Two involuntary secure-care sites are due to open in the province in late spring for people struggling with severe addiction, brain injury and mental illness while overdose prevention sites planned for Island hospitals remain on pause.
Premier David Eby, in an interview with the Times Colonist, said the province’s first chief scientific adviser for psychiatry, toxic drugs and brain injury has worked non-stop since being hired in the summer with a target date of May to open the first two secure-care facilities.
Dr. Daniel Vigo was tasked to find better care for a growing population with severe addictions, brain damage from repeated overdoses, and mental-health disorders and psychosis — people often in a revolving door of correctional and health-care systems.
Vigo has previously said that a few hundred brain-injured people in the province have such severe mental illness and addiction that they require involuntary care.
Vigo’s appointment came on the heels of stranger attacks in Vancouver — which left one man dead and another with a severed hand — and in Victoria, where a man assaulted three people on Government Street, including a woman who was pushed over a bench and hit her head on the sidewalk.
Eby said the horrific attacks are not only awful for victims but for everyone’s sense of safety and expects Vigo’s work will make “significant inroads” coupled with several other interventions.
The first secure psychiatric and addiction treatment centre inside correctional facilities under provincial jurisdiction will be 10 beds in Surrey, while the first secure housing and care facility for the most behaviourally challenged people will be in Maple Ridge.
Eby said the first few sites will serve as templates “for what we hope to do across the province.
“Our goal is we will open facilities like this across British Columbia on a regional basis to ensure that people are able to stay in the communities where their family and friends are, while getting the support that they need in a highly secure environment.”
The Health Ministry will vet locations identified by local governments with a preference for sites that require minimum renovation.
The province also plans 400 psychiatric beds, including the upgrading of about 280 outdated beds, at new and expanded hospitals providing a mix of voluntary and involuntary care.
Part of Vigo’s work includes clarifying the Mental Health Act in regard to admitting a patient with a severe mental health disorder as a result of drug and alcohol abuse. Until now there has been confusion among physicians, hospitals and health authorities.
Eby said allowing people to possess personal amounts of illicit drugs without fear of arrest in B.C.’s three-year decriminalization experiment, now in its final year, was intended to treat addiction as a health rather than criminal issue and reduce the number of toxic drug deaths among people using alone.
The effort largely failed, Eby said, after people under the influence “unfortunately and, in hindsight, perhaps predictably,” began using in public, including on the streets, in parks, in cafés and on buses.
The province significantly scaled back the experiment last spring to re-criminalize all public drug use, leaving decriminalization to apply only to a person’s shelter, sanctioned drug-testing sites and supervised consumption sites.
Eby said the commitment he made during the fall election campaign was that various evidence-based approaches need to be tried to reduce the number of toxic-drug overdose deaths in the province. About six such deaths have been occurring in the province every day.
“It’s a hard problem. We have to try different things. Some will be successful. Some won’t, and when it doesn’t work, we have to change it and find the path forward,” said Eby.
“I’m not committed to this decriminalization in the way that if it’s not working, we’re going to finish it … it’s not like that,” said Eby. He is a former junior drug prosecutor, who has experienced the futility of charging homeless addicts with small drug-possession offences.
“I take some comfort from the fact that overdoses are going down, but still one’s too many and so we’ve got a lot of work to do, and we’ve got a lot of people surviving [overdoses] with brain injury that brings other challenges that we have to deal with,” Eby said.
That embrace of evidence-based harm-reduction approaches will not immediately extend to include more overdose prevention sites in hospitals, however.
An independent group, Doctors for Safer Drug Policy, staged pop-up overdose-prevention sites outside Royal Jubilee Hospital in Victoria and Nanaimo Regional General Hospital in November and December to raise awareness about the lack of such services on hospital sites. Doctors for Safer Drug Policy says such sites would help to save the lives of patients by providing them with a monitored place to consume their drugs, instead of going off-site and facing the risk of overdosing and having no one to help them.
Island Health documents show plans for pilot overdose prevention sites at Nanaimo Regional General Hospital, Royal Jubilee Hospital and North Island Hospital in Campbell River were paused in April “on government direction.”
The sites were scuttled after nurses complained of unsafe conditions as patients with addictions smoked and injected street drugs in hospital rooms and hallways.
“Just to illustrate the challenge around these drugs, the fact that addiction doctors working at hospitals are saying that they’re having trouble meeting the needs of the patients who come in … it really illustrates the support that they need,” Eby said.
“We need to be able to support patients to not go out, to not be using in the bathrooms of the rooms and the stairwells and those kinds of things.
“Each community is going to be different. What’s required is going to be different.
“We don’t have any plans for overdose prevention sites at those two hospitals [Victoria and Nanaimo] at this point but our commitment is to do our best to support those addictions doctors and the patients and the people who are using the hospital to make sure it is safe for them.”
Doctors, nurses, hospital staff, patients and visitors should all be safe in hospitals, said Eby, adding work by the Health Ministry and health authorities on the issue is underway.
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