Harley Lawrence death highlights battle to help mentally ill

When Doug Greene heard his homeless friend haddied in a burning bus shelter in a small town in NovaScotia'sAnnapolis Valley, it reminded him of his own vulnerability.

"It could be me," said the resident ofKentvilleabout thenighttime death of Harley Lawrence inBerwickon Oct. 23.

"It's just that simple."

Greene, 48, said his own depression and alcoholism caused him toresist seeking shelter and treatment in the past.

He joins other NovaScotians, from the province's health ministerto street outreach workers, who say Lawrence's death deemedsuspicious by police has left them wondering how to bring peoplein from the cold when they're suffering from mental illnesses andaddictions.

"I know there's help there but unfortunately due to mentalillness I really don't want to go," said Greene, his hand claspinga cup of steaming coffee provided at a drop-in centre.

"Sometimes being by yourself and being isolated is better thanhaving everybody else know."

Greene says he is living in a rooming house, but he once sleptoutdoors in rural NovaScotia. He became friends with Lawrence a fewyears ago, he says, and saw him sleeping under stairwells.

Lawrence's brother Ronald says Harley was never formallydiagnosed with a mental illness, but in hismid-20she becameincreasingly reserved and paranoid, would drift from town to townand refused contact and help from his brothers and sisters when theyapproached him.

Help needed in rural N.S.

Chaplain John Andrew, the director of the Open Arms emergencyshelter inKentville, says Lawrence's case shows the need for streetoutreach workers in rural areas and highlights the lack of low-rentrooming houses and apartments.

He also says the province's Involuntary Psychiatric Treatment Actshould be altered to give families, police and mental health staffmore say on identifying and sending a person to receive psychiatriccare when sleeping outdoors becomes dangerous.

Andrew estimates he's dealing with six to 12 people in the eastern part of the Annapolis Valley who are homeless and are
unwilling or unable to seek shelter due to their deterioratingmental health.

"We are powerless to make any decision on their behalf," hesaid.

"I have a problem with that because we make decisions on behalfof our children, we make decisions on behalf of our elderly familyand friends when they become incapacitated."

The act requires a person to be "likely to suffer seriousphysical impairment or serious mental deterioration or illness,"and have recently posed a serious harm to themselves or othersbefore being involuntarily committed to care by a psychiatrist.

Andrew says in practice this often means severely mentally illhomeless people have to either commit crimes or become physicallyinjured before they're taken by police and paramedics forassessment.

Greene says he would have been angry about such an intervention,but adds: "I would have realized after some time it would have beenthe best thing to happen to me."

The Canadian Alliance to End Homelessness, a national advocacyorganization, has said the number of homeless Canadians rangesbetween a federal estimate of 150,000 people up to one million,depending on how the condition is defined.

30 to 50% of homeless struggle with mental illness

SamTsemberis, a homelessness adviser to a federally fundedresearch group, said estimates on the percentage of homeless peoplewith some form of mental illnesses range from 30 to 50 per cent, andthose who live on the street are more likely to experienceaddictions and illnesses.

Health Minister LeoGlavine, who represents the riding whereLawrence died, said the death has heightened his awareness of theneed to help people who are living on the street and suffering frommental illness.

He's reviewing about 100 recommendations from a two-member panelon involuntary treatment and expects this will lead to an"overhaul" of the act.

"We need to find a mechanism and a means and a directive withinthe act that is more open to a stronger community supportiveapproach," he said in an interview.

ButTsemberissays the existing wording on involuntary treatmentis adequate in NovaScotia, and Lawrence's story is the "tip of theiceberg" that reveals a need for deeper fixes.

EJDavis, a street outreach worker in Halifax, said offeringhousing without strings attached, and then providing mental healthtreatment and support in their own home, is the way forward.

The 42-year-old outreach worker said the "housing first"approach begins with outreach workers like himself being available
when a person will take help.

"That's the key, being that annoying face every day saying,'How's it going? How's it going? How's it going?' " he said.

But the lack of housing available to people when they're ready totake it is a problem, he said.

"It would be great if we were in the place where I had theresources to walk up to someone and say, 'Look, do you want anapartment?' "

As he does his usual rounds, Davis pauses and chats with JasonKearnes, a 41-year-old who said he is living with mental illness.

Kearnessaid a team of street outreach workers including Davishelped him move into a room.

"If I'm hearing voices and I'm not on my medication, I don'twant to be anywhere near a shelter," saidKearnes, adding he'sgrateful to have a place to stay on his own.

He said he is still battling alcoholism and has been looking fora psychiatrist to help adjust his medications.

While Ronald Lawrence says he appreciates the push to find waysto avoid further tragedies, he also says there's no single norsimple solution.

Lawrence says it's hard to know if involuntary treatment, anapartment or a persistent street worker would have saved hisbrother's life.

"It might help, it might not," he said. "He might havedisappeared again, as he did over the years. It's a catch-22. ...But it's worth a try. Anything is worth a try."