The most politically courageous move David Eby can make February 28 in his first budget as premier is to deliver British Columbians more Red Fish.
Yes, Red Fish, as in the modern, sophisticated, dignified facility to treat the concurrent challenges British Columbians face with mental health and substance use.
Eby’s courage would be expressed in a few forms. He would turn the page in defying the criticism of his pre-political employers at the Pivot Legal Society and the B.C. Civil Liberties Association. He would show persistence in taking another run where his BC NDP turtled in 2020 to amend the Mental Health Act. And he would assert his authority, even his willingness to upset his team, in picking a priority that appears unpopular but in Eby’s heart feels is the conscientious path to pursue.
The conscientious policy in question involves involuntary hospitalization and a recognition that today’s approach is not yielding tomorrow’s solution. The easy tactic would be to add a layer of public administration – a safer supply of drugs, a larger police presence, a stronger sentencing regime and an expansion of the facilities to incarcerate – to provide a surface-level perception of tackling an elusive riddle. But the premier, steeped in his adulthood as an advocate, official and minister intersecting this file, has concluded it is time to swivel.
The Red Fish in question is the Red Fish Healing Centre for Mental Health and Addictions, stationed on the lands that once housed the much-maligned, now shuttered, Riverview Hospital. The 105-bed facility is considered the model to replicate as Eby signals his determination to confront a system that has failed in its confrontation of the now-chronic opioid crisis, the ineffectiveness of the helping hands offered to those disabled by their mental health, and the public concerns about the spate of random attacks by repeat offenders.
This bedeviling amalgam touches upon critical issues of national importance that fall mainly to the provinces to address: health care, public safety, the administration of justice among them.
Eby – and for that matter, his political rival Kevin Falcon, the BC Liberal leader, who advocates involuntary care “where necessary” – cite Red Fish when they discuss the need for a redoubled effort that includes a detour into a new strategy.
The province’s Mental Health Act permits detention in a psychiatric facility if a physician deems it necessary for one’s health and safety – and for the safety of others. Some 20,000 were so treated in the last year and the province holds nearly 2,000 beds for such purpose. Eby argues the demand and supply are greater than this, as is a more concerted focus than what he considers a revolving door of unsuccessful treatment that inadequately deals with the infliction of drug-related suffering to compound mental health challenges.
At odds with any rationale for an aggressive plan that includes an expansion of involuntary treatment are clear questions about civil liberties and nightmarish memories of institutionalized techniques. Pivot says any plan to mix involuntary detention with treatment isn’t evidence-based. The civil liberties association was more personal about Eby, its former executive director, when he first raised this option in his leadership campaign last summer: “He is wrong and he knows it.”
I am more inclined to think Eby is right – at in least disrupting what hasn’t worked, even though the disruption will face opposition from his own base.
Months after he first mentioned his idea, it is unclear whether the premier has his team adequately onside. In listening in the last two weeks to his minister for mental health and addictions, Jennifer Whiteside, she appears to want to persist with the conventional voluntary route of detox, withdrawal management and treatment before amending legislation and heading down a more directive road. The premier, not wishing to disregard the medical and political advice, nevertheless senses he has to crack the eggs to make the omelette.
Thus, this would be his first true test of how he would use authority to express leadership.
His government’s first budget at month’s end will spend significantly to disburse a serendipitous $6 billion sweetener of the treasury, much of it arising from tax revenue unlikely to persist. His finance minister, Katrine Conroy, indicates the surplus will fade and quickly as the economy slows.
This is, then, the window of opportunity to invest in a broadened capacity beyond what Eby views currently as insufficient to the task. Among this would be the controversial legislative amendment of the Mental Health Act to expand secure care, almost certain to face legal challenge and public criticism – particularly if the leading-edge facilities are not there to debunk the legitimate concerns that the patients would face inhumane treatment.
There will be plenty of prizes in the budget for communities and programs to deal with an anticipated economic slowdown. This investment, if it’s there, is about turning the freighter around in the canal. It will not be swift, we will not see the instant results we too often expect of policy, but it will be the right thing to do.
There now is a frameable column in support of his idea to swim against the current. Please, reader, don’t get used to this.
Kirk LaPointe is the publisher and executive editor of Business in Vancouver and the vice-president, editorial, of Glacier Media.