A number of Ontario cities are calling on the province to consider mandatory treatment legislation to force street-involved people into addiction and mental-health programs. In a recent interview, the mayor of Barrie argued that governments have “done everything we can” and now need another tool.
“Cities and towns have done everything we can,” Barrie Mayor Alex Nuttall told CTV News, as he and other Ontario big city mayors push the province to expand its powers to mandate treatment for people experiencing severe addiction and mental health crises.
It’s an extraordinary claim, particularly from Barrie.
Last year, Nuttall declared a state of emergency over homelessness and encampments in the city. Nearly a year later, Barrie’s homeless population has increased by more than 11 per cent.
Now, Barrie’s mayor, along with 22 other mayors from the Ontario Big City Mayors (OBCM) caucus, is urging the province to explore involuntary addiction treatment. Doug Ford says he’s open to the idea.
Barrie has already demonstrated that it can make the crisis less visible by dismantling encampments. What it has not demonstrated is that it can end the structural problems that create homelessness.
And yet Nuttall’s conclusion is not that governments need to dramatically expand affordable and supportive housing, raise social assistance rates, strengthen tenant protections, or ensure that voluntary addiction treatment is available on demand. Instead, he is asking Queen’s Park for another power: the ability to force the people living through these failures into treatment.
Everything we can? Not even close.
The ethics of mandatory treatment
Removing someone from the street and confining them for medical treatment they have not consented to is an extraordinary exercise of state power. Who qualifies? Who decides? How does someone appeal? What safeguards prevent a policy ostensibly designed for exceptional circumstances from expanding?
Those questions become particularly important when homelessness, mental illness, and addictions are increasingly and shamefully discussed through the language of public disorder.
But there is another reality that cannot simply be wished away.
There are people experiencing severe substance use disorders whose lives are in immediate danger. There are families who have watched someone they love cycle through overdoses, emergency rooms, and shelters while repeatedly refusing treatment. Municipalities are confronting situations for which there is no easy intervention.
“No matter how ready they are, you can only do so much recovery in 72 hours,” she told me. “Then they’re put back out into the same circumstances.”
The political appeal of mandatory treatment is not difficult to understand. But political appeal and effective public policy are not the same thing.
And yes, the frustration of municipalities is also understandable. Cities are where the consequences of failures elsewhere become visible. It is municipal parks where encampments appear. Municipal services respond to crises.
But municipalities do not control Ontario’s healthcare system. They do not set Ontario Works or Ontario Disability Support Program rates. They cannot independently construct nor fund a province-wide addiction treatment system.
Even social housing in Barrie is not directly administered by the city. The County of Simcoe is the designated service manager responsible for planning, funding, and managing social housing programs and homelessness services.
Municipalities are being left to manage the most visible manifestations of crises whose most powerful policy levers largely sit elsewhere. That should make Queen’s Park’s role larger, not smaller.
Treatment ends. Then what?
There are also several questions that are largely absent from this political discussion. What happens when involuntary treatment ends? What happens when someone refuses to comply? Does coercive treatment ultimately become entangled with the criminal justice system through arrest, detention, or incarceration?
That possibility should concern us in a country where the burdens of incarceration are already profoundly unequal. In 2023-24, Statistics Canada found that Indigenous adults were incarcerated at roughly 10 times the rate of non-Indigenous adults. Black adults were incarcerated at three times the rate of white adults. Any expansion of the state’s coercive powers over people experiencing homelessness, mental illness, and substance use disorders therefore demands serious consideration of who is most likely to experience that coercion.
But there is another, much more immediate problem: what happens when treatment ends?
I spoke with a Salvation Army street outreach worker who told me that she regularly encounters people who are willing and looking for recovery, only to find short-term detox and be discharged back into the circumstances they came from. Some publicly funded detox programs her clients access can last as little as three days, she said, with little planning for what comes next.
“No matter how ready they are, you can only do so much recovery in 72 hours,” she told me. “Then they’re put back out into the same circumstances.”
She stressed that recovery while homeless is possible. But expecting someone to stabilize and then returning them to the same streets, shelters, and ready access to substances makes an already difficult process considerably harder.
Nor does Ontario’s income support system make securing one particularly plausible. A single person receiving OW can receive a maximum of $733 per month for basic needs and shelter combined. That has to cover housing, food, clothing, transportation, a phone, and everything else required to live, let alone rebuild a life. Ontario has increased ODSP rates in recent years, but OW has remained frozen since 2018.
We should therefore question what exactly recovery is supposed to look like under these conditions. A person can complete every counselling session. They can take every medication. They can emerge from treatment committed to changing their life. But recovery still has to happen somewhere.
A shelter bed is not a home. Neither is a tent. Returning someone directly to the instability and social environment from which they entered treatment is hardly a strategy for sustaining recovery.
The province’s own leading mental health hospital has raised this problem.
In a 2025 policy brief on involuntary treatment, the Centre for Addiction and Mental Health reported that at least 36,378 Ontarians were waiting for mental health and substance use supportive housing, with an average wait of roughly four years. CAMH has repeatedly called for tens of thousands of additional supportive housing units.
If Ontario is going to assume the extraordinary authority to decide that someone must enter treatment, surely it assumes some responsibility for what happens to them afterward.
What frontline workers actually see
The outreach worker I spoke with is skeptical that forcing someone through treatment solves these underlying problems.
“Recovery is not linear,” she told me. Relapse can be part of recovery, and in her experience readiness cannot simply be imposed on someone by the state.
She does believe there is a line. When someone poses an immediate danger to themselves or others, she supports the use of Ontario’s existing emergency mental health mechanisms to bring someone to hospital for assessment. But she does not see that as justification for creating a broader system of mandatory addiction treatment.
For people who continue using drugs but do not meet that threshold, she argues the priority should be keeping them alive through harm reduction services, including supervised consumption, while maintaining a relationship through which treatment remains available when they are ready.
Ontario is contemplating how to compel people who do not want treatment into treatment while people who are actively asking for it wait months for care.
But those are precisely the services the Doug Ford government has been dismantling. In 2025, Ontario forced the closure of 10 supervised consumption sites, including sites in Toronto, Ottawa, Hamilton, Kitchener, Guelph, and Thunder Bay. The province has also restricted municipalities from pursuing new supervised consumption sites without provincial approval. The HART Hubs that replaced nine of the affected sites are expressly prohibited from providing supervised consumption services.
Ontario is therefore debating whether to expand the state’s power to force people into treatment while simultaneously restricting one of the interventions available to keep people alive until they are ready to seek it.
CAMH, for its part, opposes creating a new involuntary substance use treatment regime, although it acknowledges that a small number of people with severe and complex substance use disorders may require involuntary hospitalization under legal powers Ontario already possesses. Involuntary hospitalization is not necessarily the same as involuntary treatment: a capable patient generally retains the right to refuse treatment.
But its proposed order of operations is important: first, build an adequately-funded voluntary treatment system and supportive housing infrastructure so people who want help can actually get it. Only then, in exceptional cases, should involuntary hospitalization enter the discussion.
Ontario has not met even that first condition. In response to the call from Ontario’s Big City Mayors Group, CAMH, the Canadian Mental Health Association Ontario, and Addictions and Mental Health Ontario note that the average wait for adult bed based addictions treatment is 61 days and for community based addictions treatment it is 124 days.
Ontario is contemplating how to compel people who do not want treatment into treatment while people who are actively asking for it wait months for care.
None of this proves that involuntary intervention can never help anyone. There may be exceptional circumstances in which someone’s substance use becomes so severe, and the danger to their life so immediate, that intervention is justified. But exceptional circumstances make poor foundations for an addiction strategy.
Given the weak evidence of long term benefit, the potential for harm, and the extraordinary infringement on individual autonomy involved, involuntary treatment should be an absolute last resort and used only after every reasonable voluntary alternative has actually been made available.
And that brings us back to Nuttall’s claim: have we really done everything we can?
Not even close.
