The head of a large shelter on Pandora Ave. in Victoria — in the midst of the street disorder of the city's most high-profile homeless encampment — told delegates at the Union of B.C. Municipalities (UBCM) conference that the province needs to shift its focus on homelessness.
Our Place CEO Julian Daly said B.C. must treat it as a health issue, and that the most compassionate way forward may be involuntary treatment for some.
"That is controversial, I know," Daly said, "but if someone is so unwell that they cannot make informed decisions about their health care, then leaving them to die on the sidewalk with little but their liberties intact is not compassion. It is abandonment."
Street disorder is high on the list of priorities at the annual UBCM convention, which began Monday (Sept. 22) in Victoria.
Several workshops and sessions are scheduled to discuss the issue. Eighteen separate resolutions on the topic are coming to a vote, including a special resolution from the UBCM executive that calls for the province to coordinate a regional approach to homelessness by increasing funding and resources for supportive housing and shelter initiatives.
Daly spoke alongside Adam Dalrymple, president of B.C.'s Crown Counsel Association, Alex McMillan, interim CEO of the B.C. Chamber of Commerce and Dr. Daniel Vigo, who is working for the province as a special advisor on psychiatry, toxic drugs and concurrent disorders.
Vigo gave three reasons for the crisis: the closure of the Riverview psychiatric hospital, the "technological revolution" of strong homemade synthetic drugs, and the failure to provide concurrent care in the same place for people's mental health and addiction problems.
He illustrated the connection between mental health and addictions, explaining that because opioid overdoses deprive the brain of oxygen, they cause damage. He showed how this has impacted a group of people participating in a long-term study in the Downtown Eastside.
"We know that the brain volume decreases in this population compared to control," Vigo said. "We know that the cognitive functions decrease in this population compared to control."
Most speakers, including several mayors on the panel, agreed that the solution will now require some form of involuntary care.
Vigo is heading the province's response, including how it will approach involuntary care, but it was Daly who stole the show with an impassioned speech on the crises he has witnessed unfold daily on the doorstep of, and within, Our Place.
"No one has encapsulated this as well in a public place as Julian Daly did today in terms of the problems," Nanaimo Mayor Leonard Krog said.
Daly developed his argument by explaining that when he began working in homelessness 17 years ago, alcohol was the primary drug of choice among the unhoused.
"Fast forward today, and the landscape is almost unrecognizable," Daly said. "The drugs have changed, and the drugs have changed everything. I can't stress that enough."
Vigo concurred, explaining that the strength of drugs has increased astronomically in the past decade. Fentanyl is 100 times more potent than morphine. Carfentanil is 100 times stronger than that, he said.
When decriminalization was introduced, it was well-intentioned, Daly said, but it ended up "feeding the problem." Add in what he called "catch-and-release" policing, with people not being incarcerated for small offences, and the situation snowballed.
"Police lost the leverage they once had to sway folk from public use," he said. "What was once hidden is now everywhere."
This has led to an escalating situation in which disturbing behaviours are normalized.
"It isn't only the drugs, we've also slid into what sometimes feels like endless accommodation of behaviours on our streets that are, frankly, not OK — behaviours that frighten people and make them feel unsafe, including other homeless people," Daly said.
His solution? Treat this as a health crisis, instead of a housing crisis. Work on the housing situation has helped, but many people experiencing entrenched homelessness have been housed and kicked out again. Daly said it takes police, health authorities, non-profits and housing services all working together.
Daly's other solution is more enforcement, but he said it needs to be targeted at those people who are selling drugs and preying on people living with addiction and mental illness.
"Enforcement for some, health care and housing for others," Daly said. "Compassion must be balanced with accountability."
The Union of B.C. Municipalities convention continues until Sept 26.
