A person takes shelter under opened umbrellas in the front door of a retail shop, while the shop next to them offers significant sales discounts. The dismantling of Canada's mental health system played a key role in creating today’s crisis that sees more than 235,000 people living on our streets annually, writes Denise Davy. (Stock photo: Dan Burton/Unsplash)

Topics: Justice, Oct/Nov 2022 | Opinion

Deinstitutionalization is one of our biggest public policy failures. Here’s how we can reverse it.

Canadians need to accept that our one-size-fits-all shelter system does not work


I met Margaret Jacobson in 1993 during a visit to a shelter in Hamilton, where I’d gone as a reporter to write a story on homeless people. Her face was deeply lined. Staff told me she was one of the city’s longest-surviving homeless women, having spent almost 10 years on the street. She was known as Princess Margaret.

I felt an immediate affection for her. She opened up about her childhood, of growing up with parents who were Pentecostal ministers. Later, I learned from Jacobson’s hospital files that she was one of the earliest victims of deinstitutionalization.

The policy began in the 1960s with the closure of psychiatric hospital beds — it was to be the first part of a plan to move people into the community. Over the next 20 years, more than 80 percent of the beds across Canada were closed, along with entire psychiatric hospitals.

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The problem, however, was that the second phase of the plan — community supports and housing for those patients — never materialized. Thousands were moved out of hospitals. Many ended up on the streets.

Each of Jacobson’s moves into temporary housing ended badly. She would be brought back to the hospital, often by ambulance, in a catatonic state and covered in bruises. Nurses would patch her up and discharge her again. One day, she refused to go back.

Instead, she slept in laundromats, in apartment lobbies, in store doorways and on friends’ couches. Two years after I met her, she died after falling and hitting her head in a sub shop. She was 51.

This dismantling of our mental health system played a key role in creating today’s crisis that sees more than 235,000 people living on our streets annually. Meanwhile, a high number of homeless people — 70 percent — have mental health problems.

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In 2012, I founded the Purses for Margaret Project, where I collect gently used purses and toiletries for homeless women. But in Hamilton, I often take food and clothing to a homeless fellow named Dimitri. He’s the new Margaret Jacobson.

Solutions do exist. Last year, Medicine Hat, Alta., became the first Canadian city to end chronic homelessness by providing housing with supports tailored to individual needs, and by catching people early when they first arrive in shelters.

To achieve this nationwide, all three levels of government must engage. We must accept that our one-size-fits-all shelter system does not work. We also need leaders who are willing to act with urgency, even if that means building temporary solutions, including tiny homes, to get people off the streets now.

Homelessness is not a choice. People like Jacobson have made that clear enough. The least we can do is stop looking away.


Denise Davy is a journalist and the author of Her Name Was Margaret: Life and Death on the Streets. She lives in Burlington, Ont.

This column first appeared in Broadview’s October/November 2022 issue with the title “Closing time.”

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Denise Davy is a journalist in Burlington, Ont.


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  • says:

    I've seen people; thinking, feeling human beings living on the street in Toronto and I've asked myself; "They started off as little babies, children, most with loving parent or parents. What happened in their lives to bring them to this?" There are many things. Too many to mention here. However, I was perplexed many years ago when the only psychiatric hospital in my home province of Newfoundland was closed. My feeling was and still is that it's not a matter of shutting people away and pretending they don't exist. It's a matter of "this is a safe place for them to be; a place where they can get the care they need and a place where their daily needs are met by professionals who care and where their families know they're being looked after. I felt it was a tragedy to close down the only safe place that these people could feel comfortable. Often-times, people in government or, indeed, any organization make decisions without giving them much thought and this is a situation that needs to be fixed. What kind of society are we if we cannot take care of the vulnerable? Certainly not a Christian society.

  • says:

    Mothers for Mental Health Care Reform appreciate the importance of highlighting the plight of people living with severe mental disorders. Ironically, addressing this key issue would save major public expenditures on ambulances, ER, policing, courts, jails. A thorough benefit / cost analysis would reveal millions in savings of our tax dollars. Personally, I feel badly that my son was bounced between 5 homeless shelters, 3 ER visits, over 23 months -for lack of taking life saving pills at 14 cents daily. Back on the same medicine taken for 11 successful years, now he is thriving again over the last year.