Written for Daily Hive Urbanized by Jack Middleton, who is the president of the board of the BC Schizophrenia Society and a public affairs and government relations professional. He is a dedicated advocate for people and families affected by severe and persistent mental illness across British Columbia.
On August 14, Vancouver City Council directed staff of the City of Vancouver to add two non-binding public safety plebiscite questions to the ballot for the 2026 civic election.
The questions are about strengthening its laws to prohibit open-air hard drug use in public spaces, and creating a secure medical facility with at least 100 involuntary treatment spaces on the site of the old St. Paul’s Hospital.
Speaking about the plebiscite, Premier David Eby noted that he “was surprised to see the vote question on which I suspect there would be 100 per cent support, including from our government.”
While his optimism for good policy having unanimous support is heartening, those opposing the idea have reduced it to a cynical political tactic, saying it is a waste of tax dollars and an unrealistic goal. Although it is important to thoroughly investigate whether the to-be-vacated old hospital site could serve this purpose, the core issue remains: our city needs better services and more beds to treat people living with mental illness.
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That is why mental illness must be a ballot question in the municipal election this year. We, as voters, should know where candidates stand on key issues like involuntary and voluntary treatment, housing, and wrap-around services in their communities.
Recently, the Supreme Court of B.C. struck down key sections of the BC Mental Health Act related to involuntary treatment. The next leaders of our city need to engage in this conversation, and we as voters deserve a chance to see what they believe and how they plan to engage in these critical decisions.
Mental health care is typically viewed solely as a provincial responsibility — an area in which municipalities often feel they have limited ability to offer solutions. But they should not feel powerless. Instead, as Vancouver has done, they should put forward bold ideas that recognize severe mental illness as an important municipal concern affecting individuals, families, and communities.
The BC Schizophrenia Society has launched a campaign platform on mental illness. Serious candidates should develop policy that promotes:
- Support for treatment — Support collaborative crisis response initiatives, frontline worker education, and early intervention programs that improve outcomes for people living with severe mental illness and their families.
- Available, accessible, and affordable treatment and care — Encourage municipal planning processes that support community-based mental health services and reduce barriers to accessing care and recovery supports.
- Supported housing — Support housing initiatives through municipal leadership, planning, partnerships, and community engagement. Appropriate supported housing is fundamental to recovery and community well-being.
- Engagement of people living with severe mental illness and their families — Ensure that people with lived experience and family caregivers are included in municipal consultations, planning, and community initiatives.
Is Mayor Ken Sim’s idea for St. Paul’s Hospital a silver bullet that captures all of these ideas?
No, but it’s a good step, and he has started a conversation. Importantly, engaging the public on the issue directly to create a mandate is not a waste of time. It’s both a privilege and an opportunity of democracy. After all, for those who disagree, you now have the chance to have your say.
Elections are not about the status quo. They are about ideas and vision. It costs nothing to critique a plebiscite, and it costs something to put a plan in front of voters and let them judge it, which is the difference between finger-wagging and leadership on one of the most critical issues facing our city.
Vancouverites ought to have a say, and they deserve to see municipal candidates with real ideas.
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- Premier David Eby questions need for Vancouver's public safety plebiscite
- It's official: Vancouver public safety plebiscite approved after heated opposition to ABC plan
- Vancouver mayor says public safety plebiscite lets voters share views they fear expressing publicly
- Vancouver plebiscite this October to ask voters about public use of hard drugs and turning the old St. Paul's Hospital into a major addictions and mental health treatment facility
- 'We don't know where the money's going': What former Vancouver mayor Larry Campbell says he's hearing from Downtown Eastside organizations