British Columbia’s stand-alone Ministry of Mental Health and Addictions, born from bold promises to tackle the province’s crises, has quietly disappeared. In 2017, the province took a groundbreaking step in addressing its escalating mental health and addiction crises by creating the Ministry of Mental Health and Addictions. It was a daring move, one that promised to save lives, revolutionize care, and bring focus to the province’s most urgent public health issues. For many, it was a sign of hope amidst an epidemic of overdoses and untreated mental illness.
Now, that ministry is no more. In a quiet yet profound shift, Premier David Eby has folded it back into the larger health portfolio, leaving advocates and critics alike questioning what went wrong. Was it a failure of vision, a lack of real power, or an impossible task from the start?
Despite its lofty ambitions, the ministry’s legacy is mired in unmet goals. Overdose deaths climbed year after year, voluntary treatment remained out of reach for most, and harm reduction policies faced growing backlash. For a ministry meant to unify and lead, it instead struggled to prove its purpose. As BC faces its worst mental health and addiction crises in history, the dissolution of the ministry leaves one pressing question: If this wasn’t the answer, what is?
A Bold Promise Fades
When the NDP government established the Ministry of Mental Health and Addictions in 2017, it made generous promises. It aimed to unify fragmented services, lead the charge against the toxic drug crisis, and build a seamless network for mental health care. Yet six years later, the promises remain.
Advocates such as Garth Mullins from the Vancouver Area Network of Drug Users described the ministry’s tenure as largely symbolic. With limited budgetary power and policy-making authority, the ministry acted more as a “sin-eater” for the government, soaking up public outrage without delivering substantive change. Even its most touted achievements—adding 659 treatment beds since its inception—did little to reduce average wait times for voluntary care, which still hovers around 35 days.
Critics argue that folding the ministry back into health might shift focus away from the urgent and distinct challenges posed by addiction and mental illness. Surrey MLA Elenore Sturko points to a growing ideological divide, claiming the ministry had been “hijacked by radical ideology” and failed to address the practical realities of addiction. However, others, including former chief coroner Lisa Lapointe, see merit in the integration, arguing that health and mental health are inextricably linked and demand unified action.
The Reality on the Ground
Behind every statistic lies a life. Overdose prevention sites, detox centres, and treatment programs are stretched to their limits, yet the demand far exceeds supply. On paper, British Columbia has over 3,600 treatment beds. In practice, accessing one often means navigating a labyrinth of bureaucracy and waiting weeks for help—a delay that can be deadly.
A Downtown Eastside advocate, Karen Ward, underscores the inequities in B.C.’s system. While the province has expanded involuntary care, voluntary care remains woefully inadequate. Over 28,000 involuntary admissions were made under the Mental Health Act in 2020/21, a figure critics say reflects desperation rather than progress.
The human toll is staggering. Toxic drug overdoses remain the leading cause of death among B.C. residents aged 10 to 59. Despite efforts to introduce safer drug supply programs and overdose prevention initiatives, critics argue that these measures are reactive rather than preventative.
What the Ministry Left Behind
The dissolution of the Ministry of Mental Health and Addictions raises serious concerns about the future of care in British Columbia. While Premier David Eby promises that the integration will streamline services, there’s no denying the ripple effects of the ministry’s collapse. Advocates call its failure a “tacit admission” that the government’s response to mental health and addiction was more symbolic than substantive.
One glaring gap is the lack of clear benchmarks. Despite promises of transparency and progress, the ministry failed to produce a province-wide report detailing treatment bed capacity or complex care outcomes. Without measurable goals, critics argue, the government operated without accountability, leaving vulnerable British Columbians to bear the brunt of systemic dysfunction.
Another glaring shortcoming was the ministry’s inability to deliver adequate complex care. This shortfall underscores a broader issue: the disconnect between political rhetoric and tangible results. Plans for regional complex care centres in underserved areas remain on paper, with little evidence of progress. This failure has left rural communities struggling to access care, forcing many to migrate to urban centres like Vancouver’s Downtown Eastside—a neighbourhood already overwhelmed by addiction and homelessness.
These gaps are more than administrative oversights; they represent missed opportunities to prevent deaths, reduce harm, and restore dignity to those in crisis. As BC moves forward under a consolidated health portfolio, the absence of a dedicated voice for mental health and addiction is deeply felt. This silence, critics fear, signals that these issues may be deprioritized, even as the crises deepen.
Where Do We Go From Here?
The dissolution of the stand-alone ministry has reignited debate over what solutions could genuinely work. Advocates like Sarah Blyth of the Overdose Prevention Society argue that no single ministry can solve these crises alone. Effective change requires collaboration across housing, social development, justice, and health portfolios.
One glaring gap is the lack of comprehensive, region-specific care. The newly opened Red Fish Health Centre added only 11 new complex care beds—a drop in the bucket compared to the estimated 2,200 British Columbians needing such services. Promises for regional centres across the North, Kootenays, and Vancouver Island remain unfulfilled, leaving many rural and remote communities without access to essential services.
Decriminalization policies have also been criticized. Sturko claims these measures worsened community-level harms without evidence of saving lives. However, proponents argue the problem isn’t the policy itself but the lack of accompanying supports, such as robust treatment options and wraparound care. The lack of a coordinated strategy to pair decriminalization with comprehensive care has turned what could have been a progressive reform into a policy failure. Without significant investment in treatment and prevention, decriminalization risks becoming another half-measure in BC’s troubled approach to addiction.
What Success Could Look Like
If BC is to turn the tide, bold, coordinated action is non-negotiable. First, the province must address the glaring lack of treatment and care infrastructure capacity. Expanding treatment beds, streamlining admission processes, and creating specialized regional facilities can ease the pressure on urban centres like Vancouver.
Prevention also needs a stronger emphasis. Public health campaigns that address the root causes of addiction—poverty, trauma, and mental illness—could help stem the flow of individuals entering crisis. Schools, workplaces, and community centres must become frontlines in promoting mental well-being.
In addition, the province must establish clear benchmarks and transparent reporting to measure progress. Without accountability, efforts will continue to flounder.
Finally, policymakers must engage those most affected by these crises: people with lived experience. Their insights into what works and what doesn’t can guide reforms beyond bureaucratic optics to create meaningful change.
A New Dawn or a False Start?
As Health Minister Josie Osborne assumes the Herculean task of overseeing mental health and addictions alongside general health care, all eyes will be on her ability to deliver results. The stakes couldn’t be higher. With every passing day, families lose loved ones, and the fabric of communities unravels further.
British Columbia has a choice: embrace this moment as an opportunity to redefine its approach to mental health and addictions or allow its systemic failures to persist under a different name. The province must decide whether it will be remembered for its courage to act or its tendency to reshuffle chairs on a sinking ship. Change is possible only if it is pursued with urgency, unity, and unwavering resolve. British Columbians deserve more than reactive policies and symbolic gestures. They deserve a system that values their lives, dignity, and futures.
Glenn is dedicated to scrutinizing government actions affecting the Downtown Eastside and holding those in power accountable for their commitments. With a focus on transparency and policy analysis, his writing aims to expose gaps between promises and outcomes, pushing for meaningful changes that benefit the community.
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