A Mental Health, Substance Use, Harm Reduction & Treatment Strategy for Toronto

Our Health, Our City: A Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto is a comprehensive strategy to reduce substance use related harms and promote mental health and well-being. This is a strategy to strengthen and protect the mental health, wellbeing and safety of all Torontonians.

Mental health experiences occur on a spectrum, and many Torontonians experience mental health challenges. Recent data demonstrates concerning trends in various mental health outcomes, including anxiety, depression, burnout, loneliness and addictions.

Similarly, substance use occurs on a spectrum, and many Torontonians use substances, including alcohol, cannabis, nicotine/tobacco, as well as unregulated/illegal substances. While most substance use does not cause problems, substance use related health and social harms do occur.

This strategy is for all of Toronto — every age group, population and neighbourhood, and even those who may not have personal experience with mental health and/or substance use challenges.

Toronto is a diverse and resilient city that prioritizes the mental health, wellbeing and safety of all residents.

Our Health, Our City envisions a Toronto where:

  • Everyone can access the health care, services, resources and community spaces they need to support their mental health and prevent substance use related harms with dignity and ease.
  • Mental health and substance use are addressed as health issues rather than criminal issues.
  • Mental health and substance use stigma and discrimination have been eliminated.

Mission

Our Health, Our City’s mission is to advance policies, programs and partnerships in the City of Toronto that reduce inequities and increase access to the social determinants of health to improve mental health and wellbeing and reduce the health and social impacts of substance use related harms.

Principles

The following principles are the framework for Our Health, Our City:

  • Health and community safety for everyone
  • Meaningful inclusion of people with lived and living experience
  • Anti-oppression, anti-racism and decolonization
  • Evidence, innovation and continuous improvement
  • City-wide, collaborative, and comprehensive

Our Health, Our City offers a range of recommended actions across seven strategic goals for City of Toronto Divisions, Agencies, Corporations, and Boards, as well as government partners, health care leaders, schools, businesses, civil society and all Torontonians:

  1. Promote mental health and wellbeing across the lifespan.
  2. Prevent and reduce the harms and deaths related to substance use across the lifespan.
  3. Expand access to the full continuum of high-quality, evidence-based and client-centred services to address mental health and/or substance use issues, including harm reduction and treatment supports.
  4. Advance community safety and wellbeing for everyone.
  5. Improve access to housing and other social determinants of health.
  6. Support mentally healthy workplaces and optimize the mental health of workers.
  7. Proactively identify and respond to emerging mental health and substance use issues.

Our Health, Our City was developed through extensive engagement that centered the lived and living experiences of people with mental health issues and/or who use drugs, and included experts, community leaders, frontline staff from the mental health, harm reduction and addictions treatment sectors, and staff from many divisions of the City of Toronto.

Consultations, community engagements and research conducted:

  • 200 participants in 18 community roundtables which included people with lived and living experiences
  • 84 external stakeholder interviews
  • 30 interviews and roundtables with people who use drugs
  • 13 City Divisions, Commissions and Corporations consulted
  • Deputy Mayor’s Mental Health Roundtable in June 2023
  • Jurisdictional scan of mental health and substance use strategies
  • Reference group to provide input on the development of the strategy and its recommendations

The 2005 Toronto Drug Strategy (TDS) was a comprehensive drug strategy for the City of Toronto based on four integrated parts – prevention, harm reduction, treatment and enforcement.

The Toronto Overdose Action Plan: Prevention & Response was endorsed by the Board of Health on March 20, 2017. It included a comprehensive set of actions for all orders of government to prevent and respond to drug overdoses.

The Toronto Overdose Action Plan was updated in 2019 based on broad community input. This update, which was a supplement to the original Toronto Overdose Action Plan, was endorsed by the Board of Health and City Council in June 2019:

The Toronto Indigenous Overdose Strategy was developed by an Indigenous facilitator and grounded in the input of Indigenous People who use/used drugs, and service providers that work with Indigenous People who use drugs.

The African, Caribbean and Black Decriminalization Working Group developed a report on the disproportionate impact of drug criminalization on African, Caribbean and Black People in Toronto. This report and its recommendations are for Health Canada’s consideration and intended to inform Toronto Public Health’s request for an exemption under section 56 (1) of the Controlled Drugs and Substances Act to decriminalize the possession of drugs for personal use in Toronto.

Mental Health — “The capacity of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual wellbeing that respects the importance of culture, equity, social justice, interconnections and personal dignity.” (Public Health Agency of Canada)
Learn more about mental health.

Substance use — “People use substances, such as controlled and illegal drugs, cannabis, tobacco/nicotine, and alcohol, for different reasons, including medical purposes; religious or ceremonial purposes; personal enjoyment; or to cope with stress, trauma or pain. Substance use is different for everyone and can be viewed on a spectrum with varying stages of benefits and harms.” (Health Canada)
Learn more about substance use.

Social Determinants of Health — The primary factors that affect our health are not health care services or treatments or even our lifestyle choices, rather, our health is shaped by the social determinants of health, which are the living conditions that we experience. Our access – or lack of access – to the social determinants of health have an impact on our mental health and well-being and influence our patterns of substance use. “…Our health is shaped by how income and wealth is distributed, whether or not we are employed and if so, the working conditions we experience. Our health is also determined by the health and social services we receive, and our ability to obtain quality education, food, and housing, among other factors. And contrary to the assumption that Canadians have personal control over these factors, in most cases these living conditions are imposed upon us by the quality of the communities, housing situations, work settings, health and social service agencies, and educational institutions with which we interact.” (The Social Determinants of Health: The Canadian Facts)

The Our Health, Our City Implementation Panel provides advice to support the the implementation of the Our Health, Our City strategy.

Panelists Responsibilities

  • Attend meetings
  • Provide advice on annual implementation priorities
  • Share data and knowledge (such as lived experience and/or professional expertise) to support implementation
  • Foster relationship building and collaboration across various sectors
  • Support recruitment of individuals for additional consultations or potential working groups, as required
  • Champion implementation of recommendations
  • Communicate implementation efforts to networks
  • Provide feedback on the annual progress report

Panel Membership

The panel consists of a total of 18 members, including:

  • One Board of Health director who serves as Panel Chair
  • Six representatives with lived or living experience of substance use and/or mental health challenges and/or illnesses, including at least one youth representative
  • Six representatives from the substance use and/or mental health sectors, including community agency leadership, health care providers and researchers
  • Six representatives from relevant City Divisions

Membership Term

The length of panel membership will be for two-and-a-half years.

Meeting Expectations

The Implementation Panel will meet approximately once every two months for up to two hours in person. The option to attend the meeting virtually will be available.