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Second Opinion

Put patients in care, not in jail

From Thursday's Globe and Mail

Jonah Fluxgold has been arrested and jailed half a dozen times, in four different provinces.

He was busted in Vancouver for jumping up and down on cars on the busy Burrard Street bridge during rush hour. His crime in Saskatoon was trying to sneak into the Juno Awards ceremony. In Banff, it was indecent exposure and some minor drug offence. In Toronto, he kissed a stranger on an elevator, a sexual assault.

Mr. Fluxgold, 31, is not a dangerous criminal. He is ill. He suffers from schizoaffective disorder bipolar type - a combination of schizophrenia and bipolar disorder.

Raised in Vancouver in a comfortable middle-class home, he was a student in the gifted program. He graduated from the University of British Columbia and began a master's degree in film studies at Concordia University.

But then he got sick. He drifted. He became a criminal instead of a patient.

The only medical condition that routinely engages police, the courts and the prison system is mental illness.

Why do our encounters with those suffering from mental illness lead to incarceration instead of provoking compassion?

Jailing those who suffer from mental illness has absolutely no dissuasive effect, and no therapeutic benefit.

Jonah Fluxgold's father, Howard Fluxgold, a plain-spoken former journalist, says: "I told police, you can arrest this guy until the cows come home. He won't learn his lesson. He's sick."

The written word cannot begin to convey the frustration in his voice; it is a profound exasperation that many family members of those suffering from mental illness know all too well.

"In whose interest is it to treat Jonah like this, to jail him? Not his, not his family's and not society's," Howard Fluxgold says.

What his son needs is treatment.

He needs long-term care: a place to live, stability, a basic income, medication and monitoring. And he needs to be forced into treatment against his will - and so do all people with severe mental illnesses that cause them to be a danger to themselves and others.

Saying so in a society where individual rights rule supreme is heresy. Civil libertarians will scream blue murder at the very suggestion.

But Mr. Fluxgold, like so many parents who have seen the zealous interpretation of civil rights destroy their children's lives, will have none of it.

"The paramount right of a patient should be the right to treatment," he says. "The health system has done a grave disservice to my son and to others. They have let the lawyers take over."

Worse yet, the privacy laws that are in place block families who want to help at every turn, he says. He only hears about his son's legal problems when he calls for bail money (the family refuses to post bail) or when a warrant is issued for Jonah when he fails to appear in court (which he does routinely).

"They call me looking for information when the shit hits the fan. But when I ask basic questions about my son, it's: 'Privacy, blah, blah, blah.' "

That we spend so much money jailing and hunting down people with mental illness who commit minor offences instead of spending those precious dollars on prevention and treatment is a perversity.

"There is no mental-health system. There is a legal system for very sick people - a system that helps them stay sick," Howard Fluxgold says.

How sick is that?

We don't need to strap people down and drug them against their will.

But we do need to acknowledge that refusing treatment is rarely a rational choice. One of the most bedevilling symptoms of severe mental illnesses such as schizophrenia is the failure to recognize one is sick - a condition called anosognosia.

Jonah Fluxgold has systematically refused treatment. But how does that make any sense? How can someone be deemed not criminally responsible for his acts (because of mental illness) on one hand, and on the other be allowed to say "no" to treatment?

It is positively perverse.

It needs to be said, too, that the rights granted to people suffering from severe mental illness are largely illusory.

How are they benefiting from their wonderful civil rights in jail, a place where those suffering from mental illness are targets for sexual and physical abuse?

What good are those much-vaunted civil rights when you're living on the streets, smoking crack cocaine and selling your body for the next fix?

How much freedom can you truly enjoy when you are being consumed by a terrifying brain disease that compels you to slash your wrists?

Instead of sentencing people with mental illness to jail time for petty crimes, why not "sentence" them to treatment?

That is the approach being taken with initiatives such as mental health courts. But for these "sentences" - involuntary committal orders essentially - to work, there must be the services in the community.

There must be programs such as active community therapy with health professionals aggressively monitoring treatment - actually standing there while people take their pills, as is done with tuberculosis treatment. There must be blood and urine testing as a condition of release. And for those who have trouble complying with their meds, there must be recourse to long-lasting injections and implantable medications.

Jonah Fluxgold needs these things if he's going to get his life back on track and live up to his potential.

He's 31 and has no money. He bounces from one jail to the next. He routinely gets beaten up. He self-medicates with street drugs. He has no meaningful relationships. He has tried killing himself, slashing his throat with a knife.

"It's not what we dream of for our kids," Howard Fluxgold says.

Every time the phone rings, he fears it will be the police telling him his son has been tasered or shot or, worse yet, that he has harmed someone.

Like many parents in his situation, Mr. Fluxgold is often tempted to give up. With brutal honesty, he says his son is manipulative, nasty and abusive. The only time he calls is for bail money. "He's not a nice person, but he's still my son."

So Mr. Fluxgold battles on. He rages. He fights. He jabs the system in the ribs at every opportunity.

"I'm not letting the system abandon him, goddammit. You can't just throw people like Jonah under the bus."

Recommend this article? 41 votes

Return to Breakdown: Canada’s Mental Health Crisis

Face it. Fund it. Fix it.

In Breakdown, The Globe and Mail documents the enormous, unaddressed cost of mental illness to Canadian individuals, families and society. The series closes with a search for solutions.


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