Opinion: After decades of the mental health and addiction crisis, B.C. owes people a way forward

Communities across B.C. face visible homelessness, mental health crises, toxic-drug deaths and concerns about public safety. For decades, Vancouver’s Downtown Eastside has served as political shorthand for these challenges, writes Keir Macdonald. Photo by NICK PROCAYLO /00099408A

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British Columbians have heard years of promises to reduce homelessness and improve mental health and addiction care. Yet suffering remains visible, help is hard to access, and concerns about safety persist. People are right to ask why we keep spending without seeing enough improvement.

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That frustration deserves a serious response. We need a clear, coordinated plan that addresses gaps in care, connects services, and turns investment into safer communities, timely help and a lasting path out of crisis.

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For decades, Vancouver’s Downtown Eastside has served as political shorthand for these challenges. Governments, strategies and funding levels have changed. Yet the same fundamental questions remain.

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Today, communities across B.C. face visible homelessness, mental health crises, toxic-drug deaths and concerns about public safety. All of us deserve safe communities. Building them means ensuring people can access appropriate housing, health care and the support they need to build stable lives. Violence, untreated illness and preventable death should never be accepted as inevitable.

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Yet we continue to debate housing, treatment, involuntary care and enforcement as separate solutions. These investments matter. But British Columbia needs more than programs. It needs a system that connects them reliably.

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As provincial candidates put forward their solutions, voters should ask: What happens the morning after? After the encampment is cleared. After someone is involuntarily admitted to hospital. After someone completes treatment. After someone is released from custody.

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Where does that person go? Who is responsible for what comes next? What makes the next crisis less likely? Until political promises answer those questions, we will continue investing in interventions while leaving people to fall through the gaps between them.

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Housing, homelessness, mental illness and addiction intersect, but they are not interchangeable. A person who cannot afford rent does not necessarily need treatment. Someone experiencing psychosis may need far more than housing. Someone leaving addiction treatment needs a home that supports recovery.

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Hospital admission and treatment must lead to stable housing and continuing care. Supportive housing must be connected to clinical services that match residents’ needs. And after an enforcement intervention, we should ask what has changed to make the next crisis less likely.

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Too often, public policy celebrates the front door while paying too little attention to what happens next. When those connections fail, people suffer and public services bear the cost of responding to the next crisis.

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B.C. needs a 10-year provincial plan to reduce homelessness, repeated crises and preventable deaths. It must survive elections and align housing, health care, treatment, corrections and community services around shared outcomes. Someone must own the result.