SPECIAL TO THE STAR
So now the hard part begins.
For the remainder of the summer and through the fall, champions of a strong, independent voice for vulnerable psychiatric patients will be working long hours to come up with a way to protect the integrity of the province’s Psychiatric Patient Advocate Office.
They will be among participants in an eleventh-hour consultation process announced at the end of July by Ontario Health and Long-Term Care Minister Deb Matthews. The announcement averted a crisis in confidence that threatened to undermine decades of work. What transpires as a result of these consultations could affect the state of advocacy throughout this province and beyond.
Who speaks for children, for seniors, for anyone potentially at risk under systems that by their very existence make it difficult to expose abuse by service providers in positions of power?
“We need to have a conversation about the state of advocacy,” said Lucy Costa, outreach worker at the Empowerment Council, which represents those who have been clients within the mental health system.
She was speaking by telephone on the heels of the shocking revelation that the health ministry, which funded and oversaw at arm’s length the Psychiatric Patient Advocate Office, was divesting that role to the organization seen as the biggest service provider.
The handover to the Canadian Mental Health Association was orchestrated by assistant deputy-minister Patricia Li as a fait accompli. No consultation. No public announcement. And certainly no acknowledgement of the blatant conflict of interest protested by a broad spectrum of human rights advocates.
Condemnation came from legal groups, scholars, seniors’ groups, groups of workers who themselves provide services to psychiatric patients and from the Coalition for an Independent PPAO (cippao.com), which collected a growing list of allies and desperately lobbied for consultations.
It argued that the minimum parameters for an independent Psychiatric Patient Advocate Office should include: accountability to the people it serves, accountability to the public, complete independence from service providers and stable long-term funding.
Among the most impassioned statements of concern about the transfer came from the office of the Provincial Advocate for Children and Youth, which itself reports directly to the provincial legislature.
In the last 15 years in Ontario, there were 27 inquests into the deaths of young people in care, many of whom “had diagnosed or undiagnosed mental health issues,” the statement said. In particular, it noted, after the 2005 death of Jeffrey James, “a Coroner’s Jury recommended the expansion of the safeguards provided by the Psychiatric Patient Advocate Office.
“To our knowledge, the decision to divest … was taken without public dialogue and meaningful stakeholder consultation with those who are most directly
affected by this decision,” it said, noting that local branches of the Canadian Mental Health Association provide services “such as Community Treatment
Orders, that may be the subject of rights advice and/or rights advocacy delivered by the Psychiatric Patient Advocate Office.”
Matthews is to be commended for her admission in a letter to Costa that: “I now realize that implementing this change requires greater conversation and
That letter arrived in the same week as new guidelines from the Ontario Association of Chiefs of Police, stipulating that routine police information checks
will no longer automatically include references to mental health incidents that did not lead to criminal charges.
The optimism generated by all this is cautious, to say the least. In terms of the Psychiatric Patient Advocate Office, Matthews promises that consultations
through the fall will include patients and their advocates. She also promises to listen.
Let’s hope so.
Helen Henderson is a freelance writer and disability-studies student at Ryerson University. Her column appears Saturdays.