Dr. Bill MacEwan is uniquely qualified to help people who are homeless and mentally ill, and for the past nine months, he has been regularly treating people in Maple Ridge.
MacEwan has worked for 20 years on Vancouver’s notorious Downtown Eastside, is a clinical professor at the UBC department of psychiatry, and was head of psychiatry at St. Paul’s Hospital in Vancouver.
Every Friday, he sits down with people at the three facilities run by Coast Mental Health – Garibaldi Ridge Supportive Housing, Royal Crescent modular housing, and at Alouette Heights – with people who were living on the streets.
Among the population, drug use and mental illness are rampant.
MacEwan recalled the first time he did this kind of work. He was at St. Paul’s in the late 1990s, and Vancouver had become the methamphetamine capital of the country. He did a tour, to see where his patients were ending up, and found himself at the Stanley Hotel in Blood Alley. He asked if there was anything he could do, and was almost dared to come and work on site.
Friends warned him it was too dangerous. There had been a recent stabbing there. He talked to a cop he knew to ask about the stabbing, and was met with a shruggish attitude. There were always stabbings at the Stanley.
Having second thoughts, he called the operator with the Portland Hotel Society, and asked whether it was safe.
“Well, I’m here,” she said, and that was reassurance enough.
“She’s still working down there,” he said. “She’s lovely.”
Working there was an eye opener.
“I never knew slums like that existed in Vancouver,” he said.
Out of 96 people he saw 56 who were psychotic, and 80 per cent of them were using meth.
If the shrieking for help was an eye opener, so was his reaction to working directly with street people. He developed a love for working with them. The Portland Hotel Society would take “the worst of the worst,” and he embraced that philosophy. He sees them as “characters.” He sees the best in them – the “upside.”
Darrell Burnham, the CEO of Coast Mental Health, has known MacEwan for decades, and recruited him to come to Maple Ridge.
“He’s one of the few psychiatrists who went into the some awful places, and worked with challenging individuals.”
Burnham said the doctor’s involvement has been encouraging to the staff, and made an obvious difference at the Maple Ridge facilities.
“We notice how much more settled it is,” said Burnham. “And the staff feel so supported.”
MacEwan said he has seen between half and two-thirds of the residents of the two facilities, over time, and about 10 more people who are at Alouette Heights. The staff refer people who are in crisis, and those who are suffering.
“The problems here are no different than the Downtown Eastside,” he said.
That means people with extreme behavioural difficulties, drug use, and psychosis.
With all of his experience dealing with street people, he sees the modular housing and shelters as a help. For a homeless person to get their life stabilized at Garibaldi Ridge is a huge step toward starting their life over.
Every resident would benefit from some level of mental health support – although not all need a psychiatrist, he said.
He is enjoying his work in Maple Ridge.
“The part I like about here, is I’m part of a team,” he said.
The staff know the clients better than he does, and they offer good information and advice.
MacEwan believes Maple Ridge is fortunate to have Coast Mental Health running its facilities. They connect with people, and form attachments. They set out the rules and boundaries, “And then say, ‘I’m here for you,’” he said.
“They are head and shoulders above everyone else in how they deal with mental health and addictions,” he said. “They’re organized. Palpably you feel there is an approach, and there’s a philosophy behind it, and it’s good.”
As good as they are, there is no quick fix for the problem of homelessness, in any city, he asserts.
MacEwan sees the social determinants of mental illness getting worse – issues like divorce and family dysfunction. Mental health – particularly schizophrenia – is made worse by using street drugs, but they are more accessible than ever. People seek out drugs to help them cope with their mental illness, but it makes them more sick, in a vicious cycle.
“We’re not going to get rid of this.”
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