It seems so simple. So basic of an idea that you wonder why it has not been implemented yet.
It is involuntary care.
As communities across the province grapple with street disorder and a sense of insecurity, involuntary care is seen by many as a solution. Politicians of all stripes have offered it up to concerned residents and businesses as a path forward.
The problem is it is unlikely to be what people are expecting. The expectation is that it will be a panacea; the reality will be quite different.
Currently, the perception is that involuntary care will be a method for sweeping the streets clean, getting people into treatment and rebuilding contributing members of society.
The reality is that people are likely to be disappointed as we get a classic example of overpromise and underdeliver.
There are a lot of reasons for this.
Without doubt, there are a number of individuals who need help, who are not in a place where they can make decisions. The CEO of Our Place in Victoria summed it up well recently. “If someone is so unwell that they cannot make informed decisions about their health care, then leaving them to die on the sidewalk with little but their liberties intact is not compassion. It is abandonment,” said Julian Daly.
These people need care and, quite possibly, may never be in a place to return to life without supports.
What doesn’t get discussed enough is the toxicity of the drugs awash in our streets. These drugs, laced with fentanyl and carfentanil, are rewiring the brains of users and causing massive damage. The reality is that some may need constant care in a facility designed to deal with their complex needs. Sadly, it will mean something closer to involuntary confinement.
Calls for using jails or recreating Riverview are far off the mark. No matter how it happened, these folks are worthy of compassionate care to protect themselves and others. Warehousing is wrong, morally and practically.
Next up as a challenge are the courts. They are highly unlikely to allow a roundup of people who can then be forced into treatment. The courts have been clear that when removing encampments, there need to be dignified alternatives. Expecting them to approve a clean sweep is wishful thinking.
The biggest challenge, though, is that involuntary care for most individuals is doomed — even if allowed. It needs to be voluntary to make the needed changes in mindset and habits. I know people who have gone to treatment at the behest of others and were taking a shot, snort or swig as they waited outside the gate to enter rehab. They wanted to do right by others, but they were not there yet. Success did not follow.
Which is why the current trend of calling for dry-only facilities for those just emerging from hardship is so frustrating. Yes, there needs to be housing where people — who are ready — can live and not be surrounded by temptation. We also need more treatment beds to help people achieve this.
But trying to jump straight to a sober life is impractical for many and decidedly dangerous as well.
An operator of Tiny Homes says there are four basic rules: no pooping, no fighting, no dealing and no using alone.
And that final one is important. Developing the routine of not using in your home is a step forward; it is a mental divide you can bridge. It does not mean the desire will magically disappear, but it gives a framework for progress.
With all the political rhetoric that flies, what gets lost is that progress is measured in inches and not yards. Rare is the person who can go cold turkey and not suffer a relapse.
Yet politicians are succumbing to the temptation of easy fixes. In Surrey, on Vancouver Island, in Vancouver and in Penticton, we see what should be pathways to success being blocked or removed.
So, if these pathways work, why can’t we see results? (People are tired of stats; they are trusting their eyes.)
In our haste to warehouse people, we have not built the support. British Columbia has a two-tier health-care system when it comes to treatment beds. Six years ago, a 30-day stay paid privately cost $20,000, and that has only gone up. We do not have enough public beds.
And when people get out? Supportive housing gets caught up in a tangle of red tape, whether that be for seniors, youth, working families or those on the comeback trail. We bottleneck the system.
We are also wildly behind when it comes to preventing people from sliding into homelessness, which then often leads to addiction and mental health issues. They are three crises that become one. Another simple idea that works is a rent bank, and yet the provincial funding is threatened.
Now being of a certain age, I can remember when the belief was you just needed some willpower to overcome addiction. That is not the case anymore. The toxicity is killing our family, friends and communities.
Involuntary care sounds great. It is not enough. Not nearly enough.
There is an old joke about stopping smoking: “Quitting cigs is easy. I’ve done it a dozen times.” Except what we are going through is not a gag.
Many years ago, an unlikely advocate for a balanced, comprehensive approach came along. Philip Owen was the mayor of Vancouver and championed the Four Pillars — equal focus on harm reduction, prevention, treatment and enforcement.
What we need is a return to that balance and courage.
Without it, we will be the joke. ![[Tyee]](https://thetyee.ca/design-article.thetyee.ca/ui/img/yellowblob.png)








