The forced mental health treatment debate in Ontario has escalated amid rising costs and conflicting views over patient autonomy. One woman’s case has drawn national attention, with a CBC News investigation estimating the health and justice system has spent over $811,000 on her since 2018. Diagnosed with bipolar I disorder, her case exemplifies the friction between rights-based approaches and medically driven solutions in treating severe and persistent mental illness.
Dr. Karen Shin, chief of psychiatry at St. Michael’s Hospital and chair of the Ontario Psychiatric Association, says the system often incurs “extremely high costs” when people remain untreated. In this woman’s case, police, courts, hospitals, and community services have cycled her through jails, tent encampments, and hospital beds repeatedly — without stable or lasting results.
Shin argues that some level of forced mental health treatment, in carefully defined circumstances, protects patients whose illness impairs their decision-making capacity. “Choice has to be a capable choice,” she emphasizes, highlighting how delusional thinking and lack of insight can prevent people from seeking or accepting care voluntarily.
Meanwhile, Cornwall police report dealing with about 20 individuals like her daily, with just five of them accounting for over 250 police incidents in 2024 alone. These repetitive interventions show the strain that unresolved psychiatric cases place on law enforcement and emergency care systems.
Divided Perspectives on Patient Autonomy and Safety
Not everyone agrees with expanding forced mental health treatment in Ontario. The Empowerment Council, which advocates for patient rights, says coercive treatment can cause trauma and disrupt therapeutic relationships. Its executive director, Jennifer Chambers, stresses that medication isn’t always tolerable for every patient and that evidence-based community support should be exhausted before resorting to involuntary care.
“Why spend a half million dollars on carceral responses,” Chambers asks, “when we could invest in supports that research shows actually help?” She points out the failure to provide adequate transitional services for patients released from hospitals or jails, leading many to bounce back into crisis.
Chambers believes Ontario once led in peer support programs, which helped individuals connect with others who had lived experience. But such services have faced budget cuts, leaving gaps in community-based care. She contends that peers are uniquely equipped to meet people “where they are” instead of pushing them toward a system they fear.
The woman at the center of this debate, Cleary, shared how she was strapped down and detained for half a day in a hospital before being released back onto the street. Her experience with multiple arrests, homelessness, and brief hospital stays reflects a system that often intervenes too late, and fails to provide long-term solutions.
Asked what she really needs, Cleary pointed to more psychiatrists in Cornwall, a stable home, and someone to help with daily tasks. Despite her challenges, she finds community among fellow unhoused individuals, though she acknowledges the risks of exploitation. Her plea underscores that support systems need to be personal, consistent, and sustainable.
A Call for Legislative Reform and Integrated Care
Dr. Shin, who co-leads the Ontario Psychiatric Association’s mental health and law reform task force, supports amending the Mental Health Act to allow for timely intervention that includes mandatory treatment where necessary. She argues that without treatment, repeated episodes can become more entrenched and resistant, leading to long-term disability and greater public cost.
She emphasizes that most jurisdictions weigh the risks of treatment refusal, and have legal safeguards that allow for involuntary care paired with treatment, avoiding indefinite detainment without progress. According to Shin, legislation must evolve with modern understanding of mental illness progression, neurobiology, and recovery timelines.
While both advocates and clinicians agree that wrap-around support services are crucial, the divide lies in how far the system should go in compelling individuals to receive treatment. As Ontario considers revisiting its mental health laws, this debate will likely intensify, especially as public attention grows around the high human and financial costs of current approaches.
Ontario’s Ministries of Health and the Attorney General have yet to respond to repeated media inquiries on the matter. However, this ongoing policy struggle reflects a broader global debate about how best to care for individuals with serious mental health needs—balancing compassionate intervention with the right to autonomy.
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To explore how public systems manage climate and health emergencies, read about Tex the Grizzly Bear’s death in Canada and the deadly U.S. floods affecting families. For the full report on this mental health policy debate, see the CBC News article.
