About the founder

2015 Vol. 10 No. 3 VISIONS 11
A Roller-Coaster of Hope and Despair
Angel Strehlen
Angel was born and raised in Vancouver.
She is a single mother, an artist and
a health care support worker, with
experience providing care to clients
with developmental disability, dementia
and mental illness. When she’s not
working 16-hour days, Angel assists
her two adult children who live with
mental illness
LOOKING OUT FOR ADAM
I’m a third-generation Vancouverite who knows the BC health care system as both a health
professional and a family caregiver for a client. I have provided community support care to health
care clients for 37 years. And, my son Adam, 32, was diagnosed with schizophrenia in 2002.

Over the years I’ve had many home
support clients who were suffering
undiagnosed mental illness. I
commonly encountered hoarding,
delusional behaviour, depression,
paranoia, alcoholism and neurosis.
I was never trained to work effectively
with clients with complex issues—it
was as if the health authority hoped
these issues would just go away.
It wasn’t until 2000, when my son
Adam turned 18 and began behaving
strangely, that I realized the truth of
this suspicion.

Desperately seeking sanity
Adam had been a well-behaved honour
student, the most popular in his school,
and a promising, self-taught artist and
musician. Although he experimented
with drugs like any teenager, he wasn’t
doing drugs or alcohol when these
behaviours started.

My formerly social son now kept to
himself in his room and never made
eye contact. He obsessively picked up
garbage to clean the streets, then six
months later lost the ability to even take
care of his own personal hygiene.
His behaviour became increasingly
alarming: swinging a baseball bat,
screaming that he wanted to kill
someone; talking about rape constantly;
and walking the streets all night
shouting profanities

I had immediately begun seeking
medical help for Adam—though,
because at 18 he was legally an adult, I
had no authority over him. I continually
phoned the police, the mental health
hotlines and any emergency service I
could find. None of them could help,
they said, because my son wasn’t
causing harm to others or to himself.
When I finally convinced Adam to go to
the hospital, the ER doctor declared that
Adam was “on drugs” and once they
wore off he would be better. I begged
the doctor to do a drug test or keep my
son for observation, but he dismissed
my concerns with disdain.

I finally got help from a young clinic
doctor who saw the mental and
physical deterioration of a young
man and the distress of his family,
and signed commitment documents.
At age 20, Adam was diagnosed and
finally received the treatment he
desperately needed.

The surreal nightmare continues...
Adam lived with me for the next
four years. In the first two years after
diagnosis, he was hospitalized twice for
three months each time, then released
into my care with no follow-up. His
medical care has consisted of monthly
visits to see a mental health worker at
one of the Vancouver Coastal Health
mental health teams. For years I’ve
accompanied Adam on these visits,
to make sure he gets his meds.

Though the antipsychotic medications
help reduce hallucinations, Adam will
never be the same promising young
man again. He needs proper housing
and staff to help him with daily
activities for the rest of his life.
These mental health workers (probably
psychiatric nurses) are mandated to
look after the health of the client. This
does not cover case management, help
with finances or, apparently, finding
housing. No mental health worker
ever put Adam on a wait-list.

I supported Adam with all of his needs.
I made sure my son bathed, brushed
his teeth, slept, took his meds and ate
properly. I took care of his finances and
housing needs.
And I had to ‘work’ the system on his
behalf. There is no possible way that
a person with severe mental illness
can navigate the maze of bureaucracy.
First I had to convince Adam to sign
permission documents. Given his
deluded state of mind, this was not
easy. It then took three months to get
basic income assistance—and I found
out the welfare system no longer
has social or financial aid workers to
assist people with their finances. It
took another two years to get Adam
disability status. Just acquiring a
yearly bus pass is an ordeal.

Over the past 12 years, I asked
every single mental health care
worker about permanent housing
with support staff, but my queries
seemed to fall on deaf ears.
The long and winding ‘road’ to
supported housing
In 2005, I finally got Adam into a
group home through Fraser Health
Authority. It was a glorious six
months—I had some respite and
Adam was much happier. When he
has support, he is cleaner, well fed,
calmer and less likely to lapse into
psychosis. He was with people his
own age, there were no episodes of
agitated, late-night roaming and he
ate three meals a day.

Unfortunately, these group home
programs are typically six months
long. The intent is to assess clients and
find them a place to live. The reality is,
they tell you what you want to hear,
but the housing doesn’t materialize.
Luckily, I was able to arrange for
Adam to live in a bachelor apartment,
below me in my building. And it was
back to the trenches, trying to support
his needs as best I could. Then, in 2008, he got into a large
subsidized apartment operated by
Fraserside Community Services. Adam
lived alone, with no support services
at all, and the location was nowhere
near where I lived. He did not do well.
And, it turned out, this housing was,
again, temporary. Because the housing
managers wouldn’t tell me anything,
and because Adam often can’t grasp
what he’s being told or remember to
tell me, the fact that this housing was
for just two years escaped me.
I was able to get Adam into a shared
apartment through a friend of mine.
However, this only lasted about a year.
Adam was evicted for poor hygiene.
For about six months, in 2011, Adam
was homeless in the Mount Pleasant
area of Vancouver. He stayed in the
Yukon shelter when possible, and
otherwise, stayed outdoors.

This time, the housing I was able to
find for Adam was in the Downtown
Eastside (DTES)—a single-room
occupancy (SRO) hotel. It was a decent
hotel, but he was renovicted (i.e.,
evicted for planned renovations) from
there, with three months notice.
When Adam was given the renoviction
notice, I really stepped up my efforts
to get him decent housing. The
housing advocate at a mental health
non-profit told me there was nothing
he could do unless my son was
homeless. When my son was homeless,
I went back to them and was told there
was nothing he could do because my
son was homeless now.

At another outreach agency in the
DTES, the staffer was positive she
could help my son find a place to live,
and even offered to help him move.
I was thrilled. Six months later,
the day before my son’s eviction
date, this worker returned to her
office after a long illness—and my
son ended up with only a phone
number to get on another wait-
list. I was devastated. I scrambled
to find a last-minute room, and
the only place I could find was a
decrepit SRO. Because my son had
no help moving, he lost most of
his possessions.

In spite of all my efforts to help
my son, he ended up living in a
horrible DTES SRO (see my photos,
opposite). He had no place to cook
and the shared bathroom was
disgusting. He had to spend some
of his disability support money to
supplement his rent, so, consequently,
ate out of garbage cans. He was
exposed to criminals, violence, drugs,
theft and disease. And I couldn’t visit
my son because of the bedbugs—I
couldn’t even give him a hug.
I became the proverbial “squeaky
wheel”—once a week phoning a staffer
at Vancouver Coastal Health. And,
finally, the wheel got “greased”: in
November 2014, Adam got moved into
supported housing operated by the
MPA.

Strain on family
The lack of support from Vancouver’s
social agencies is alarming. The
services are difficult to find out about
and to access—there clearly aren’t
enough of them to meet the demand—
and the lack of continuity of care is
beyond frustrating.
It’s been hard to see all kinds of other
people getting help, while my son
was forced to live in vermin-infested,
substandard and dangerous housing
and often went hungry. For example,
my ex-son-in-law, who comes from
a prominent Aboriginal family, is
employed and fully capable, waited
just six months for for a brand new
two-bedroom unit and pays $200 a
month rent. My quadriplegic neighbour
lives in a new subsidized apartment.
The task of caring for my son is a 24/7
job, and there has been no one to help
me. Because of the stigma and fear
around mental illness, I was shunned
by family, and I’ve had no time,
money or energy to foster friendships
or other kinds of support. The BC
Schizophrenia Society has support
groups for caregivers, but they were
very inconvenient for me to attend.
I can’t imagine how Adam would have
managed to this point without me. I am
convinced he would’ve been forever
lost if I hadn’t been there for him.
Many nights I lay awake contemplating
suicide—not because of my suffering,
but because I wondered if my son
would get more help if I were dead.
This is how our government saves
taxpayer dollars—by putting this
incredible burden of care onto families.
Amazingly, and in spite of all his
miserable circumstances, Adam doesn’t
do drugs or alcohol, has never been
in trouble with the law and is a
pleasant and happy person. When he’s
hungry, instead of complaining, he’ll
say, “I just try not to be hungry.” He
even thanked me for the horrible SRO:
“It’s fabulous, Mom.” He’s happy with
whatever he’s given. But he deserved
a lot more, a lot sooner.

Postscript
My daughter, 29, has recently been
diagnosed with severe depression
and post-traumatic stress disorder,
and has addiction issues. I have also
been helping my daughter fight for
treatment and support, and I pay half
her rent so she won’t be subjected
to another year of homelessness and
abuse. I honestly feel that my daughter
might not be ill today if I’d been able to
pay more attention to her