Of course it’s going to be challenging, that’s not an excuse to not provide healthcare to those who need it. Â
 Addicts who are so far gone aren’t able to give or refuse consent, it can be implied.Â
danke-you on
Unfortunately, the mentally ill and drug addicted folks with the most desperate need for intensive mental health care are the least likely to voluntarily pursue it. The harm reduction advocates paint it as an issue of stigma or fear of arrest flowing from “the continued war on drugs”, but the truth is that delusions, hallucinations, paranoia, and long-term biochemical dependence that start taking priority over even the most basic forms of personal care (e.g, using a toilet; washing; not consuming trash off the cement) or personal safety (e.g., not teetering on the edge of the skytrain track; not shouting threats to strangers; not trying to grab a cop’s gun) or safety of others (e.g., not randomly attacking strangers) make those the most afflicted also the most unable to ever pursue voluntary care even where it is necessary to save their life or the lives of others.
Ironically, “investing in voluntary care first, then dealing with involuntary care” runs not only the risks of prioritizing the treatment of those of lesser need over those in the most need and neglecting to tackle imminent risks to public safety, but may also be rather discriminatory. A well-functioning and well-paid lawyer with a cocaine habit on the weekends should be out at the top of the priority list, but someone lying in a puddle of feces in an alleyway because their 10 years of heroin use has destroyed their ability to control their colon who exists in a hellish cycle of prostitution and high-risk daily drug use should be left to later? The latter will probably be dead before you ever turn your mind back to them. Even more eggregiously, the latter person you neglect to help is more likely to be racialized (disproportionately likely to be indigenous) and poor. To add insult to injury, the “progressuve” advocates will say leaving her to die in that puddle of feces is compassionate because depriving her of agency to decline care is oppressive. What could be more oppressive than leaving her to suffer until her inevitable untimely death? It’s absolutely disgusting.
Any form of involuntary care needs multiple layers of safeguards. We can learn from historic abuses and improve, rather than react by performing greater injustices, like denying the necessary care one needs but lacks the capacity to voluntarily access.
I am hopeful Eby moves big on this. It should be apolitical. A lack of capacity to access necessary care should not be an impediment to saving their lives or the lives of potential victims in these stranger attacks. If you cannot live in society because of a mental illness or addictions challenge, it’s not your fault, we’re not punishing you for it, you’re not going to jail, but we can and should create an alternative environment in which your basic needs can be met and your dignity and safety protected.
The NDP and LPC have been pushing to make dental care and pharmacare happen to supplement our medical system. It’s time we got serious as a country around mental health care. The bare minimum iright now should be helping those in the worst situations requiring high intensity care on an urgent basis, but the long-term goal should be full coverage for therapy and counseling for every Canadian. Ideally, we should be able to intercept mental health and addictions challenges facing everyday people before they ever get that severe. But let’s start with prioritizing those in the greatest need, just like we triage those in greatest danger in the ER.
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Of course it’s going to be challenging, that’s not an excuse to not provide healthcare to those who need it. Â
 Addicts who are so far gone aren’t able to give or refuse consent, it can be implied.Â
Unfortunately, the mentally ill and drug addicted folks with the most desperate need for intensive mental health care are the least likely to voluntarily pursue it. The harm reduction advocates paint it as an issue of stigma or fear of arrest flowing from “the continued war on drugs”, but the truth is that delusions, hallucinations, paranoia, and long-term biochemical dependence that start taking priority over even the most basic forms of personal care (e.g, using a toilet; washing; not consuming trash off the cement) or personal safety (e.g., not teetering on the edge of the skytrain track; not shouting threats to strangers; not trying to grab a cop’s gun) or safety of others (e.g., not randomly attacking strangers) make those the most afflicted also the most unable to ever pursue voluntary care even where it is necessary to save their life or the lives of others.
Ironically, “investing in voluntary care first, then dealing with involuntary care” runs not only the risks of prioritizing the treatment of those of lesser need over those in the most need and neglecting to tackle imminent risks to public safety, but may also be rather discriminatory. A well-functioning and well-paid lawyer with a cocaine habit on the weekends should be out at the top of the priority list, but someone lying in a puddle of feces in an alleyway because their 10 years of heroin use has destroyed their ability to control their colon who exists in a hellish cycle of prostitution and high-risk daily drug use should be left to later? The latter will probably be dead before you ever turn your mind back to them. Even more eggregiously, the latter person you neglect to help is more likely to be racialized (disproportionately likely to be indigenous) and poor. To add insult to injury, the “progressuve” advocates will say leaving her to die in that puddle of feces is compassionate because depriving her of agency to decline care is oppressive. What could be more oppressive than leaving her to suffer until her inevitable untimely death? It’s absolutely disgusting.
Any form of involuntary care needs multiple layers of safeguards. We can learn from historic abuses and improve, rather than react by performing greater injustices, like denying the necessary care one needs but lacks the capacity to voluntarily access.
I am hopeful Eby moves big on this. It should be apolitical. A lack of capacity to access necessary care should not be an impediment to saving their lives or the lives of potential victims in these stranger attacks. If you cannot live in society because of a mental illness or addictions challenge, it’s not your fault, we’re not punishing you for it, you’re not going to jail, but we can and should create an alternative environment in which your basic needs can be met and your dignity and safety protected.
The NDP and LPC have been pushing to make dental care and pharmacare happen to supplement our medical system. It’s time we got serious as a country around mental health care. The bare minimum iright now should be helping those in the worst situations requiring high intensity care on an urgent basis, but the long-term goal should be full coverage for therapy and counseling for every Canadian. Ideally, we should be able to intercept mental health and addictions challenges facing everyday people before they ever get that severe. But let’s start with prioritizing those in the greatest need, just like we triage those in greatest danger in the ER.