Foucault's final chapter, the DTES

Vancouver’s Downtown Eastside is the final chapter of Madness and Civilization, one of historian Michel Foucault’s most celebrated works. If he were alive to see a recent Vancouver Sun article, Police becoming de facto mental health workers of our society, he would be convinced once and for all that a society can rationalize anything.

This comparison has been a long time coming.

Michel Foucault observed that prior to the Enlightenment in the 17th century, mental illness, especially diseases like schizophrenia, were revered as having a spiritual or gifted quality. People suffering from mental illness were cared for within the community, walking amongst the population, essential to the fabric of society.

When the Age of Reason arose the asylum came with it. Rationality, the ability to reason and think, was considered the highest of human faculties. Consequently, its two greatest exercises, science and republicanism, took the stage as elite pastimes.

Mental illness stood as a dark contrast to the perfection of reason, and was considered paradoxical to the “new” mind of humanity. The unwillingness to tolerate a walking and breathing challenge to reason, and a desire to scientifically understand “madness,” led to the creation of the first European mental institutions and the practice of locking people away from the eyes of rational society.

Fast forward to the 21st century and one can see a new model of mental health care emerging on the streets of Vancouver’s DTES: criminalization.

A new report by the Vancouver Police department, Lost in Transition: How a Lack of Capacity in the Mental Health System is Failing Vancouver’s Mentally Ill and Draining Police Resources, should be considered a scathing indictment on government policy designers who turned the DTES into Canada’s largest free range mental asylum.

The downsizing of Riverview Hospital programs and the outsourcing of mental health care, turned DTES SRO hotels into mini asylums, housing the mentally ill, drug dealers, and addicts under the same roof.

One statistic in the VPD report, that 49% of police calls in the DTES are mental health related, is particularly shocking. Even more telling, is the story of one mental health sufferer, a man known only as “Bill,” a schizophrenic and drug addict, who had 34 police encounters, 49 stays in mental health care, and a staggering 78 days in jail over a 10-month period.

Foucault’s analysis of mental health can now authoritatively conclude: from normalization, to institutionalization, to criminalization.