Forced treatment approach for mental health, addictions likely to fail health-care CEO says in opposition

As some politicians across the province show support for a forced treatment model for people struggling with mental health and addictions, the CEO of a Windsor hospital says he doesn't support that.

Hôtel-Dieu Grace Healthcare, which provides mental health and addiction services, released a letter from CEO Bill Marra that said involuntary treatment is not the best model.

Marra said Wednesday the letter is meant to open a dialogue, calling Hôtel-Dieu Grace Healthcare the "single most major provider" of mental health and addictions services in Windsor-Essex. 

"The intent is not to get into a public debate or with anyone, but it's as health-care professionals and as service providers, I think it was incumbent upon us to respond to some of the concerns that have been expressed," Marra told CBC News. 

In the letter, signed by Marra, he says there's a lack of evidence that forced treatment yields better outcomes and it also involves an increased risk of trauma and human rights issues. 

Instead there are evidence-based alternatives that yield results, including harm reduction and community-based programs, the letter states.

"If we take a step back, what's really happened right now with the opioid crisis is that we're at this intersection of seeing addiction and homelessness in a real visible way. And that will trigger a reaction," Marra said. "People are reacting to what they're seeing in their community, whether it be in their neighbourhood or in the downtown area. There tends to be at times a reaction that's not always the best response.

"It's such a complex, complicated issue that a one stop approach by forcing treatment will likely be very unsuccessful and in fact in some cases could do more harm in the long term."

Marra said that recovery is more likely to stick when a person is ready for and wants to seek treatment. 

WATCH: Is forcing people into drug treatment the right way to go?

Is forcing people into drug treatment the right way to go?

17 days ago

Duration 7:18

As cities across Canada struggle with an addiction crisis, a growing number of politicians are proposing involuntary drug treatment as a solution, but as CBC’s Mike Crawley explains, the evidence is far from clear that forced care is the right way to go.

The letter comes as cities grappling with mental health, addictions and homelessness issues have started to look for more drastic ways to address the issue. 

The idea of forced addiction treatment was raised by Brampton Mayor Patrick Brown when he requested the province allow for involuntary treatment, something that would require changes to provincial legislation. 

In October, Windsor city council wrote a letter and voted to send it to the province asking to be consulted and participate in any pilot on involuntary treatment.

"The current system is not working," Windsor Mayor Drew Dilkens said at the time. 

"No city has all of the resources that are required to be able to deal with the problems that we see happening on our streets ... [for] some of the extreme cases, there is a role for institutionalized mental health care." 

Involuntary treatment would need more resources: CEO

Marra said any sort of involuntary treatment model would have to come with additional resources, calling funding for hospitals across the province "precarious."

"We're having a hard time keeping up with inflation… so existing resources can't be used because they're maxed out right now," Marra said. 

There aren't any conversions between Hôtel-Dieu's community partners about involuntary treatment at this point, he says, noting they're focused on the province's announcement of  Homelessness and Addiction Recovery Treatment (HART) hubs. 

The province this summer announced that it would not approve any new consumption and treatment service (CTS) sites and will instead fund HART hubs. Windsor has applied for a HART hub and is awaiting approval, with Hôtel-Dieu as the lead agency. 

But Marra said he commends the HART Hub model, calling the philosophy "very holistic."

"We haven't even seen the projects allocated yet, let alone see the results of it," he said,

Marra said he wants to see the data and evidence from six or 12 months of operating a HART Hub — and doing anything else right now would be "premature."

'I completely sympathize with members of council and community leaders. I sat in that chair before," he said, a nod to his years as a city councillor. 

"There's this innate human instinct to want to react and create a solution right away. A quick solution won't do it. I think we need to be very smart about what we do, base it on evidence-based practice, evidence-based treatment modalities and I think that'll create longer-term sustainable results rather than short-term gains in the period of time that people are looking at right now."