Homelessness, Addiction and Mental Health

[thommyjo]

I am getting quite worried because I have heard that EPS is planning to reopen the Remand Centre as a drug jail that they will be empowered to hold our brothers, sisters, parents, and neighbours indefinitely once Premier Danielle passes her forced treatment act.

I still feel conflicted and need to read more studies on forced treatment. Buts what’s clear is that the model of dealing with drugs, addiction, and houselessness in canada and much of America isn’t working. And places like San Francisco have spent hundreds of billions more than we’ll ever be able to and it’s still horrible down there. So I don’t think we should rule anything out yet.

Innocent assault victims, tens of thousands of more vulnerable citizens afraid to use transit/be downtown, significant economic losses…. We gotta find a solution. Being serious about illegal activity and drug use and treating those who choose to do that harshly is preferable to me vs letting those people be harsh to innocent people. We’ve let a train system used by tens of thousands have its reputation destroyed by a few hundred vagrants. Yes they’re suffering from addiction and there is often a story there we could all empathize with. But they also have free will and are choosing a destructive lifestyle that’s hurting a significant number of people, as well as themselves. That’s not ok. For their sake and others, forced treatment might be best. For anyone that’s experienced addiction in a friend or family member, you know that sometimes the voluntary options just don’t work anymore.

 

[trevorhayden]

No.

 

[edm13]

I rode my bike into work downtown yesterday, from the northeast. My god. I biked by at least 3 people shooting up. And eventually it got to the point where I was worried about biking further down the path into downtown. So I opted for a busier street, but even there there were blocks of tents, really bad. I’d like to see the province make sure they have the spaces for all of the people who need it. Then from there, everyone needs to decide where they want to go.. they can either go to the space provided, or go to a forced treatment, or go to jail. Watching you destroy yourself in real time on the street should not be allowed, and in my opinion, is actually the worst thing we can do as a society.

 

[thommyjo]

No.

Good chat. So what’s the solution then? Because everything the city is pushing for more of also has been done for years in other cities and most are still in dire circumstances. I’m more concerned about my grandparents, wife, and children being safe in our city then continuing to accommodate illegal activity (which doesn’t mean there can’t be compassionate responses. But compassion to a bulimic teen doesn’t mean helping them keep puking. It means getting them in rehab to save their life). If you talk to parents who have kids on the street, they rarely see safe consumption sites and decriminalization as compassionate. Most are heartbroken and feel the government has failed to protect their children.

Of course we need shelter spaces and transitional housing, mental health supports and social workers, properly trained police and security. But we might also need more intense methods for the segment of those using drugs who become violent, unsafe, and who are not voluntarily willing to get treatment. I don’t imagine you would suggest someone consistently on drugs, with multiple assault charges, who is breaking windows downtown, and carrying weapons on them should be simply left to their own until they’re interested in getting help? For most like that, they simply go through the revolving door of arrests, releases, and then eventually OD. That can’t be our solution either. Is involuntary treatment worse than death?

 

[TAS]

Good chat. So what’s the solution then? Because everything the city is pushing for more of also has been done for years in other cities and most are still in dire circumstances. I’m more concerned about my grandparents, wife, and children being safe in our city then continuing to accommodate illegal activity (which doesn’t mean there can’t be compassionate responses. But compassion to a bulimic teen doesn’t mean helping them keep puking. It means getting them in rehab to save their life). If you talk to parents who have kids on the street, they rarely see safe consumption sites and decriminalization as compassionate. Most are heartbroken and feel the government has failed to protect their children.

Of course we need shelter spaces and transitional housing, mental health supports and social workers, properly trained police and security. But we might also need more intense methods for the segment of those using drugs who become violent, unsafe, and who are not voluntarily willing to get treatment. I don’t imagine you would suggest someone consistently on drugs, with multiple assault charges, who is breaking windows downtown, and carrying weapons on them should be simply left to their own until they’re interested in getting help? For most like that, they simply go through the revolving door of arrests, releases, and then eventually OD. That can’t be our solution either. Is involuntary treatment worse than death?

You argue that people committing criminal and violent and destructive acts should be better managed by the legal system. I don't disagree with that. In terms of safe consumption sites - do you think everyone who uses these falls into the category mentioned above?

Housing first has been a success in Finland vs some other approaches.

Linda McQuaig: How Finland managed to virtually end homelessness

Given a place to live, Finland’s homeless were better able to deal with addictions and other problems, not to mention handling job applications.

www.google.com

"It turns out that, given a place to live, Finland’s homeless were better able to deal with addictions and other problems, not to mention handling job applications. So, more than a decade after the launch of the “Housing First” policy, 80 per cent of Finland’s homeless are doing well, still living in the housing they’d been provided with — but now paying the rent on their own."

Finland’s Zero Homeless Strategy: Lessons from a Success Story

By Laurence Boone, Boris Cournède, OECD Economics Department; and Marissa Plouin, OECD Directorate for Employment, Labour and Social Affairs Following a period when homele…

www.google.com

 

[kcantor]

I am getting quite worried because I have heard that EPS is planning to reopen the Remand Centre as a drug jail that they will be empowered to hold our brothers, sisters, parents, and neighbours indefinitely once Premier Danielle passes her forced treatment act.

eps - as a municipal entity - has no access to or control over the remand centre. it is a provincial building. as to the province’s plans, if this is the current thinking that would be one very long and very expensive retrofit.

on the other hand, now that you’ve raised it, i wish I couldn’t imagine this government inflicting that on our brothers, sisters, parents, and neighbours or on downtown edmonton as political payback all while trumpeting it as a better investment than housing and health care…

 

[TAS]

@thommyjo have you watched this?

Addiction is a different beast (especially from eating disorders) and forced treatment doesn't appear to have the intended outcome we would hope - that people would beat the addiction, not be a danger to society and be able to lead good quality lives.

Addictions tend to take many years to beat (on again off again), but those in forced treatment programs have much higher outcomes of death and problems afterwards according to the analysis of these programs, at least from the guest who was a part of Stephen Harper's team and has since done a 180 on the issue.

Issue is so frustrating.

 

[trevorhayden]

Heavens to Betsy, I must clutch my pearls when I see a less privileged person trying to medicate themselves through illegal means because they are denied legal means. The housing first comment was perfect. We need at least 1000 units built in the City core every year, basically forever, to meet affordable housing needs. That, or we provide all Canadians with a complete social safety net so they don't need to see their homes as investments, negating the eye popping rent and land price increases we have recently seen. I wonder how many empty apartments there are in Edmonton simply because rent is so unaffordable?

 

[thommyjo]

You argue that people committing criminal and violent and destructive acts should be better managed by the legal system. I don't disagree with that. In terms of safe consumption sites - do you think everyone who uses these falls into the category mentioned above?

Housing first has been a success in Finland vs some other approaches.

Linda McQuaig: How Finland managed to virtually end homelessness

Given a place to live, Finland’s homeless were better able to deal with addictions and other problems, not to mention handling job applications.

www.google.com

"It turns out that, given a place to live, Finland’s homeless were better able to deal with addictions and other problems, not to mention handling job applications. So, more than a decade after the launch of the “Housing First” policy, 80 per cent of Finland’s homeless are doing well, still living in the housing they’d been provided with — but now paying the rent on their own."

Finland’s Zero Homeless Strategy: Lessons from a Success Story

By Laurence Boone, Boris Cournède, OECD Economics Department; and Marissa Plouin, OECD Directorate for Employment, Labour and Social Affairs Following a period when homele…

www.google.com

Finland is a great success story, but anyone that’s read on this topic for a while knows it’s the “gateway” example people love to point to. It’s been popularly shared on socials for years. But similar policies have been adopted it countless other places with a lot less success. So it’s not as simple.

Here’s a good read on cali doing the same thing.

https://www.cato.org/blog/evidence-also-calls-californias-housing-first-homelessness-strategy-question

 

[thommyjo]

Heavens to Betsy, I must clutch my pearls when I see a less privileged person trying to medicate themselves through illegal means

These sorts of comments are condescending and dismissive to very fair concerns and genuine risks experienced by people.

Are you actually going to look 16 year old teens, elderly people, and small women in the eyes and say this to them when they express fear and concern about what should not be a normalized condition of someone? (High, violent, schizophrenic, or whatever else they are expressing in the moment).

 

[TAS]

Finland is a great success story, but anyone that’s read on this topic for a while knows it’s the “gateway” example people love to point to. It’s been popularly shared on socials for years. But similar policies have been adopted it countless other places with a lot less success. So it’s not as simple.

Here’s a good read on cali doing the same thing.

https://www.cato.org/blog/evidence-also-calls-californias-housing-first-homelessness-strategy-question

View attachment 490971

Even harm reduction advocates say if you could just get somebody off the street, put somebody in treatment even if it's not their choice, and after 1, 2, 3 months they would will have overcome their addiction and it will never be a problem again, they would say yes, do it. But unfortunately that's not what happens by a longshot. These addictions are much more difficult to overcome and it is very rare that addictions like these don't reoccur over and over again even if somebody had overcome their addiction for a period of time.

No doubt, the 'easier' answer is forced treatment but the consensus among experts (and it's not by any means unanimous among those in this field just like climate change is not unanimous among scientists - although i think it's pretty darn close to being) is that it has worse outcomes.

I work for a wellness consulting company and a lot of companies say they want to incorpate wellness into their company - give us a program to make people well so they will be more productive and live better. But it's not so easy as just that. Some don't really want to spend the money, or they don't have the right culture or environment to just make a change so suddenly.
I think that's where we are here, too, to some degree.

Even on affordable housing, you have cities like Vienna who go virtually all in with building below market housing and as a result have some of the most affordable housing there is - certainly in Europe. Other countries/province's don't invest the same way and don't have the same results.

 

[archited]

There is...
the PTSD-ravaged soldier -- usually a young infantryman -- who just can't cope with society and turns to living on the street in isolation;
the Fentanyl/Oxycontin addicted -- again usually a youngster, but not always -- who may have been the recipient of prescribed pain medication not realizing at the time that the prescribed drug was addicting or maybe someone who fell for the Fentanyl weight-loss promise, again missing the addictive nature of the drug;
the idiot who fell for the "hey man, you gotta try these pills, they are euphoric-inducing" just-to-be-cool a-hole who then lives in a trapped world of not being able to work or function in society;
the down on his/her luck person who was evicted and morally bankrupt by the rat-race syndrome who is forced to live on the street;
the mentally retarded who don't even know how to function in society all else being equal;
etc., etc.

The point being that solutions are not one solution-fits-all types. They have to be parsed and individualized. For some a "place to call home" is a good starting point; for others a caring social network helps, for still others an institution that helps with coping is ideal.
I remember reading a few years back that in Los Angeles over half of the homeless were ex-military. One time when I was taking the bus (yetch) I struck up a conversation with a youngish black woman at the bus-stop... she was speaking fairly coherently at the time but a few minutes into our conversation she excused herself and walked to the back of a near-by building... when she returned I asked why she had disappeared for a brief period of time... I had to take care of some business was her reply... she got on a bus different than the one that I was waiting for so I took a moment to go behind the building that was subject to our conversation disruption and there saw a smallish pile of human excrement. I thought of Dickens' "A Christmas Carol" and Tiny Tim's line... God Bless Us, Everyone.

 

[thommyjo]

Even harm reduction advocates say if you could just get somebody off the street, put somebody in treatment even if it's not their choice, and after 1, 2, 3 months they would will have overcome their addiction and it will never be a problem again, they would say yes, do it. But unfortunately that's not what happens by a longshot. These addictions are much more difficult to overcome and it is very rare that addictions like these don't reoccur over and over again even if somebody had overcome their addiction for a period of time.

No doubt, the 'easier' answer is forced treatment but the consensus among experts (and it's not by any means unanimous among those in this field just like climate change is not unanimous among scientists - although i think it's pretty darn close to being) is that it has worse outcomes.

I work for a wellness consulting company and a lot of companies say they want to incorpate wellness into their company - give us a program to make people well so they will be more productive and live better. But it's not so easy as just that. Some don't really want to spend the money, or they don't have the right culture or environment to just make a change so suddenly.
I think that's where we are here, too, to some degree.

Even on affordable housing, you have cities like Vienna who go virtually all in with building below market housing and as a result have some of the most affordable housing there is - certainly in Europe. Other countries/province's don't invest the same way and don't have the same results.

I agree. But I think there’s a few problems we are trying to solve.

Addiction and the rehabilitation of those suffering from it back into healthy people.

But also, safety of the general public. Who should not have to be fearful for their lives.

Forced treatment, I agree, has not be proven to always work for those in treatment. But does it help public safety? Yes.

It’s complex because we want to be humane, we want to honour people’s rights, all of that is important. AND we have to ask questions about to what extent a drug user has the right to certain freedoms when they become a risk to themself and others.

When someone is suicidal, we restrain them and check them into hospitals. When we look at gun laws in canada vs the US, we value public safety and the freedom FROM potential harms more than the freedom TO carry.

I’ve spent the last 6 years being all for all the mainstream progressive ideas around harm reduction, housing first, and decriminalization. But I think I’m starting to swing back on some things. The evidence is not conclusive at scale. At an individual level, safe injection sites can help. At a societal level, their impact is not as favourable. Just look at any city that has adopted all of these policies and it’s clear….they have been unsuccessful in reducing homelessness, addiction, and crime. Instead, most have significant increases. We have to ask why and not be too settled on what we think works.

 

[trevorhayden]

Forced treatment actually makes public safety worse because it breaks up families and spreads trauma further into marginalized communities.

 

[kcantor]

to a large degree this is a “how many angels on the head of a pin” discussion.

it is too often entirely too focused on the nozzle at the end of the hose and whether it is set to harm reduction or personal and public safety or safe supply or criminalization/decriminalization or forced treatment…

unfortunately, until we focus on turning off the tap, it won’t matter which nozzle is fitted at any particular point in time, they will all be failures.

to a large degree we are witnessing the manifestations of generational neglect and it will take at least a generation to overcome but that is where our attention and our diligence needs to remain focused - housing, child support, education, mental as well as physical health care, community involvement and commitment…

we won’t be doing this for ourselves for this year any more than we can plant a tree for ourselves to enjoy this year but there is no better time to start both than this year.