Health Minister Terry Lake is offering to raise the salaries of forensic psychiatrists. Whatever the amount of the raise, let鈥檚 not begrudge a penny of it. It鈥檚 probably not enough.
A severe shortage of the specialists, as well as a shortage of beds at the Forensic Psychiatric Hospital in Port Coquitlam, means mentally ill people are being confined in jail cells when they should be undergoing treatment in a hospital.
The saying goes that you can鈥檛 solve problems by simply throwing money at them. While money won鈥檛 resolve all the difficulties in this issue, it will certainly help. In the past, forensic psychiatrists were paid more than general psychiatrists, but their salaries have fallen behind, reducing the incentive to continue in a career that is already challenging.
Forensic psychiatrists assess and treat mentally ill people who have dealings with the criminal justice system. They are required to work with some of the most difficult and disturbed patients in the field of psychiatry. In many cases, patients are not willing to come under a psychiatrist鈥檚 care or don鈥檛 recognize that they need help. These patients can be unco-operative at best, and combative and dangerous at worst.
For the psychiatrist, job satisfaction must often be elusive 鈥� progress and success are measured in small steps.
It鈥檚 not easy to be compassionate toward someone who has committed a serious crime, is violent or otherwise poses a danger to society. Forensic patients are often doubly stigmatized, because they are offenders and mentally ill. Many of them have themselves been victims.
They need help. We need to help them, for pragmatic as well as compassionate reasons. Everyone benefits when a mentally ill offender can be led toward a more productive life, or at least away from destructive behaviour.
It is not enough to simply confine offenders whose actions are caused or exacerbated by severe mental illness. We are more enlightened than a century or so ago, when mentally ill people were chained in 鈥渕adhouses.鈥�
Yet it still happens when mentally ill people encounter the justice system, not because police and judges are at fault, but because they have few choices.
sa国际传媒 reporter Louise Dickson wrote of a distraught young man who had a confrontation with police in which it became evident he was severely mentally ill. He was certified under the Mental Health Act and confined to a cell. When he appeared in provincial court two weeks later, the judge ordered that he be assessed at the psychiatric hospital within 30 days.
Trouble is, the hospital is not always able to fulfil such orders according to the court鈥檚 schedule, and people who need medical help languish in jail.
The man鈥檚 defence lawyer went before the sa国际传媒 Supreme Court seeking an order to have him transferred immediately to the hospital after he had been kept in a bare cell with a rubber mat for a bed, with a video camera watching his every move. He was shackled and chained around the waist. He was cold and isolated, with nothing to occupy his time.
Dickson quoted a forensic psychiatrist on the ill effects of that experience, but it doesn鈥檛 take a psychiatrist to figure out that such treatment will do nothing to alleviate symptoms of mental illness. That would cause even perfectly healthy people to become distraught, off-balance and out of touch with reality.
There鈥檚 no question that people who pose a danger to themselves and others need to be restrained, but a jail cell is a poor substitute for a hospital bed.
Recruiting and retaining forensic psychiatrists is a challenge, and paying them more won鈥檛 solve all the issues, but it鈥檚 a good place to start.
