Downtown Eastside residents living in the city’s derelict hotels are dying at a rate more than eight times the national average, a UBC study has found. The risk is especially great for people living with a mental illness, even when that group is compared to people similarly living in poverty.
“The probability that an individual with psychosis would survive to age 50 is 68% compared with 94% for those without the diagnosis among marginally housed individuals,” reads an August 2015 paper published in the British Medical Journal Open. “Individuals with psychosis may face a greater than eightfold increase in mortality risk compared with those without psychosis.”
While those grim statistics may not come as a shock to those familiar with the impoverished neighbourhood, what’s causing many of these early deaths did surprise researchers.
The paper presents findings based on a sample of 290 men and 81 women who were recruited through Downtown Eastside single-room occupancy hotels (SROs) and Vancouver’s Downtown Community Court. The group was monitored from November 2008 to August 2012 and, during that time, 31 participants died. That’s a rate of eight times the national average. And for those aged 20 to 59, the mortality rate was 10 times the Canadian average.
Contrary to popular assumptions, researchers “did not find any link with HIV or substance addiction”, a UBC media release states. In cases where participants passed away, psychosis and hepatitis C-related liver dysfunction was “significantly associated with increased mortality”.
For younger participants under the age of 59, the situation is even worse. For that group of Downtown Eastside residents, the mortality rate was found to be 10 times Canada’s average.
“We were somewhat surprised because most people thinking about the Downtown Eastside think about HIV/AIDS or the possibility of overdosing on opioids like heroin,” said William Honer, one of the study’s co-authors and head of UBC’s department of psychiatry, quoted in the release. “Our system is not doing as well in getting treatments out there for psychosis and hepatitis C in this group, and it’s interesting that those two illnesses are causing risk for early mortality.”
It was discovered only one-third of the 173 participants diagnosed with psychosis were receiving treatment for that mental-health condition. And for the 57 people with an active hepatitis C infection and related liver dysfunction, not one of them was receiving treatment for that illness.
“Psychosis is an extremely prevalent issue among inner city populations and we need to address this,” said Andrea Jones, another of the study’s authors and an MD/PhD candidate in mental health and addictions research at UBC, quoted in the release. “We need to be ready to detect and treat mental illness in an integrated way that really meets the patients where they’re at. We need to improve the detection and treatment of psychosis and hepatitis C in marginalized people across Canada.”
The study was funded by the Canadian Institutes of Health Research and by B.C. Mental Health and Substance Use Services.
It states there are some 3,800 people living in SROs in the Downtown Eastside.
There are an estimated 2,000 “severely ill” SRO tenants not receiving the care they require for mental-health and addiction challenges, according to a September 2014 report of the Mayor’s Task Force on Mental Health and Addictions.
Vancouver Coastal Health (VCH) is the regional authority the province tasks with delivering the bulk of health-care services provided to the Downtown Eastside. It spends roughly $55 million a year in the neighbourhood. A February 2015 policy paper lays out strategies and specific recommendations for a “second generation” of health-care designed for the Downtown Eastside. It acknowledges that VCH has largely failed to keep pace with changing needs, and promises the health authority will adapt and improve.
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The article was originally published in print and online at Straight.com on September 10, 2015.