First, do no harm

“primum non nocere”

That’s Latin, from what we think is from the Hippocratic Oath physicians take, and it means “first, do no harm.” In fact, this is not a part of the Oath; it is from another of Hippocrates’s works, Of The Epidemics.

Nonetheless, we expect nothing other from our health care providers than that they abide by this idea. Do no harm.

Yet, harm is inflicted here almost daily on the sunny, happy, hippy, affluent Sunshine Coast when mentally ill patients at Sechelt Hospital are released from care without any sort of discharge plan.

The psych unit here – as are most all across the province – is badly overburdened, under-staffed, and overloaded.  Vancouver Coastal Health (VCH) funds mental health services on the Coast, but it has chosen to shrink funding to this area while demand increases.

Back to the discharge plan. This is what medical professionals, in concert with social service providers, should create: a plan for what happens next.

What happens to a poor soul who has been drawn out of the weeds, talked out of the trees, drugged into oblivion (the chemical nurse), with no available lines of support, and bounced from care because beds were needed? Where is this vulnerable person to stay, to find safety, to heal, to thrive?

On the Sunshine Coast, the answer is this: There is no discharge plan. There are no resources to plan for a vulnerable patient’s release. There is nothing.

And where do newly released mental health patients go? Mostly, out onto the streets. Into the greedy hands of predators, pimps, and drug dealers who patrol the shelters, laneways, and homeless camps in the forest for new victims.

It’s all about the money.

We here on the Sunshine Coast need funding for out-patient services to pay for discharge plans and for qualified people to implement them. Until this happens, the ongoing human tragedy – and the lost potential of ill but willing and gifted members of our community – will continue.





  1. Thanks for this article, Hugh. It’s a problem everywhere. This happened to my son five years ago. He’d been evicted and was in a psychotic state. The police took him to Surrey Memorial because he was violent and threatening. Next I heard, he was calling me, sounding very out-of-it on medication. They’d dumped him out on the street with no home to go to. At that time I didn’t understand that this is standard practice–a revolving door of police bringing someone in and the hospital discharging them the next day with no discharge plan.

    I called the hospital to ask to speak to the doctor that had okayed my son’s release. I spoke to a very flippant young woman who actually LAUGHED about the situation before she promised to have the doctor call me. That call never came. Despite the fact that my son had a record of psychotic episodes since adolescence each time he was hospitalized it was treated as a whole new thing! He could not, at that point, come and stay with me because he would not voluntarily take meds and his paranoid delusions prevented him from being able to live with others. He was homeless or semi-homeless for months (he was kicked out of a homeless shelter at least once because he was paranoid and threatened another resident).

    Police officers have told me that it takes much of their valuable time taking the same people to hospital again and again, only to have the hospital release them before they are stabilized.

  2. Great article, Hugh! In my book, Mental Case 101: Trussed Issues, I talk about precisely that–being discharged into a community where I had nothing, had nowhere to go, and had totally lost my trust. I’ve been feeling angry enough about this again to decide to have an event at my home on Wednesday, May 3rd, which I’m calling, ‘Mental Cases’, an open mic night where people can talk about their mental health issues and/or read from their work on mental illness, theirs or that of others in their lives. Again, from 7 to 9, and all are welcome! And again, GREAT article!

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