NIABY.COM

(*Not In Anyone's Back Yard) "When he was on the radio, Rafe Mair used to say, "Always take what the government says with a grain of salt because much of the time they are either lying or twisting the truth to serve their own ends."
-- Vancouver Sun March 26th 2007.

Attention: Mr. Darrell Burnham (Risk Manager, Coast Mental Health)

Regarding: Coast Mental Health needs to embrace and embed neighbourhood accountability and transparency protocols in Operational Management Plan for 16th and Dunbar

The current draft operational management plan (OMP) for 16th and Dunbar consists of numerous actions and recommendations to keep tenants safe from each other and their guests. Listening to housing bureaucrats, the community is led to believe that this facility comes with no added risk to families. If that is the case, then why is it that security measures such as restricted access, building surveillance cameras, special key fobs, etc. are even necessary?

While we are told that the proposed operational staff will be trained and experienced, the trust of a community only goes so far when evaluating a new large facility that is both risky and houses a very complex patient population. How can the community reasonably assess that the operator is not ignoring operational protocols or gradually moving the goalposts if the objectives and operational criteria are not clearly defined at the outset? We need to see clear and specific requirements in the OMP risk management protocols to ensure accountability of the operator and to decrease/mitigate risks to the surrounding community. As cited below, the risks and problems with such patients are well documented and we believe that the plan to deal with those risks must also be well documented.

There is a lack of evidence to show psychiatric improvements for those in supportive housing. (Read what the local CARHMA experts say »)
Addiction treatments within supportive housing are not effective at eliminating substance abuse. Addiction is chronic and relapsing. City Hall’s own commissioned reports show 70% of mentally ill drug addicts in supportive housing use drugs within 6 months. (Learn more »)
There has been no significant improvement with newer antipsychotic medications over the past 30 years despite what Colin Hansen and other spokespersons believe. The conventional wisdom that there are newer, better antipsychotic medications for treating schizophrenia has been proven wrong by recent, robust clinical trials. (Learn more »)
There is a large body of peer reviewed, published evidence that addicted and/or certain portions of the severely mentally ill commit violent crime in much greater proportion than the general population. This population is likely to be in supportive housing, in particular those who have a history of substance abuse. (Learn more »)

Without effectiveness evidence of supportive housing the following steps are required to ensure community safety and effectiveness of the facility.

An accountable, transparent and effective Operational Management Plan for 16th and Dunbar requires:

  1. A strict, well defined, transparent (website posted), admission criteria. Without strict admission criteria you cannot assess or control the risks presented to the neighbourhood by the patient population.
    Exclude individuals with a current or past history of substance abuse.
    Exclude individuals with a current or past history of aggression.
    Exclude individuals with repeated, negative interactions with the police. Negative Interactions defined as: any statutory complaints or "assist to general public" incidents regarding tenants at 16th and Dunbar. Statutory complaint defined as a complaint of a violation of municipal, provincial or federal statutes.
  2. Frequent, random drug testing.
    Addiction is chronic and relapsing.
  3. Monitoring of complaints about tenants or operation of the building.
    A transparent (published on website) monthly report on complaints and what specific steps are being implemented to effectively curtail the possibility of repeated, similar actions by patient or patients.
    The OMP should also mandate monitoring of complaints involving the tenants where the incidents are classified as "assistance to general public", "suspicious occurrences", or "suspicious persons", as these classifications are commonly used by police officers to write off incidents that might have and/or should have been classified as offenses.
  4. An enforceable, community approved, eviction policy.
    How many times does a patient have "negative interactions" with the community before eviction?
    How many times does a patient get a verbal warning or "written up for a breach" before eviction?
    Certain offences should be identified as zero- tolerance (ie. requiring immediate eviction), such as criminal activity, violence to a staff member, possession of drugs on site, etc.
  5. Protocols for monitoring, measuring clinically significant, objective outcomes and costs to ensure effective use of taxpayers' money. Publication of results by an annual audit.
    This annual audit should be done by an independent contractor who is experienced in measuring and reporting of outcomes with evidence-based medicine. The audit should be independent of bias, and therefore, not involve City Hall bureaucrats, social planners or consultants who have financial interest or bias toward positive results. Results should be posted on Coast Mental Health's website.

Summary Conclusion:

The Coast Mental Health OMP for 16th and Dunbar should enthusiastically embrace accountability to the families and businesses in the neighbourhood.

Without evidence of effectiveness for "psychosocial rehabilitation" - the large supportive housing model proposed for 16th and Dunbar - it is essential that the OMP written by Coast Mental Health include specific prevention protocols to keep the neighbourhood safe.

That means an OMP should include a strict, transparent admissions criteria, a random drug testing program, a community-approved, enforceable eviction policy, and an evaluation program monitoring objective, measureable, and clinically meaningful outcomes to ensure taxpayers' money is spent in an effective manner.

By publishing on your website, the data collected at regular intervals, the operator will empower the community to objectively assess the benefits and impact this facility is having and to hold the operator accountable when necessary. Such transparency will also prevent the gradual meandering of the goalposts over time and will ensure that the protocols and objectives proposed during the original approval process endure throughout the life of the facility.

Sincerely, NIABY.com

Published October 29, 2008.

Articles - November 20, 2008
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Need Answers?

City of Vancouver,
Mayor and Council

#310 - East Tower, 555 West 12th Avenue, Vancouver, BC V5Z 3X7
mayorandcouncil@vancouver.ca
604-873-7248

Colin Hansen, MLA
5640 Dunbar Street, Vancouver, BC V6N 1W7
colin.hansen.mla@leg.bc.ca
604-664-0748

Rich Coleman, MLA
Minister Responsible for Housing
rich.coleman.mla@leg.bc.ca

Coast Mental Health
Non-profit Housing Provider for 16th & Dunbar info@coastmentalhealth.com

Dr. David Marsh
Addiction Medicine Specialist, Vancouver Coastal Health
feedback@vch.ca

Cameron Gray
Director of Housing Centre, City of Vancouver
cameron_gray@city.vancouver.bc.ca