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A view of East Hastings street in the Downtown Eastside neighbourhood of Vancouver, on Jan. 31.JENNIFER GAUTHIER/Reuters

A legal group representing marginalized people on Vancouver’s Downtown Eastside has issued a stern rebuke of the provincial government’s plans to force mental-health and addictions treatment on people who present a danger to themselves and others.

Pivot Legal Society released a report Thursday calling on British Columbia to halt its proposed expansion of “involuntary care” beds, arguing such treatment is an outdated approach that is harmful, degrading and often discriminatory.

It also says recent local and international research has found people may face a higher risk of dying from an overdose after completing forced treatment.

The group formed in 2001 to fight against laws and policies it says undermine human rights, intensify poverty and further stigmatize those in Vancouver’s poorest areas.

The issue of forcing people who repeatedly commit crimes into treatment has gained political traction in recent months as mayors and opposition provincial politicians have repeatedly raised concerns about public safety. As the toxic drug crisis continues to defy efforts to reduce the death toll, Premier David Eby has said the province needs to expand the availability of involuntary care and to update the Mental Health Act to provide clearer options for intervention.

Tyson Singh Kelsall, a Downtown Eastside social worker and PhD student at Simon Fraser University who approved Pivot’s report, said the heavily politicized rhetoric surrounding involuntary care belies the extremely low level of government supports available to those seeking help for mental-health and substance-use problems.

“Expanding involuntary apprehensions, while voluntary supports are inaccessible to most, and floating policy that would force reduced tolerance before discharging people back to a toxic street supply setting, is not only cruel, but dangerous,” he said in a news release from Pivot.

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Nanaimo Mayor Leonard Krog disagreed with Pivot’s critique. He has been arguing to increase the mandatory treatment of repeat offenders since shortly after leaving his position as an NDP MLA to run for the mayor’s job in 2018.

“If it had been published on April Fool’s Day I might have believed it,” Mr. Krog said in an interview. “The comments by the people in the report indicate to me that they have no appreciation of the sentiments and feelings of the vast majority of British Columbians who know that involuntary, secure care for some of the people in our streets is absolutely appropriate and necessary – we are in the middle of the result of 30 to 40 years of failed social policy.”

Last week, Mr. Krog called on the provincial and federal governments to help his city fix its public-safety crisis after a shop owner was shot at a tent city while trying to recover his stolen tools.

Mr. Krog had no estimate for how many in his city would need such involuntary care, but conceded that a certain portion of people living on the streets would inevitably need to live in a medical facility for the rest of their lives.

Under the provincial Mental Health Act, a person can be detained in a psychiatric facility if a physician deems it necessary for their health and safety, as well as the safety of others. Last year, almost 20,000 British Columbians were involuntarily hospitalized this way, but the province only has 1,984 beds within the health care system designated for this forced care, and there are not enough long-term options to treat complex mental-health and addiction issues.

Mr. Eby, who joined Pivot early in his career in 2005 to advocate for homeless people, said more such treatment is needed amid a toxic drug crisis that has killed 11,000 and disabled tens of thousands over the past seven years.

“For every person that fatally overdoses, there are at least three people that are seriously brain-injured,” Mr. Eby told The Globe and Mail’s editorial board during a meeting in Toronto earlier this year. “And until you’re sufficiently brain-injured to the point of permanent long-term care, then people are being really spat out from the emergency room back into the community. So it’s cruel and it’s a miserable existence.”

Mr. Eby said he is also conscious of the many occasions that the provincial government has harmed those under mandatory care. He said B.C. will craft its new approach in consultation with First Nations leaders, mental-health professionals and people with experience using illicit drugs “to make sure we’re not making things worse, because sometimes you can go in with the best of intentions.”

Instead of forcing treatment upon people, Pivot issued seven recommendations for the provincial government, including to invest much more into voluntary options such as detox and treatment programs with strict oversight, as well as create a safe supply of illicit drugs. Pivot wants these services to be made available upon request everywhere across B.C.

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