Why Involuntary Medical Admission and Treatment Won’t Solve Homelessness

The Rise in Involuntary Treatments

The housing crisis is pushing more and more people onto the streets. More than one in 10 Canadians report experiencing some form of homelessness in their lifetime. For those forced to camp out, they are increasingly victims of the not-in-my-backyard (NIMBY) phenomenon. Governments are dismantling encampments and some are willing to use the notwithstanding clause to circumvent court rulings on their actions, as well as banning supervised drug consumption sites near day-care centers and schools.

The Rise in Involuntary Treatments

It is currently possible to forcibly treat someone anywhere in Canada. Provincial mental health legislation allows involuntary admission and involuntary treatment. Criteria vary from danger to a lack of capacity for consent and the need for treatment. But involuntary admission and treatment should only be used as a last resort.

The rights of citizens to decide what happens to them is fundamental. According to the Supreme Court of Canada, the right to self-determination outweighs other interests, including what physicians may think is in the patient’s best interests. Psychiatric diagnoses or substance addictions have no legal impact on the right to consent to care.

Structural Violations

Research shows structural violations of the rights of people who are involuntarily admitted or treated. Class-action lawsuits have been won or are underway in several Canadian provinces for abuse of rights in psychiatric wards. Québec will have to compensate people detained illegally. The New Brunswick ombudsperson concluded that patients at Restigouche Hospital Centre in Campbellton were “victims of negligence, abuse and unacceptable treatment.”

Baseless Arguments

The arguments made by advocates for involuntary treatments aren’t supported by science. First, they often suggest homelessness is due to mental health issues or addiction, while research shows that financial difficulties are the primary cause of homelessness. Rising housing and living costs and low incomes are behind the unprecedented rise in homelessness.

Second, involuntary treatment proponents make an association between mental health/addiction and public safety, suggesting that people with mental health problems or drug users are violent. Research has long since disproven this association in terms of mental health and the situation is nuanced for addiction.

Third, involuntary treatment advocates argue that treating people against their will is necessary because they are unable to make decisions for themselves. This assumption is also disproven by research, which reveals a much more complex reality.

Changing the Language

Proponents of involuntary treatments, like Patrick Brown, the mayor of Brampton, Ont., claim “the old approach isn’t working.” Because the term “involuntary treatment” has a negative connotation, they talk now of “compassionate care.” This change in terminology aligns with the CARE program implemented in California in 2022. Homeless people with certain psychiatric diagnoses can be subjected to involuntary treatment through “a compassionate civil court process.” CARE’s compassionate approach is presented as a paradigm shift.

Conclusion

Making it easier to confine homeless and marginalized people is, to say the least, not a new or original idea. Rather, it’s a very old approach dating back to the Middle Ages. Involuntary treatment is claimed to be necessary because people would not enter therapy voluntarily. Yet mental health and addiction services are difficult to access across Canada thanks to decades of under-funding. It’s tough to justify violating people’s rights to engage them in involuntary treatments when voluntary treatments are inaccessible.

FAQs

Q: What is the current state of homelessness in Canada?
A: More than one in 10 Canadians report experiencing some form of homelessness in their lifetime.

Q: What is the NIMBY phenomenon?
A: The not-in-my-backyard phenomenon refers to the phenomenon where governments and communities are unwilling to allow homeless encampments in their own territories.

Q: What is the current state of involuntary treatment in Canada?
A: It is currently possible to forcibly treat someone anywhere in Canada. Provincial mental health legislation allows involuntary admission and involuntary treatment.

Q: What is the right to self-determination?
A: According to the Supreme Court of Canada, the right to self-determination outweighs other interests, including what physicians may think is in the patient’s best interests.