mental health in the long term,” she said.
Regarding care after a patient is discharged, Ford said she understands the need for continued improvement.
“I know that the BC NDP government is always looking for ways to improve care for vulnerable people, including those living with schizophrenia, and I agree about the importance of community and hospital resources both during and after discharge and on the importance of family involvement whenever possible,” she said, adding she is committed to hearing from advocates and experts on how we can further improve access to care, including to life-changing medications, especially for those in rural communities with limited access to health-care settings like hospitals.
She also took the opportunity to take shots at the leader of the Conservative Party, John Rustad, and BC United leader Kevin Falcon, saying they made cuts to mental-health support for people the last time they were in power.
“They would make cuts to the health-care that people experiencing psychosis and schizophrenia need—and people who need treatment can't afford that. A BC NDP government will continue to invest in accessible treatment for people in communities across the province.”
Find out more about schizophrenia by going to the BC Schizophrenia Society website.
As of the date of publication, Ford and Valeriote are the only declared candidates in this riding.
The provincial election is scheduled for Oct. 19.
