Vancouver's mental health crisis

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1:16Welcome to the documentary from the BBC World Service. I'm Sam Gruet on assignment this week in Canada. It's a place I've called home for the last couple of years, most recently in Vancouver on the West Coast. It's a beautiful place with sandy beaches, snow-capped mountains and towering fir trees. But it's also been dealing with its own challenges, mainly around drug addiction and mental health. Hello, I'm glad you're in my thought of work. Hi, Chrissy. Hi. Hey, how are you? Thank you. Christy Watkins steps out of the elevator slowly. She walks with small, uneasy steps, resting on a walking stick.

2:03Her baggy T-shirt with graphic print, cap and gold jewellery wouldn't be out of place at a music festival. And she is a DJ after all. I have to be moving all the time to feel a little bit better. She guides us slowly through the ground floor of her apartment building, stopping to show us her fingers.

2:36Christy takes us into a small private garden where we sit. She tells us about another day around six weeks earlier. Yeah, it was a really, really great day. It was just a big celebration of our Filipino heritage and our culture and just one place to gather and to share that with the rest of the city as well. April 26th, Lapu Lapu Day. It's a Filipino national holiday and a big celebration here in Vancouver where the local community held a street festival. The event was attended by tens of thousands of people and culminated in a performance by American hip-hop group The Black Eyed Peas Here we go!

3:23Come on! Here we go! Being backstage, watching that sea of people with their hands in the air and enjoying that with my 11-year-old son and just sharing in that experience was so special and we were like, OK, time to wrap it up, we're going to go home now But because I had been so busy and he really wanted to check out some food trucks, that's where we ended the day. Christy and her son Knox joined a queue of people waiting to order food on a street corner. And then the next thing I know, I was holding my son's hand with my right hand. And then I just remember getting hit. We start with breaking news.

4:05Police in the Canadian city of Vancouver say a number of people have been killed and multiple others injured after a vehicle was driven into a crowd at a street festival. Vancouver police are now saying at least nine people have died, one of them a child. The car hit me from behind. I was conscious through everything. And mentally, how my mind was processing everything that was happening was I got hit by a car. The impact is so huge. As I rolled onto my back, I remember looking at the sky and I kept saying to myself, keep your eyes open and keep breathing, keep your eyes open and keep breathing.

4:42As Christy lay unable to move on the pavement, her thoughts turned to her 11-year-old son who'd been standing next to her. I remember hearing people around me and there was what I assumed was a girl that was literally arm's length away from me to my right side and I reached out and I touched her. And I just remember above me people were saying, Don't stop doing CPR. She has no pulse. Don't stop doing CPR. She has no pulse. And somebody was above me trying to help me. And my son has shoulder length hair. And he gets mistaken for a girl all the time. So I immediately started to panic. I think that was the scariest part of all of that.

5:29Was thinking that who they were helping was my son. And I just... And then weirdly enough with the timing. a friend of mine who I've been friends with since I was 16. She kind of like just appeared and she's like, I have knocks. I have your son. He's okay. Just worry about you. And it took a minute for my, for my mind to like process what she was telling me. Cause I was like, what? I was so confused. And then I guess I just understood what she was telling me. And so I, I just kind of took a deep breath and I was like, okay. And then the next thing I know, I hear the ambulances and I'm thinking, OK, finally.

6:08Nox suffered a broken nose, but was otherwise physically unharmed. Christy was taken to hospital with multiple fractures and a punctured lung. My sister was in the room with me, and the first question I asked her was, did anybody die? That's how aware I was of how this crash could have killed anybody. 11 people in total lost their lives, making it the deadliest attack in Vancouver's history. The youngest victim was just five years old.

6:43I'm Sam Gruet and on this week's assignment, I'm asking whether Vancouver and its neighbouring cities in British Columbia, also known as BC in Canada, are facing a mental health crisis. With BC battling widespread opioid addiction and several apparently random attacks linked to people living with severe mental health issues, what can the province do to better protect and care for its people? What has happened to us here in Vancouver, we've seen it happen in other cities. It has never happened to us here and it has absolutely shaken our entire community to the core. In the days after the Lapu-Lapu festival tragedy, Vancouver's police department held a press conference.

7:33The accused in this case, the person in custody, has now been charged with eight counts of second degree murder. That person's name is Kai G. Adam Lowe. The suspect is 30 years old and we learn other details about him too. The accused in this case, as we've said before, is a person who has had previous interactions with police and medical professionals related to mental health. A hearing is being held to conclude whether the suspect is fit to stand trial for murder due to his mental health. Well, surprisingly, this isn't the first time that my family has been affected by something like this. Leaning on her walking stick, Christy's demeanor stiffens as she describes another day in September 2023.

8:27During Light Up Chinatown, my son was dancing for the festival and there was a section where the kids were all playing. About 10 or 15 minutes right after we left, there were some stabbings that had occurred for the exact same reason. The suspect in this case is accused of stabbing three people at a Chinatown festival in Vancouver. He was on a day pass from a psychiatric hospital, unescorted by authorities. He'd been a resident there since 2006, after being found not criminally responsible by way of a mental disorder, of stabbing his 16-year-old daughter to death. mental health person had a pass that was known to police and was randomly stabbing people.

9:16Thankfully, we weren't around. Now, this is the second time that someone who has been suffering from mental health has been given leave, that has been known by police, and now successfully has you know, killed 11 people with many more injured. We got in touch with the Vancouver Police Department, who told us they work closely with health services and community partners. Police officers are not mental health professionals, they said, and they should not be the default responders for what is fundamentally a health issue. We believe that secure care is important to ensure public safety, and the safety of those who are a danger to themselves.

10:03The statement finished. Here's Christy again. That's what makes me quite upset about this incident being completely preventable if the proper people were there to take care of him.

10:22It's a short drive from where Christy lives in Vancouver to the busy neighbourhood streets where the Lapu Lapu Day Festival took place. This corner of East 43rd and Fraser Street is where, during the day, crowds of people would have been packed together, dancing to music, eating Filipino food and just generally having a good time. Along here there was music stages, a basketball tournament and a breakdancing tournament. And a bit further along here, at this part of the street, just on the corner, is where food trucks were parked up, with people queuing just along here, which is where the car was driven into the crowd.

11:04A few steps in front of me, there's a wire fence running along the edge of a local school. You can see the children's play park in the distance. and attached to it there are hundreds of written tributes, cards, flowers, teddy bears, candles. One says together in pain, together we will heal. Another, we have to change the system together. And there's a brown teddy bear holding a love heart with the words Politicians, please stop the mental health crisis. A message the city is saying loud and clear.

11:47The tragedy has reignited a conversation that was already bubbling under the surface about mental health and the way it's dealt with, or not dealt with, and not just in Vancouver, but across BC. A 2019 report by the BC Schizophrenia Society found an increase of almost a third in psychiatric admissions in the province over 11 years, but with no increase in available beds. Hi. Hi, nice to meet you. How's it going? Good. Me and my producer Megan have come to the nearby city of Richmond, a few minutes south of Vancouver. We're meeting Cash Heed. He's a former chief police officer of more than two decades in Vancouver and is now a city councillor here in Richmond.

12:36We sit down by a water fountain outside of his office. There have been several incidents recently in Vancouver where in fact people that are in mental health crisis have been violently acting out in public spaces. We've had individuals that have been killed, innocent individuals that have been killed, people that have had their hands chopped off, individuals that are forcing police to shoot at them. We've got this ongoing, prolonged problem of people having significant mental health issues that need to be treated, that are out there in public spaces. Last year, Cash brought a motion to his city council, urging the BC government to create more secure care for those living with acute drug addiction and severe mental illness, which he tells us are intrinsically linked.

13:29So those people that have significant mental health issues such as schizophrenia are taken out of the public spaces, put in a facility and cared for and treated in a humane way. People that have severe drug addiction, acute drug addiction, are taken to a secure facility and given treatment to get them out of the circumstances they're in. The conversation around secure care, facilities designed for individuals with severe mental health conditions, often involving involuntary treatment, is a divisive one. And Cash's solution is one that's frequently criticised for its potential to cause trauma, erode trust in the healthcare system and for its failure to address the underlying issues contributing to a person's crisis.

14:21To play devil's advocate here, you are a politician. Is there more that you could have done yourself? Absolutely. Always. In hindsight, there's a lot more I could do. However, you always hit that brick wall when you want to make those big changes that are needed.

14:47so it's a few days after we met with cash and he's invited us today to a city council meeting where he says he wants to raise issues around mental health and policing so here we are

15:04The meeting starts with a tap of the mic. 20 minutes later, Cash addresses the city's police chief superintendent, Dave Chowan.

15:19Cash tells the room about one person who generated 34 mental health calls in just the previous month. There's shock in the room as the police chief superintendent replies. Some of these individuals are let go. That can be within hours, something or longer. It does get frustrating for the police. It can impact them mentally, emotionally, and it impacts us corporationally as well.

15:51After the meeting, we catch up with Cash in a small room off the council chamber. I think that's what came out of it, is the officers that are on the ground are frustrated, where they apprehend the person if the evidence is there under the Mental Health Act, Section 28, where they're a danger to themselves or a danger to others, and they apprehend them, they go to the hospital, they get put in the psych ward, and they're turned around and released. What we seem to have right now is just a door that's spinning. This is the documentary from the BBC World Service.

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18:54Download the Wise app today. T's and C's apply. I'm Sam Gruet with Assignment from Canada.

19:06The spinning door is an analogy that's stayed with me as we've made this programme. When I've been speaking to people about mental health care in BC, one place has come up time and again. It's a mental health facility known as Riverview, about 15 kilometres east of Vancouver, in a place called Coquitlam. It was once BC's only mental health institution, housing thousands of people. But in the 1980s, the province planned to close it and integrate people back into communities. So we're heading there to meet someone who might actually have an idea of what it's like to be in that spinning door. We've arrived at the grounds, pulled up outside a row of quite grand looking red brick buildings with big cream coloured columns.

20:01This could almost be the grounds of an old university. The place has been used as a set for Hollywood movies. Recently, it was an orphanage for wayward mutant children in the Deadpool franchise. Richard. Yes. Hi. Hello, hello. But today, it's deserted. It's OK. Until a man called Richard Stewart appears, riding an electric bike. How can I help you and what's the BBC doing? We wanted to come and speak to you. Yeah, this is good. And you wanted us to meet you here. He's actually the mayor of this city. But his connection to these grounds doesn't end there. This means a lot to our community. This former mental hospital, an asylum as it was built 110 years ago, became the largest mental health facility in the province.

20:47And I've lived a kilometre from here my whole life. And this is a pretty special place. It's not used like it was before. The dilapidated red brick buildings in front of us are no longer used for mental health care. But a new hospital opened on the grounds in 2021. a residential clinic for those living with the most severe substance and mental health issues. It's home to 105 people, a far cry from the site's former function. With the advent of these new ways of treating people, one flew over the cuckoo's nest kind of insane asylum fell out of favour. When I was at Simon Fraser University in my teen years, I studied abnormal psychology and we talked a lot about deinstitutionalisation And that was the wave in the 1980s, where we started to move these people into facilities that might be more appropriate for them, started to treat them differently, and not hide them away from society.

21:48And that worked for many, but it didn't work for lots of others. And they ended up self-medicating, typically in Vancouver, right in the downtown. And the skid row and the alcoholism and eventually much harder narcotic drugs took over as their way of medicating. Then, a decade ago, the issue came closer to home. Richard's daughter was hospitalized for the first time with bipolar disorder, an experience that repeated itself several more times in the following years. I remember pondering that if that had happened 50 years earlier, she likely would have been here. Her family would have visited her every now and then, but she would be a residential guest, a residential occupant of these buildings.

22:39Richard's daughter was admitted to a psychiatric ward elsewhere and given treatment. They were lucky to get it, he says. But despite this, it didn't prove to be an effective form of care. And the waiting list for more appropriate treatment was months long. That's one of the things that I constantly return to, is that we were able to treat the illness that she had. We were able to purchase treatment for it. Eventually she was stable enough to be able to return to college and she changed her major and she went into psychiatric nursing. She's now a psychiatric nurse on Vancouver Island and it's a lump in my throat every time I contemplate that so many don't end up there.

23:29Richard's experience is just one of many here in BC, a place where it's difficult to talk about mental health without speaking about drug addiction and homelessness too. A 2022 BC government report found that almost two-thirds of those who died from illicit drug toxicity were experiencing mental health issues. It's being fuelled by fentanyl, a synthetic opioid 50 times stronger than heroin. And drug overdose is now the leading cause of death in BC for people aged 10 to 59. Now, I'll go past our homeless shelter, and there's open drug use in front of it. There is a street disorder issue which creates a lot of animosity within the community.

24:17But it's also just terribly tragic to see people's daughters and sons shooting up in front of a homeless shelter with no hope of being able to move to a better place to be able to get their lives back. Homelessness here is visible in person and in statistics. Around 2 ,500 people were sleeping rough in Vancouver in 2023, according to one survey. Across BC, that figure was around 11 ,000 in 2021, although it's difficult to get an up-to-date, accurate number. As Richard pulls a tissue out of his pocket and wipes his eyes, I ask him about whether there's a solution to all of this. It's a sad reality that we lose sons and daughters and fathers and mothers because we're not contemplating how best to treat them, whether it's in a facility, but enough of them to meet the demand so that when a young person reaches that point where they realize this street life is not working for me and I'm stable enough right now, I need to find help.

25:30When they put their hand up and say, could someone please help me? There's a six month waiting list. And so we lose them. We see this playing out on the streets in different ways. And there are various incidents and various tragedies that have happened that have been connected to people regarding mental health. Mental illness kills. It kills the host, but it can also kill others, innocent parties. And it's tragic that we aren't giving it the kind of attention that we could because we know that we hear elements of the treatment options that an individual might have had before he climbed into a car and that this, you know, I'm not going to second guess that incident and say it was avoidable, but a lot of the tragedy associated with mental illness is entirely avoidable.

26:28we recognize as a last resort as an absolute last resort sometimes it's necessary for someone to be admitted to hospital and sometimes that's involuntarily johnny morris leads the canadian mental health association bc division a charity that provides direct service to tens of thousands of people across the province each year but we need to be really making sure that we're doing all that we can before it gets to that crisis point with services to make sure that we're not using involuntary care as the first option or the first resort, that we're really, really making sure that it is that last resort in someone's journey of care.

27:08Involuntary care is treatment given to a person without their consent because of concerns about their safety or the safety of others. Cash mentioned it earlier and it's a divisive topic. So why are people calling for it now? We need to make sure that everyone feels safe. Are we doing everything in our power? Are the community mental health teams, are they adequately resourced to provide the kind of wraparound care, the follow-up, the assertive care, making sure that people are doing okay, that we're dealing with housing and making sure that people are able to make ends meet in community? Are we doing all of those things?