CTO's in the News

A running media report on Harris' re-election platform on mental health.

Tuesday, January 23, 2001

New funding eases way to mandatory treatment
From Canadian Press
c. 2001, The Toronto Star

The province's Health Ministry announced funding Tuesday aimed at smoothing the way for a controversial new law allowing seriously ill psychiatric patients to be forced to accept medical treatment.

Health Minister Elizabeth Witmer said the $15.8 million in new funding is her ministry's response to the near-unanimous call for better mental-health care, a call she heard during consultations for the so-called Brian's Law.

''The key to ensuring effective treatment for patients with serious mental illness is the need to invest in community-based services,'' Witmer told a news conference at Toronto's Centres for Addiction and Mental Health.

Brian's Law, or Bill 160 [correction: Bill 68], came into effect Dec. 1 and is named after Ottawa sportscaster Brian Smith, who was killed by a mentally ill man in 1995.

The law makes it easier to commit people to psychiatric hospitals and it introduces community treatment orders - a kind of parole for psychiatric patients that forces them to comply with prescribed treatment.

The province says the law will help protect people with serious mental illness who pose a risk to themselves or others, while also protecting society and making the streets safer.

Opponents of the law, including mental-health groups, have said it violates the rights of individuals to refuse treatment. Critics have also said the law will be meaningless if services to help the mentally ill integrate into society are not improved.

Witmer's announcement was designed to quell that criticism by directing the bulk of the money - $13.3 million - toward better services for mental-health patients outside hospitals: community care, case management and sessional support for physicians and psychiatrists.

The money will provide ''a continuum from hospital to community,'' said Witmer.

Dr. Robert Zipursky of the Centres for Addiction and Mental Health said the funding will enable the law to improve the overall health of psychiatric patients, while giving them a better base for re-integrating into the community.

''If you're going to use (community treatment orders), for goodness' sake, make sure individuals have full access to the range of services they require to achieve health in the community,'' he said.

Community treatment orders have already been used more than once since the bill became law Dec. 1, Witmer said.

One patient at the Centres for Addiction signed her own treatment order forms willingly, while another patient at a different facility has challenged the order, said Dr. David Goldbloom, physician in chief for the Centres for Addiction.

A million dollars of the funding will also go to the Ontario Council of Alternative Businesses to create more job opportunities for mental health patients, Witmer said.

Another million will also go to the Ontario Mental Health Foundation to fund research to assist the development of mental-health policies and programs, and $500,000 will go to the Ontario Federation of Community and Mental Health Addiction Programs to monitor the quality of mental health services in Canada.

Thursday, June 22, 2000

Psychiatric 'leash law' under attack
Group argues bill unfair to mentally ill

By Antonella Artuso,
Toronto Sun's Queen's Park Bureau
c. 2000 The Toronto Sun

Psychiatric survivors vow to fight the provincial government's "leash law" that would force them to take drug therapy or be institutionalized. "Brian's Law," named for Ottawa sportscaster Brian Smith who was killed in 1995 by a mentally ill man, passed third and final reading in the Legislature by a margin of 82-10.

A smattering of Liberal and NDP members opposed the legislation.

The legislation creates community treatment orders, under which a seriously mentally ill person could be required to undergo treatment as a condition of living in the community. The current law allows authorities to intervene only when there's proof of "imminent" harm to the patient or others. Brian's Law would broaden the criteria under which a mentally ill person in crisis could be committed to a psychiatric facility.

Barry Wilson, a spokesman for Health Minister Elizabeth Witmer, said the legislation has the support of the Ontario Medical Association and the Schizophrenia Society of Ontario as well as the majority of the Legislature.

"This is an example of a bill where there was intensive public input to ensure a balance between patient rights and the safety of our communities," Wilson said.

But Lawyer Anita Szigeti, of the Mental Health Legal Committee, said they will challenge the constitutionality of each community treatment order in court because the mentally ill will become the only people under law who can be detained for refusing medication.

"Under Bill 68, you can then become coercively medicated against your will and in your own home," Szigeti said.

Erick Fabris, a member of the No Force Coalition, said naming the law after a homicide victim is also unfair to the mentally ill.

"Unfortunately, our whole group has been painted ... the very name of the law suggests we are violent," Fabris said. No date has been set yet for Bill 68 to be proclaimed into law.

March 23, 2000

Mental health changes on way
New powers can force the sick into treatment

By Caroline Mallan
Toronto Star Queen's Park Bureau Chief
c. 2000, The Toronto Star

Police and health professionals will get more power this spring to force the mentally ill into treatment, Health Minister Elizabeth Witmer says.

She announced yesterday that proposed legislative changes will be open to public discussion for two weeks early next month before final changes are brought forward.

"We need to ensure that the rights of the seriously mentally ill patients are protected but we also need to ensure that public safety is protected as well,'' Witmer said of the changes.

The proposals include plans for community treatment orders, a parole-type system whereby patients with a history of chronic rehospitalization would live in the community but would be required to report in regularly with the mental health system and possibly take prescribed medication. Failure to take medications would result in a return to hospital.

A substitute decision-maker, likely a family member, will be chosen if the patient is deemed incapable.

Calls for changes to mental health laws came after several high profile incidents involving the mentally ill.

In February, 1997, Edmond Yu, a schizophrenic who was not taking medication, was shot dead by police on a bus. Yu was holding a hammer when he was gunned down.

In March, 1997, 2-year-old Zachary Antidormi of Hamilton was stabbed and killed by a mentally ill neighbour while being pulled in a wagon near his home by a friend. The 60-year-old woman with a history of mental illness was found not criminally responsible for the boy's death.

And in September, 1997, Herbert Cheong, a man with a 20-year history of mental illness, pushed a complete stranger, 23-year-old Charlene Minkowski of Mississauga, beneath the wheels of a subway train.

Witmer stressed that the new laws would not be an attack on the vulnerable mentally ill, but rather an effort to get them help at an early stage in their illness.

She said the changes are in response to the requests she has heard from family members and health-care professionals, and all will include a rigourous appeal process that the patients can access.

The proposed changes would remove the requirement that police officers ``observe'' first hand disorderly behaviour in cases where they believe the person might need to be committed for treatment.

Some in the mental health field oppose the changes, saying that they will cause the most seriously ill to run and hide from formal health care and that drugs are not a cure-all for the mentally ill since they fail in more than 30 per cent of cases.

But Ted Fielding of the Schizophrenia Society of Ontario, where Witmer made her announcement, said the society supports the new laws and does not believe the aim is to lock unwilling patients in psychiatric wards.

``The consumer/survivor people generally are people who have not suffered from schizophrenia and their concern is that they will somehow be swept up into this net,'' he said of some people who have recovered from bouts of mental illness and feel their freedom will be at risk under the new laws.

Dr. Stephen Connell of the Coalition of Ontario Psychiatrists said it strikes the right balance for patients and the community.

Chris Higgins, executive director of the Ontario Federation of Community Mental health and Addiction Programs, said he opposes the changes because he feels they will further alienate high-risk people from the health care system.

``People who need help are not going to come for help if they fear they're going to lose their freedom,'' said Higgins.

``Edmond Yu had retreated from the formal mental health system.''

Saskatchewan is the sole province in Canada with community treatment orders, although British Columbia has laws with a similar purpose.

New Brunswick considered them in 1998, but - following a provincial consultation - decided to put greater resources into other community supports.

March 22, 2000

Press Release From the Ontario Ministry of Health:

Ontario to introduce stronger mental health law this spring to help patients and protect communities

(See the No Force Coalition's Response Press Release)

The Ontario government will introduce stronger mental health laws this spring to make sure people with serious mental illness get the treatment they need, announced Health and Long-Term Care Minister Elizabeth Witmer today.

"We are now following through on our Blueprint election commitment to make sure that people with serious mental illness who pose a danger to themselves or to others are getting the treatment they need," said Witmer. Brad Clark, Parliamentary Assistant to the Minister of Health and Long-Term Care and MPP for Stoney Creek, will lead consultations on the government's proposed amendments to the Mental Health Act and the Health Care Consent Act, in Toronto, Ottawa, Kingston, London, Hamilton, Thunder Bay and Sudbury.

"Some people who are mentally ill are not getting the help they need," said Witmer. "Our government will introduce changes to the law that will help families and health professionals make sure their loved ones and patients get care and treatment."

Dr. Stephen Connell of the Coalition of Ontario Psychiatrists welcomed the government's announcement. "This is the next step in building a modern mental health system that provides safe, effective care, treatment and support for individuals who have a mental illness," Connell said.

"We are taking responsible action to balance the needs of patients with public safety," said Brad Clark. Input gathered from the consultations will assist in the design of legislation that will support a comprehensive and integrated mental health system. The government is moving forward with its Blueprint commitment to propose legislative changes that will ensure that people with serious mental illness get the care and treatment they need in a community-based system.

The proposed changes will remove barriers to families, police and social workers in order to ensure that people posing a risk to themselves or others get the care and treatment they need. This will include proposed amendments to the Mental Health Act and related legislation to support implementation of community treatment orders.

Community treatment orders/leave agreements are a legal mechanism by which a physician recommends treatment be provided in the community for a person with serious mental illness, with the person's consent. If the person is incapable of consenting to treatment, authorization is given by a substitute decision-maker. The ministry will be consulting with mental health stakeholders to ensure the successful design and implementation of proposed amendments to the legislation.

Initiatives

• The government is creating the basis for a comprehensive system of mental health services that is more accessible. Listed below are major government initiatives in mental health policy reform, expanded forensic mental health capacity and the steps taken to improve integration of the mental health system since 1995:
  
• Then-Parliamentary Assistant Dan Newman, MPP Scarborough Centre, conducted a review of mental health reform strategy, releasing the results in June 1998 as 2000 and Beyond: Strengthening Ontario's Mental Health System
  
• Mental Health Law Education Project was developed to inform Ontarians, especially professionals, about their rights and responsibilities under existing mental health legislation
  
• Making It Happen(1999), provincial mental health reform implementation strategy and service guidelines, released with benchmarks, performance measures, and an accountability framework
  
• Mental Health Implementation Task Forces established in northeastern and northwestern Ontario with a commitment to establish task forces in other regions of the province
  
• A Provincial Strategy to Coordinate Human Services and Justice Systems, a provincial forensic policy is developed
  
• 446 new forensic beds opened across the province with another 144 beds to be opened as part of the expanded regional forensic programs
  
• Review of the Mental Health Act and related legislation to ensure a mental health service delivery system is accessible, accountable , cost-effective, and promotes public safety
  
• Recommendations developed for a comprehensive housing policy for people with serious mental illness and an inter-ministerial committee set up to deal with supportive housing issues
  
• 84 supportive housing programs designated for people with a serious mental illness has been transferred to the Ministry of Health and Long-Term Care from the Ministry of Municipal Affairs and Housing
  
• 25 per cent increase in per diem funding for clients in Homes for Special Care
  
• The Centre for Addiction and Mental Health is established with four Toronto locations

Support increased for the Consent and Capacity Board and the Ontario Review Board through increased funding and increased accountability through new Memoranda of Understanding

Investments

Since 1995, the government has reinvested $150 million in mental health care services:

• $19.1 million to expand community-based mental health services to a total of 51 Assertive Community Treatment Teams (ACTTs) and to enhance court diversion, psychogeriatric outreach; case management and crisis support services
  
• $23.5 million for Community Investment Funding (CIF) to establish and enhance ACTTs, case management, family support and crisis response services across the province
  
• $60 million for additional mental health beds and increased community-based services, including ACTTs, case management, family support and crisis services
  
• $45 million to provide housing support and mental health care supports and services for homeless individuals
  
• $2.5 million for hard to reach, socially isolated people with serious mental illness in Toronto, Ottawa, Hamilton and London

February 1, 2000

Community Treatment Orders Coming in June 2000
Original source:
http://www.canoe.ca/OntQueTicker/CANOE-wire.Mental-Health-Act.html

TORONTO (CP) -- Proposed changes to Ontario's Mental Health Act might make it easier to force the mentally ill into treatment but could violate patient rights and won't necessarily make the streets safer, critics say.

In last June's election campaign, the governing Tories promised to change laws so that anyone who poses a danger to themselves or others could be removed from the streets and forced into care. Ontario's doctors are also urging Health Minister Elizabeth Witmer to give them the right to force patients to accept treatment after they leave hospital -- essentially a sort of parole.

But Glenn Thompson of the Canadian Mental Health Association says it's discriminatory to forcibly treat the mentally ill if they aren't dangerous to others. "There are lots of people who are a danger to themselves, such as smokers," Thompson argues, adding that the success of forced treatment is debatable .

But Dr. Richard O'Reilly, a London, Ont. psychiatrist, who helped articulate the doctors' proposal, calls that "an extreme libertarian point of view" that risks neglect of the severely mentally ill. "Individuals lose the ability to understand they are ill," O'Reilly said in an interview. They cannot make an informed decision." Those individuals can be "really tortured by delusions" and it would be wrong to allow them to languish in the community without proper care, O'Reilly said.

Witmer, who intends to introduce legislation in June after further consultations, said Tuesday she recognizes the issue is a tricky one. "What we need to do is balance the rights of patients with the safety of the public. That's why the consultation will be quite informative."

David Goldbloom, a psychiatry professor at the University of Toronto, says he doesn't think the proposed changes will have a "profound impact" on making the streets safer. "The problems of violence are not going to be resolved by treatment orders," Goldbloom said. The changes proposed by the Ontario Medical Association and Ontario Psychiatric Association will only have meaning if there's "a well-funded system of community supports in place," he said.

Witmer said the government has spent an additional $150 million since 1995 on expanding mental-health services and community-based care. "We want to ensure that any reform does bring about smooth transition from the institution to the community," she added.

Janice Wiggins of the Schizophrenia Society of Ontario said she welcomed the proposed changes but conceded "there is no absolute guarantee the streets would be safer." She also stressed the need for proper community supports for the mentally ill."More and more families from across Ontario say they can't get a bed for their relative when it's desperately needed."

October 22, 1999

By Theresa Boyle
Toronto Star Queen's Park Bureau
c. 1999 The Toronto Star

The Ontario government is committed to spending an additional $3.8 billion on health care, which it calls ``its most urgent concern.'' The government also promised in its throne speech yesterday to introduce a Patient's Bill of Rights, guarantee 60 hours of hospital care for new mothers and amend controversial mental health laws.

Health Minister Elizabeth Witmer said later that spending will jump by 20 per cent to $22.7 billion by 2004 from current levels. ``The financial commitment the government has made reflects the fact that this is the No. 1 issue and we want to ensure that health services are there and accessible for all Ontarians,'' she said. This year, the government is spending $18.9 billion on health care, the highest level in Ontario history, representing 34 per cent of the budget. In the run-up to the election last June, polls consistently rated health care as the most pressing problem for Ontarians.

``Making sure that every person in Ontario has access to top-quality health care is your government's most urgent concern,'' the throne speech read. The speech noted that the population is aging and the cost of medical care is growing. But it went on to say that money alone is not the answer to creating a better health care system. ``Tough decisions have been made and are still necessary to build and sustain a modern health care system. . . . More must be done to ensure that every dollar spent on health care is spent effectively,'' the speech said.

Many of the promises were part of the Conservatives' election platform. These included the Patients Bill of Rights, which will ensure access to health services, full information on one's health record and respect for privacy and amendments to mental health laws "that stand in the way of families, police and social workers, to ensure people posing a danger to themselves or others get the care they need.''

The Liberal caucus chuckled when Lieutenant-Governor Hilary Weston read a passage from the speech, promising free tuition to students entering medical school, provided they move and practise for five years in under-serviced areas.

The Tories borrowed the idea from the Liberals' election platform. '`I'm delighted to see that they saw some of the light by adopting a proposal that we put forward,'' Liberal Leader Dalton McGuinty said. He criticized the speech for not addressing financial problems faced by hospitals and the resulting delays in services. `How come half of our hospitals are running deficits?'' he asked. ``There was no reference to the fact that we are still sending people south fo the border for cancer treatment,'' McGuinty added.

NDP Leader Howard Hampton charged that the Tories are misleading Ontarians by boasting that health care spending is at record levels. The level of health care spending per capita has actually fallen by more than $75 in the last six years, he said. ''As the population has been growing, the per-capita investment in health care has actually been dropping. On a per-capita basis, Ontario is investing less in health care now than it did in 1993 or '94. . . And it's going to continue to drop,'' he said.

Barb Wahl, president of the Ontario Nurses' Association, said she was disappointed the throne speech was short on commitments to front-line health care workers. She accused the Tories of reneging on a pre-election promise of hiring 12,000 more nurses. '`I am concerned about what wasn't in the throne speech today for nurses. We heard nothing about supports for nurses,'' she said. She noted that the Lake of the Woods Hospital in Kenora has cancelled elective surgery for three weeks because of a nursing shortage. ``What about the front-line nurses who are in such a short supply? Nurses in nursing homes are looking after 90 patients alone at night,'' Wahl said.

For anyone wishing to wade through it the entire Throne Speech is available online at http://www.ontla.on.ca/hansard/37_parl/session1/L002_1.htm#L1

June 16, 1999

Mental health laws changing
Must balance public and patient rights: Witmer By Theresa Boyle
Toronto Star Queen's Park Bureau
c. 1999 The Toronto Star

Ontario will have to strike a ``delicate balance'' between respecting civil liberties and protecting society when it introduces legislation making it easier to treat dangerous mentally ill people, Health Minister Elizabeth Witmer says.

``We will strike a balance between individual rights and public safety. We will treat our social responsibility seriously toward families, the community and above all, toward those citizens who need our humane attention,'' Witmer told the 24th International Congress on Law and Mental Health at the University of Toronto yesterday.

The Conservative government campaigned on a promise to introduce ``community treatment orders'' or ``outpatient committal'' to ensure people who pose a danger to themselves or others can be taken off the streets to get the care they need.

Families of the mentally ill and many doctors have long argued such measures are needed. Variations of outpatient commitment and community treatment orders exist in British Columbia, Saskatchewan, 36 American states and New Zealand.

But critics argue treatment orders are too coercive and give too much power to doctors and the police. They fear that power could be abused.

``We are fully aware of the debate surrounding outpatient committal and community treatment but we feel that we will not benefit society by retreating from the hard questions that must be answered.''

Witmer said her government will release a discussion paper soon on amending mental health legislation.

"Given our commitment to public safety and access to services for the seriously mentally ill, we will ensure that the law does not stand in the way of patients receiving the treatment they require,'' she said.

She told the gathering that mental health reform is a priority for her government. The province is in the process of closing six of 10 provincial psychiatric hospitals and making a massive reinvestment into community supports.

Dr. Rachel Jenkins, of the Institute of Psychiatry in London and an adviser to the World Health Organization, said Ontario is not alone in the challenges it faces.

She said stigma, caused by fear and ignorance about mental illness, is at the root of these challenges.

`It results in an enormous lack of attention from the public'' and, in turn, in a lack of public resources, she said.

Jenkins said there are many ``pernicious myths'' about mental disorders. Some people do not believe they are ``real'' illnesses and others think they are caused by addictions.

``This is why we need an explicit national mental health policy in every country,'' Jenkins said.

There is no such policy in Canada, noted Steve Lurie of the Canadian Mental Health Association.

`We've been trying to get the federal government interested in one for at least two years,'' he said.

``With the infusion of federal dollars into health, it would be in the federal government's best interest to ensure that the one in five Canadians with mental health problems gets decent care and support.''

The week-long conference will hear from more than 500 speakers at 100 separate sessions.

May 14, 1999

By Joel Ruimy
Toronto Star Queen's Park Bureau Chief
c. 1999 The Toronto Star

The Progressive Conservatives have vowed to pass legislation forcing the mentally ill into treatment even if they don't want it.

But yesterday's campaign promise got off to a shaky start when Premier Mike Harris was unable to give details about how he would expand Ontario's already strained network of mental-health facilities. And there was a minor embarrassment for the Conservatives: they quoted the former president of the Schizophrenia Society of Ontario in their campaign release, only to learn she is now the Liberal candidate in Niagara Falls.

Selina Volpatti said she wants an apology from the Tories for quoting her without her permission. She added that she is running for the Liberals because the Tories have done nothing about the issue over the last four years.

But despite the political stumbles, Harris appeared resolute during a campaign meeting in Toronto with a half-dozen members of the Schizophrenia Society of Ontario.

``The suffering of untreated mentally ill people is a real problem,'' he told reporters after meeting with one man who told of hearing messages from aliens and with a woman whose schizophrenic husband shot their teenage son to death several years ago.

``For too long, we've given up on the mentally ill, some of whom do end up on our streets. We feel there sometimes is little we can do to help and we pretend that a problem doesn't exist.''

At present, provincial laws require that a person be an immediate threat to themselves or others before they can be forced into treatment. The Tories would change the law to make it easier to institutionalize such people.

Asked where all those people would be treated - an estimated 100,000 Ontarians have or could develop schizophrenia - Harris was unable to offer details. ``That's going to be part of the challenge . . . we are going to have to provide more resources,'' including earmarking a greater share of the province's $19 billion health-care budget for treatment for the mentally ill.

The plan has set off alarm bells from some who say it could be used to clear the streets of beggars, squeegee kids and others who, while not mentally ill, could be viewed as undesirable.

``We'll have to make sure that the legislation is to be aimed at those who will make a decision on behalf of individuals who cannot,'' Harris said at a news conference. ``It can't be an arbitrary type of thing,'' he added.

After Harris left the campaign event yesterday, Schizophrenia Society president Ted Fielding said he was pleased with Harris' commitment.

Asked about his having served as an apparent campaign prop, Fielding, who has an adult schizophrenic daughter, answered:

``I'm not concerned that we're being used. If they do what we want them to do, that's fine with us. We don't care which party introduces the legislation.''

April 30, 1999

The Progressive Conservatives are promising to ensure mentally ill people considered dangerous will comply with prescribed treatment regimens.

The party's election platform outlines plans to "change the laws that stand in the way of families, police and social workers so that people who pose a danger to themselves or others can be taken off the streets to get the care they need."

That would mean the introduction of community treatment orders that have been advocated by numerous coroner's juries probing tragic deaths involving the mentally ill. These include, most recently, the inquest into the death of Edmond Yu, a paranoid schizophrenic shot by police in 1997.

``The reality is we're responding to the needs of individuals who (require) assistance. A very significant part of what needs to be done is that these people need to be helped and (have) treatment provided for them,'' Health Minister Elizabeth Witmer said yesterday. While many families and doctors hailed the announcement, advocates for the mentally ill said they are alarmed.

``It sounds like this government is declaring war on the poor and the homeless and the mentally ill,'' charged lawyer Suzan Fraser, who represented the Queen Street Patients Council at the Yu inquest.

``Any time you force people to take mind-altering drugs against their will, it infringes on their charter rights,'' she said.

The Tory platform says people end up on the streets for many reasons. ``Many of them need medical or psychiatric help, but are refusing it or can't understand their own problems.''

It goes on to say that existing mental health legislation is inadequate because it ``makes it very hard to put people into care, even if they are suffering from serious mental illness, or alcohol or drug addiction that makes them a danger to themselves and other people.''

Dr. Stephen Connell, of the Coalition of Ontario Psychiatrists, said his organization is pleased about the government's ``sensitivity'' toward the mentally ill.

March 16, 1999

The provincial government has developed a mental health reform plan that better co-ordinates services and offers more community supports to ensure people like Edmond Yu don't fall through the cracks, an inquest into his death has been told.

``Consumers and families tell us how difficult it is to access service. There is no map to the system,'' Catherine Brown, a policy co-ordinator with the health ministry, testified yesterday.

``One of the biggest problems . . . is that the linkages aren't there. That's what allows people to fall through the gap. We are asking (for services) to be linked as closely as possible, so the system is seamless and consumers can move through the different levels as easily as possible.''

The coroner's inquest is examining Ontario's mental health system and police alternatives to the use of lethal force. Yu, 35, was shot on a TTC bus Feb. 20, 1997, by Toronto Constable Lou Pasquino after he threatened officers with a hammer. Police were cleared of wrongdoing by the province's special investigations unit.

Yesterday, the jury was shown a draft copy of the ``Making It Happen'' report, which the province has yet to formally release.

It is different from other reform strategies attempted since de-institutionalization of the mental health system began in the 1960s, because it sets out concrete steps to get long-held but stalled initiatives off the ground, Brown said.

Health Minister Elizabeth Witmer last year directed the creation of a new strategy, recognizing ``there wasn't enough action taking place'' on recommendations in previous reports, she said.

For example, a strategy released by the then-NDP government in 1993 called for a significant shift from institutional to community care over 10 years. But the province was behind on targets set in that report. One reason was that mental health planning was losing out in the competition with other health initiatives, Brown said. The mentally ill were often unable to fight for their needs, she said.

The new strategy addresses that problem by creating about seven mental health task forces throughout the province that would be responsible for assessing the needs of the mentally ill in various communities, devising service-delivery plans and ensuring those plans are implemented.

For example, they would make sure discharge plans are in place for those leaving hospital and that individuals with serious mental illnesses have case managers or a team of workers to help them with everything from housing to medical treatment.

The inquest has heard there were numerous gaps in the system that contributed to Yu's downfall. The new strategy would ``ensure people don't get lost,'' Brown said.

The mental health system is made up of more than 300 community mental health programs, 59 general hospital psychiatric units and 10 psychiatric hospitals, six of which are earmarked for closing.

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