In the lead-up to Calgary’s 2017 election, Mayor Naheed Nenshi watched someone he knew fall into a crisis of mental illness and addiction.
In between emergency room visits, the mayor offered to help, but was stymied by a confusing system that made it difficult to find out what services were available and how to use them.
“I thought to myself, ‘I’m the mayor – I can call anybody, and I know everybody,’ ” Mr. Nenshi said in an interview. “If I’m having trouble helping this person access the system, then how can anyone access the system?”
During his re-election campaign, Mr. Nenshi promised to make the issues of mental health and addiction a major theme of his third term as mayor and make it easier for people to navigate those services. The following year, the city formed an advisory group and launched a three-year process to develop a municipal mental health and addiction strategy with a budget of $25-million.
City council voted this week to approve the plan, which aims to bring together governments, social service agencies, non-profits, businesses and philanthropists to build a system designed to dramatically expand access to prevention and treatment for mental illness and addiction.
And Mr. Nenshi is urging mayors across the country to adopt what he describes as the Calgary model, which leaned on members of the community to create a plan that would ensure that agencies and governments that touch on mental health and addiction are working together. The goal is to let people quickly access help when and where they need it – at school, at work, at home – while also preventing those problems from turning into a crisis in the first place.
Mr. Nenshi said municipal governments can no longer see mental health and addiction as issues best left to higher levels of government. While health care is primarily within provincial jurisdiction, cities are left to deal with the consequences if those issues aren’t given the appropriate resources or if provincial services don’t reflect what’s needed in a community.
“We don’t control the health care system. We don’t control big chunks of the housing system. We don’t control big chunks to the social services system,” he said.
“But what we have is convening power – the ability to bring everyone together.”
Mr. Nenshi plans to pitch other Canadian mayors to follow Calgary’s lead in a meeting next month.
Calgary’s approach was celebrated in a paper published earlier this year by the Stanford Social Innovation Review, which said the city’s work underscored the need for collaboration to tackle complex social issues.
The city formed a stewardship group to develop the strategy that included municipal staff and provincial health officials, as well as representatives from emergency services such as police and fire, non-profits, and businesses including Petronas Calgary and Benevity. Mr. Nenshi also credited the province’s first associate minister for mental health, Jason Luan, for supporting the city’s work.
The resulting 49-page document lays out a plan to research and develop programs for schools, workplaces and other areas of the community to reach people where they are. For example, the strategy calls for a youth mental health strategy and programming for schools. The city also plans to create a system to allow providers to work together and ensure clients, such as people recovering from addiction, are able to more easily move between the various services they need.
Even before the plan was finished, the city focused on getting money out the door. The first $10-million of the plan’s budget has already been used to fund existing services while also helping local organizations to create pilot projects through a program called Change Can’t Wait.
Change Can’t Wait received $1-million from the city and also attracted $275,000 in private money, which together funded 29 projects. They included a phone and video counselling service called Community Connect YYC; the Nine Block Program, which focuses on outreach in the area around city hall downtown; and a service in being developed by the Calgary chapter of the Canadian Mental Health Association that will match people with mental health and addictions support.
Another $1-million went to addressing concerns about social disorder around the city’s supervised drug-use site, which is located in an urgent care centre just south of the downtown core.
The stewardship group was co-chaired by Karen Gosbee, who has become an advocate and speaker on mental health and addiction issues since the death of her husband, George Gosbee, a prominent Calgary banker who died by suicide in November, 2017, after his own struggles with mental illness and drug use. She wrote a book about what happened.
Ms. Gosbee said many of the services people need already exist, but there is no one working to figure out what’s available and stitch them together. That’s where the city’s approach can excel.
“There were supports out there that people didn’t know and we had to connect to make it easier, faster, more efficient,” she said.
Kwame McKenzie, CEO of the Wellesley Institute and a professor in the University of Toronto’s psychiatry department, said that while mental health and addiction aren’t typically seen as a municipal issues, cities can’t afford to ignore them. He said cities have a unique ability to co-ordinate between different levels of government, non-profits and other organizations that often don’t work together.
He said cities such as Vancouver and Toronto have already done some work on issues related to mental health and addiction but nothing as expansive as what Calgary is proposing.
“What you often find is that there are loads of different organizations involved and no one co-ordinates it,” he said.
“So you get over-support for some groups, under-support for other groups, but no strategy. Someone’s got to take control and it has to be somebody who can convene.”
Mr. McKenzie said the COVID-19 pandemic has underscored how vulnerable many communities are to mental health crises, and he said it’s crucial to have support available during the post-pandemic recovery.
“Cities that have been hardest hit [from the pandemic] will be hardest hit during the mental health problems that we’ve got,” he said.
“This is the time. They have to make sure that the services meet the needs of their people, otherwise, their economic recovery will not happen the way they wanted it to.”
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