Item - 2023.HL8.1

The Board of Health:

1. Endorsed Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto attached as Attachment 1 to the report (November 13, 2023).

2. Directed the Medical Officer of Health to establish an implementation panel for Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto, and report back to the Board of Health in the first quarter of 2024 with recommendations on the panel terms of reference and membership selection criteria.

3. Directed the Medical Officer of Health to provide dedicated staffing resources from Toronto Public Health to support the implementation of Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto, responsible for convening stakeholders, advocating with appropriate levels of government, and monitoring progress on implementation.

4. Directed the Medical Officer of Health to report to the Board of Health with annual progress reports on the implementation of Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.

5. Requested the Province of Ontario and Government of Canada to provide increased, ongoing and sustainable funding for shelter services, affordable housing and supportive housing, including supportive housing for people experiencing homelessness, complex mental health and/or substance use related challenges. 

6. Requested the Province of Ontario to fund low-barrier crisis stabilization spaces for people with mental health and/or substance use related issues that operate 24 hours per day, seven days per week across the city as part of a full continuum of evidence-based services, treatment and wrap around supports.

7. Requested the Medical Officer of Health to collaborate with first responders and hospitals to implement a coordination protocol that enhances the seamless transfer of individuals experiencing mental health and/or substance use crises to the most appropriate services.

8. Endorsed the expansion of the Toronto Community Crisis Service to be city-wide, as Toronto's fourth emergency service.

9. Forwarded Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto attached as Attachment 1 to the report (November 13, 2023) from the Medical Officer of Health, to the following Federal Ministers: Minister of Mental Health and Addictions, Minister of Health, Minister of Employment, Workforce and Official Languages, Minister of Housing, Infrastructure and Communities, Minister for Women and Gender Equality and Youth, and Minister of Families, Children and Social Development.

10. Forwarded Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto attached as Attachment 1 to the report (November 13, 2023) from the Medical Officer of Health, to the following Provincial Ministers for their information and consideration: Minister of Health, Minister of Children, Community and Social Services, Minister for Seniors and Accessibility, Minister of Municipal Affairs and Housing, Minister of Economic Development, Job Creation and Trade, Associate Minister of Mental Health and Addictions, Associate Minister of Housing, and Associate Minister of Women’s Social and Economic Opportunity.

11. Directed the Medical Officer of Health to develop a public dashboard that will track the progress of the implementation for Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.

12. Directed the Medical Officer of Health to provide an update, including an implementation plan and outcomes measured, to the Board of Health as soon as a Health Canada decision is granted in response to the City of Toronto's application for decriminalization.

The Director, Public Health, Strategy and Clinical Services, Toronto Public Health, together with Dr. Kwame McKenzie, Chief Executive Officer, Wellesley Institute, and Susan Davis, Executive Director, Gerstein Crisis Centre, gave a presentation on Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.

With a diverse and growing population, the City of Toronto offers an extraordinary wealth of cultural, social, and economic opportunities, making it one of the most livable cities in the world. To keep Toronto vibrant and welcoming, individuals and communities in the city must have equitable access to opportunities to optimize their health and achieve their full potential.

In June 2022, the Board of Health requested the Medical Officer of Health to develop a Mental Health and Addictions Strategy for Toronto. At the same time, the Board of Health directed the Medical Officer of Health to engage with stakeholders throughout summer and fall 2022 to refresh the Toronto Drug Strategy. This staff report presents Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.

The strategy was developed through extensive consultation over the last 18 months with many stakeholders and partners, including people with lived and living experience of mental health and/or substance use issues. The strategy presents a city-wide, comprehensive population-level approach with recommendations for all levels of government, City divisions, and community partners to help address mental health and substance use related issues across the lifespan. This report outlines the proposed vision, mission, guiding principles, strategic goals and recommended actions to guide the city for the next five years.

Multiple City divisions were consulted in the development of this strategy.