Premier Ford’s openness to involuntary addiction treatment facing constitutional and capacity challenges

The Ford government would need to dramatically increase health care resources and build stand-alone treatment centres if the province wants to involuntarily enter drug addicts to rehabilitation programs, according to mental health and addiction experts.

Premier Doug Ford recently suggested that he’s willing to pursue a controversial policy that would force Ontarians battling addiction into treatment, regardless of whether consent is obtained – something he believes is a “moral obligation.”

“I travel to a lot of cities and it’s terrible. People are crunched over. They’re lying on the streets, you know, close to overdosing,” Ford said at an unrelated news conference on Wednesday.

“We need to help those people. And we’ve had this discussion amongst our premiers.”

While the idea has been pushed by Ontario’s Big City Mayors, who called for the government to review both the Mental Health Act and the Health Care Consent Act to allow for involuntary treatment, the mechanism to allow it remains unclear.

Dr. Leslie Buckley, the chief of the addiction division at the Centre for Addiction and Mental Health (CAMH), said while the experts can provide medical understanding and context on the research, the province would need to put up the resources for treatment.

“You can look at Alberta to see what they’re doing with their major, major shift,” Buckley told Global News. “They were very very careful to maintain the voluntary system, and then consider adding new resources for the involuntary system.”

While Ontario currently has 5,064 mental health inpatient beds across the province, roughly half are considered general inpatient capacity while the rest are allocated to certain subgroups.

Data from Public Health Ontario shows there were 2,800 people who visited an emergency department in January experiencing an opioid-related poisoning, offering a glimpse into the scope of the problem.

Even Premier Ford suggested Ontario doesn’t have enough resources to immediately address the issue.

“We need to build more capacity. We want to work with and we will work with CAMH and other experts when it comes to helping these people, making sure they have a roof over their heads, that they’re getting support, that they’re getting help and getting off the drugs that they’re on because it’s terrible right now,” Ford said.

Ford’s openness to the idea triggered another push from Brampton’s Mayor Patrick Brown, urging the province to launch a pilot project in Peel Region.

“The proposal contemplated a process allowing first responders to bring a person to a psychiatric facility where a physician determines it is necessary for that person’s health and safety and the safety of others,” the city said in a news release.

“The call was framed around three outcomes: connecting people to care they cannot currently access, easing the burden on emergency services, and improving community safety, while balancing the dignity of the individual.”

Buckley said CAMH and the province are not in any official talks regarding involuntary care but stressed that any provincial legislation on involuntary care would need to emphasize evidence and oversight.

Any potential involuntary care legislation could face another road block before it even gets to be implemented.

The Canadian Civil Liberties Association (CCLA), which has successfully challenged previous Ford government legislation in court, is already taking issue with the concept.

“We understand the serious issues that are facing so many communities in Ontario, especially around homelessness, mental health and substance use, but that urgency cannot be the excuse for coercion,” said Harini Sivalingam, the CCLA’s equality program director.

“Our fundamental position is that expanding forced treatment is not a substitute for a functioning health and social service system.”

In British Columbia, portions of the involuntary psychiatric legislation tabled by the NDP government was struck down after the Council of Canadians with Disabilities argued it violated Charter rights.The B.C. Supreme Court agreed, ruling the Mental Health Act gave hospital directors what it called blanket power to impose psychiatric treatment.

Ontario NDP Leader Marit Stiles said it would be the wrong approach for Ontario.

“I don’t think it’s realistic, at this point, given how short we are in treatment spaces and beds,” Stiles said.

“People who are seeking voluntary treatment and beds are on massive waiting lists, there are nowhere near enough spaces.”

Stiles called for an urgent investment in the number of treatment beds as a first measure before the government considers alternate options.