Historical Context

Bitter Medicine takes place during a time when North America's healthcare system began to change. In the late 1960s and 1970s many psychiatric services were deinstitutionalized. The goal had been to lesson the burden on already busy hospitals and replace the services they once provided for mental health to be delegated by services supported by the community. Although the initial concept was noble, patients needing a changed environment to improve their health rather than being drugged into a docile state with adverse side effects for many, it quickly became obvious the new services that were meant to replace what hospitals once offered were never going to materialize or were severely underfunded.

Statistically this appeared as a promising plan. More funding could be dedicated to hospitals themselves or other areas, less patients were remaining in the system for long and proposed ideas seemed to work. This was far from the case as Bitter Medicine even documents when discussing Olivier's own struggle with the healthcare system. Without the supervision of more dedicated care and lacking the proposed decentralized solution many patients were simply unable to cope. They would be constantly warned and arrested for petty crimes and disturbances until finally sent to prison. Rather than the proposed system helping with the hospital's burden, it seemed the prison system instead shouldered the problem.

While literary pieces like Bitter Medicine and other technical papers are revealing the failure of Canada's healthcare system when it comes to psychiatric services there has yet emerged a real solution as of 2018.