[Northern Light]

I am not aware of any treatment option that can be imposed short of the individual meeting the criteria under the Mental Health Act
- Paul

Perhaps we need to review the grounds for committal:

C and F would seem to me to apply to the majority of persons whom you are describing.

****

Source: https://www.ontario.ca/laws/statute/90m07#BK13

I would argue this empowers either a police officer or a Justice of the Peace to take the steps to detain someone for involuntary psychiatric treatment.

****

On to the matter of holding such a patient, if necessary:

I think there is ample room under The Act, to take reasonable action as required.

The issue has been the guiding philosophy in mental healthcare, the shortage of mental healthcare beds, the shortage of step down mental healthcare (outside a hospital/clinical setting, but with supervision /assistance as required), and, in some cases, the Capacity and Consent board has been both appointed and trained in such a fashion as to interpret the basis for involuntary care very narrowly.

Keeping in mind that we all agree that institutionalization has been over-done in the past, and we don't want people who experience a brief episode of moderate distress, or who are willing and able through therapy or medication to function outside of confinement to find themselves committed for months or years.........

I think its really a matter of sending the institutions involved both the money and the direction that a slightly more assertive interpretation of the Act is required, particularly where someone who has been discharged has failed to follow a plan of care.

Should that be insufficient, The Act can be amended to provide clearer direction on this point.

But I would rather leave the decision in the hands of physicians and under the watchful eye of a third party charged with restraining abuse of power; than have government dictate the details of care. I just think the system needs the resources and a healthy nudge.

 

[crs1026]

^I'm all in favour of adding resources, our system is sadly threadbare.

The missing or weak link to me is the presumption that the discovery of an individual in distress will result in the police officer conveying the individual to a physician and the physician then making a decision that delivers useful care.

Most likely, police officer will either instruct the individual to exit the transit vehicle, or they will make that choice themselves. That in itself can be criticised as cruel (on a cold night for instance) - hence my theory that any ejection carries with it the risk of imposing some minimal duty of care and the officer may have to answer in the court of public opinion for solving the problem so directly..

Also, the threshold for behaviour that transit needs to enforce may fall short of those criteria in law. An individual may be alarming to other passengers without overtly threatening harm..... the individual who chants or utters a stream of profanity to no one in particular, for instance. Or the person who is smelly and dirty to an extreme that is unsanitary but not making utterances or engaging with others.

The system needs to operate at the level of "eye of the beholder". A physician's or justice's post-hoc decision that the individual is not a threat matters little once passengers (on the basis of a less expert knowledge base) have been made fearful or have been in contact that appears to impact their health..

The officer on the scene needs to have confidence that if they exercise their powers, the next step in the process will not just put the person back on the street. In effect, the officer is second guessing the call that will be made by the physician or justice of the peace. That seems to me to incent the officer to leave the problem alone. It may need more than a nudge to set a threshold that satisfies the need to assure passengers and that can be applied without triggering legal challenges.

- Paul

 

[Northern Light]

^I'm all in favour of adding resources, our system is sadly threadbare.

The missing or weak link to me is the presumption that the discovery of an individual in distress will result in the police officer conveying the individual to a physician and the physician then making a decision that delivers useful care.

Most likely, police officer will either instruct the individual to exit the transit vehicle, or they will make that choice themselves. That in itself can be criticised as cruel (on a cold night for instance) - hence my theory that any ejection carries with it the risk of imposing some minimal duty of care and the officer may have to answer in the court of public opinion for solving the problem so directly..

Also, the threshold for behaviour that transit needs to enforce may fall short of those criteria in law. An individual may be alarming to other passengers without overtly threatening harm..... the individual who chants or utters a stream of profanity to no one in particular, for instance. Or the person who is smelly and dirty to an extreme that is unsanitary but not making utterances or engaging with others.

The system needs to operate at the level of "eye of the beholder". A physician's or justice's post-hoc decision that the individual is not a threat matters little once passengers (on the basis of a less expert knowledge base) have been made fearful or have been in contact that appears to impact their health..

The officer on the scene needs to have confidence that if they exercise their powers, the next step in the process will not just put the person back on the street. In effect, the officer is second guessing the call that will be made by the physician or justice of the peace. That seems to me to incent the officer to leave the problem alone. It may need more than a nudge to set a threshold that satisfies the need to assure passengers and that can be applied without triggering legal challenges.

- Paul

Again, I think its important to understand what the law says:

That is not 'a threat, or acting violently' those are addressed separately. If you are routinely, intentionally, sleeping on transit, or defecating on transit, or barricading yourself on transit, or clearly not meeting the barest standards of hygiene, you clearly meet the standard for intervention.

Its a choice not to exercise the authority the law already provides.

Yes, the entire system needs to operate differently, no disagreement, but the legal authority is there now; its a matter of wisely using it, and of course, the requisite resources being there to made use of...

 

[SubHuman]

... Its a choice not to exercise the authority the law already provides.
... the legal authority is there now; its a matter of wisely using it, and of course, the requisite resources being there to made use of...

So then what is the problem now? Is it a lack of psychiatric institutions or spaces inside them, or just the unwillingness to enforce the law because of the bad optics they feel it presents?

Whether it's intentional or not, people and particularly politicians who constantly misdescribe this as a "homeless" issue are obscuring it and ensuring nothing is done to improve the situation.

 

[Richard White]

So then what is the problem now? Is it a lack of psychiatric institutions or spaces inside them, or just the unwillingness to enforce the law because of the bad optics they feel it presents?

Whether it's intentional or not, people and particularly poiliticians who constantly misdescribe this as a "homeless" issue are obscuring it and ensuring nothing is done to improve the situation.

Honestly, without proper treatment a good portion of the homeless population could never hold a steady job.

Nobody will hire someone who talks to themselves on a regular basis or has psychiatric episodes. They will also not hire someone who feels the need to smoke crack or shoot up Heroin during the work day.

Without proper treatment these people cannot survive on their own. Yes it is nice to open more shelter spaces but if the people they are designed for are not permitted to use them for mental health and addiction reasons something needs to be done.

 

[Northern Light]

So then what is the problem now? Is it a lack of psychiatric institutions or spaces inside them, or just the unwillingness to enforce the law because of the bad optics they feel it presents?

Both.

We (the province) closed a lot of institutional care beds back in a day. Since then, the population of the province is up over 50%; so we do have a shortage of space, which in the best of all worlds is being rationed.

That said, there is also, I would argue, a bit too much sensitivity on the subject of extended, involuntary care, where a person has clearly shown they are unwilling or unable to keep to a plan of care that keeps them stable in the outside world.

 

[Sky High Arch]

Interesting article came out today in york region. ​

"After rejecting men's shelter, Aurora Mayor Mrakas wants to explore sheltering homeless in York Region headquarters"​

After rejecting men’s shelter, Aurora Mayor Mrakas wants to explore sheltering homeless in York Region headquarters

With hybrid work model, there is unused space in regional buildings for other uses, including for homeless residents, Mayor Tom Mrakas suggests.

www.yorkregion.com

“Whereas York Region has recently adopted a true hybrid work policy where 60 per cent of the staff will work only 50 per cent of their work week on site (and) whereas regional office buildings, including the 422,000-square-foot regional head office on Yonge Street will now, as a consequence, have sizeable areas of under and unused taxpayer-funded office space available for other purposes, therefore, be it resolved that regional staff be directed to undertake a review of all regionally-owned buildings for the purposes of identifying those that are under and/or unused and provide an analysis of those that can be potentially repurposed for other regional priorities, including supportive housing,” Mrakas said in his notice of motion coming to the committee meeting.

 

[ssiguy2]

In terms of transit, there is absolutely NO excuse for homelessness. This is were I draw the line between empathy and the civic good. No one should be allowed on any transit lands {ie not only the vehicles but also the area around it like subway entrances} and personally I don't care if they have to drag them off the site.

People have the RIGHT to enter a gov't office or gov't provided service {ie transit} without feeling threatened or even somewhat uncomfortable. It wouldn't be allowed at a MTO office or law court so it shouldn't be allowed at transit stations/vehicles. Even though a person maybe homeless that does not give them the right to set up shop anywhere they feel like it. The idea espoused by these left-wing do-gooders politicians that we have to tolerate this is an abomination. We are suppose to accept it but you can be damn sure they won't open their gov't funded constituency offices to these people.

 

[crs1026]

That said, there is also, I would argue, a bit too much sensitivity on the subject of extended, involuntary care, where a person has clearly shown they are unwilling or unable to keep to a plan of care that keeps them stable in the outside world.

I don't disagree, but I do think there is a broken link between the point where a dozen riders say "this person is in no fit state to be seated next to me in this transit vehicle" - and the cop agrees - and the point where the receiving physician or justice says " this person is not so serious that they warrant detention for treatment, so let them go on their way". - and they do so.

No police officer is going to go to the trouble of arresting the person (in today's world, possibly while someone makes phone videos)(while other high priority radio calls are pending) , making the necessary notes and paperwork, transporting them (in a police vehicle that the officer will have to disinfect afterwards) (and possibly processing intake into a holding cell prior to appearing before the JP) and then subjecting themselves to inquiry from the physician or judge (possibly abetted by a homelessness advocate).... unless they have clear mandate to do so. That mandate is lacking. And, letting the individual wander back into a freezing night is something that our society (commendably) won't accept.

There is a lot of stuff missing in the middle.

- Paul

 

[SubHuman]

Typical TTC scene. Homeless white guy riding the subway with his shopping cart, eating Jolibee fried chicken, throwing his bones on the floor, and ranting loudly about someone calling him a Paki (which obviously did not happen). Everyone obviously feeling very uncomfortable and staring at their phones.

Yes, along with the other more serious problems of these people who should be in psychiatric institutions, conscientiously placing their garbage in the appropriate receptacles is not one of their strong suits.

 

[jje1000]

I hate to say it, but the disappearance of ultra-cheap apartments, flophouses, and motels in inner city neighborhoods has been almost equally disastrous for the precariously housed and urban poor as the loss of institutional mental health spaces.

Without this supply of housing, the net result has been a second disgorging of this populace into the public realm.

 

[Richard White]

I hate to say it, but the disappearance of ultra-cheap apartments, flophouses, and motels in inner city neighborhoods has been almost equally disastrous for the precariously housed and urban poor as the loss of institutional mental health spaces.

The Kingston Road Motels are a prime example of this though some of them are scary at the best of times.

In Scarborough, the Hav-A-Nap motel was known for "renting by the hour" and brought new meaning to the words "Don't let the bedbugs bite" though I suspect not much sleeping was done there.

 

[christiesplits]

I hate to say it, but the disappearance of ultra-cheap apartments, flophouses, and motels in inner city neighborhoods has been almost equally disastrous for the precariously housed and urban poor as the loss of institutional mental health spaces.

Without this supply of housing, the net result has been a second disgorging of this populace into the public realm.

Yep. I was friendly with a homeless guy on the Danforth in the early 00s. I recall him saying he could get a room for around $30 at a Kingston Road motel on nights he wanted a bed and shower.

 

[allengeorge]

I don’t think anything will change. The public has accepted that transit users should be dealing with this (out of sight, out of mind). And, we’re unwilling to commit to the funds, resources or strategies necessary to deal with this issue.

BTW - no police officer or transit officer will move someone off a transit vehicle until they feel like they have political or societal acceptance to do so - and that’s in short supply nowadays. The organization and individual will be ripped apart online, and it’ll be politically expedient not to come to their defence, unfortunately.

 

[goodcitywhenfinished]

If the BC NDP is willing to move towards involuntary treatment I think its safe to say the social acceptance of a more strict approach to mental health & homelessness is increasing in this country.

Also, if @Northern Light is right in their estimate of 200-300 people consistently using the TTC for shelter I don't see how the cost of housing these individuals could be in any way prohibitively high or outrageous.