Toronto aims to open more respite centres to address mental health, substance use

Toronto plans to open up more 24-hour respite centres as part of its latest strategy to mitigate substance use-related harms and mental health challenges among city residents. 

In a report published Monday, the City of Toronto outlined a number of steps it plans to take in order to address the increased need for mental health and substance use support services. 

"It's all hands on deck. We are in a crisis situation and something needs to be done," said Coun. Chris Moise, chair of Toronto's Board of Health at a news conference. 

"This comprehensive strategy takes a holistic approach to addressing mental health and substance use challenges across all age groups and communities."

The five-year plan includes a list of measures to promote mental health, prevent deaths from substance use, expand access to services, community safety, housing and maintain mentally healthy workplaces.

While the city says it has requested funding from provincial and federal governments, it could not say how much the project would cost in total.

"I'm hopeful, I'm optimistic, you have to be right? People's lives depend on it," Moise said, when asked how the services will be funded as Toronto faces a $1.5-billion budget deficit this year.

Earlier this month, city council voted unanimously to endorse the citywide expansion of a program that sees mental health experts instead of police respond to some calls involving people in crisis.

More crisis response services needed

As part of the plan, the city would implement low-barrier crisis stabilization spaces for people with mental health or substance use related issues. Those services would be open 24/7 and would provide access to evidence-based services, treatment and wrap-around supports for residents.

Susan Davis, executive director of Gerstein Crisis Centre, a 24/7 crisis response service in downtown Toronto, says the organization is faces a growing demand for support. 

"The situation out there right now is probably one of the worst times I've ever seen ... in terms of accessing both mental health services and supports for substance use but also all of the other social determinants," Davis said. 

"The beauty of 24-hour crisis response is it is accessible care in the moment when people need it, which is so essential. Having said that, we need services before a crisis occurs and we need services post-crisis and that is a big challenge for us as an organization."

Deputy Mayor Coun. Ausma Malik has been vocal in her support for more crisis response service and beds for those who don't have housing.

"By envisioning a Toronto free of mental health and substance use stigma, this strategy paves the way for accessible healthcare, services, resources and community spaces," Malik said Monday.

The report notes some initial steps the city would implement in the first year as part of the strategy. Those include collaborating with first responders and hospitals to implement a coordination protocol that enhances the seamless transfer of individuals experiencing mental health and/or substance use crises to the most appropriate services.

As well as expanding Toronto Community Crisis Service to be city-wide, as Toronto's fourth emergency service.

Nearly 3,000 opioid-related deaths since 2015

The report comes as Toronto faces an urgent and severe drug toxicity crisis, intensified the city says by a hazardous, unregulated drug supply. 

Since 2015, nearly 2,900 people died due to opioid-related toxicity, according to the report. Paramedics are seeing an "alarming trend" of substance use-related emergency calls, said Toronto EMS Chief Bikram Chawla. 

"We welcome this strategy, we think it's very timely," Chawla said. "This is something that we see everyday at the front lines."

This past summer, Toronto Public Health reported a rise in opioid-related emergency calls, prompting it to issue three drug alerts to the public. 

The strategy will be considered by the Toronto Board of Health in a meeting next Monday.