Backgrounder: Toronto’s Mental Health and Addictions Crisis
2023-05-23

“Mental health is a health issue and a social issue. We need a fully-integrated all-hands-on-deck approach.” – Mark Saunders

Toronto is facing a mental health and addiction crisis.

Even before the stresses of COVID made the situation worse, experts warned that more resources were needed in the community, including treatment and recovery options, a more cohesive and connected service delivery model that would provide wrap-around around-the-clock supports, and more supportive housing. But City Hall didn't take action.

Getting Help After Hours

Throughout his 38 year career in policing, Saunders experienced firsthand the devastating effects of mental health and addiction on those who were suffering, and on their loved ones. Saunders was frustrated that after 5 p.m., many crises were left to police or an emergency room. In fact, from 2020 to 2021, Toronto Police Service responded to more than 35,000 "Person in Crisis" calls made to 911, when there are many resources and facilities better equipped to step in and provide treatment and care.

When Saunders tried to find a non-profit treatment space for someone in crisis who couldn't afford private care, most often there wasn't one available. Additionally, when someone reaches out and says "I want help" - whether to their doctor or a loved one or staff at a supervised injection site - and there's no place to go, the system is letting them down and a valuable opportunity for recovery is lost.

Addressing Needs by Stream

When looking at addressing mental health, addictions, and homelessness issues, it is important to ensure those receiving help are not being lumped together for services. Each group requires its own “stream” of specialized services and supports depending on their situation, whether that’s treatment, rehabilitation, transitional or supportive housing, or employment services. Each group also requires help outside of the current 9-to-5 level of service.

Toronto needs a fully-integrated all-hands-on-deck approach to all of these issues. The city has seen what happens when people with mental health or addictions do not receive timely treatment. It can lead to impacts on neighbourhood quality of life, disorder, petty crimes, or even violent crimes, if left unaddressed. More importantly, without treatment, the person’s own quality of life suffers and that of their loved ones too. When it comes to mental health specifically, it must be treated as a health and social policy issue. If we recognize mental health is health, it’s not a choice anymore.

Supportive and Transitional Housing

For those experiencing homelessness, Saunders understands that a wrap-around service model is essential, where clients are provided with supports that meet their individual needs, such as access to housing, medical care or training for those who want sustainable employment. A lack of connectedness between parts of the non-profit system can perpetuate the "sites to streets" revolving door. Clients receive help from one agency but if there isn't a mechanism to directly connect them with the next step on their journey, they don't know where to turn and too often return to the streets.

Saunders knows that City Hall can also help grow the number of supportive housing units to be operated by non-profits, where clients can get the individualized full-time supports needed to help them improve their situation and live with dignity and stability.

Staffing Up

Increasing access to service means hiring more staff. Just as we saw a shortage of nurses and personal support workers during COVID, Saunders knows there is a shortage of mental health and addiction workers and supportive housing workers to meet the crisis and then sustain services.

Here again, the City can play an important role in growing this important health workforce. City agencies and nonprofits need to have access to a talent pipeline of workers, so they can help more people. It starts with working with Toronto colleges and universities to train and hire more staff, as well as giving service providers more space and resources to deliver services.

A Plan for for Wrap-around Mental Health and Addictions Supports

Mark Saunders has a comprehensive plan that will prioritize treatment and wrap-around supports for those struggling with mental health issues or addictions. The plan will engage all levels of government, non-profits, and other partners to build up the workforce and infrastructure necessary to support those who need help.

As Mayor, Mark Saunders will:

Focus on collaboration and wrap-around supports

  • Launching and leading a Mayor’s Wellness Circle to create an all-hands-on deck approach with the full weight of the Mayor’s Office behind it. The initiative will encourage everyone to contribute, bringing together non-profits, health partners, employers, community groups, and those with first-hand experience with recovery.
  • With an emphasis on service delivery outside of 9-to-5, convene a stakeholder summit that includes representatives of the federal and provincial governments to identify gaps in existing mental health and addiction services.
  • Develop a wrap-around services strategy that recognizes a continuum of care between the City, Toronto Public Health, and the network of community service providers to improve connectivity and coordination so that clients can easily and seamlessly access the specific supports they need throughout their journey of recovery.
  • Increase the number of mobile crisis response teams to provide a more consistent and around-the-clock response.
  • Introduce an accountable case management model to establish clear agency accountability for those seeking services and supports.

Focus on treatment and rehabilitation

  • Provide free space in unused City-owned buildings for non-profits already providing addiction treatment but can't expand services because they can't find or afford more space, or non-profits who want to provide addiction services but can't find or afford the space. Non-profits in turn can use the money saved on rents to provide help for more people.
  • In return for this space, earmark a set number of spaces for emergency referrals from City agencies, such as police and paramedic services, the Toronto Transit Commission, Toronto Public Health and Streets to Homes.

Focus on building a more robust workforce and infrastructure

  • Call on the province to waive tuition for the next three years for Toronto residents pursuing a certificate at a Toronto college as a mental health or addiction worker or supportive housing worker, and for those pursuing certification in supportive housing management.
  • Hire up to 100 of these grads to work within various City agencies that serve these clients.
  • In consultation with Toronto Public Health, hire additional public health nurses.
  • Negotiate with builders of new rental buildings to include supportive units in their projects, which would be provided to non-profits to operate their own programs.

See also: Plan for Wrap-around Mental Health and Addictions Supports