A streetcar heads east on King Street in downtown Toronto on Nov. 3, 2020.Fred Lum/The Globe and Mail
Should authorities detain people who refuse to get treatment for severe mental illness and addiction? That question has moved to the front burner in many Canadian cities. My ride to work on a Toronto streetcar this week showed why.
When I got on, a guy was lying passed out or asleep on the long bench at the back, taking up all the seats. A barefoot man in dirty clothes was walking up and down the aisle. At Yonge Street, just in front of the Eaton Centre, he got off and meandered unsteadily through the midday crowd.
Three others got on. One was a big guy in sweats and a hoodie. He took a seat, talking incoherently to no one in particular. Every few words was a curse. Another was a skinny guy with tangled hair who was dragging a beat-up rolling suitcase and muttering to himself in Spanish. The third was a middle-aged woman in jean shorts and red slippers in the shape of rabbits. She was playing music on a portable speaker, turned up high, and shouting at some invisible enemy.
In another age, a cop might have carted them all off to a jail cell or a dank asylum. The mentally ill were society’s ultimate outcasts, locked away and forgotten. Those days are thankfully over.
But that it was wrong to pen them up doesn’t make it right to leave them to wander the streets in such a state. Scenes like the one on my streetcar, and often far worse, have become common in our cities as Canada suffers through a triple epidemic of mental illness, addiction and homelessness.
It’s heartbreaking to see these lost souls lying on the sidewalks or riding the subway, alone and unaided. Though the vast majority pose no threat to anyone, a rare few can be violent. The case last month in which one man was killed and another left with a severed hand in downtown Vancouver stands out. Authorities said the suspect in the attacks had a long record of interactions with police related to his mental condition.
Governments are promising to take action. In British Columbia, NDP Premier David Eby says that if his government is re-elected on Oct. 19 it will develop a system to compel those with severe addictions, mental illnesses or brain injuries to get treatment. Alberta’s United Conservative Party government is working on something similar.
Mayors have been especially vocal. This week Brampton’s Patrick Brown became the latest to call for more involuntary care. He said that, since 2022, regional police have taken more than 30,000 calls related to mental health and addictions.
Some advocates for the mentally ill say it is all part of a vicious backlash that would criminalize and stigmatize society’s most vulnerable members. That is a simplification. Most people are not demanding change because they are bigots. They are reacting to what they see all around them. And what they see is not good. Whatever systems exist to care for the unfortunate people who live on our streets are visibly failing.
For those who are not willing or able to accept help, perhaps because they have stopped taking their medications and have lost the ability to make sensible decisions, some measure of compulsion – with all the right checks and balances – seems reasonable.
As British Columbia’s Mr. Eby put it, “this is a group of people that need intensive interventionist support.” They are “incapable, by definition, of asking for the care that they need.”
Remember that he is a former head of the province’s civil liberties association, and so well aware of the importance of limiting the state’s power to hold citizens against their will. Yet, like many of us, he can see that something is not working.
Under the current rules in many jurisdictions, people can be detained for more than 72 hours only if they pose a danger to themselves or others. In practice that often means that unless they are demonstrably suicidal or violent, they are given minimal attention then released to roam the streets again. Their families are left powerless to help them and they descend into the miserable condition in which the rest of us so often see them.
In the name of respecting the rights of the mentally ill, we have essentially abandoned them to their fate. And what a fate. Today’s streets carry many dangers. They can be stripped of their belongings in an instant. They can become the victim of a sexual assault. They can get addicted to drugs and succumb to a deadly dose of fentanyl.
The mood on my midday streetcar ride was tense. My fellow commuters exchanged nervous glances or stared blankly out the windows, trying to pretend nothing was happening. The streetcar rolled on.