The State of Emergency that may never end: Niagara Region grapples with mental health, homelessness & opioid addiction 

Earlier this month, the Public Health and Social Services Committee of the Niagara Region met for its monthly meeting. The agenda included a Community Health Assessment; reporting on disease rates; drug mortality numbers and mental health status of Niagara’s residents; the Public Health department's annual submission to the Ministry of Health for funding; the Region’s investment into its homelessness prevention plan and the recommendations of a cross-sector action table focused on mental health and addiction issues.

That the reports covered matters regarding mental health, homelessness and opioid addiction issues should come as no surprise considering Niagara Region’s declaration of three “States of Emergency” on the issues a little over a year ago.

While no one would dispute the pervasiveness of these issues in Niagara, whether or not the declarations have had any substantive impact is subject to debate. 

The last report listed on Tuesday’s agenda was a long promised staff commitment to provide a “data update” on the declared states of emergency.    

In February 2021, Niagara community activist and sometime political candidate, Steven Soos and Niagara Falls City Councillor Wayne Campbell appeared before the Region’s Public Health and Social Services Committee. Their delegation was the culmination of similar appearances at local councils, armed with a resolution that originated from Niagara Falls City Council, ultimately supported by ten other lower area municipalities, calling on the upper-tier Niagara Region to declare a state of emergency on mental health, homelessness and addiction.

At the same meeting, Committee member and Fort Erie Regional Councillor Tom Insinna had authored a related resolution to have Regional Council acknowledge that a significant crisis existed in Niagara in regard to the prevalence of chronic homelessness and the lack of affordable housing. 

The resolution was less detailed on mental health and addiction issues, but did note that the former had been identified in the Council’s strategic priorities and called upon the Overdose Prevention and Education Network of Niagara (OPENN) to update Council on “the current status of the actions being taken to address addiction related issues in Niagara”. The resolution primarily recommended advocacy to the senior levels of government, especially to the Provincial government, the predominant funder of services and treatment related to the three issues.

Councillor Insinna’s resolution did not go as far as declaring a state of emergency, as requested by Soos and Campbell, which was in keeping with the related advice from staff at the time. 

Commissioner of Community Services Adrienne Jugley, in a memo, had noted that the declaration of an emergency was governed by the Emergency Management and Civil Protection Act, which typically dealt with natural, technological and human-caused hazards that were more finite in nature. At that point in time, the only other Ontario municipality to contemplate a similar motion on social issues was the City of Ottawa. While their Council recognized that an emergency had been created by the critical lack of affordable housing and the growing prevalence of homelessness, they stopped short of declaring a formal emergency under the auspices of the Act. 

Commissioner Jugley’s memo explained that the issues of mental health, homelessness and addiction require the development of sustainable, long-term solutions and could not be solved in a matter of days, weeks or months like the emergencies traditionally dealt with under the provincial legislation. Also, provincial funding would not necessarily flow as a result of such an emergency declaration from Regional Council.

Approximately two years after the approval of Councillor Insinna’s resolution by Regional Council, with seemingly no abatement in the related issues, another attempt was made to declare a state of emergency.  

Welland Councillor and Co-Chair of the Public Health and Social Services Committee, Pat Chiocchio brought forward another resolution, which was more assertive. Regional Chair Jim Bradley, as per the Emergency Management and Civil Protection Act, would be directed to formally issue three separate declarations of emergency in the areas of homelessness, mental health and opioid addiction. In addition, the resolution piggybacked on the recommendations of the Association of Local Public Health Agencies, which had previously been endorsed by Regional Council, calling for, amongst other recommendations, the creation of a multi-sectoral task force to guide the development of a robust provincial opioid response plan and a long-term financial commitment to create more affordable and supportive housing for people in need.

Chiocchio’s rationale was that the Region “needed more” to get the Province’s attention, as the previous resolution had fallen on deaf ears.

When questioned by St. Catharines’ Regional Councillor and Mayor Mat Siscoe, Commissioner Jugley reiterated her 2021 comments that the declaration of an emergency was not an ideal fit under the circumstances. The issues were not time-limited and such declarations would not likely trigger any money from the Province. In addition, with other emergency declarations the local area would only receive funding after it exhausted all local resources. Siscoe, who was generally supportive of the resolution, warned his colleagues that with budget deliberations starting, the Council better be prepared to invest heavily in any regional services related to the three areas.

Councillor Insinna and St. Catharines Councillor Laura Ip questioned the appropriateness of making such a declaration. Councillor Ip described the motion as a “feel good public relations move” and said there was no prospect for success because the related issues were never likely to be completely eradicated. Insinna and Ip would be the only councillors to vote against Chiocchio’s motion at the meeting and on February 23, 2023 when the matter was brought before regional council for ratification.

Less than six months after the declarations of the three emergencies, staff provided an information update in July 2023 to the Public Health and Social Services Committee. Although there was no formal recommendation the report questioned efficacy of the declarations:

“[T]he Regional Emergency Operations Centre(REOC) members have met eight times between March and June 2023 to share updates on the resolution approved by Council. Given that emergency management typically deals with time-limited, uncommon events that are sudden, rapid shocks to the community, meetings were not effective in reflecting the traditional structure of a REOC meeting.”

The related report noted that while provincial Ministers of Health and Municipal Affairs and Housing had responded to Chair Bradley’s letters, neither minister specifically mentioned Council's Declaration of Emergency choosing instead to highlight various funding programs available at the provincial level.

West Lincoln Councillor Albert Witteveen claimed the declaration must have served its purpose as the City of Hamilton had followed the Region’s lead in also declaring a similar State of Emergency and the staff report had noted that an additional $9.6 million in Homelessness Prevention Program funding had flowed to the Region subsequent to the declarations. 

Commissioner Jugley explained that the homeless funding was more likely a result of an Auditor General’s report that outlined funding inequities in how the Province allotted such monies. Nonetheless, she felt that the Regional Council’s advocacy efforts were having some impact.

Councillor Chiocchio also felt that the State of Emergency declarations were not for naught.  He reasoned that the declarations heightened the Council, and the Province’s, awareness of the issues. However, when pressed, the Region’s Chief Administrative Officer Ron Tripp felt that the REOC activities surrounding the declarations added no value, other than the consolidated report being provided by staff, which outlined the various activities already being done by staff, regardless of the states of emergency.

The result of the July 2023 committee meeting was a recommendation that passed 7 to 4 “that the states of emergency for homelessness, mental health and opioid addictions as defined under the Emergency Management and Civil Protection Act be transitioned to be states of crisis.”

When the recommendation came before Regional Council the next week, Fort Erie Councillor and Mayor Wayne Redekop effectively curtailed debate by moving a motion to refer the matter back to the Public Health and Social Services Committee “to bring back data to Council to justify the change to crisis.”

The report that went before Committee on March 5th was the promised data update, but it came with some major provisos, most notably:

“[W]hen Council declared its States of Emergency, no threshold or key metrics were benchmarked or established.”  

Despite the lack of key performance indicators, staff did provide some data, though it was accompanied with the caution that: 

“[N]one of these metrics or trends can be conclusively said to be the result of Council’s declared States of Emergency. This data also does not seek to quantify the efficacy or contribution that the declaration of the States of Emergency may have had on opioid addiction, mental illness and homelessness, but rather serves to give a general update on the health of the community in those regards.”

The report noted that in 2023, there were 734 suspected opioid overdoses responded to by Niagara EMS, while an increase over 2022 totals, the numbers were less than the 1,005 suspected overdoses in 2021. Suspected overdoses reported at hospitals and opioid deaths followed similar patterns, with figures less than 2021 highs, but up from the previous calendar year.

Number of opioid related deaths in Niagara Region from 2021 to mid-2023.

(Niagara Region)

On mental health, the report indicated that while mental health caseload numbers had remained stable, there had been an increase in the percentage of clients suffering from more complex mental illness and an increase in those who required more intensive community health services.  The Region did receive a 5 percent increase in base funding from the Province but staff estimated that a potential $1.23 million shortfall could mean future service cuts.

Regarding homelessness, the number of people experiencing homelessness in Niagara increased 12 percent from 1099 in December 2022 to 1231, a year later. The numbers of the chronic homeless, those who experience extended periods of homelessness, were also up from 550 to 594 persons in 2023.  

Regional staff did take some solace in the effectiveness of their By-Name List project, which identifies the Region’s chronic homeless, and by the average 28 monthly “move-ins”, the number of the chronic homeless transitioning to housing.

Regional staff, however, did not offer any firm recommendations to Council on next steps, other possible benchmarks or indicators that the states of emergency are achieving their goals.

The related report was on the Consent Items for Information section of the agenda and would have been received without discussion had Councillor Haley Bateman not “lifted” the item but even then nothing substantive, as far as next steps was offered.  Both CAO Tripp and Commissioner Jugley indicated that staff would continue to provide information on trends in the three areas and await future direction from Council.

With nothing offered, Councillor Chiocchio, chairing the meeting, summed up his feelings “that we keep it as a State of Emergency”, albeit a state with no discernible end in sight or clear indicators of success. 

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