A crack addict’s trail of devastation

His mother, a doctor, was shocked by how difficult it was to find a solution for her son
By Lora Grindlay, The Province, June 7, 2009 

In Ellen’s words, the single biggest difference between her son’s life three years ago and his life now is this: “Housing, housing, housing. It’s everything. The appropriate housing for somebody is everything.”

Her son, Steven, had a psychotic breakdown at 29 after being hit with depression on and off for most of his 20s. He’s a diagnosed schizophrenic and a crack addict, the duo of conditions known as concurrent disorders. Steven doesn’t believe he’s ill, says drugs are a lifestyle choice and he doesn’t participate in the mental-health system.

“His perspective is very skewed, and he’s pretty certain he’s fine,” said his dad, Alan. “We don’t know whether he has pure schizophrenia or whether he’s on the edge of being schizophrenic [and] the drugs push him over the edge.”

Ellen, a respected Vancouver family doctor who doesn’t want her family identified, provides a snapshot of Steven’s life in the two years after schizophrenia landed in his lap. It’s not only a grim, heart-breaking picture, but it’s one that cost taxpayers a pricey sum.

Ellen and Alan did what any parent would do when Steven first got sick. They brought him home to live with them.

“That first year was absolute hell. We did everything within our power to help him and he just got worse and worse and worse until it was scary to live with him,” Ellen told The Province. “He would get so paranoid he wasn’t sure that we were who we were . . . that’s the kind of situation in which schizophrenics have murdered their parents.”

Unable to live with the clever, successful young man they once knew, his parents, both of whom are well-off and well-connected, rented him an apartment and hired a private support worker. In just months, Steven got evicted. He had descended into very severe substance abuse.

They then bought an apartment for him so he couldn’t be evicted. That didn’t work either.

“We had no idea how badly his behaviour had deteriorated. It was absolute hell. His fellow tenants — these were owners of apartments — were afraid to go in and out of their own homes,” said Ellen. “I never would have done that to people if we’d known how bad it was. We were desperate.”

Steven allowed armed drug dealers and prostitutes to stay in his apartment in exchange for drugs. Bloody needles were left lying around common areas and residents were woken up regularly by breaking glass and screaming.

By this time, Steven was costing the taxpayer thousands and thousands of dollars.

There were times when the police were called daily and an ambulance would follow. He was hospitalized over and over again. By this time, Ellen figures she and her husband had spent $30,000 of their own money on private support workers and other expenses.

“In the first two years of Steven’s illness, we all spent a fortune,” said Ellen.

A Vancouver Police Department study released last year found almost half of the calls for police service in the Downtown Eastside involved a mentally ill person and that an estimated $9 million is lost in officer hours dealing with the city’s mentally ill.

Ellen worked tirelessly to find someone, somewhere to help Steven. She got nowhere.

“There was no social housing that will take somebody who has nothing to do with the mental-health system because he doesn’t believe he is sick and who actively uses drugs,” she said, adding that no supported housing units for the mentally ill would take her addicted son either.

Since her housing search, the provincial government has stepped up purchases of downtown buildings and now owns or leases 25 of them, comprising 1,550 living units. They are spending $82 million renovating them and turning them over to non-profits to run as low-barrier, supported housing.

Vancouver Coastal Health’s concurrent disorders group is voluntary and Steven doesn’t think he’s ill. And Ellen would hit roadblocks with agencies — Steven was from the wrong neighbourhood, too old, too young or he didn’t fit that group’s criteria.

“I was shocked that I didn’t have what it took to get him the help. With love and money and connections and knowledge, I should have been able to help him,” said Ellen, who has been a family doctor for more than 30 years. “Negotiating this system . . . I’m good at it. I’m skilled and negotiating it for our son was unbelievably difficult.”

A year ago, Ellen was able to secure a room at the Regal Place Hotel on West Hastings Street, run by the PHS Community Services Society. They are one of a few non-profit groups who provide housing for those deemed hard to house because of drug use, mental illness and disruptive behaviour.

Rooms in the Regal, unlike many other SRO rooms, have their own bathrooms. The building is owned by Metro Vancouver and run by PHS with financial assistance from the provincial government.

“Since he’s been living in the Regal . . . he’s been stable. He’s not been in hospital. Police don’t get called. He’s healthier than he’s been,” Ellen said. He’s still doing street drugs and not getting any psychiatric care but he’s treated by Regal staff “as a human being, as somebody who has some worth.”

“The difference is night and day — thousands and thousands and thousands of dollars’ difference,” she said. “I know our son cost all levels of government and private citizens a huge amount of money the first two years of his illness, and the third year, because of the Portland Hotel Society, he has cost very little and he has caused so much less harm and grief to his parents, his neighbours and society in general,” said Ellen.

His hotel is secure, has a strict policy limiting visitors and is always staffed by support workers.

They find it funny that they were once told by professional, knowledgeable people that a Downtown Eastside hotel room would be an absolute last resort, because they are thrilled with it and the Portland.

Steven, who receives a disability pension, has a circle of friends, some good and some bad. He hates the hotel’s rules, but his dad doesn’t think he could live in any other neighbourhood and is sure he would be homeless if it wasn’t for the Regal.

Steven had been committed under the Mental Health Act numerous times but was only in hospital long enough to be calmed by medication. His parents are critical of a mental-health system that allows their sick son to refuse the treatment he desperately needs.

Filling in the gaps her son fell through isn’t complicated, they say. There are agencies that are good at housing difficult people, they just don’t get enough funding to help all those who need it, she said.

“[The mentally ill] cost a lot of money and there’s no way around it. They’ve always cost a lot of money, but they will cost much, much less if they are housed properly.”