(Pasting this in in its entirety so everyone doesn't need to fight Google for it)

Roofs needed to patch mental health system

ANDRÉ PICARD

From Thursday's Globe and Mail

The recent Senate committee report entitled Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada got a lot of media attention because of one of its quirky recommendations -- a nickel-a-drink tax on alcoholic beverages to fund a transformation of the mental health system.

Unfortunately, the focus on the tax proposal detracted attention away from a host of excellent and forward-looking recommendations including an employment program to help people with mental illness land and hold jobs, a call to change employment insurance rules so those suffering from mental illness can qualify more easily, the creation of a mental health commission, and a large-scale anti-stigma campaign designed to change public attitudes about the mentally ill.

But the most striking and important aspect of the committee's work -- led by Senators Michael Kirby and Wilbert Keon -- is its emphasis on housing.

The report makes it clear that investing in housing is key to transforming the mental-health system and, more generally, to improving the health of Canadians.

Housing is a fundamental determinant of health.

You cannot get healthy, or stay healthy, if you do not have a roof over your head.

Yet, homelessness is all too pervasive in Canada.

As the Most Reverend Andrew Hutchison, primate of the Anglican Church of Canada, noted in a recent commentary piece: "Canada is a rich country. Yet tens of thousands of people live on the street, and millions are without affordable and adequate housing."

The homeless are not merely those familiar figures panhandling on street corners, or sleeping on grates.

The vast majority of the homeless -- or perhaps more accurately, the precariously housed -- are bunking with friends or family, living in shelters, squatting in abandoned buildings, hanging out in all-night coffee shops, or spending virtually every penny for a bed in a dank welfare hotel.

The ranks of the homeless are as diverse as larger society, a mix of young and old, families with children, couples and single people.

What they have in common is poverty -- poverty that is the result of any number of underlying causes.

The most common reason is mental health problems and/or addiction to alcohol or drugs.

The Kirby report estimates, conservatively, that there are at least 140,000 people suffering from mental illness without adequate housing.

When the health system embraced deinstitutionalization decades ago, it neglected to provide community housing.

Today, our prisons and streets have become de facto asylums.

In addition to those with mental illnesses, there are as many again who are homeless because of physical ailments, unemployment (or, for the working poor, insufficient income from employment), physical or sexual abuse, addiction to alcohol or drugs, a criminal record, or any combination of the above.

When a person is precariously housed, their health is poor and their health prospects poorer still. When you are one paycheque, or one unexpected expense away from the street, life can quickly spiral downward.

In Canada, we have a terrible habit of tiptoeing around the problem of homelessness.

We build soup kitchens and food banks to feed the homeless; we create needle exchanges for intravenous drug addicts; we provide blankets and sleeping bags to street people and even tend to their pets; we build "emergency" shelters and put homeless people up in motels; and we churn the homeless in and out of hospital emergency rooms at tremendous expense.

But, for all the dollars spent, we invest very little in providing what is really needed -- affordable, permanent housing.

Doing so -- with co-ops, subsidized rent, low-cost mortgages and other measures -- should be a fundamental aspect of Canada's social safety net.

The failure to provide affordable housing to those in need shows on our streets.

Major cities like New York, London and Stockholm do not have the hordes of homeless beggars that we see in Toronto, Montreal and Vancouver. That's because they have focused on permanent housing rather than stopgap measures.

In the past decade, rental housing construction in Canada has fallen by half. The real estate boom is fuelling the rapid destruction of cheap apartments and rooming houses that kept many on the margins off the streets.

The federal government has, for its part, promised more than $1-billion for affordable housing, but only a fraction of the money has been spent because the provinces will not (they say cannot) provide matching funds.

And the Canada Mortgage and Housing Corporation, which is supposed to help Canadians buy homes, turned a $728-million profit last year, so it has a lot of wiggle room.

The only solution to homelessness is housing.

It's time for Canada to get building -- affordable homes and better health.

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Robyn Kalda
Health Promotion Information Specialist
OPC Health Promotion Resource Centre
(416) 408-2249 x226 
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