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Sandy Simpson is the chair in forensic psychiatry at the Centre for Addiction and Mental Health (CAMH) and the University of Toronto.

The tragic events and rising frequency of violent incidents on Toronto’s transit system is rightly a source of major public concern. We now know that the incidence of these events on the TTC has been slowly rising and at an increasing rate in the last two years. We have no studies of who the people are or why these events are happening, but experts working in this area have identified certain important themes.

The first theme is poverty and homelessness, which have become structural in our city; other cities are also experiencing these problems. Second is intoxication with certain drugs known to cause agitation, fear and violence, especially crystal methamphetamine and crack cocaine. Third is acute mental health disturbance, which can result in fear and agitation. These themes work synergistically to make life very hard. People feel frustration, alienation and distrust that any of the social systems that are meant to help them will help them. With that, too, can come anger.

These issues are not new, so why are they worsening? In terms of poverty, ODSP (Ontario’s income support for people with disabilities) is set at only 60 per cent of the income needed to be above the poverty line. The waiting list for subsidized housing is eight to 10 years long. The cost of survival (food, rent) is escalating. Cheap and dangerous drugs are increasingly common, and access to addictions services are limited and difficult to navigate. Mental health services are perhaps only 60 per cent of the size they should be. People experiencing mental illness and homelessness should get support from Assertive Community Treatment teams, but it takes 10 to 12 months to access that level of care in this city.

We expect people troubled by addictions, mental illness and/or histories of trauma to live at 60 per cent of the poverty line and wait for months or years for the clinical services or housing that they need. It’s little surprise then that they feel rejected and unsupported, and lose hope that their community wants to assist them. With no housing, they may ride the TTC through the night because it is warm and relatively safe, but it’s also where they can come into conflict with others.

This problem of violence is not only a poverty problem or an addictions problem or a mental health problem. Criminal justice responses are needed and there needs to be accountability for criminal behaviour, but we cannot police or imprison our way out of this situation. In my work in a major remand centre, I see these stories. Incarceration further fractures troubled lives, and there is too little time and resources to mend these fractures.

So what are the answers? We need to recognize the complexity of these issues and not jump to narrow conclusions. It is of course a security issue. The public has the right to feel safe on the TTC. Increasing the presence of police and mental health outreach workers, along with increased communication and staffing, makes sense for short-term security. We need to examine the situation more closely, but we need not wait for further study to take positive steps.

Long-term security requires addressing the fundamentals noted above (more addictions services and better access to them; enhanced mental health services, especially ACT teams) but unless the fundamental issues of poverty are addressed, we will not help people rise from these feelings of desperation and alienation. Guaranteed Basic Income (GBI) is the best answer to this problem. It is a model widely trialled internationally. Its social and economic impacts are well demonstrated. GBI is transformative for people in poverty and on the fringes of society with other social problems. Already piloted in Ontario, we know GBI improves physical and mental health, decreases stress and feelings of anger, and reduces housing and food insecurity. It has been associated with a reduction in property crime.

The increase in violence on the TTC has exposed problems that have been getting progressively worse. We know this as we walk the streets of Toronto and step around marginalized people, but we have turned away and allowed this neglect to progressively accumulate. We are seeing now that we have failed to create a compassionate society, and that security and safety needs to extend to all people. To achieve this, we need a change in heart, and expenditure.

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