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If words in a newspaper could solve the social crisis on our streets, we'd be on our way with the back-and-forths that have been happening in the Victoria Times Colonist since a Sept. 24 column by Les Leyne kicked things off.
But things have gotten confusing on Facebook what with the ridiculous fight between Meta and the Canadian government that has left us unable to share newspaper links in Canada. So here's all four parts of the back-and-forth laid out in order - Les's piece, then my response, then a comment piece by retired nurse Barbara Wiggins, then my response to that.
Hope this helps for those trying to follow all of this. And while there are some differences in opinion throughout, it's really heartening to see the TC devoting all these column inches to this issue.
B.C. has slid into an attitude of “endless accommodation” of antisocial behaviour by desperately ill people on downtown streets, says the man at the epicentre of the epicentre of Victoria’s downtown decay.
Julian Daly, CEO of Our Place, the agency most directly involved in the drug-infused mental-health crisis most obvious on Pandora Avenue, told municipal leaders at the Union of B.C. Municipalities convention that the balance between compassion and enforcing expectations has been lost.
The ongoing “what to do” debate has flattened into an overly simple artificial choice between compassion and enforcement, he said, but both elements and a lot more are needed to make a difference.
One camp, which the B.C. government endorsed for years, focuses on empathizing with drug addicts. It stresses that addiction is a health problem, not a choice, and concentrates on the sufferers.
On the other side are people suffering the consequences of the disintegration of social order and losing patience.
But reducing it to that choice is a mistake, said Daly, who has spent his career caring for the marginalized.
“We’ve slid into what sometimes feels like endless accommodation of behaviours on our streets that … frighten people and make them feel unsafe, including other homeless people.
“In our desire to be compassionate, we have sometimes lost the balance for accountability.
“When ‘anything goes,’ it really does.”
Our Place is the largest provider of free meals on Vancouver Island, but Daly said “many people who desperately need our food … are simply too frightened to come into our building … because of what’s happening outside.”
Meanwhile, the charitable donations the organization relies on are dropping because of disgust at the situation outside their doors.
“Long-time generous donors have told me bluntly they’re no longer giving because they associate us with the disorder … They believe wrongly that we are somehow responsible …”
Daly said that while the desperately ill are being demonized by some, the compassion-first stand is also problematic.
The NDP’s disastrous decriminalization effort, which disintegrated as an official policy within months, was well-intentioned, Daly said, but had unintended consequences.
It gave people permission to use drugs openly and took away police leverage to discourage drug abuse.
“What was once hidden is now everywhere at the same time.”
The firmly established catch-and-release process in the judicial system has reduced police morale, Daly said.
Police want to maintain order, but when the legal system doesn’t impose consequences for criminal behaviour, they shy away from enforcement, and there is no fear of repercussion on the street.
“It may sound harsh to say, but sometimes well-meaning interventions can end up feeding the problem.”
Once-shocking scenes of misbehaviour have been normalized now and are a routine part of city life, Daly said.
People just walk on by, which fosters complacency.
The government spent millions buying motels for homeless people, and housed 800 of them in the region in recent years. But many of those still on the street today were in safe housing. They lost it because of their continued addiction and mental-health problems, he said.
An all-encompassing strategy of housing, treatment, recovery and enforcement is needed.
He said involuntary care is controversial, but has to be part of the solution. Leaving someone to die on the sidewalk — with their liberty intact — “is not compassion, it’s abandonment.”
“Sometimes the most compassionate thing we can do is intervene.”
After years of dithering, the NDP government took the first tentative steps toward secure involuntary care last year. It was telling that they had to hire an outside special advisor — psychiatrist Dr. Daniel Vigo — to chart the rationale for doing so.
Daly said the New Roads recovery programs are showing real results.
He urged more targeted enforcement by police. Not to criminalize addiction or poverty, but to attack predators within the street population who exploit homeless victims.
“Enforcement used wisely is not the enemy of compassion. It is a tool of protection.”
He also stressed the need for prevention, by way of immediate interventions before the cycle gets entrenched.
That means stepping in “when the first tent goes up” in order to start solving the crisis instead of just managing it.
It feels like the province has adjusted its stance over the past year or so, partly in the general direction that Daly advocates.
But the government drifted a long way from the balance he stressed is needed before the course correction came.
My response to Les Leyne’s column, which ran as a comment piece Sept. 27:
Everything about Les Leyne’s Sept 24 column filled me with rage, most especially Our Place CEO Julian Daly’s stunning misrepresentation of problems at the core of this social crisis burning in the hearts of our communities.
To take the tragic situation that is happening on our streets and blame it on our “anything goes” attitude and “endless accommodation” – I don’t even have words for the fury that evokes in me after decades of observing how this four-alarm social crisis came to be. We simply must quit listening to people speaking from the comfort of their nice, non-impoverished lives and get a grip on this tragic humanitarian crisis from the point of view of the people living it.
Medical triaging treats the sickest people first. Social triaging works in the opposite way – you must prove yourself to be sufficiently ready, worthy and stable enough to get help like housing and treatment. What that approach has created is a situation where the absolute sickest people are the ones left without care.
Imagine if cancer patients had to prove themselves “ready” to qualify for support. Still smoking? Not eating enough greens? Overweight? No care for you. Unable to fill out dozens of forms that you don’t even know exist while maintaining a polite, pro-social façade despite being racked with pain and anguish? Back of the line, buddy.
As if. But that’s what we’ve done here. We set up rules that only the healthiest of a sick population can possibly achieve, and blame the ones left behind for not trying hard enough. We dangle the promise of housing like a carrot to be had if someone can sufficiently demonstrate that they’re worthy of it. We tear apart encampments as if we expect the people living in them will vanish.
This is the criminalization of poverty and disability. We are sectioning people under the Mental Health Act as risks to themselves or others and then sending them, still sectioned, into the community to live homeless. We are walking all over people’s human rights, every single damn day.
This is not “endless accommodation” – this is brutal, socially sanctioned neglect of extremely ill human beings, who are viewed with something far from compassion.
None of this is about drugs. Any of us would be using drugs if left in this situation. The drugs are the top layer on people’s multi-layered problems, but they’re the symptom, not the cause.
Why does this deepening social crisis never respond to any of our actions? Think about that. They’re the wrong actions. The sickest people are being shut out of support. That’s not “endless accommodation,” that’s just stupid, inhumane policy that leaves the very visible flames of a four-alarm social crisis to burn unattended on our streets.
Next, retired nurse Barbara Wiggins responds to my piece with her own comment Oct. 9. She has a degree in health informatics from the University of Victoria:
I am pleased to see several letters and opinions recently on our urban crisis of addictions and social disorder.
It is worthwhile to revisit the theories that our policies are based on and determine if evidence supports those theories.
With any social policy, evaluating our efforts and determining whether we are making a difference, whether we could do better and whether our policies are creating new problems is imperative.
Jody Paterson wrote an impassioned commentary from which I inferred she believes that compassion is the ultimate guiding principle.
I believe that she and many others employed in this sector are both sincere and committed to their noble cause.
But there is a key element to her argument that needs to be examined.
She contends that in medical triage, the sickest are treated first, whereas in social triage, they are treated last. In fact, the exact opposite is true.
Medical triage was established as a means of streaming the injured into similar groups in a mass-casualty event.
The first group is the walking wounded and those whose treatment can safely be delayed. Their treatment is delayed.
The second group is those who need immediate, usually intensive, intervention to survive. This group receives priority care.
The third group is those who are terminal — either dead on arrival, or whose condition is so dire that death is inevitable. This group gets little or no intensive treatment, as the efforts to revive them will be futile, and comfort measures may be the best that can be offered.
Furthermore, the efforts of caregivers are better spent on those outcomes that can be improved by medical interventions. This system, far from being heartless, is born of both compassion and logic.
I am not advocating a harsh “let them fend for themselves” approach.
But I will support the notion that some individuals are in the unfortunate overlap of brain injury, addiction, mental health disorders and criminality, who are not only not benefiting from our social programs, but who make it more difficult to provide effective service and care to those who have a chance of being helped.
Also, some of these individuals may victimize those clients for whom the programs were created.
Unfortunately, there is so little hard data or program evaluation to guide decision-makers one way or the other.
But it has become clear that we have an unmanageable, expensive, inefficient, illogical, heartless mishmash of programs.
Can we at least agree that the state of unresolved addiction is a hell we wouldn’t wish on our worst enemy?
If we can agree on that, then perhaps we could all get off our ideological soapboxes and start planning and funding programs based on the likelihood of success in helping people transition back to a non-addicted life, where it is possible to have a healthy life with healthy social connections.
And we provide compassionate care to those for whom recovery is no longer part of their care plan, as long as their programs don’t increase the risk of harm to others.
And, for those who perpetually victimize the most vulnerable, we need to have the courage to incarcerate them using the prison system.
If this smacks of heartlessness, it is anything but.
Out here in the homes and neighbourhoods, we live with and witness the damage done by the addiction/social disorder crisis.
We witness our children, the children of our friends and the friends of our children fall victim to this mass casualty event. We see that not all approaches work for all people and that some are lost despite massive attempts to help.
We have a vested interest in this problem that goes way beyond our role as taxpayers. We have skin in this game.
One definition of madness is to endlessly repeat the same action and expect a different outcome. It is time for a fresh perspective.
And my Oct. 16 response to Barbara Wiggins' piece. Last in the series, so far....:
Thank you to Barbara Wiggins for her informed commentary on Oct. 9, which clarified that medical triage actually has three groupings: Help these ones right away; these ones can wait a bit but must be prioritized for care; and the group that is essentially the walking dead, who need medical help the least because there’s no chance they’ll make it.
The social triage is similar but different: Easiest to help so pick them first; these ones next because at least they’ve got an advocate; and the final group, essentially the “dead man walking” group noted in the medical triage description. The people who the system decides are not worth helping.
But while this group takes care of itself neatly in the medical world — they just die — that’s not how it goes with social crisis.
The people deemed “hopeless” don’t die, they end up living hard, sick, poor, incredibly stigmatized lives in ways that are not only cruel, wrong and expensive, but that annoy the hell out of the neighbours, business owners, city councils and every colour of government.
Wiggins rightly points out that the hopeless group at least get comfort in medical triage. In the social triage, this group is treated as harshly as possible.
They live in dystopian conditions — chased from place to place, personal items freely taken from them, rounded up for forced injections and then released to the street.
A young man is shuffling his feet endlessly on Pandora right now, affected by a major side-effect of the psychiatric drug he has to be on and is helpless to challenge. More importantly, the people we’re talking about are only looked at as hopeless cases because they’ve been left for years without the support they need.
In medical triage terms, a lot of them would have been in the “priority care” group once, born into challenges and with disabilities, but they were left in line so long that now they’ve come to be thought of as beyond help.
They’re definitely not. But they also don’t fit in our boxes. We keep pushing them in and they keep falling back out.
That’s not an unsolvable problem. But it is if you continue to view the problem from the perspective of the people wanting it gone, not living it.
