Illustration by Sébastien Thibault
Emergency plan
Re “At Canadian emergency departments, waiting times look grim. But in many places, there is no data” (Oct. 5): I served on the board of a rural hospital organization composed of four hospitals in different towns. While emergency departments are portrayed as being in desperate circumstances, what has not been conveyed is how successful they are at dealing with increasing patient demand.
The organization I served took many actions to divert patients with less urgent issues, according to the Canadian Triage Acuity Scale, to more appropriate treatment options. Hospitals are required to submit CTAS data to the Canadian Institute for Health Information, which allows for current data to be available on volumes and the nature of patients treated in EDs.
In 2012, former Globe columnist Jeffrey Simpson wrote Chronic Condition, a landmark book that revealed the issues plaguing Canadian hospitals including alternate-level-of-care patients and overworked EDs. Sadly, they still abound.
Until these issues are addressed by governments, our health care system will likely continue to struggle.
Stuart Wright Quinte West, Ont.
Growing up in the United States, we were taught that Canadian health care was the model for the rest of the world. Now it’s in a frightening state.
As an expat, I pay for expensive insurance I can barely afford, only to find that access even to urgent care is beyond difficult, seemingly based on luck as much as anything. I lie awake at night, fearful about what will happen when, not if, my family, particularly our 15-month-old son, requires emergency or any other kind of care.
Something has to be done as soon as possible.
Gabriel Miller Victoria
Take care
Re “My Toronto transit ride shows why it’s not wrong to consider involuntary care for mental illness” (Oct. 5): I am a psychiatrist who works with patients like those observed by columnist Marcus Gee on his recent streetcar ride.
It is likely that some of the people described are receiving “treatment” in the form of injectable antipsychotic medication, possibly started during an involuntary admission to hospital, and then continued as part of a community treatment order. Sadly, “treatment” for some with severe and persistent mental illness does not equate with cure.
What these patients are not receiving is “care,” in the form of appropriately supportive housing and opportunities to engage in meaningful activity and be part of a community. Such care is rarely available to our patients; if only we could compel ourselves as a society to prioritize it, perhaps we would all benefit.
Laila Jamal MD, FRCPC; Toronto
My heart aches to read this story, a reflection of our family’s battle with the mental health system on behalf of our brother, a diagnosed schizophrenic.
He is 62 and not as healthy as he used to be. He is luckier than most, as he still has an apartment, but is one step from being evicted because of his paranoia. After COVID-19, he lost his doctor and so he stopped taking his medications and spiralled into his illness.
Since then, he has been in and out of hospital. If he loses his housing, he would end up living on the streets. We would lose sight of him; he would get beat up or die of exposure.
That’s better than a hospital for the mentally ill, right?
Paula Cook Whitchurch-Stouffville, Ont.
Despite studies showing that forced treatment is ineffective and traumatic, many governments are going down this path in the name of compassion. Association between coercion and compassion emerged with the 2022 Community Assistance, Recovery and Empowerment Act in California, where being homeless with a psychiatric diagnosis is enough to be subject to forced treatment through a “compassionate civil court process.”
By focusing on mental health and addiction, governments avoid addressing structural issues and responsibility for the current social crisis: disinvestment in social and health services, assistance and housing. Rhetoric on risk and inability to make decisions in mental health conceals a worrying reality: that people subjected to forced treatment live in greater precarity, are impoverished and marginalized by these measures and are subjected to other forms of coercion by the criminal justice system and child welfare services.
Which is anything but compassionate.
Emmanuelle Bernheim Canada Research Chair in Mental Health and Access to Justice, University of Ottawa
Lessons learned
Re “We don’t need no education: How Canada’s broken university system holds us back” (Report on Business, Oct. 5): Do we have too many institutions offering essentially the same product? Are we sending too many high-school graduates to university, rather than to community colleges or directly to the labour force?
Have non-academic administrative costs grown out of control? Are professor and administrator salaries too high?
How would additional funding increase the quality of education inputs and student achievement outcomes? Should we pour more money into a system that is in obvious need of reform?
Are faculty unions standing in the way of reform? How can universities be more productive? Why does the German economy outperform Canada’s, with vastly lower levels of university enrolment?
Academic, heal thyself.
Ron Freedman Toronto
I have taught at universities in Britain, the United States and currently in Canada.
We have a higher percentage of 18-year-olds entering full-time higher education than in Britain and the United States. Tuition fees charged here are the lowest among comparator countries.
But I can also confirm that funding of higher education in all countries is challenging and changing. Reductions in state funding lead to applications for grants from research agencies, private-public partnerships and the spawning of new enterprises and startups. Political and economic frameworks evolve and change with elections and societal values, and so higher education funding changes, too.
On Canadian campuses today, I do not see doom and gloom but rather youthful energy, excitement and a respectful student body. Students are excited about a technological future in which we have meaningful careers and care about each other, which the contributor correctly describes as a “healthy democratic society.”
Abhay Sharma Toronto
Past sins
Re “The small Newfoundland town that seized its own church” (Oct. 5): How pathetic that the Roman Catholic Church resorts to what amounts to petty theft from Portugal Cove South to settle a debt perpetrated by its own historical abuse.
If the Newfoundland diocese were to ask nicely, the other Portugal across the pond could mine the opulence of Lisbon and Porto churches, or perhaps sell icons from the Pope’s own church in Buenos Aires, to settle the undervalued debt. This bullying of the underdog continues into the present day while the church, with its billions of dollars in holdings, seems to go unpunished for past crimes committed against Canadians.
Disgraceful. Go to confession.
Jane Crist The Blue Mountains, Ont.
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