Premier David Eby admitted closing the ministry was due to challenges it faced in delivering infrastructure such as treatment facilities
After a seven-year experiment with a stand-alone Ministry of Mental Health and Addictions, Premier David Eby returned the responsibility to the Ministry of Health as part of Monday’s cabinet shuffle.
Recommended Videos
The move was greeted with little surprise. Advocates, political opponents and a Metro Vancouver mayor said the ministry was never given a chance to succeed, despite the need for action on a toxic drug crisis that has killed over 15,000 British Columbians since 2016.
Eby told reporters the change is a reflection of the difficulties the ministry faced in delivering services to tackle the crisis after it was created in 2017.
“It’s about the challenge and the critical importance of delivering infrastructure related to mental health and addiction, treatment centres, detox centres, the kind of infrastructure we need across the province through a ministry separate from the Ministry of Health,” said the premier.
“There’s no question, British Columbians sent us back to Victoria to do this work with a narrow majority. I think one of the issues, absolutely, was the toxic drug crisis and the impact on our streets, and I hope they see with this cabinet, we take that very seriously.”
Dr. Perry Kendall, B.C.’s provincial health officer from 1999 to 2018, said the NDP never gave any of the three ministers in charge of the ministry in its lifespan their own operating budget.
He said it ended up creating a bureaucratic nightmare as the responsibility over the portfolio rested with Mental Health and Addictions but the money was left with the Ministry of Health.
“While it always seems a good idea to create a separate ministry to get a focus on an area, … (they) invariably end up failing to achieve their goal,” said Kendall. “Mostly because the resources are in the ‘big’ ministry and very hard to disentangle, bureaucracies want to ring fence their dollars and, as in this case, it was no longer a problem for the Ministry of Health.”
He said officials in the Mental Health and Addictions Ministry “had no desire to confront (then health minister Adrian) Dix and impose their will on the parts of their agenda that were actually in his bailiwick.”
While the Ministry of Health is a behemoth, making up around 40 per cent of the total provincial budget, the Ministry of Mental Health and Addictions was never more than a small blip on the government’s bank statements.
According to the first quarterly update in September, Health Ministry spending was expected to reach over $32.8 billion in 2024-25. Mental Health And Addictions spending was only $41 million, second-lowest among all 23 ministries.
Kendall says he hopes the shift will end the challenges around resources, but is concerned the government has shifted away from harm-reduction policies and back toward a “war on drugs” mentality.
“My concern at the moment is we’re seeing a resurgence of criminalization and trying to use law a little bit more, not really pushing forward effective harm-reduction type-programming,” he said.
“You saw this with the last government before the election, you see it at the federal level as well, with politicians recoiling from harm reduction and federal Conservative leader Pierre Poilievre calling supervised consumption sites ‘drug dens.’”
Despite this, there is optimism that the shift away from a separate ministry could signal a step toward an all-of-government approach to the toxic-drug crisis.
Downtown Eastside advocate Karen Ward said it is time for the government to recognize that people are dying from substances, such as fentanyl, making its way into the province’s illicit drug supply, and that many of the victims did not have a drug addiction.
“It’s not like the Ministry of Mental Health and Addictions was really a separate entity at a given point. It didn’t have any budgetary authority or legislative power. So those were all programs that were still being run and funded by the Ministry of Health,” she said.
Ward says the ministry functioned more in a communications role than as an actual ministry, a viewpoint partly shared by a recovery advocate, Guy Felicella.
Felicella, who is as a peer clinical adviser with B.C. Centre on Substance Use, is critical of the effectiveness with which the ministry served as a communications arm of the government.
He believes the inability of the ministry to effectively inform the public about government policies is responsible for some of the backlash against harm-reduction measures such as decriminalization.
Mayor Brad West of Port Coquitlam said the Ministry of Mental Health and Addictions was unable to meaningfully reduce the number of drug deaths over the past seven years, despite that being its express purpose.
“When it was stood up as a stand-alone ministry, there was this idea that there’s going to be a real focus on this particular area, and things will get better as a result,” said West.
“I didn’t see any evidence of that. I think maybe we make too much of whether something is its own ministry or not, because clearly, over the last number of years in which we’ve had this stand-alone ministry, things have gotten worse, rather than better, with respect to mental health and addiction.”
West also likened the reintegration of the portfolio into the Ministry of Health as being a bit like “shuffling deck chairs on the Titanic,” saying what is really needed is action to address the crisis.
Unlike Kendall and Ward, who want more harm reduction, West believes the government should be focused on building up treatment services and opening a modern version of the Riverview Hospital for people who are mentally ill and prone to violence.
Conservative MLA Elenore Sturko agrees with West, pointing out that the NDP promised to do more to open up treatment spaces on the campaign trail as well as expand the use of involuntary care.
She said her party will be holding the government to account on those promises. She said the past seven years under the NDP have been spent focused more on “trying to make drugs safe than on trying to make people healthier.”
“My sincere hope is that going back toward the health-care system that they’re ready to get serious treating the health-care issue of addiction,” said Sturko.
Green Leader Sonia Furstenau said she hopes the elimination of the stand-alone ministry is a recognition that mental health is indistinguishable from other medical issues treated by doctors and nurses.
She said that it is also clear the previous setup of a stand-alone ministry did not work.
“I think this is a good move. I think that the separate ministry really hasn’t delivered the outcomes that people should expect,” said Furstenau.
“Recognizing that mental health is health, and not carving it out into a separate category is a really important step and signal, and I hope that it results in a much greater integration of mental health into the health-care system.”