Is neglect of the mentally ill leading to violence on Vancouver streets?

The news is shocking. A man shot in broad daylight at a Yaletown Starbucks. Sirens wail.

Police pursue, more shots are fired as they take down the suspect outside a tourist attraction full of children. Onlookers say they've never seen anything like it.

The initial reaction: How can this happen in a place like Vancouver? But the fact is — it happens all the time. Remember Nicholas Osuteye? How about Jerome Bonneric? Mohamed Amer?

All three men were charged with the unprovoked, inexplicable, attempted murders of strangers. One — like this week's Yaletown shooting - even happened in a coffee shop full of horrified onlookers in the middle of the day.

And all three accused were found not criminally responsible for their actions because of mental illness.

Gerald Battersby has been charged in the attempted murder of his former boss. His family says he was showing signs of mental illness before the alleged attack. (Colin Barkhouse)

Police say the accused in Tuesday's incident, Gerald Battersby, knew the victim.

The 61-year-old remains in hospital recovering from injuries he sustained in the police take down, while the charges against him remain unproven in court.

But once again, police are exploring the possibility mental illness may have played a role in a shooting on Vancouver's streets.

"Just on the face of what happened, you have to wonder about that," said Acting Police Chief Doug Lepard, after the shooting.

Are we tackling the root cause?

Indeed. Sadly — extraordinary as this episode was, unexpected and shocking incidents of violence happen all the time. But we struggle to tackle the root cause.

For decades, a chorus of advocates, police and family have called for greater resources and attention to the mental health "crisis" in our community.

Government has responded with sporadic investment, but after this week's brazen attack, it's worth asking whether we're doing enough.

The B.C. government supports a wide range of homeless shelters, including emergency shelters like this one during cold weather snaps. (CBC)

Last fall, a police report called Vancouver's Mental Health Crisis noted a 43 per cent increase in the past three years in admissions to St. Paul's Hospital because of severe mental illness and/or addiction.

During the same time, apprehensions under the Mental Health Act rose by nearly 20 per cent.

And in the past two years, police identified 96 serious incidents ranging from suicides to random violent attacks involving mentally ill people.

It's true the vast majority of people with mental illness do not commit criminal offences; the challenge is reaching those who fall between the cracks before their actions draw them in contact with the criminal justice system.

Police don't want to act as mental health workers. Crown lawyers don't want to prosecute the mentally ill. And all agree jails are no place for treatment.

The accused in the Yaletown shootings had reportedly struggled with mental illness in the weeks before the attack. Gerald Battersby's brother says he was also evicted from his house in April.

Shelter also factors into this problem. Despite attempts to eliminate homelessness by 2015, the most recent homeless count found street homelessness actually doubled in Vancouver during the last three years.

In the same time-period police say emergency room admissions rose and mental-illness related incidents accounted for 21 per cent of their workload.

Is enough being done?

In response to repeated calls for action by police and Vancouver Mayor Gregor Robertson, the Ministry of Health announced a $20 million investment last fall.

That includes a new psychiatric assessment unit at St. Paul's and the creation of outreach teams to serve people in the Downtown Eastside, along with new group homes and a new six-bed inpatient facility.

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Health Minister Terry Lake (l) and Vancouver Mayor Gregor Robinson announced a $20 million program that includes outreach teams to serve people in Vancouver's impoverished Downtown Eastside. (CBC)

Health Minister Terry Lake admitted the money can only go so far.

Indeed — Vancouver had asked for 300 new long-term and secure mental-health treatment beds. But the plan only makes room for 20.

Lake is calling for a committee of stakeholders to look for "evidence-based" strategies for the future.

Maybe part of the problem has to do with the media itself, and the failure to follow up these stories?

Nicholas Osuteye garnered national headlines in 2012 when he beat and kicked three elderly women only hours after being released from St. Paul's Hospital. Two of his victims suffered brain damage.

His initial court dates drew dozens of reporters. But only one attended Osuteye's final appearance.

The clean-cut, slump-shouldered man who sat meekly beside his lawyer in a new shirt and running shoes cut a completely different figure from the one police arrested in his underwear a year before, saying he "planned to hunt human beings like animals."

One of the few onlookers: his mother, Mercy Osuteye.

She offered an apology to her son's victims and said she hoped her family's struggle might inspire others to support those with mental illness.