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That said, Dr. Cooper does believe the island offers leading-edge services in his field, including a rapid-response mental-health team.
Treatment ranges from hospitalization and electric shock therapy to an outreach program that offers specialized counselling.
But when Karen Baldwin, who lives in Ontario, realized that her mother was quickly descending into another episode on a long weekend last year, she found it wasn't easy to track down help from her home.
Eventually, the local police were dispatched to fetch her mother to the hospital. They arrived to find Mrs. Baldwin locked in her bedroom.
An officer patiently stood at the locked door for half an hour, coaxing her out. She was in a heightened religious state. When she demanded he provide the "magic password," he responded: "Jesus Christ."
It worked. She opened the door and allowed him to escort her to the Eric Martin Pavilion, a mental-health facility, where she would remain for two months.
"I've learned after 13 episodes, I've learned to say, 'Yes, I have a mental illness and this is who I am,' " Mrs. Baldwin said.
Karen Baldwin sees progress after a long, arduous journey. But she knows her mother cannot be relied on to tell people when an episode is coming - her manic energy proves seductive.
"That's the beast," she said.
And she's concerned that each one is harder on both her parents: "I worry how if it were to happen again, could she survive it? I worry about what happens if Dad has another stroke."
'THEY CALLED ME GRANDPA'
In the 1980s, Joe Scaletta was one of the few social workers in Victoria focused on seniors and mental health. His caseload - about 120 people - was overwhelming. When he saw a funding opportunity, he jumped at it with a proposal for an outreach program.
Today, Victoria's Elderly Outreach Service sees close to 1,000 clients with late-onset mental-health problems each year. Staff are so overloaded they are working on an exit plan the moment a new client walks in the front door.
Clients find their way to the program a number of ways.
"We get a call from police, there's a woman who calls police repeatedly because someone is in her house leaving her notes," Mr. Scaletta said. "We find out the notes were in her handwriting but she can't remember writing them."
A typical case, however, looks like this: A man in his mid-eighties, recently widowed, starts showing up at the wrong house, appears dishevelled or underfed. He would receive a psychiatric assessment, and the team would decide what he needs. Sometimes it means getting a warm meal delivered regularly, sometimes it means getting him hospitalized.
Next door is the Victoria Innovative Seniors Treatment Approach program, an arm of the same agency. It is one of the few programs where seniors with addictions can get counselling with peers.
"At Elderly Outreach, we're doing a jitterbug. At VISTA we are doing the slow dance," Mr. Scaletta explained. Clients here often don't want to be here. "A lot of the cases are picked up because people have done enough damage to themselves that they end up in the emergency ward."
Ron Thompson, 65, found himself in the VISTA program recently after a rapid slide into depression and alcoholism.
After a lengthy career as a television news cameraman - earlier this year he became the first cameraman to be named a life member of the Victoria Press Gallery - Mr. Thompson found himself sidelined from the physically demanding job following a bout with prostate cancer six years ago.
"I had no strength for the work, I just got more and more depressed," he said.
He was put on antidepressants but began to "self-medicate" with alcohol. Since he left work, he's ended up in hospital four times because of alcohol abuse.
He's now separated from his wife of 40 years, estranged from the son he is so proud of. He's had a stroke, lost his driver's licence and handed over control of his finances.
But he doesn't fit in the mainstream addiction programs. Last spring, he found himself in a detox centre surrounded by youth who were being treated for addictions to street drugs.
"They called me grandpa," he said. "There was no one there my age."