More mental health supports needed as homeless crisis deepens, advocates warn

People living on London's streets and struggling with complex mental health problems need more help and support, a mom whose son has been sleeping rough for about two years said.

"The biggest gap is ongoing wrap-around psychiatric care. People like my son have very complex needs so he needs long-term psychiatric care and that's no longer," said Sharon Bankes McArthur, whose 38-year-old son was diagnosed with schizophrenia at age 16.

There's a months-long wait list to see specialized team that helps people with severe, complex and ongoing mental illness in the region, Jodi Younger, a vice-president with St. Joseph's Health Care London, told CBC News.

The seven assertive community treatment (ACT) teams that operate in London as well as Middlesex, Elgin and Oxford counties have a patient load of 600 people, Younger said.

"The population growth as well as our homelessness and mental health needs have increased over time," she said. "We could definitely use one or two more ACT teams to support the needs of folks who live in the London area."

When Bankes McArthur's son was first diagnosed with schizophrenia, he was involved with a team from the prevention and early intervention program for psychoses (PEPP), which helps people with intensive treatment after they are first diagnosed.

He was referred to the ACT team about five years ago and has been in and out of hospitals ever since, his mother said. "He's never been able to successfully live independently and he is now on the streets and now he's also an addict. Of course, my husband and I are heartbroken."

Each ACT team, made up of psychiatrists, nurses, social workers and addiction workers, among others, is supposed to serve about 85 clients each, though demand for their services exceeds available resources, Younger said. Teams meet people in the community to help them get the medications and follow-up they need, without having to be in hospital.

People with serious, persistent mental health needs such as schizophrenia or bipolar disorder, and who have had prolonged hospital stays and cannot manage without highly-intensive supports, can get help from ACT teams.

"Anyone who is unsheltered or is sleeping rough obviously has additional barriers that they are dealing with, such as not having a phone, not knowing what day it is, not knowing what time it is, being unable to keep scheduled appointments or intakes they might have scheduled," said Carole-Anne Blanchard, who heads the London Homeless Coalition.

"Unfortunately, when there are wait lists for resources, those individuals might not always make those appointments that were assigned three weeks prior, and so it's a barrier, because then they get moved down to the bottom of the wait list."

The city estimates there are more than 2,000 people living without a home in London, about half of them chronically homeless. More than a third have the highest possible acuity level, meaning they need the most care.

Bankes McArthur said her son has started to self-medicate and can't make decisions for himself. What she really wants is something akin to a long-term care facility for people with psychiatric illness, Bankes McArthur said.

"I think about (my son) huddled up in a fetal position, sleeping in a doorway, and hopefully not freezing to death," she said. "Frontline workers are doing everything possible to assist people, but it's not enough. It's nowhere near enough."