Thank you.
A couple weeks ago we talked about the public disorder that characterizes a lot of downtown areas, seemingly swirling around drug use. I'm glad to see a couple of people here who were talking about mental health issues in part of this discussion.
I'd like to talk more about how much of the problem is drug use and how much of the problem is mental health disorders.
We've also talked about it being difficult to distinguish between the two, being a chicken-and-the-egg problem. Some drugs, like methamphetamines and even marijuana, can cause psychosis.
Maybe I can start with Dr. Mathew, but maybe go on afterwards to Dr. Morin.
How much of the kind of Downtown Eastside scenario of homelessness, drug use, crime and social disorder is really a drug problem, and how much is psychiatric problems that are being inadequately addressed?
With respect to that, in my last number of weeks in considering this issue, I've talked to psychiatrists about the availability of treatment and treatment for addictions. They said, Marcus, there are no beds. We discharge people from our psychiatric unit with rope burns around their necks from trying to hang themselves, so how are we going to find beds for them?
There are not enough beds, and certainly not enough outpatient services. I've also heard from someone in Thunder Bay who said there should be like a hundred people in Thunder Bay on court-ordered treatment, long-term anti-psychotics, but who aren't. Part of the problem is apparently concurrent disorders and distinguishing between psychiatric problems and addiction problems.
How much are these problems a result of there not being enough chronic care beds? We closed all the chronic psychiatric hospitals years ago, replacing them with long-term anti-psychotics. Should we be re-examining whether that's an issue?
I know I've talked about a lot of this, but maybe, Dr. Mathew, you could start by addressing some of those issues relating to the intersection between psychiatric illness and addictions.