Mary W. Rowe [00:00:05] Hi, everybody. Good morning and good afternoon wherever you happen to be. Welcome to CityTalk. I’m Mary Rowe at the Canadian Urban Institute. Today I am in an extraordinary place, Rocky Harbor, Newfoundland, which is the traditional territories of the Mi’Kmaq and the Beothuk, and has a long, long relationship with being an unceded traditional territory of First Nations that are actually no longer resident here. And that’s a whole set of challenges upon itself. We would ask everybody to sign in across the country and tell us where you’re coming in from and what your particular attachment is to the ancestral territory from which you come. These conversations, as we know, have taken place with people from all across … coast to coast to coast, and they’re intended as candid conversations about what’s working, what’s not, and what’s next for Canadian cities. And we’re really happy to have you here for what is a really profound and important and compelling challenge and topic, which is the future of our downtowns and main streets and how they’re being affected by what is a mental health crisis. I just got off a call earlier today with city managers across the country who were continuing to describe what they see as a mental health crisis. So we’ve been fortunate to have such a great group of practitioners and people providing different perspectives on what they’re actually seeing on their radar. As we always say, you know, what are you seeing right outside your front door? What are you seeing on the street? And the adage we always use is what’s working, what’s not and what’s next in terms of addressing mental health. Many of you know that CUI has stayed focused on downtowns and main streets as our two primary lenses of how our cities are doing. We’ve come out a couple of weeks ago with a report on the potential for conversion of commercial buildings into residential buildings and other uses and how are we going to readapt and reimagine our spaces. Obviously one of the key challenges is what is actually present now if we don’t have a lot of workers, or   as many workers coming into downtown commercial areas, what is happening in the downtowns and what’s happening on our main streets? And all you have to do is read the papers to know that we’ve got a significantly visible, visceral challenge of people needing supports, mental health supports, interventions and supportive housing. I also just want to put a shout out that we have a big chunk of the country disproportionately continuing to fight fires in May. In this part where I am, I flew over the the fires that were happening in Halifax. We know that the West, Alberta and almost all of Alberta and part of B.C were clouded in smoke for the last three weeks. So this is a remarkable moment for us to just be in solidarity with each other as we try to continue to think about how we make our communities more resilient economically, environmentally, socially, and obviously to the kinds of challenges that our communities that are dealing with fires are in. So I encourage you to use the chat. Those of you that are new to City Talk need to know that if you haven’t ever gone on to the chat, you should because there’s a whole parallel universe. I’m watching it right this minute popping up people saying where they’re coming in from and through the hour that we’re going to spend together, people raise issues here, they ask questions, and lots of conversation goes on in parallel because city talk audience is a multitasking one who can listen to this panel and have a conversation there. And everything that you put in the chat we publish and we keep. So if you’re putting resources in there about new leads that people could follow about mental health interventions that are working, please put them there. And we would encourage those of you that have never actually participated in the chat, give it a try, participate, because it’s a really interesting way for us to continue to share knowledge with each other. So I’m going to invite our panelists to put their cameras on and we’ve got quite a few this time. As you know, we try to sometimes keep it a bit smaller, but this topic was just so pressing for us that we felt we wanted to get a broad range of perspective. And  this is a very difficult topic. And I just want to say to the City Talk producers, thank you for whatever that beautiful music was that you put on at the beginning, because that really set a kind of tone about how to have a serious conversation in a respectful and gentle way. And  so that’s what we’re going to do. And so I’m going to start … Usually it’s pretty random how I choose for people to go, But we’re going to go west to east because I’m at the far east and ask each of the contributors to just give us for a couple of minutes their perspective about what they’re seeing, what do they see as the particular challenges around mental health provision and services and what are the challenges you’re facing? And and we’ll do that around the country and then we’ll come back and have a group conversation. So I’m going to start, if I can, with Superintendent Howard Tran, who is in Vancouver in the police department. Over to you. And as I said, we’re going to drop titles once I’ve just done the introduction, a full bio appears in the chat guys, if you want to see exactly what what Howard is about. But Howard will go first and just tell us a bit of what what he’s actually seeing . So welcome everybody to CityTalk, Howard, off to you.

Supt. Howard Tran [00:04:48] Thank you, Mary. Good morning, everyone. I want to  start off by acknowledging that I’m speaking to you from the traditional and unceded territories of the Musqueam Squamish and Tsleil-Waututh First Nations people. Yeah, very happy to be here. What are we seeing on the ground? I think. Now, I’ve been doing this work for a number of years, and you know that the challenges that we have identified 20 years ago remain the challenges that we’re talking about today. And these are sort of lack of of mental health beds, lack of services, lack of coordinations. We have what we call silos of excellence, but system failure, You know, we’ve replaced basically our prisons … our mental institutions with prisons. Basically, the four walls have just changed. But, you know, the folks that are within these places are still the ones that are the most marginalized, most vulnerable, the ones that are suffering the most from mental health issues and substance use issues. So I think, you know, Vancouver, of course, is in front and center of many of these issues. We obviously have the fentanyl crisis going on right now. We have the encampments in Vancouver. And so the issues that we’re facing are really sort of, I think, seen across the country. But really, you know, for us, it’s really concentrated in a particular area and we’re really trying to dig our way out. And, you know, I think if I had to sort of sum up, we just need more services and more … You know, all the service providers and all the community groups and all the institutions to get together and really be coordinated on the what we’re delivering here. So I’m sure there’ll be more questions to come, and I’ll just leave it at that.

Mary W. Rowe [00:06:31] It’s interesting what you’re pointing out. You know, we’ve been doing a lot of these sessions on housing and homelessness and everybody points to that moment. I’m going to actually … I’m going to skip and go a little bit, not as methodically through the country because I’m going to go to Andrew Bond next. Al, I haven’t forgotten about you, but I’m just going to go to Toronto next, only because of this, that this moment where we made some public policy decisions around deinstitutionalization, which is a several decades ago. But it has had these extraordinary implications in terms of how that … does that decision … that decision, public policy decision was made without the supports being in place. I guess that’s the dilemma. And so what you’re saying is I can see it on the streets. Andrew Bond, we’ll go to you next. And then Al I’m going to come back to Winnipeg. Won’t forget you. So Andrew in Toronto. Go ahead, Andrew.

Dr. Andrew Bond [00:07:19] Thanks so much, Mary and Howard, for that framing, I think it’s really critical. I think it really gets at the pressure points that we’re all feeling, I suspect, right across the country at ground level. We know that we at some version of boiling point, however you want to characterize it, where the needs and demands are just so deeply mismatched right now. This takes place to your point, Mary, on a backdrop of a bit of a historical trajectory here, I think it is important to really also do the contemporary piece of the framing where we know that with the economic challenges and instability of the last few years and the impact on housing markets and affordability that those two dimensions of a larger macro economic and macro structural policy changes and environments are interacting with this historical trajectory of not having the degree of intensive support in the community that were always needed to actually successfully transition from an institutional approach to mental health care into the community. And so now we are seeing what is ultimately about a 35 to 40 year old trajectory coming together at this point, that where the health care systems are at our weakest because we’ve just been through three of the most grueling years and resource depleted, we know, and also even more so than that, personnel depleted just through the wear and tear. And so now we have all of us trying to do our best at the hardest time to be able to actually support. And so we know, to your point, from that transition from the institutional to the community … And the only way to successfully make a transition like that is to deepen and intensify the support available in the community. And these are certainly not cheap, but they are cheaper and more effective than can happen in institutional environments. But we have not done that. We’ve taken the approach of both doing it as lightly and cost efficiently as possible, but not effectively, and not doing it to the point that Howard’s raised with the degree of coordination that might happen in an institutional environment. So institutional environments do provide closed systems for the most part for highly coordinated integrated care. That same functionality has to exist in the community, and we don’t have that. We’ve never invested in that. And so there are those of us who are working very hard to try to develop that right now. But if we’re going to be able to get through this, we do have to actually see the investment and build on the strengths that have been built up through the pandemic period. So I think I’m hopeful that we can get there, but we need a combination of policy support, no question, the funding support through this, there’s no way to make it through this without it and the on the ground engagement and coordination that Howard’s speaking to you, that has to come from both the public and private sector partnerships together in neighborhoods and communities.

Mary W. Rowe [00:10:14] Interesting the point you just made about, you know, the old adage, one stop shop, you know, the idea that if you’re in an institutional setting, the belief is, oh, we can coordinate things because the fourth floor is talking to the seventh floor and we’ll just do it. But we do know that fails, too. So even when you’re in the same institution, you know, just saying … But I hear you that that dilemma then is that when you disperse into the community and you’ve got so many delivery agents or maybe you don’t have enough delivery agents, how do you actually create that community piece? So policy support, funding support, and then this on the ground coordinating support and and how we’re going to get at that. Okay. Al, now to you in the center of the universe, Winnipeg

Al Wiebe [00:10:59] Well, you know, with our current government, we’ve seen massive, massive cuts to our health care system. And that is truly affecting what folks can do with the mental health issue on our streets. And it’s a real shame that that’s happening. We are you know, we’ve seen, again, due to the pandemic and other measures, we’re seeing middle class people drop into into poverty. Beneath the poverty line. We’re seeing people beneath the poverty line drop into homelessness. And those numbers are increasing. And one of the things that’s, you know, it … shows everybody that, well, it’s become way more visible. You’re seeing people in the bus shelters. We’re seeing now people in tents everywhere. They’re expanding and and there’s an outcry about that. But, you know, our current time counts show that, you know, one of the biggest reasons for homelessness is certainly mental health issues and people’s families and relations not knowing how to deal with it. People end up on the street and, you know, we’d had this long argument about putting health care professionals with the police and there’s this big defunding the police thing, which I don’t believe, but we have to add to the police budget to put health care professionals with the police to deal with the homeless factions. And what has happened on that issue is that I’m really happy to say this, that organizations like Main Street Project, the big shelter here out in Winnipeg is sending out, you know, people with mental health acuity to work with folks on the street. They’ll have three member teams on in the outreach vans and working with folks because it’s such an issue and it’s not only the homeless though, but it’s the people newly impoverished folks who are newly … that are not dealing with the trauma of today’s society and dealing with the trauma of not being able to pay the bills and not being able to feed their children, kids. And we’re seeing a lot more violence from that. And or, you know, it’s things like broken windows in downtown like never before. And, you know, also, you know, with the rise in cheap drugs on the streets that the psychosis goes up and we’re seeing a lot of that as well. So right now, I’m not I’m not seeing a great deal of progress in dealing with the mental health issue in downtown Winnipeg. But, you know, thank goodness there are organizations that work towards that end, whereas the city and the province hasn’t really made a great deal of progress in that regard.

Mary W. Rowe [00:13:56] It’s interesting Al, what you describe, because I was doing an interview earlier this week with a mid-sized city who has vacant storefronts. As you say, it’s like a cascading effect, right?

Al Wiebe [00:14:10] And it is.

Mary W. Rowe [00:14:11] This is … If anybody’s on the call from London, Ontario, chime in and show us that you’re on on the chat. But London’s challenged because it has empty storefronts, vacant storefronts and parking lots. And so as you suggest, and then if you add on to that cheaper drugs, higher contamination reat, I don’t know what the right word is for drugs and then not a lot of supports. And I want to come back to the point you mentioned about who should be delivering services, these kinds of outreach services to people. Where is it right to situate those resources? I’ll come back to you on that Al, Thank you.

Al Wiebe [00:14:44] Thank you.

Mary W. Rowe [00:14:45] And let’s go now to the north part of Ontario, to Kyle Marcus, who’s in Sudbury. Go ahead, Kyle.

Kyle Marcus [00:14:52] Hi, Mary. I’m super grateful to be here today and a little overwhelmed to be sitting with such a great group of panelists. I come from a unique perspective. I am the managing director of a downtown BIA, so I represent about 450 businesses and about 100 property owners, of which I also have a business within our membership. So I actually have two front doors to look out of for perspective, and both of them kind of see the same thing. All day, every day I just see people trying their hardest. I see our vulnerable populations trying to navigate what I would describe as  a inhumane and unkind landscape. Whether that’s the stigma attached to poverty and addiction and mental crisis, or mental health or lack of housing or anything like that, we see them trying to to navigate this landscape, especially when there’s not enough supports or services. And on the flip side of that, I see businesses, people just like me, you know, trying to feed their families, follow their dreams, contribute back to the community we love. While we see these social issues seemingly continuing to consume our neighborhoods. And all of this happens under the guise of almost finger pointing. It feels like nobody is rushing to help. Other areas of cities, you know, point to the downtown like we invented addiction or homelessness or mental crisis, you know, and we forget other parts of cities that aren’t in downtown seem to forget that these are our uncles, aunts, our neighbors or cousins and loved ones, and that eventually it becomes all our responsibility to take care of these people. And it’s not until it seemingly spreads outside of downtowns to these suburban areas that we start to see solutions. So it’s been an interesting place to stand, I don’t say between businesses and vulnerable populations, but with them both and trying to find workable, feasible solutions for everyone that that brings human dignity back to people that have had it removed as well as, you know, the ability to feed your family and, you know, pursue the avenue in which you’d like to make economic difference.

Mary W. Rowe [00:17:11] You know, it’s interesting Kyle, the point you make about when does it touch us personally. I mean, I would have thought there’s not a person on this panel or in this gathering of several hundred people that are on this call that aren’t either experiencing themselves some degree of mental health challenge or have someone in their family who is, particularly through the pandemic. So I don’t know how we all cut ourselves some slack here. We’ve got to build more empathy for each other because we’re, as you suggest, it’s your sister, it’s your brother, it’s your cousin, it’s your colleague, whatever it is. And then the question then is, how do we create these … I appreciate your language, that we’ve got inhuman landscapes. You know, you had a second word, which I’ve forgotten. What it was, brutal, maybe, [Unkind]. Thank you. Unkind. So how do we get where … It’s really about how are we going to re-institutionalize kindness? I mean, it’s more than that, obviously. Okay. Mayor Guthrie, let’s go to you in Guelph and then we’ll give Suzanne a chance to0.

Mayor Cam Guthrie [00:18:06] Thanks, Mary. Thanks. Everyone who has spoken so far. You probably see some common threads here amongst everything that we’re seeing on the ground. And so in my 2 minutes about what am I seeing, I’m seeing a complete failure of our health care systems. That’s really what it comes down to. For me. It is very difficult for people that are in these vulnerable positions to be able to navigate through the system. There is, I would feel, a lack of coordination between the system as it is. And so what’s happening in especially from a municipality lens, is that cities are having to step into the health care arena and municipalities were never set up for that. We never were set up for financially dealing with this issue. We were never set up from a stopping capacity side to deal with this issue. But it has become so in our face that we have not been able to ignore it any more. Just to give some perspective, I was the chair of the Ontario Big City Mayors Caucus for a few years and and last year the caucus, which represented 29 cities in Ontario, which was 70% of the population of Ontario, we passed a motion unanimously asking for an emergency meeting with the province on this very issue, especially because we were seeing it play out in our downtown cores. And we were very worrisome for the people that are struggling. That should be our main focus and concern, of course. But for the businesses in the area, they’re just coming out of COVID after a couple of years of barely holding on. They’re trying to keep their businesses alive and thriving and their employees still hired. And instead they’re shifting from trying to focus on creating a great public space and a great welcoming space for tourism and for economic development. And instead they’re shifting even themselves into the social services realm. And so we needed to try to elevate this to upper levels of government. And we still continue to do that. And it’s very difficult conversations that I’m having to have. I’ve been the mayor for almost nine years. I never, ever thought that I would be probably dealing with two or three issues a day on these topics, whereas eight years ago it was hardly at all. So there’s a system failure here and everyone’s heart is in the right place. But it’s something that’s so dearly needed. And I’m seeing it and hearing about it all the time. So I hope that I hope that this conversation and others and and those that listen after this really try to figure out some ways we can work together with those upper levels of government that I believe really have a duty and a jurisdictional place to be helping with this issue a lot more than they are.

Mary W. Rowe [00:21:07] It’s always interesting to hear, and we hear it frequently … just Kyle was echoing in many ways what you’re saying, Cam … all of a sudden, people that work for BIA is our social workers, and all of a sudden people in the permitting office have to do referrals to mental health supports, if they have supports that they can find or refer to. So it’s as if we’ve all had to do the pivot to becoming sort of stewards. And I think this is part of what Al was getting at too, is that … and Al has his own experience of this about when you’re in a vulnerable situation and you need help, sometimes the provider of the help isn’t the one who thought they would be. I’m appreciative that people are checking in from libraries, including I see Luke from the London Library. And, you know, libraries are now on the front lines of providing these social services. They’re becoming like the new emergency rooms, I guess. So this is part of the shakedown that’s going on. And how are we going to cope with it? You know, because I worry that we can ring our hands. We can say, no, I won’t do it. But the truth of it is we’re all having to do it, you know, And then how do we realign resources? How do we make sure that the people that are being expected to provide this kind of service actually are equipped and resourced to do it in ways that are positive and not harmful? So, okay, Dr. Suzanne Shush is joining us. Over to you, Suzanne. welcome to CityTalk. Really, really glad to have you part of the conversation. Go ahead.

Dr. Suzanne Shoush [00:22:30] Hi. Thank you so much. So I’m Doctor Suzanne Shoush, I’m here in Toronto. I’m personally First Nations through my mother, who’s Coast Salish, and my father is from the Sudan. Interesting when we talk about this conversation and it’s really important to take a few steps back. I know that the beginning of the conversation started around the challenges that we’re seeing in mental health and when it comes to our cities and our streets and the reality that this is a public health crisis, this is something that is just as relevant to our community and our public health as COVID 19 pandemic was. And the biggest challenges that we’re going to see are rooted in policies and the absence of policies that address the universal right to housing that address safe housing, harm reduction and other supports for people experiencing homelessness. We really see … another issue is always around resources and resource allocation. And I do very much believe that we do need to take a hard look at our city budgets and the way that our decision makers are allocating a very limited resource. So when you have a budget is by definition a very limited resource, and the way that we use that money is going to impact every single person in the city. And I often see that we’ve had this chronic defunding of our social services over decades that results in these crises or these crises, and we fall into the trap where we look at this moment, where the crisis is happening or has already happened without looking at the decades of policies that contributed to this. Right. So we are looking at issues where there are in large cities, certainly in Toronto, very inflated police budgets. For example, somebody mentioned defunding the police, which is actually a movement I deeply support. I really do believe that we need to defund in order to improve the way that police can offer services and have the proper people doing the other services, providing the health care, providing the housing support, providing the social work. I think that there is a real harm when we see mass amounts of money hoarded in police budgets because that comes at the expense of community services, of transportation, of housing, of all of these social determinants that contribute to good health, to safe health. We know that the healthiest and the safest and the most well communities are not the communities that are overpoliced. They are the communities that are the most well-resourced and the most privileged. So when we’re talking about that, we also have to consider the impact that systemic racism plays in this mental health crisis. Privilege is deeply intertwined with issues of systemic racism, especially anti-indigenous racism, anti-black racism. We see this in Toronto alone where where 91% of indigenous adults are living below the low income cutoff line. This is a direct result of systemic policies that our government has put in place. So when people say that these are policy failures, these are actually policy successes. What we need to do is change our policies to see these outcomes change. We definitely need to address that. We need to address, you know, solutions based to public health. Unfortunately, you know, I don’t know who mentioned this, but apathy is a big issue. Apathy and fear and a lack of understanding. And when there was the COVID 19 pandemic, we were able to, as a community, spring into action for the most part and really understand how to work together. Because protecting my neighbor, protected me and my family, if I could protect my neighbor from getting an infection, it meant I could protect my mother, my elder, my children. Unfortunately, when we are walking around, to grossly oversimplify thi … You can’t catch a mental health or you can’t catch addiction from walking past a neighbor that has this. So it’s often harder for us to understand that that helping that neighbor will still help me. It will help my community. It will help the safety of my family and and the general wellness of everyone around us. Health care is so much more than just what, you know, a physician interaction or an interaction with a primary care provider or a health care provider is. We really need to look at health care as encompassing every social determinants of health and and really understanding that businesses work together with community members, work together with health care providers. We just need to shift our policies and stop considering this as some kind of a systemic failure and realize that these are systemic successes. These are the outcomes of the policies and the laws and the budgets that we put in place. These are the results of the amounts of money that we asked for. The way that we continuously deprive some organizations of resources and then over resource other other aspects. I think that it’s really important to understand this is not something that we can police our way out of. This is not something that we can address without including the voices of Indigenous, black people, people experiencing homelessness and and other marginalized people who are very often do have solutions. You know, I do not believe that our health care system is completely broken. I believe that there are solutions that exist within the communities that have not been listened to. Some of the work and some of the people that I work with through ICHA, through the Indigenous Health Program and ICHA, has proven that we can make wonders work when the resources and power and decision making is put into our hands.

Mary W. Rowe [00:27:39] Wow, That’s a lot. Just a couple of quick comments. First of all, apologies, those of you that had to look at me instead of Suzanne, I don’t know quite what’s going on with the tech guys are trying to figure that out. You do not need to look at me. You need to look at her. But we heard you. We heard and I saw you and we heard you loud and clear. And I’m interested, Suzanne, you talked about public health and you talked about community health. Are they the same thing?

Dr. Suzanne Shoush [00:28:03] Oh, my goodness. I feel like Andrew Bond would be able to give a much clearer, more articulate answer than I can.

Mary W. Rowe [00:28:10] Both of you can have a go at it. But but you know what I’m getting at because part of what I’m hearing from all of you is and this is a this is a very common challenge in urban life. It may in fact be that the best intervention and the best support that can be provided on any number of issues mental health, economic development, land use should actually be being done at the community level. But the dilemma is that we’re not set up in Canada to fund … The big money is not at the community. And so we’re in a situation where it gets bumped up and then Cam, is they’re saying, Mayor Cam, is saying, I need the money. So I sometimes feel like we shouldn’t try to … we should try to, if we can, before we talk about how we don’t have enough money, can we talk about where most appropriately, should we be providing mental health services? So why don’t Suzanne, you take a go at that and then Andrew and then others can jump into.

Dr. Suzanne Shoush [00:29:06] Yeah, I believe that mental health services need to be provided to any … So the person who’s providing the service should be the person that the patient will go to. Right. Right. So that is what we have to have. There has to be access to culturally appropriate care, to culturally safe care, to somebody who is able to provide a service in a way that a person is able to access it. So when we see decades and centuries of exclusion and policies, very harmful colonial policies that have driven indigenous people and many black communities from being able to access health care structurally, we then need to shift and look at … there’s obviously an inertia in the status quo that has created this condition of marginalization that we’re seeing. And therefore we need to have actually new solutions. Our existing structure is the way that that we’re that we’re providing care is is not working for everyone. So how do we make that work for everyone? We need more representation. We need to have more indigenous health care providers. We need to have community health care workers. We need to look through the lens of social medicine. So social medicine is really, truly the way in which, for example, indigenous people have been providing care for each other through this kinship system for centuries, where you have a family of support, where you have people in support, where there is always a pathway to somebody that you trust and then that person can help you. And for example, a network of what we call aunties. So we just have a network of people here in Toronto the Call Auntie Network where we really are just consistent, reliable, present and available. And you can access us and we make we maybe the nice aunty, the mean aunty, the difficult aunty, but we will always be reliable.

Mary W. Rowe [00:30:44] But you might be all of those things all at once and you just described a story though about how during COVID somehow we realized we had to … To save ourselves, we had to be supportive of the other and now we seem to have lost that commitment collectively. But I hear what you’re suggesting about peer to peer support provided at the local level with people that are appropriate to be providing it. And I can see Al nodding his head from his own experience. I guess the question … I want to get to the money piece and how we’re going to fund it. But Andrew, can you just speak to that and then we can hear from Superintendent Tran as well, because the police are obviously always a lightning rod about this, about should they be providing any service or not, or do people not want the cops in this space at all? Andrew And then Al and then Howard.

Dr. Andrew Bond [00:31:28] Yeah. Thanks so much And thanks, Suzanne, for that initial framing. I really agree that it’s really starting from the point of where will people actually meaningfully access care. Right. The bottom line is the connection. Nothing happens without a durable connection over time. And then it has to be a connection that actually has the skills and resources to be able to deliver on the outcomes that we’re all trying to strive for. And so in terms of the where and the funding, we know now that the vast majority of mental health care outside of some of the most dire emergencies where people have to sometimes be involuntarily brought into hospital, and that is a new lightning rod issue as well, that we can come back to some point along the way here. We know it’s quite politicized now, but what is involuntary versus not? But where is it truly necessary? Outside of that, the vast majority of care can and should happen in the community because of two things. One, that is where we know most people will go for their care. That is where they live, that is where they work, that is where they get care and support, and that builds up community and neighborhoods. And secondly, it’s more cost efficient, substantially more so and so any cost efficient, wise public policy would take the perspective of what works more effectively, what builds communities better and what does it more cost efficiently.

Mary W. Rowe [00:32:45] And so what do we do about the fact that the health care traditionally in Canada is funded by provinces? [That’s right]. The dilemma, though, is that you guys are all describing services that are delivered at the hyperlocal by the municipal government or even by NGOs and community groups. And yet the province holds the dough and then the feds hold the dough that the provinces get. So in that context and Andrew, you’re funded, I’m assuming, by the Ministry of Health, Right? [That’s right] So what do you think the … and I see a lot of people in the chat saying cities don’t have enough money. Toronto is running off the property tax. Fair enough. Maybe that’s a larger discussion. But in terms of actually getting dough on the ground, functioning. What is your experience with that? Should we just be spending more time talking to the provinces about getting money into the hands of people?

Dr. Andrew Bond [00:33:35] Without question. I hope that …

Mary W. Rowe [00:33:37] Suzanne is shaking her head and you’re saying, yes. Okay.

Dr. Andrew Bond [00:33:40] So I think we absolutely need more provincial funding to be able to to back to the supports we’re talking about. I’m truly interested in and please jump in on on what to think of that. But I would never say no to that for sure in terms of seeing that that transition happen. We know the balance between acute care and community care from the province is substantially imbalanced and not in ways that actually make sense from driving population health. And so one thing that you’ll see in the United States, for example, and I’m going to be risky in talking and looking to the states for as an exemplar in the health care space for the moment is to say that the idea of value based care, which is health policy that is funded on outcomes, not the service delivery units, actually changes the way that everybody tries to start changing the care, even in the private sector. Now, not to say that we should go with that path, that is not what I’m encouraging here in terms of the overall policy approach. But the idea, the health policy idea of investing in outcomes will then drive and incentivize the kinds of things that we’re actually talking about, because then it actually is around what actually changes outcomes for people in the most cost efficient way. And that’s what we’re talking about here.

Mary W. Rowe [00:34:49] So value based care is another way of saying outcomes based care.

Dr. Andrew Bond [00:34:53] Yes, that’s correct.

Mary W. Rowe [00:34:55] Suzanne, do you want to jump in on that? And then I’m going to go back to Alan and Howard. Go ahead. Suzanne.

Dr. Suzanne Shoush [00:34:58] Yes, I would just very quickly say I agree with Andrew. Ontario Health should always continue to get to fund and …

Mary W. Rowe [00:35:03] Take the money!

Dr. Suzanne Shoush [00:35:05]  Take the money … But there is also a lot of money in the city budget. There’s a huge amount of money in the city budget. And the reality is, is that if you shift around the way that you allocate the resources within this budget, it will improve the health of our community. You know, we have a housing crisis, we have an affordability crisis, we have a public transportation crisis, we have an infrastructure crisis. And we see consistently the only aspect of our budget that keeps and I’m not trying to hate on the police, it’s constantly this increasing police budget. And again, we cannot police our way out of poverty. We cannot police our way out of systemic racism. We cannot police our way out of homelessness and we cannot police are we out of the drug crisis. We do not need to … We need to look at a solutions based approach in the way that we divide a city budget, in the way that decisions are made within it. At the municipal level, I think the municipal government has a lot of power in improving the health care of a city. And of course, Ontario Health just needs to let us have the funding that we need.

Mary W. Rowe [00:36:03] And then you would and then you would hold the city accountable. And I’m going to go to Al and then Howard and then Cam, I know you’re dying to come in on that. So because Suzanne’s thrown the comment down and said, get the money into the local hands and then hold them accountable for delivering the service. Right. Have I got you right, Suzanne, Did I summarize you pretty well? Close enough.

Dr. Suzanne Shoush [00:36:21] Yeah. Close enough. We just got to … We got to make good decisions.

Mary W. Rowe [00:36:24] About how we spend the money we’ve got. Yeah. Okay. Al. Howard, Cam. I haven’t forgot your Kyle. Al first.

Al Wiebe [00:36:32] Sure.

Al Wiebe [00:36:33] I’m involved in in several different areas of being vice chair of CAP here in Winnipeg, and it …

Mary W. Rowe [00:36:38] Explain CAP …

Al Wiebe [00:36:40] Community Advisory Board. We are the the guardians of the community money that comes to  Winnipeg from the federal government for issues of housing and homelessness and I think that that’s one of the areas that we’re involved in. And in this particular area, I think that that perhaps we could … because we do spend money on programing, we do spend money on capital. But I think programming … Maybe there should be a mandate to try and have a heavier emphasis on mental health programing. Right. And I think that would go a long way.

Mary W. Rowe [00:37:18] Who would you give that mandate to Al?

Al Wiebe [00:37:22] Well to the entity in Winnipeg, which is End Homelessness Winnipeg.

Mary W. Rowe [00:37:26] Oh, I see. So you would … so you would charge that whatever the architecture that’s created, you would charge that to be accountable.

Al Wiebe [00:37:32] And then they could. And that’s our job is to perhaps give End Homelessness Winnipeg the direction which way to go. And so we do have several entities in Winnipeg like Canadian Major Health Association and … But they just haven’t been given a little enough rope or give them enough money to really make a difference. You know, I did work for the Canadian Mental Health Association for a while and we had such a great job in in working with their participants from not only a lived experience lens, but through a mental health lens. And I think it’s really important that we change the mandates of some of the reaching of money and program, which is to really emphasize on mental health. Sure, we need capital to reduce housing, to use homelessness, because you don’t reduce homelessness without housing. And that’s always an issue. But also, I’m on the community advisory board for the library here in Winnipeg, and we create a space called Community Connections. And in that space, we had different service providers throughout the city come in 20 days a month and actually Saturdays as well. And we did have to close it because there was a murder due to mental health issues in our library foyer. And so we did have to close it and still not open four months later, but we’re working on that. But you know, in that in that space, there were crisis workers as well, 3 crisis workers … we’re about to, you know, get funding for more. But funding is always an issue with libraries. And they’re really fighting the city on that.

Mary W. Rowe [00:39:06] So I’m going to come to you, Howard, and then Cam and then Kyle. But the thing that’s interesting about what Al’s describing and I think what Suzanne was getting at as well, is that community based services can be provided by municipal employee. They can also be provided by an NGO or they can be provided by a kinship group. So I guess that’s the question is how do we make it more possible to have various ways of delivering these services? And maybe it’s not going to be the same in every place. Howard, let’s hear from you. In terms of your obviously, your perspective is you’re part of an institution, you’re part of the police force. Do you have a sense in the Vancouver environment, how you think the approach to community care could be improved? Should it be more centralized? Should it be more distributed? What’s your gut instinct on that?

Supt. Howard Tran [00:39:52] Yeah, before I do that, can I take some time to just kind of respond to Suzanne’s comments about increasing budgets? I think it’s important to see that in context. Yes, our budgets are also increasing, but as a percentage of the overall city budget has remained consistent at 20 to 21%. And I know that’s the case across the entire country. And, you know, so you’re seeing the fire department getting similar sort of percentage increases and engineering and stuff. So, you know, these are all pressures from inflation, etc., etc.. And the reality is, you know, the police budget as a percentage of the overall city budget has not increased to the degree that people think they do. And I think I sort of want to echo what the mayor said about, you know, some of the services that are being sort of tagged at the city level are really not city responsibilities. And I think one of the biggest you know, I know from some of the literature that I’ve looked into that, you know, Canada spends about 7 to 9% of our overall health budget on mental health issues. When the impact of mental health on the health budget, on our health system is actually quite, quite a bit higher upwards of 15 to 20%, whereas other countries in the world are spending about 12%. So, you know, when you talk about 2 to 3%, you’re talking about billions of dollars here. So I think there needs to be more investment in our mental health system. And I’ll just go back to the city level stuff. And, you know, the reality is, is if you went to police officers that if you never had to go to another mental health call again and would you reduce your police budget, you know, to do that, everyone would say yes. I mean, mental health related calls are sort of the the ones that police officer least like to go to. And we feel like we’re being you know, we’ve become the de facto response for mental health crisis in the first instance. And the reality in Vancouver is, you know, of the 17 to 20% of the calls that we attend annually that have a mental health related factor to them, 26%, or those are actually calls that we get from our health partners in helping to create to provide that support. So we are in this space not because we want to, but because there is a need for us.

Mary W. Rowe [00:42:01] And Howard, this is the dilemma because librarians might say the same thing. They don’t think they signed up for this either. And I suspect business improvement area leaders say they didn’t sign up for this either. And, you know, that’s part of, I think, this larger conversation that we’ve got to evolve to. How do we collectively solve this challenge instead of saying … Look it, I didn’t sign up, you know. In fact the only person that seems to have signed up is Dr. Andrew Bond. And you know …How many can there be? So this …   Go ahead.

Supt. Howard Tran [00:42:31] Yeah, we’re doing a number of things. I mean, I don’t know if folks on the call know from across Canada, but, you know, the new mayor and council have been made a huge investment into mental health response and addiction response in this city. And a part of that service is called diversion and triaging. So we’re kind of piloting a program where we actually embed clinical nursing staff into our operational command center to go through some of these calls because we know that many of them could be diverted to community services and don’t require police attendance. So, you know, these kind of pack teams that you hear about, the peer assisted community treatment teams …  And so we’re looking at diverting a number of those calls to those community-based teams.

Mary W. Rowe [00:43:16] Right. So you’re playing more of a kind of a central coordinating role. And I’ve got to say diversion, triage, not the most attractive terms to say about this and command centers, but the idea of peer assisted community training, I get that. And the idea that you would be a referral agent to be able to then bring in the real supports that Andrew and Suzanne are speaking of Cam, talk to us, if you can, about what the municipal government perspective is on this. You know, you can see, as is often the case, we all want you to do everything. And I don’t quite know how you navigate that. Tell us.

Mayor Cam Guthrie [00:43:50] Yeah. So, you know, a fair discussion. And I mean, I’ve always viewed, you know, every budget is not a sacred cow with every department in this inner city. I mean, we should always be scrutinizing everything and seeing what the outcomes can be in a budget. Um, I will just say, though, that, you know, I just came from the Federation of Canadian Municipalities Conference that was in Toronto just last week. And the overall theme of that conference was straight up about a new fiscal framework for municipalities where these conversations have to happen with the upper levels of government because we are now entering, as I said in my opening remarks, we’re entering this arena of health care. And if that’s the arena that we’re going to have to play in the absence of the provincial or federal government helping us with this, then fine. At least jurisdictionally tells us that we’re now entering that arena. But you’re going to have to help us with the resources to do it. And so …

Mary W. Rowe [00:44:48] I mean, and it is bizarre to think that property taxes should be paying for mental health supports. That’s kind of crazy that … The math wouldn’t work even if our property taxes aren’t assessed as equitably as they should be. It’s a weird way to do it.

Mayor Cam Guthrie [00:45:03] Right. Correct. And I don’t think it is as easy to just pick one department and pick on that one department. Say we’re going to find something else out of that. I think a budget is about values, which I think we should all agree on, and it can come from multiple places to try to achieve those results of the value driven type of budget cities are trying to to manage and balance. And I want to get to the solution part, too, because you mentioned that earlier. Well, what do you think we should do? And so my perspective is it has to be housing focused. When we give people dignity and safety and security for them and themselves or their work, their life belongings that are with them. It changes the perspective of having that ability to have a roof over someone’s head, to give that supportive housing to those people that are in need so they can get the actual health care requirements that can wrap around them, including community nonprofits, the neighbor down the street, anybody that can wrap around these people. I think, in Guelph we had zero sort of supportive housing projects a few years ago. This year alone or opening 72 beds. So we’ve been really, really, really putting our efforts into that. But if we don’t give people that dignity of a house. And I think it was Andrew that mentioned this, but it is substantial. As a fiscal conservative, you want to do the housing. I mean, you save so much money by doing the housing it saves in all the emergency responses, all of them police, ambulance, fire even, our own municipal bylaw, etc.. It also diverts away from the emergency rooms where all of our emergency rooms are being overrun. It is so much cheaper to actually just put the focus on housing. It’s financially the best thing, it’s mentally the best thing. It’s dignity. And that’s where you got to go. And that’s what we’re trying to do here as best as we possibly can. But my last comment would be that the federal government has been pretty good on the capital side of trying to help with housing, where the province needs to step up a little bit more, in my view, is on the operating side. So if the bricks and mortar are there, the province has to step up with the oversight and the operational funds and then the city on our municipal and we can approve all day long these types of housing projects. And that’s where the collaboration come together to help these people, because that should be our focus.

Mary W. Rowe [00:47:43] I just want to thank the chat as usual. Never disappointing … tons of ideas, questions, thoughts in that chat. Thanks, everybody. Keep chatting away. I’m trying to feed them in as best I can. Can we spend the last 10 minutes on this session talking specifically about solutions that you’re watching that are working. And Cam’s just said housing, housing, housing or Housing first or what everybody else is suggesting. Let’s hear from Kyle, because he is in fact, he’s pioneered a program that I think actually started maybe in Guelph right Kyle? But it’s a very tangible Welcoming Streets program. Can you just speak about how that is working and how you … we’ve heard you speak about it. I’m interested for you to tell the larger group.

Kyle Marcus [00:48:21] Well, we actually have a few programs within our community that are both here as support for our business population as well as supports for our vulnerable populations. One of them is our Welcoming Streets. We haven’t actually launched that program yet. It’s going through municipal funding at the moment. But we we look to have, you know, just as we have outreach for our vulnerable populations, have outreach for our commercial, our merchants as well. So, in fact, it speaks to all this, you know, defund the police or rather more like a reallocation of funds. So we got our police service to invest with us in putting … And they don’t show up in uniform. We would have our own workers that go out and they’re the point of contact for our businesses. So if someone’s having a mental episode or an overdose or just needs some help finding a place to go, you call them instead of calling police, you would call them to de-escalate. You would call them for education or empowerment, because in this scenario we’ve been left with and like I said, I get to walk right down the center of all worlds. I work with our police service and I work with our vulnerable populations as well as our outreach. And, you know, everybody wants the same thing. Everybody wants people to get the help that they need. They need them to get the services they need. Our police services recognizes that it’s not them that’s going to deliver this. They need to be there for safety at some times, but it’s not necessarily them that’s going to deliver this so we can get police back to policing, doing traditional police work and deal with their mental health as well. Because one of the things that’s never discussed is the mental health of our police service, which is in steady decline as well. And we don’t get the the service that we need, we don’t get the response that we need and we don’t get acceptable response. Likewise, in our scenario, you know, we know that our vulnerable populations are primarily black, brown, indigenous, racialized people. And you know, for us to get service, we need to essentially say that we’re feeling threatened, which then puts that person in further jeopardy. So what we need to do is remove that entire scenario and find a way to access someone that can either direct them where they need to go or have the information. Because let’s be honest, not all of us have either, you know, the gall, the bravery, the education to to stand up to some of these these things that we have to face on a daily basis. It’s not a comfortable environment.

Mary W. Rowe [00:50:51] Yeah. Yeah. And the point that Suzanne was mentioning is that it’s all well and good to provide the support, but if it’s not coming from a peer, from someone that the recipient can actually be responsive to, I mean, it’s not … This is sophisticated, thoughtful stuff. And a lot is being expected of people that are engaged in any kind of street facing, public facing work, whether you were a librarian or a cop or a firefighter or you’re just a neighbor. Alot is expected.

Kyle Marcus [00:51:16] And to add to that conversation, you know, one of the things that I would like to see, you know, I’m a typical entrepreneur. You know, efficiency is where I’m at, trying to, you know, keep everything streamlined. And what I would worry about is I think we need … I know we have a general strategy, but we need to pinpoint where we’re actually going and what actually is important to these programs to solve first, the root cause of the issue we can’t keep bandaiding anymore. You know, my biggest fear is that we create a siloed industry of of poverty and homelessness. I don’t want to see overlapping services … I’m so grateful for everyone out there doing this fantastic work. You know, hats off to everyone. But if we have overlapping services, we can throw all the money in the world at them … They’re going to start competing for the money and then we’re getting less service in the road.

Mary W. Rowe [00:52:03] So I just want to point out that the chat is predictably blowing up, as it tends to do late in the session. And and they all want more. We’re going to have a longer session. I see that Mayor Carter’s here from Oshawa talking about the … Nice to have you on on the session Mayor Carter, talking about the Welcoming Streets program they’ve had for a few years. And so lots of good examples that we probably need to highlight and service. So please, folks, put more solutions into the chat and we’ll broadcast them. And maybe we need to do a deeper dive on this. We’ve got five more minutes and so I’m going to ask each of you to just highlight briefly one tangible solution that you’re seeing that’s working. So we’ve had the Welcoming Streets initiative. Al, you mentioned the 20 days in the library that got shut down because of an unfortunate situation. But it sounds as if that was a really interesting intervention. At Superintendent Tran, you’ve talked about these coordinated services and that you’re now working more and more with agencies. Anybody else that has a particular solution they want to highlight that people should look more into … Suzanne and then Andrew or Andrew and then Suzanne. Go ahead, Andrew, and Cam …

Dr. Andrew Bond [00:53:00] Thanks so much. Mary And I’ll be quick Suzanne. So the piece I’d like to highlight is that we’re working right now in a partnership, and I want to come back to Howard spoke to around the justice system. So because what we’ve done is we’ve left, aside from the discussion for the moment, which does happen, the visibility of all those who would be in the downtown core is for the now incarcerated, but that is probably for many of their actual home communities. And they are part, even though they are currently segregated in that community still. And so what we’re doing is we’re in a partnership right now at inner city health with the ministry of the Attorney General, [Soundtimes?] Community Services, which is a municipal group, the city, the attorney general’s office, and ourselves as health care providers to operate a justice center with a health focused approach to our care, to work on both decriminalizing and directing folks who are cycling through the system. We know Mary Hogan just did a piece recently about the crisis in the in the justice system around mental health as the de facto, I think is as Howard shared, you know, in the new institutional setting, we can change that by these types of systems that they do exist in other locations, like in the Bronx, for example … 7 South Central LA …

Mary W. Rowe [00:54:06] I’m going to move you on, Andrew, because I want to get the others in, but we should get Mary Hogan to talk about the Community Justice Center model as it exists in the Center for Court Intervention in Red Hook and other places. You’re quite right. And it’s co-locating and providing that referral service. And yeah really great model. Thank you Andrew … Suzanne, then Cam.

Dr. Suzanne Shoush [00:54:22] Yes. To be really fast. I definitely think that a housing first policy, a universal right to housing, is absolutely critical. I believe that resources and health care and services provided by peers is unbelievably important. Community health care workers, the model of work that inner city health associates that Andrew Bond and myself work under has been has been truly successful. I believe so deeply in this care. I really do.

Mary W. Rowe [00:54:44] It works. It works. Peer to peer. Okay. Cam.

Mayor Cam Guthrie [00:54:49] Yes. So one of the things I’ve been really trying to do with our community is to raise awareness about the issue in the community, because so often people think, well, government can solve the issue. So one of the amazing things that we did in Guelph last year was council agreed – We only had $500,000 left in our affordable housing, supportive housing reserves, but we had no projects really on the horizon. So we agreed to actually connect with the United Way and the Community Foundation to create a matching donation program for the entire community of Guelph. And we just had an announcement today that that $500,000 got surpassed by the matching of little tiny donations like pizza party things at a business or large donations, but that’s $500,000 turned into $1,000,000 to go towards supportive housing projects here in the city of Guelph. And it’s just, I think, a testament [you leveraged …] leveraged 500, turn it into a million, but at the same time brought awareness to the people of Guelph because it can’t be solution oriented only by government. It has to have the awareness and everybody involved. And it’s not just about handing out clothing or food, and that’s all perfectly fine. But we need resources as well. And the people of Guelph and businesses stepped up. And I just wanted to say that matching program was a pretty cool idea and it’s worked really well.

Mary W. Rowe [00:56:13] Great. Howard … Kyle,Al … Quick solution.

Supt. Howard Tran [00:56:19] I think there needs to be acknowledgment of everyone here that mental health and addiction are really interconnected. I know we’re talking about mental health only here, but it also, for me, treatment on demand, harm reduction. We totally believe in the safe supply, decriminalization, all that stuff. But we really need to bring up the other pillars, which is treatment and prevention. So treatment on demand, I think, to deal with the folks that are using our resources the most.

Mary W. Rowe [00:56:46] All right. Al, then, Kyle …

Mayor Cam Guthrie [00:56:48] Yeah. Six words. Housing first. Housing first. Housing first. [Okay]. Yes, That’s it.

Mary W. Rowe [00:56:55] Yeah. It is interesting the question you all posed about … We had all this COVID momentum, right? We all had a sense of urgency. There were no excuses. It was like, get her done. And now we’re in this post-COVID period, and it feels like we’re lapsing back into all the complications and what can’t be done. So how do we get back into that? This is a crisis and how do we address that? Kyle, last word to you. Have you got another solution to throw in?

Kyle Marcus [00:57:20] No, I’m with everyone else. I just want to make sure that if we are putting housing first and we’re putting the supports that make people successful within those housing, you know, at the forefront without, you know, if we’re just going to get someone in an apartment that’s at the other end of town and not near their children are not near their support, or not near their job. We might as well leave them on the street because they’re not going to be successful in that environment. We need to make sure that we’re holding up people where they need to be. If they have an episode and a window gets broken, that the landlord’s not going to throw them out. Someone’s there to fix that window and make sure that these people stay housed and don’t end up right back where they started.

Mary W. Rowe [00:57:57] You know, I think it’s so heartening to have you guys on here. Thank you so much for being part of this conversation and for reminding us that we’re not powerless. Right. We all have some agency to be able to participate in flagging how we can support, how other organizations can support, how do they all … how do these efforts … all of you are doing the important work of stitching together the urban fabric and connecting with each other. And let’s work with the police and let’s work with vendors and let’s work with small business. Let’s work with health care, let’s work with the mayor, all the different players, and let’s work with people that are experiencing frontline … what’s happening to them in terms of their own struggles. So thank you for calling that out to all of us and reminding us that we all have a role to play here in trying to support and create a collective, healthy environment for everyone to be able to flourish. And housing first, supportive housing. Let’s get to the basics. Thanks so much for joining us, everybody on City Talk. We’re doing one in a couple of weeks on mobility and transit, which is another piece of the equation. But this conversation is just the beginning. You really touched on a whole bunch of nerves and we won’t lose track of it, we will continue it. Andrew, Cam, Al, Suzanne, Howard, Kyle, thanks so much for joining us on City Talk.

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Hello from Waterloo, ON – unceded territory of the Haldiman tract and traditional land of several FN communities.
12:07:42 From Emilie Charlebois (CUI) to Everyone:
Superintendent Howard Tran – Investigative Support Services, Vancouver Police Department (Vancouver, BC) Superintendent Tran joined the Vancouver Police Department in 1997 and has worked on a wide variety of assignments throughout his career, including the establishment of mental health treatment and outreach teams under the Youth Services Section. He has participated in a number of advisory councils related to mental health, addiction, and youth justice, most notably as the co-chair of “Project Link” – VPD-VCH Steering Committee on Mental Health, the Mayor’s Task Force on Mental Health and Addiction, the BC Alliance on Mental Health and Addiction, the Advisory Council to the BC Representative for Children and Youth, the Inter-Ministry Committee on Youth Justice, and the Douglas College Youth Justice Program Advisory Committee. He is the recipient of three Chief Constable’s Unit Citations, one Deputy Chief Constable Citation, and one Inspector’s Commendation.
12:07:53 From Emilie Charlebois (CUI) to Everyone:
@HowardTranVPD
12:08:01 From Amber Livingstone to Everyone:
Hello from Downtown North Bay & Waterfront.
12:08:15 From Celeste Kitsemetry to Everyone:
🌞Greetings from Barrie, Ontario!
12:08:21 From Nathan Rogers to Everyone:
Hi from Halifax
12:08:25 From Luke Edwards to Everyone:
Good Afternoon everyone, Luke from London Ontario – London Public Library
12:08:35 From Wenda Bradley to Everyone:
Good Morning – Whitehorse, Canada – from the traditional land of the Kwanlin Dun and Taan Kwachin council
12:08:45 From Lenny Kishi to Everyone:
Hello from Musqueam Indian Band
12:09:01 From Emilie Charlebois (CUI) to Everyone:
Please note that given the limited duration of these sessions, we are not able to answer to raised hands. Do you have specific questions for the panellists? Post them in the chat, and we’ll try to answer as many as possible.
12:09:14 From Emilie Charlebois (CUI) to Everyone:
Responses to questions and additional resources will be provided in the chat by CUI staff.
12:09:17 From stephanie gonos to Everyone:
Toronto🌞
12:09:32 From Andrea Betty to Everyone:
Hello from Penetanguishene the traditional and Treaty territory of the Anishinabek people and their ancestors, now known as the Williams Treaties First Nations territory
12:09:45 From Russ Disotell to Everyone:
Downtown Brockville BIA
12:10:19 From Emilie Charlebois (CUI) to Everyone:
Dr. Andrew Bond – Medical Director, Inner City Health Associates (Toronto, ON) Dr. Andrew Bond is Medical Director of Inner City Health Associates, a group of 200 physicians and nurses offering specialized services to people living on the street and in shelters, encampments and precarious housing across Toronto. He is also a National Health Fellow at McMaster University, a lecturer in the Department of Family and Community Medicine at the University of Toronto, and co-founder of the Canadian Network for the Health and Housing of People Experiencing Homelessness (CNH3). Dr. Bond is a national leader in health systems innovation with a focus on developing integrated health and social care models that drive population health equity with efficiency and impact. Dr. Bond completed his MD at the University of Ottawa, postgraduate specialty training in Family Medicine at the University of Toronto and a Master of Health Administration from the Johnson Shoyama Graduate School of Public Policy.
12:10:26 From Michael Anderson to Everyone:
Downtown Tkaronto
12:10:36 From Jennifer Roth to Everyone:
Excellent book on deinstitutionalization and homelessness – https://www.amazon.ca/Her-Name-Was-Margaret-Streets/dp/1989496326
12:11:09 From Jackie Gervais to Everyone:
Hello from Niagara Region, Ontario. ​​Niagara Region is situated on treaty land. This land is steeped in the rich history of the First Nations such as the Hatiwendaronk, the Haudenosaunee, and the Anishinaabe, including the Mississaugas of the Credit First Nation. There are many First Nations, Métis, and Inuit peoples from across Turtle Island that live and work in Niagara today. The Regional Municipality of Niagara stands with all Indigenous peoples, past and present, in promoting the wise stewardship of the lands on which we live.
12:12:39 From Kim Huntley to Everyone:
Good afternoon everyone from Kim at Toronto Public Library, situated on the traditional territory of the Haudenosaunee Confederacy, the Wendat and the Mississaugas of the Credit First Nation.
12:13:57 From Emilie Charlebois (CUI) to Everyone:
Al Wiebe – Homelessness Advocate and Peer and Community Engagement Leader (Winnipeg, MB) Al Wiebe is an advocate and community engagement leader, who has experienced homelessness first-hand. After losing a six-figure income as an advertising executive, Al faced mental health struggles and lived on the streets for a period of 28 months. Throughout this time, he survived multiple experiences of seeking out and failing to receive mental health support within the healthcare system. After a long recovery and lengthy struggles with the shelter and health care systems, Al now works 24/7 to improve the lives of the homeless and those in poverty. He engages with the Winnipeg police service and city council, and many organizations at the local, provincial and federal orders — including Make Poverty History Manitoba, the Lived Experience Circle, and the Canadian Alliance to End Homelessness. Al hosts a radio show called “Of no fixed address”, showcasing spoken word focusing on the lived experiences of homelessness.
12:14:15 From Emilie Charlebois (CUI) to Everyone:
@AlWiebe3
12:16:06 From Kirsten Moy to Everyone:
Kirsten Moy from San Leandro in the Bay Area, traditional land of the Ohlone
12:16:33 From Mary Huang to Everyone:
homelessness is rising fast in Ottawa, Canada and food security an issue too
12:17:31 From Leah Thomas to Everyone:
huge problem in London.
12:17:47 From Luke Edwards to Everyone:
agreed, we are at ground zero here at LPL
12:17:55 From Emilie Charlebois (CUI) to Everyone:
Kyle Marcus – Managing Director, Downtown Sudbury Business Improvement Area (Sudbury, ON) Kyle Marcus took over as Managing Director of the Downtown Sudbury BIA in 2021 following a desire to help with the economic recovery of his community. He holds an Honors Bachelor of Commerce Degree form Laurentian University as well as a Business Administration diploma from Cambrian College. Following University Kyle became an entrepreneur, investing in one of downtown Sudbury’s marquee establishments, SRO Nightclub, now one of the top night-time venues in the province. Kyle is also the owner and founder of The Alibi Room, a modern take on a prohibition era speakeasy specializing in High end cocktails with a focus on sustainability. During the pandemic Kyle applied his entrepreneurial skills by leading the downtown charge towards innovative ideas including an immersive and expansive patio program, and founding The Hand Up Collective to fundraise, finance and lobby for long term housing solutions.
12:18:28 From Mary W. Rowe to Everyone:
hello LONDON 🙂
12:18:34 From Maureen Johnstone to Everyone:
Hi everyone, I am calling in from Whitehorse, Yukon, the traditional territory of Kwanlin Dun First Nation and Ta’an Kwäch’än Council
12:19:04 From Rick Reinhard to Everyone:
Rockville, Maryland, USA, traditional territory of the Piscataway.
12:21:05 From Emilie Charlebois (CUI) to Everyone:
Cam Guthrie – Mayor, City of Guelph (Guelph, ON) Cam Guthrie was re-elected Mayor of Guelph in 2022, after serving two terms as Mayor from 2014 to 2022, and as a Councillor for Ward 4 from 2010 to 2014. He completed a 3-year term, serving as the Chair of Ontario’s Big City Mayors (OBCM), a group of 29 Mayors of cities with 100,000 people or more, who collectively represent 70 per cent of Ontario’s population, in December 2022. In March 2022, he was appointed to the Global Covenant of Mayors for Climate and Energy (GCoM) Board of Mayors, representing North America. An avid community volunteer, Cam has served on the Boards of several local not-for-profit organizations and mentored startups and small business owners through the Business Centre of Guelph-Wellington. In January 2019, Mayor Guthrie convened a task force of community leaders and agencies to take action on the issues of homelessness, addiction, and mental health needs in Guelph.
12:21:09 From Voncelle Volté to Everyone:
⚡ I’m here to learn from Kyle Marcus … His website link is broken. 🌻🌻🌻
12:22:05 From Emilie Charlebois (CUI) to Everyone:
Mayor Cam Guthrie (continued): @CamGuthrie
12:22:36 From Sue Uteck to Everyone:
There is a serious lack of coordination between the province and the city here in Halifax- I think we all agree that it begins with a lack of affordable housing.
12:23:26 From Emilie Charlebois (CUI) to Everyone:
Welcome new joiners! Just a reminder to please change your chat settings to “Everyone” so we can all see your comments.
12:23:42 From Jeff MacIntyre to Everyone:
This is something that is getting lost, we moved from a pandemic with support, but the businesses are dealing with similar if not worse conditions since.
12:23:54 From justine smith to Everyone:
Addressing housing, poverty, food insecurity, & funding mental health/ addiction services, AND regulating inflation (on housing/food/necessities) is a must… UBI would be nice too for ppl making below living wages…
Until those issues are funded and properly addressed, we will continue to see a rise in addiction and our neighbours living in the streets.
Criminalization is expensive, ineffective and creates a revolving door system that perpetuates/ exacerbates issues. Regulating the cost of living/ living wages and funding social services is crucial.
12:24:41 From David Scrivener to Everyone:
Hi Voncelle, the Downtown Sudbury BIA can be reached at (705) 674-5115 or kyle@downtownsudbury.com while the website issues are resolved. Thanks for the flag.
12:25:40 From Emilie Charlebois (CUI) to Everyone:
Dr. Suzanne Shoush is the inaugural Director of Indigenous Health Program for Inner City Health Associates, a group of 200 physicians and nurses offering specialized services to people living on the street and in shelters, encampments, and precarious housing across Toronto. She has degrees in Engineering and Medicine and is the lead physician for community and culture-based, trauma informed, culturally safe, and low barrier comprehensive primary care clinics. Dr. Shoush is also the Indigenous Health Faculty Lead for the Department of Family and Community Medicine with the University of Toronto Faculty of Medicine. In addition to her work in Toronto’s shelter systems, she has also worked throughout Ontario in rural and remote communities as a rural family physician and is a member of the Call Auntie Clinic. Dr. Shoush grew up in Alberta, her mother is Li’wat Coast Salish, and her father is Sudanese.
12:25:41 From Lisa Jayne to Everyone:
comment/question – Toronto is whining that they are ‘broke’ but Toronto citizens pay lower property taxes than neighbouring areas e.g. Mississaugua, Peterborough. The ‘average’ Torontian seems to be voting for a Mayor that promises NOT to increase property taxes.
12:25:55 From Nathan Rogers to Everyone:
very true that public libraries are acting as a sort of waiting room
12:26:38 From Emilie Charlebois (CUI) to Everyone:
We love all the thoughtful and engaging comments in the chat. Amplify the conversation on social media! @canurb #citytalk
12:27:05 From Catherine Hacksel to Everyone:
Thank you Suzanne!! Let’s fund what we know works!
12:27:20 From Robin McPherson to Everyone:
The funding model for cities does not reflect the reality of services that cities are providing to all residents.
12:29:15 From Jillian Hardie to Everyone:
Is there an opportunity to start a solutions lab? Which would provide opportunities for input from Front line workers to those who would not normally be included in these opportunities such as Security companies, business owners who understand the issues, etc.
12:30:02 From Mikaela Malcolm to Everyone:
Amazingly articulated Dr. Shoush, I agree with every point for the City of Toronto and GTA wide
12:30:23 From Catherine Hacksel to Everyone:
The Homelessness Hub online has lots of resources for those concerned about feeling ill-equipped
12:31:11 From Brent Kalinowski to Everyone:
Although I agree whole heartedly in enhancing funding where it is needed (MH/Addictions/Housing) sooner than later,……….with the goal to naturally reduce the need and expense of policing…….the immediate defund of policing is NOT the solution. Let’s be careful with knee jerk reactions and movements.
12:31:17 From Rhonda Jessup to Everyone:
Libraries are a waiting room and a bellwether. We have been sanctuaries for a very long time for vulnerable residents
12:32:15 From Emilie Charlebois (CUI) to Everyone:
We love your comments and questions in the chat! Share them with everyone by changing your chat settings to “Everyone”. Thanks!
12:32:17 From Catherine Hacksel to Everyone:
Drop ins and shelters can be set up quickly – COVID has demonstrated this & how it’s simply the political will that’s key
12:32:54 From Nathan Rogers to Everyone:
Does Canada need provinces when most people live in cities? Or is there a City-National government model
12:33:34 From Luke Edwards to Everyone:
Our challenge is balancing the needs of the most vulnerable populations vs the safety and wellbeing of staff and patrons. We partner with the Police who are an outstanding partner. As with Brent, we need to take a careful approach when speaking about defunding Police.
12:35:01 From Catherine Hacksel to Everyone:
Luke keep in mind that perceptions of safety are not always reflective of actual social benefit (displacing & incarcerating poverty compounds costly harms)
12:35:07 From Lisa Jayne to Everyone:
yes, there seems to be a shift – at one time (during the pandemic) we were talking about ‘build back better’ ….but we are not hearing about that so much now (post-pandemic)
12:35:07 From Leah Thomas to Everyone:
@Brent and @Luke most defund police initiatives are not about removing police overall but reevaluating how police are used and the authority they are granted in certain situations.
12:35:08 From David Scrivener (CUI) to Everyone:
If you’re interested in learning more about social medicine and the Call Auntie Clinic that Dr. Shoush referenced: https://www.callauntieclinic.com
12:36:54 From Robin McPherson to Everyone:
In Niagara, the Regional govt is in charge of housing. Another layer to the funding and implementation.
12:38:04 From Russ Disotell to Everyone:
I still hold to Build Back Better, but no one told us it would be easy. Have to take a clear look, ask hard questions and cobble viable solutions.
12:38:08 From Rick Reinhard to Everyone:
The Downtown Washington DC BID (BIA) has a reasonably comprehensive homeless services program, including contracting with a social-services not-for-profit. Not a solution, but a step in the right direction. https://www.downtowndc.org/program/homeless-services/
12:39:11 From Amber Livingstone to Everyone:
Sometimes public perception of service providers is that they are only available from 9-5. Sometimes that perception is accurate.
12:39:34 From Geoff McCausland to Everyone:
I disagree with that. Municipalities make 9 cents of every dollar Canadians pay in taxes, and have billions of dollars in infrastructure deficits. Fundamentally, if municipalities operated with accrual accounting rather than cash, it would be very clear that almost every city in North America is insolvent. To look to them for funding is asking them to further neglect the foundation upon which our communities are built, and they do not have the control necessary to increase taxation in a meaningful way.
12:40:23 From Kelsey Santarossa to Everyone:
I am curious to know about how referral pathways are standardized and promoted in your communities to ensure that the broader network of community supports understand who will be best served where.
12:40:28 From Linda Williams to Everyone:
As a longtime community worker in Winnipeg, I don’t believe we will have a choice but to deal with homelessness and housing but at the community level via outreach. Yes, sitting in an office at a computer is safer, etc. but it will not work with this issue. There appears to be a long term avoidance of working on prevention – just symptoms. We cannot afford this anymore.
12:40:43 From Dan Carter to Everyone:
The Budget for Durham Region for Social Service and Health is three times what the Police budget is.
12:41:05 From Kelly Goz to Everyone:
The mandate for providing MH & A supports to people experiencing homelessness MUST be applied to MH&A funded agencies through the Ministry of Health.
12:41:50 From Geoff McCausland to Everyone:
Our cities, healthcare system, water/wastewater systems, housing providers and court systems are all at a breaking point. We need to stop looking to our neighbours to the south as role models, and tax our population and businesses appropriately to reach a point of sustainability in the years ahead.
12:42:01 From Emilie Charlebois (CUI) to Everyone:
Thanks to all for the lively chat. You can also share your thoughts and amplify the conversation on social media @canurb #citytalk
12:42:08 From David Scrivener (CUI) to Everyone:
If interested about the organization Al mentioned, you can learn more about End Homelessness Winnipeg here: https://endhomelessnesswinnipeg.ca
12:42:15 From Rachel Braithwaite to Everyone:
Not all municipalities experience the same levels of homelessness (often because they don’t provide the supports). Should municipalities that don’t provide the supports pay to help fund those that do?
12:43:24 From Suzy Godefroy to Everyone:
We have a pilot program in the Downtown Brampton core called Welcoming Streets that is funded by the Region of Peel and managed by the City of Brampton. This is a good start but not enough – we keep seeing more people on the streets and in need.
12:44:15 From Erin Mifflin to Everyone:
Peel Region is using its own funding to extend health care services for people experiencing homelessness that was started during the pandemic.
12:45:19 From Chloe Good to Everyone:
housing
12:45:54 From Jeff MacIntyre to Everyone:
It’s not just that they didn’t sign up for this they aren’t getting the support to adapt.
12:46:49 From Meeri Durand to Everyone:
So happy to see representation from my hometown of North Bay. We are a small rural municipality in BC and have recently created a ‘Community Connections Center’ and ‘Integrated Services Collaborative’ in response to need at a local level. Local governments can be leaders in this space by incubating innovation and collaboration. There is no easy fix to complex issues – but it should not be a barrier to taking even small steps. I also think including those with lived experience is critical in this space.
12:49:17 From Carole Fischer to Everyone:
I Agree – Housing First!
12:49:53 From Mariah Patterson to Everyone:
River View is sitting empty, why?
12:49:59 From justine smith to Everyone:
Housing first! I agree!
12:50:09 From Carole Fischer to Everyone:
Even well employed folks, with union jobs often go into mental health crisis when housing stability is threatened.
12:50:27 From Geoff McCausland to Everyone:
YES YES YES to needs for operational funding missing from all of these issues.
12:50:39 From Sandra Severs to Everyone:
Riverview is not sitting empty. Coast Mental Health has been running programming out of there for years.
12:50:50 From Alex Doran to Everyone:
well said Cam
12:50:51 From Geoff McCausland to Everyone:
Feds and Prov love the big splashy announcements of capital investment, but operational is where the real change happens.
12:50:51 From Luke Edwards to Everyone:
Any thoughts on long term in-patient mental health care funding?
12:51:41 From Leah Thomas to Everyone:
^ would love to hear about pros and cons of that as well
12:52:01 From Chloe Good to Everyone:
River View: https://news.gov.bc.ca/releases/2021MMHA0056-002058
12:52:09 From Sue Uteck to Everyone:
Kyle, can you post your email?
12:53:12 From David Scrivener (CUI) to Everyone:
Some of the media on Kyle Marcus’ program in Sudbury: https://www.cbc.ca/news/canada/sudbury/welcoming-streets-mental-health-support-1.6812886
12:53:27 From Ben DiRaimo to Everyone:
we need a few hours to drill down on this critical issue.
12:53:48 From Carole Fischer to Everyone:
Bigger view on housing crisis is the financialization of our housing stock – finally a topic on Federal speaking notes
12:53:49 From David Scrivener (CUI) to Everyone:
Sue, Kyle’s email is kyle@downtownsudbury.com and the the Downtown Sudbury BIA can also be reached at (705) 674-5115.
12:53:58 From Lisa Jayne to Everyone:
good point -Kyle! We need to be concerned about the mental health of our first-responders (police, social workers, paramedics) …as well as the mental health of vulnerable people …
12:53:58 From Linda Williams to Everyone:
In Finland, they do housing first and they use Finland owned land, Cities acquire land from those who abandon their properties, and another potential is acquiring land that was used for criminal activities. How about using this land to develop housing like pocket housing and do housing first and then provide services and treatment to assist people to succeed in their new place.
12:54:04 From Jeff MacIntyre to Everyone:
A big part of the issue is easing people into the traditional systems of work and housing.
12:54:04 From Dan Carter to Everyone:
Oshawa has had the Welcoming Streets program for the past three years
12:54:34 From Lisa Jayne to Everyone:
Yes, I have seen a program on Finland – housing & health care models – very inclusive (all ages …)
12:55:01 From Jeff MacIntyre to Everyone:
We need some flexibility in integration into getting from houseless to housed and jobless to employed.
12:55:30 From Leah Thomas to Everyone:
i believe Geulph also has a welcoming streets program. It would be great to have an amalgamated info package on these various programs and how to implement them.
12:55:48 From Jeff MacIntyre to Everyone:
Also the mental health of the Businesses that are the front lines of this.
12:55:49 From Leah Thomas to Everyone:
agreed Jeff.
12:55:53 From Emilie Charlebois (CUI) to Everyone:
Keep the conversation going #CityTalk @canurb
12:55:56 From Anna Chrzaniecki to Everyone:
Brampton downtown has the Welcoming Streets pilot program too
12:56:18 From Rosie Beaulieu to Everyone:
Kyle you are awesome I really appreciate your Downtown clean up program that the Downtown BIA in Sudbury implemented which provides folks experiencing employment barriers an opportunity to help clean up the downtown for an honorarium. It’s such a win win for our community and so respectful
12:56:31 From Geoff McCausland to Everyone:
Here is a graph that shows the complete drop-off of federal investment in public housing in 1995 that has resulted in the housing crisis that we are experiencing today. The current investments of the Federal government are not even enough to keep the current affordable housing units online, let alone adding to that stock: https://ecm11081-my.sharepoint.com/:i:/g/personal/chris_tammi_mgre_ca/EVd7BCZUv8dLg_4s7nOBcZkBu3w_GJrkJ81QB2GJ1HFzVg?e=CBIbTf
12:57:04 From Brent Kalinowski to Everyone:
9-5 isn’t working. Strong need to adapt our MH and social services to 5-9?
12:57:23 From Emilie Charlebois (CUI) to Everyone:
If you have any questions you would like us to follow up on, please send to cui@canurb.org
12:57:38 From Jeff MacIntyre to Everyone:
Absolutely Brent, also weekends
12:58:44 From Sandra Severs to Everyone:
Perhaps we need to move from talking about services (not that they aren’t critically important) but about relationships? How do we strengthen community resilience?
12:58:51 From Patricia Gray to Everyone:
Look up The Village in Duncan BC very successful.
12:59:03 From Emilie Charlebois (CUI) to Everyone:
Stay tuned for our late June CityTalk on Mobility as a Service along with other summer sessions! https://canurb.org/subscribe/
12:59:13 From Christy Chrus to Everyone:
In Downtown Whitby the Town worked with the BIA and just distributed ‘Community Support’ cards directing them to a website on where to find access to info, who to call (i.e. where are food banks located, what to do if you find a needle), etc. We are working with Regional partners, police, staff from various departments and the Salvation Army, Library, local churches. Community lifts up community
12:59:54 From Rosie Beaulieu to Everyone:
I want to say thank you to everyone for all the wisdom I gleaned and especially the respectful and compassionate wording. Wonderful learning opportunity <3
13:00:01 From Jeff MacIntyre to Everyone:
Part of the issue is the feeling that communities are off boarding these issue onto their downtowns. NIMBY has become Downtowns Backyard is fine
13:00:04 From Emilie Charlebois (CUI) to Everyone:
Thank you for joining us! We have recorded today’s session and will share it online within a week at canurb.org/citytalk-canada/
13:00:18 From David Scrivener (CUI) to Everyone:
Some recent news that Cam mentioned out of Guelph and supportive housing expansions in that community: https://globalnews.ca/news/9733947/supportive-housing-guelph-fundraising-boost/
13:00:24 From elisabeth miller to Everyone:
What is the contact for Kyle Marcus Sudbury BIA….the above link or name did not work
13:00:35 From M A to Everyone:
Agreed @Rosie! So much learning in one hour. Thank you everyone for sharing your wisdom.
13:01:06 From Geoff McCausland to Everyone:
kyle@downtownsudbury.com
13:01:20 From David Scrivener (CUI) to Everyone:
HI all, Kyle and the Downtown Sudbury BIA can be reached at (705) 674-5115 or kyle@downtownsudbury.com
13:01:21 From Rosie Beaulieu to Everyone:
Or just go downtown in Sudbury and yell Kyle! He will be there
13:01:25 From Kristina Craig to Everyone:
Thank you all for your time
13:01:32 From Robin McPherson to Everyone:
Thank you all so much.
13:01:34 From Luke Edwards to Everyone:
Thank you to all for this insightful conversation.
13:01:41 From Leandro Santos (CUI) to Everyone:
Thanks to all the panellists!
13:01:43 From Rachel Braithwaite to Everyone:
Thank you!
13:01:45 From Amber Livingstone to Everyone:
Great conversation. Thank you.
13:01:46 From M. Alejandra Fajardo to Everyone:
Thank you so much!
13:01:48 From gabriela masfarre to Everyone:
THank you!!
13:01:51 From Geoff McCausland to Everyone:
Thank you, everyone!
13:01:52 From Cassandra Alves to Everyone:
Thank you!
13:01:52 From Cathy van Poorten to Everyone:
Thank you!
13:01:52 From John Gyepi-Garbrah to Everyone:
Thank you!
13:01:53 From Alex Doran to Everyone:
thank you!
13:01:54 From Alex Atkinson to Everyone:
Thank you
13:01:58 From Toma Beit-Arie to Everyone:
Thank you!
13:01:58 From Jackie Gervais to Everyone:
Thank you! This was wonderful. Thanks to all of you!
13:01:59 From Christopher Hardy to Everyone:
Thank you
13:02:00 From Voncelle Volté to Everyone:
⚡ Thank you. I always learn something new. 🌻🌻🌻
13:02:01 From Anna Chrzaniecki to Everyone:
Thank you