Pubdate: Sat, 07 Feb 2009 Source: Victoria Times-Colonist (CN BC) Copyright: 2009 Times Colonist Contact: http://www.canada.com/victoriatimescolonist/letters.html Website: http://www.canada.com/victoriatimescolonist/ Details: http://www.mapinc.org/media/481 Author: Jack Knox HELP INADEQUATE FOR THOSE FIGHTING TWIN MONSTERS He is 17 years old. We'll call him Bob, because that's not his real name. Two years ago, Bob got into drugs -- crack, marijuana, booze, ecstasy, LSD, the works. He dropped out of school, was soon spending days at a time on the streets of Victoria. When given the choice, Bob moved into foster care rather than quit drugs and stay at home. It got worse. Just over a year ago, his mother says, Bob became psychotic, delusional, paranoid and extremely frightened. Committed under the Mental Health Act, he was placed in the Queen Alexandra Hospital's Ledger House program. He developed Capgras syndrome, a condition that left him believing his mother was an impostor who had killed his real mother. He thought his brother was an impostor, too. He contemplated harming others, including his mother. The mother says a number of local treatment programs, including the one at Ledger, did little for Bob, though medicines helped him become less fearful and less delusional. His mother looked around for options, but found B.C. has a dearth of facilities treating dual diagnosis -- that is, both mental illness and addictions. So she began looking elsewhere, found a Utah hospital that dealt with dual diagnosis. Last August, B.C.'s Medical Services Plan paid to send Bob there for assessment. The Utah doctors recommended long-term residential care for Bob. He ended up in Youth Care, a private, $480-a-day residential teen-treatment facility in Utah. His mother was happy, says the success rate, measured by a patient's abstinence from drugs and his ability to work or go on to college, is high. She liked the mix of services, including specialized education programming of the sort that would allow Bob to finish high school. "He was getting incredible care down there, the kind he needs." The province covered the cost. But in October the government began to balk, saying the best course of treatment for Bob was back in B.C., that he should be brought home. No way, the mother said, there's nothing for him here. Armed with letters from Youth Care and a Victoria psychiatrist who warned against returning Bob to a "patchwork" of services with low-level supervision, she fought the decision tooth and nail -- ultimately to no avail. Bob returned to Victoria last week. The mother is beside herself. She wants her son returned to Utah, wants -- ultimately -- to move with him somewhere he can get a fresh start. This is where these stories hit a wall. Confidentiality issues prevent the government from commenting on individual cases directly. All it can do is speak in general terms: "Care plans are dependent on the needs of the individual," said the Health Ministry. "What is critical, and what the professionals try to achieve every time, is a comprehensive and co-ordinated approach to ensure the care plan best meets the needs of the client." Which is another way of saying that the government has its own health professionals -- in the Health Ministry, the Children and Families Ministry, the Vancouver Island Health Authority and elsewhere -- who are doing their best to decide what is best for clients, and sometimes those decisions clash with the desires of the clients' families. What no one disputes is the difficulty in tackling the twin monsters of mental illness and addiction. Dual diagnosis isn't rare. A VIHA report estimates up to 70 per cent of people with substance abuse disorders also have a mental health problem. Don't expect the problem to become any less pervasive, not if drug and alcohol use continue to climb. Between 1994 and 2004, the percentage of Canadians who drink rose to 79 per cent from 72. Marijuana use doubled from seven per cent to 14, cocaine and crack from less than one per cent to almost two. Just over one per cent use LSD, meth, heroin. The Health Ministry notes that B.C. has hired 321 additional child and youth mental health specialists in the past four years, bringing the total to 515. Work is beginning on a new 10-year strategic mental health plan. That's good, but means little today to Bob or his mother. Just pray that somewhere, someone gives them the help they need. - --- MAP posted-by: Larry Seguin