Emergency mental health in Vancouver - US citizen, bipolar and homeless
September 6, 2014 6:20 AM   Subscribe

A bipolar-diagnosed friend has recently gone off his meds and into a manic episode for the ages. Along the way he has lost his high-paying job, his apartment, his savings, most of his friends. He has been living on the streets of San Francisco for the last few months and, though it hasn't been kind to him, he has steadfastly refused pleas to get into treatment. He is apparently making his way to Vancouver, I'm trying to figure out what to expect / how to help. Specific questions below the fold.

My questions:
* What happens to a penniless U.S. citizen with severe mental health issues in Canada? Do they bus him back home when he is inevitably picked up by the police for petty larceny or drugs or public intoxication or whatever?
* Is there any chance the kinder / gentler Canadian healthcare system will have pity on him and try to help? This is an individual who has come back from bad shape before. (Friends have funds to support treatment, but the individual is not trusted to hold onto money -- so we can pay, but we would need to pay the provider and not the patient).
* Are there mechanisms for getting him committed against his will? (In California, the 5150 commitment process is effectively weak, at least in this case a seriously troubled individual has been very able to avoid it despite suicide threats and death threats and an inability to care for himself)
* What are the agencies / organizations to call to get him into any systems that might be available?

Many thanks.
posted by anonymous to Health & Fitness (7 answers total) 2 users marked this as a favorite
I wish I knew the answers. In lieu of that, I think in your situation I'd call the NAMI Helpline to see if they could tell me anything about certainly your third bullet point, and maybe some pointers to NAMI's Canadian equivalent.
posted by Stacey at 8:03 AM on September 6, 2014 [1 favorite]

If your friend is able to make it across the border to Vancouver, there are a few places you can call for more information:

8-1-1 HealthLink information line which connects you to nurses and other health services that might be able to answer your questions. The number to call from outside Vancouver/BC is 604-215-8110.
US Consulate Emergency Line Information. They would have information on the legalities of your friends situation.

The Canadian equivalent of NAMI is Canadian Mental Health Association. I linked to their Vancouver branch office.
posted by carabiner at 8:30 AM on September 6, 2014 [1 favorite]

If he is as badly off as you say, I would be very surprised if he will be able to make it across the border. He will have to have his passport and look presentable to the border authorities, and be able to assure them that he is not a job seeker or someone who will become a burden to the Canadian state. People in the middle of giant manic episodes often have difficulty dealing with authority figures who appear to be impeding them.

American authorities have lately been turning away bipolar visitors at the border, as shown in this story and others, and it would not surprise me if Canadian authorities do the same. So, if you would expect to be contacted if he is turned away, you may need to be prepared to go down to the other side of the border to help him out.
posted by ubiquity at 10:08 AM on September 6, 2014 [2 favorites]

Call the Pine Free Clinic, see if they can help. http://www.vch.ca/locations_and_services/find_locations/?site_id=127 They are closing at the end of October. Services are transferring to Raven Song but don't know if they have a free Clinic. Worth a call: http://www.vch.ca/locations_and_services/find_locations/find_locations?site_id=132

MDABC is a great resource for mental health in Vancouver. Their support groups are free with a $30 membership, you can also enrol in group therapy as a member at affordable rates. They take PayPal. The doctors expect BC Health insurance, you can call and ask if they'll take alternative payment arrangements.

Vancouver is a terrible place to be if you need to be hospitalized as an indigent person. There is no affordable housing, conditions on the streets can be deplorable. Even if there was pity to be had in the Canadian health system it would not be here, you might get care but I can guarantee it would be unpleasant and short. MDABC has nice, safe, clean offices on Robson street so somehow if you could get under their care you would be golden.
posted by crazycanuck at 3:50 PM on September 6, 2014

The last 2 times I've traveled to Canada I've been asked if I had health insurance; I have no idea what happens to people who say no.
posted by brujita at 7:42 PM on September 6, 2014

Unless your friend does something egregious enough to warrant attention from the police nothing will happen to him and even then, depending on how out of hand he was, he might just be sternly told to go home.

He won't qualify for health insurance unless he meets a number of qualifications including needing to be a resident of the province. We'd have pity on him if life and limb were at stake, otherwise the mental health system (heck the whole system!) is so overwhelming underfunded and overburdened our citizenry can't get the help they need. eg: only about half of those who need it seek out mental health care and only the half of them get the care they need. It's appalling. Once he was ambulatory he'd be sent state side.

Committed against his will? As in civil commitment? It exists for our citizenry under s.28(4) of the Mental Health Act, but wouldn't for him in this scenario as a visiting foreigner.
posted by squeak at 7:01 AM on September 7, 2014

I work in the social services nonprofit field in a major American city, and although it's not the same as Canada, a lot of social service nonprofits provide free basic health care, meals, housing, and other basic needs to anyone who come to them, regardless of mental health issues, being homeless, an immigrant etc.

I imagine Canada has these services, too. If they don't, I imagine that walking into the local food pantry or clinic can garner up some references and referrals for more proper help.
posted by fancydancing at 8:24 AM on September 7, 2014

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