Toronto's Centre for Addiction and Mental Health, the largest mental-health facility in the country, has backtracked on a plan to ban smoking from its grounds.
Instead of enacting an all-out ban that would force patients off-site to smoke, CAMH now plans to set up designated outdoor smoking areas for patients and staff.
The change was prompted by nearby businesses and homeowners who objected to smokers taking up residence on the public sidewalk.
"It's not a change that was made for clinical reasons," said Susan Pigott, vice-president of communications and community engagement at CAMH. "It was a change that was made because we are a hospital. We're not on the edge of town. We do have a lot of neighbours and we really want to be a good neighbour."
Although not a full ban, the new policy is more restrictive than the current one, which prohibits smoking indoors or within nine metres of an entrance.
Smoking is a sensitive topic for CAMH and other mental-health centres.
While smoking has come under increasing restrictions elsewhere in recent years, the mental-health community has been reluctant to act because of the pervasive view that patients already struggling with mental illness shouldn't be forced to endure the stress of giving up a habit that many say helps to calm them.
That means that when mental-health centres such as CAMH move to ban smoking, they are likely to be met with resistance from patients - and perhaps even staff concerned about the effect on the psychological state of those in their care.
But those concerns aren't what prompted CAMH to retreat from its proposal to ban smoking entirely.
Rather, Ms. Pigott said the policy was changed after businesses and residents near the centre's three main Toronto sites spoke out about having patients smoke in front of their stores or on their lawns.
"We have no desire to be seen to be sort of moving our perceived problem to somebody else's territory," Ms. Pigott said. "At CAMH, we never unilaterally lay down policy changes. We always bring about change after we consult with our clients and family and, where we think the issue is relevant, with our neighbours."
She said the centre stands behind strong smoking restrictions that will help protect the health of patients, staff and visitors.
In April, Tony George, clinical director of CAMH's schizophrenia program and chair in addiction psychiatry at the University of Toronto, said research has shown full bans reduce aggressive behaviour in patients and may also protect patients from smoking-related diseases.
He added that a complete smoking ban could also help patients quit by making it more cumbersome to duck out for a cigarette.
Dr. George was not available for comment on Wednesday.
The designated smoking areas will be located on the east side of the centre's Queen Street location and in an area in front of the two sites on College and Russell Streets. Smoking will also be permitted at the Queen Street site in the Paul E. Garfinkel Park, a city park, and Shaw Park, which is expected to be handed over to the city in the next few years, Ms. Pigott said. The policy will take effect on July 27.