Not only that, a community coalition says in a joint letter that research shows forced treatment rarely works, that police are not health care professionals able to diagnose a person’s needs and Ontario’s limited treatment capacity already turns away many people who want help

While municipal associations across Ontario call on the provincial government to legislate involuntary care for people with severe substance use disorders and mental health crises, Sudbury’s frontline organizations say that not only does forced care violate human rights, it does little to solve the crisis.

In a statement sent to Sudbury.com and signed by eight local organizations, advocates warned that this request is not only “extremely dangerous and problematic,” but that it is not backed by evidence about how best to support and protect community members.

The community coalition (Réseau ACCESS Network, Coalition for a Liveable Sudbury, Sudbury Temporary Overdose Prevention Society (STOPS), The Go-Give Project, Fierté Sudbury Pride, SWANS, and Black Lives Matter Sudbury) stressed that mental health and substance use are health care concerns that must remain between an individual and a health care provider.

The eight argued that what is considered appropriate treatment is a question for health care professionals, not enforcement officers, noting that the police board and municipalities don’t have the health care expertise to prepare a position on or advocate for treatment options.

Leadership at Health Sciences North and Public Health Sudbury and Districts have similarly questioned the efficacy of involuntary care.

However, as communities search for answers to a severe and ongoing toxic drug crisis, the City of Greater Sudbury Mayor Paul Lefebvre and the Greater Sudbury Police Services Board have joined the Federation of Northern Ontario Municipalities (FONOM) and Ontario’s Big City Mayors in advocating for reforms to the provincial Mental Health Act, allowing for “compassionate intervention,” a more politically neutral term for involuntarily forcing people into treatment.

Involuntary care, also called mandatory rehabilitation, involves legal mechanisms that allow medical, legal, or family authorities to detain and treat individuals without their explicit consent. While adults in Canada generally cannot be forced into medical care unless they lack decision-making capacity or represent an immediate risk of harm, other jurisdictions have already expanded these powers.

The call from the municipalities appears to be specific to what they call Severe Substance Use Disorder. An evidence brief from the Canadian Centre on Substance Use and Addiction (CCSA) states that medical definitions draw a distinction between general substance use, a substance use disorder and Severe Substance Use Disorder (SSUD), which is the specific target of most involuntary care proposals.

Substance-use disorders are characterized as mild, moderate or severe based on meeting six or more out of 11 diagnostic criteria in the DSM-5, considered a complex health and social condition affecting a person’s brain, behavior, and relationships due to chronic substance use that causes significant harm.

But frontline organizations are pointing to a lack of staffed beds to house the influx of patients resulting from the change, especially since, according to the Sudbury’s Go-Give Project, only about half of the individuals who request treatment are able to access it.

Tracking data from their service hub location at the Energy Court encampment, numbers show that between January and July, 39 people actively searched for or applied for a space, but only 21 managed to secure placements in treatment or long-term detox.

In terms of mental health care spaces in Sudbury, there are 60 adult acute-mental-health spaces at Health Sciences North and six child and adolescent mental health beds.

The safe beds program (community residential crisis support) has six beds total (two short-stay crisis beds and four police-referred safe beds) at Health Sciences North on Pine Street

This local shortage appears to reflect a widespread provincial crisis. A statement from the Canadian Mental Health Association highlights that average Ontario wait times sit at 61 days for adult bed-based addiction treatment and 124 days for community-based care.

Further, the association emphasized that the claim that individuals are unresponsive to voluntary treatment ignores the reality that voluntary care is frequently unreachable when people are ready to accept it.

In 2023, the number of hospital beds per 1,000 inhabitants in Canada was 2.49. Between 1976 and 2023, the figure dropped by 4.43.

Per Canadian Association of Mental Health (CAMH), while mental illness accounts for about 10 per cent of the burden of disease in Ontario, it receives just seven per cent of health care dollars. Relative to this burden, they said mental health care in Ontario is underfunded by about $1.5 billion.

A review article from the Canadian Journal of Addiction states that from an economic standpoint, involuntary care models are highly expensive and resource-intensive, threatening to divert critical funding away from voluntary treatment infrastructure and potentially life-saving harm reduction services.

Even at the meeting of the police board, though ahead of the unanimous vote to approve a letter calling on the province for new legislation surrounding involuntary care, HSN CEO David McNeil told the board under involuntary care, a patient’s condition tends to improve temporarily, simply because their environment has been significantly changed.

However, McNeil noted that the long-term success of involuntary treatment “is mixed,” and that the push from a health care perspective should be centered around quick access to assessment, treatment, and ongoing support.

He stated that the primary point of advocacy from a health care perspective should be adding more supportive housing, alongside timely access to community support services and early intervention.

“By the time they hit the hospital emergency department with a mental health or addictions issue, there’s often been a significant amount of time where a person has lived with a low-level addictions issue, and sometimes the intervention is getting that assessment and treatment much earlier in the illness trajectory,” McNeil said.

Early intervention, such as seeing a counsellor, often relies on the private sector, which comes at a cost.

This, McNeil said, “is the dilemma.”

When asked why the police board should pursue involuntary options when capacity does not exist for those who ask for it, Lefebvre said Aug. 11, “there’s a multitude of things that we need to do. … Let’s make every effort we can to open those doors and offer that service.”

Public Health Sudbury and Districts spoke even more directly against mandatory measures, in 2024, stating in a policy brief that a critical ingredient to success is a person’s readiness to change. The public health unit cautioned that when people are forced into treatment against their will, it is unlikely to succeed, pointing instead toward affordable housing, expanded treatment access, harm reduction, and wrap-around social support.

The clinical and human rights risks of forced treatment are also documented in medical literature. The CCSA evidence brief stresses that high-quality scientific evidence supporting involuntary treatment remains overwhelmingly limited and inconclusive. Crucially, individuals who undergo periods of forced abstinence experience a marked reduction in their opioid tolerance. If an individual relapses after release—which occurs at high rates without robust post-discharge community care—they face a drastically elevated risk of fatal overdose.

Furthermore, the research on compulsory care presents severe ethical challenges regarding personal autonomy, bodily integrity, and civil liberties.

Advocacy groups emphasize that forced treatment policies would disproportionately impact Indigenous, Black, and racialized individuals who are systematically unhoused and marginalized by existing institutions.

In response, local advocacy organizations are calling on Lefebvre, the municipality and the police services board to rescind its motion requesting involuntary treatment legislation. Sudbury’s frontline workers and health authorities maintain that homelessness, substance use, and mental health concerns can’t be used as justification for stripping away bodily autonomy. Instead, they demand that municipal leadership reallocate its advocacy efforts toward fully funding evidence-based harm reduction, immediate voluntary treatment spaces, and supportive housing.

Jenny Lamothe is a reporter with Sudbury.com.