“The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life, the sick, the needy and the handicapped.”
In the age of internet memes and misquotes, many attribute the above to Gandhi yet it was former American vice president Hubert H. Humphrey who spoke about the treatment of the weakest members of society as a measure of government – words I find, four decades later, to be more poignant than ever.
When speaking of Niagara, one word consistently comes to mind: crisis. Whether it be the opioid overdose rate, the suicide rate, lack of affordable housing, lack of good employment opportunities, political chicanery… not to mention physical barriers that exist with the lack of proper inter-municipal regional public transit and our extensive waitlists for services including mental health and supportive housing.
I know people who stay in bad relationships for no other reason than because neither party can afford to move and/or they share a vehicle; working poor who can’t afford housing on their own while maintaining a reasonable commute – the lack of an adequate inter-municipal regional transit system limits many, isolates even more, and contributes to the overall sense of depression within our people and our region.
Thankfully, odds are slim that we repeat the 90% increase in mortality rates we saw in 2017; it should be noted, deaths have remained steady – by the end of June, Niagara had already lost more people in 2018 to opioid overdose than in all of 2016 or any year previous.
The availability of, and ease of access to, Naloxone® has helped stymie the impact of fentanyl in the Niagara drug supply, yet, overdose deaths continue to break records, suicide rates remain unchecked, the unemployment rate is relatively unchanging at high, and, the demand for, and use of, food security and shelter services continue to climb.
Additional emergency shelter beds were added in both St Catharines and Niagara Falls, with Welland looking to open an Out of the Cold program of their own, but facilities region-wide continue to operate past capacity. While some do choose to remain outdoors, some have no choice – or their homelessness is hidden by couch-surfing.
The province recently stepped up to allocate some of the federal mental health funding to Niagara (yes those were federal dollars Christine Elliott and Doug Ford insist on claiming are some big gift to the People), giving us 8 additional mental health beds at the St Catharines site of Niagara Health. In addition, Queens Park has passed a motion to see $2.5 million for the operation of three 24/7 crisis and resource centres in Niagara, to be located in St Catharines, Niagara Falls, and Welland.
The nine percent increase to Niagara Health System (NHS) mental health unit capacity should help the average of 16.85* people who, according to NHS, go through the four bed Psychiatric Emergency Rapid Treatment unit in Niagara, every single day, before being admitted to one of the 85 inpatient beds, referred to outpatient treatments, or simply discharged once stable (or upon patient request).
*16.85/daily = average of 30,000 over 5 year period or 6,000 per annum assuming 356 days.
For those looking to access certain treatments, or are currently receiving services, spring 2019, will see the opening of two new facilities on Queenston in east downtown St Catharines. One will house short-term inpatient units including Safe Beds and Withdrawal Management Services (Detox), the other is to be a permanent home for the Safe Consumption Site with additional resources and day treatments.
While new facilities will ease access for some, promote harm reduction, and work to revive the community health care services lost when the old hospital shut down, these new facilities are consolidating services – in some cases, like withdrawal management services, the move will result in a reduction from 18 to 8 mens beds.
Hickory Dickory Dock
Niagara’s fucked up (what a shock!)
Humpty Dumpty thought he was wise
Til bullets sprayed and mothers cried
A dillar a dollar a twelve-o’clock scholar
Add fentanyl to their fix then they can’t hollar
Rock-a-bye baby in the treetop
Selling your dreams down at the pawnshop
Now I lay me down to sleep
I pray my beer is good and cheap
But if I die, before you wake,
Remember, I told you my heart ached.
But don’t assume it is those who call abandoned buildings home, our marginalized and vulnerable populations, who are most likely to die from a drug overdose; long-term users are amongst those most likely to access harm reduction services (just as those who complete suicide are more likely to have multiple previous interactions, or attempts at interaction, with mental health providers).
Paradoxically, the problem isn’t as obvious as the creepy guy leering in the corner, or a drunk-texting ex proclaiming their undying devotion, reeking of cheap cologne and desperation; Niagara continues to see a rise death amongst those with hidden substance use and abuse – young people who leave families utterly shocked, often dying at home, alone.
People are as different as their fingerprints – they check different mental health, substance (ab)use, gender, orientation, and socioeconomic boxes, yet we continue to formulate symptom-based cookie cutter treatments which ignore the complexity of the patchwork that make us individual quilts.
Much like the old General Hospital, Niagara has become stagnant, half-stuck in its cocoon, unable to break free from the small-farming-community-turned-city identity crisis to look twenty-first century realities head-on; St Catharines and the Region of Niagara must stop addressing social issues piecemeal, the existing tapestry of emergency plugs have sprang too many leaks to repair; come undone, strained well beyond capacity, bursting at the seams, we can no longer pretend to fix the existing institutions. It’s time we break free from the enigma that is our paradox: harm reduction and evidence-based solutions save lives, random increases in programming chosen by politicians do not.
Would Niagara Health be better allocating those eight new mental health beds to detox services? Perhaps. Would Niagara be better served by increasing rehab beds from 32 to 40? Perhaps. Would increasing community supportive services have the biggest impact for our dollars? Most definitely- emergency housing and the rotating psychiatric door at the hospital cost tens of thousands per day while supportive housing for those who live with chronic mental illness and homelessness costs less than $20 a day.
Drug testing kits for those who aren’t ready to admit they use, let alone abuse, drugs? Around the price of a coffee.
The wind howls, rattling what remains of the window panes, the smell of urine permeates despite the draft. The ceiling and walls spill ripped wires and bits of pipes while broken glass crunches underfoot, an epitaph to drug use and the occasional used condom, adding to the feeling of stepping within an eviscerated carcass.
The once bustling building now stands a cavernous mausoleum, whatever’s left after five years of scavenging acts as a home for some of the cities most vulnerable persons; squatters call the squalor that is the shuttered hospital home. Human beings who believe living with rodents and exposed pipes is their best, or perhaps safest, option.