Prise en charge des personnes en crise : L’urgence d’agir maintenant

Les événements tragiques du 6 janvier dernier nous rappellent de façon brutale une triste réalité : trop de personnes en crise, souffrant de graves problèmes de santé mentale ou de toxicomanie, se retrouvent à la rue et sont, de ce fait, extrêmement vulnérables. Leur sécurité et celle des autres peuvent éventuellement être mises en danger. Ces personnes difficiles à rejoindre et à suivre ont besoin de soins adaptés à leurs problèmes et à leurs conditions.

Le réseau de la santé, le réseau communautaire, la Ville, les arrondissements et le Service de police ont, au fil des ans, déployé une importante gamme de services de première ligne pour les personnes itinérantes. Il s’agit là d’un fait reconnu et d’un acquis important; la Ville de Montréal reconnaît les efforts gouvernementaux dans ce domaine et ne veut pas se livrer ici à une bataille de chiffres qui serait tout à fait improductive. Ce qui nous préoccupe ici, c’est la prise en charge des personnes itinérantes en crise par le réseau de la santé. Beaucoup de professionnels, de citoyens et d’organismes en ont témoigné : la situation est alarmante. Tous en conviennent, ces personnes doivent recevoir des soins adaptés à leurs conditions de vie et de santé et obtenir un suivi médical continue et à long terme pour favoriser leur réinsertion sociale. Nous sommes confrontés à un enjeu de santé et de services sociaux. Et nous sommes animés par un véritable sentiment d’urgence, compte tenu des réalités quotidiennes auxquelles nos citoyens, nos commerçants, nos entrepreneurs et nos visiteurs sont confrontés. En juin dernier, suite au décès de deux citoyens, la Ville de Montréal a proposé au gouvernement du Québec la mise en place rapide de six mesures clés, pragmatiques et concrètes qui, de notre point de vue, peuvent avoir un impact rapide sur la situation:

1- Assurer l’accès aux services et aux lits d’urgence;
2- Améliorer les mécanismes d’application de la loi concernant le droit de refus au traitement (Loi P-38);
3- Consolider immédiatement l’Équipe mobile de référence et d’intervention en itinérance (ÉMRII);
4- Convenir d’une entente de partenariat formelle entre tous les acteurs impliqués;
5- Garantir la pérennité du Programme d’accompagnement justice et santé mentale de la cour municipale;
6- Assurer un meilleur suivi aux personnes en situation d’itinérance référées aux hôpitaux.

Des discussions ouvertes se déroulent déjà et plusieurs avancées ont été faites par nos fonctionnaires, mais il y a urgence d’agir, rappelons-le ! Ces solutions n’impliquent pas l’ajout de centaines de millions dans le système de santé. Le défi consiste essentiellement à penser « en dehors de la boîte », à accepter de revoir certaines pratiques, telles que la rotation à la semaine entre les établissements, et à nous inspirer des meilleures pratiques comme le programme ÉMRII et les équipes mixtes santé police. La préoccupation centrale de notre administration est de maintenir un climat social serein inclusif et

sécuritaire en développant des solutions pour prévenir l’itinérance et venir en aide de façon durable aux personnes en difficulté. Dans les domaines qui relèvent de ses compétences, la Ville de Montréal poursuivra sans relâche ses efforts pour lutter contre l’itinérance. Mais pour plusieurs personnes itinérantes aux prises avec des troubles majeurs, un virage s’impose au niveau de l’organisation des soins qui doivent impérativement leur être fournis. Le gouvernement du Québec peut être assuré de notre entière collaboration à ces égards et nous comptons sur lui, et sur la collaboration amorcée, pour accélérer la recherche rapide de solutions concrètes

As Vice-President of Interaction Peter McGill, I was at the Plan de développement de Montréal meeting on Feb. 1, 2012 along with our intrepedid President Jean-Yves.  I had to excuse myself from the meeting at the two-hour mark, but I would like to report to the membership my reactions to the presentation and the comments and questions from the assembled attendees.

The meeting actually started five minutes early, which I thought was great.  I have often said that if you aren’t five minutes early you are late!  After introducing the team of professionals from the central municipal government that are working on the Plan, the PowerPoint presentation lasted a little bit less than an hour.  The preamble was that this is a work in progress and that final version of would be coming in months, not weeks or days.  The plan was a reaction from the Provincial government challenge to have cities table high level plans for long-term development.  The professionals who presented the plan were focused on validating their initial direction with grass roots community groups like Interaction Peter Mcgill from every corner of our island.

The early working-stage of the plan is generic.  It was quite “vanilla” in it’s discussion about making the city an ideal place for people to enjoy living and working.  They had conducted a survey of Montrealers and concluded the one word picked most often by Montrealers to describe their city is “Diversity.”  Diversity is a difficult ideal to work towards, because a expectations will naturally be diversified.

I am choosing not to get into the meat and potatoes of this version of the plan, because they will evolve as the plan matures.  What was most impactful during the presentation was showing how business and human activity is really impacted by our (ageing, decrepit, and failing in my humble opinion) transportation infrastructure.  According to this presentation less than half of the daily commuters use public transport, and given the concentration of 9-5 workers in Peter McGill, this has a huge impact on the way systems work for us.  As much as I found the plan to be short on ideas, and tall on ideals, what I learned was that with all the moving parts in the city a uniform and simple plan for the entire city will be a difficult task to say the least.

During the question period, my impression was strengthened by the diversity of questions and concerns.  I have to admit that when colleagues at the table talked about the city constantly forgetting about their parts of the town, I was quite ignorant about their needs as well.  The only common idea was that every area thinks they are under represented and getting less than they deserve.  Ideas and complaints were all very central to their own patch, it seems as though nobody was able to see the bigger picture.  Nobody was interested in baking a better pie, they just wanted a bigger slice of what was available now.  I held back from lecturing my colleagues on their self centred statements because I realized that was the expected result when you solicit feedback from local groups.

My feedback to the planning committees is this.  Act like a decentralized city with very high standards.  Let the boroughs hold PPU’s (Plan Particulier d’Urbanisme) for their local needs on how to obtain minimum, standard and high service levels to their citizens.

Real, published, and binding standards written into law seem to me to be the best way for a central agency to achieve improvements over a diversified network of boroughs and communities.  I am talking about standards like number of low cost housing units.  Capacity of places in early childhood, elementary and high school education.  Capacity in terms of recreation for children, adults and seniors.  Guaranteed amounts of green space.  Limits on automobile encroachment.   Each borough can be scored in quantitative measure on their success and failure to achieve these standards and each citizen will be able judge for him or herself how their local representative is performing.  Boroughs that do well could be allotted bonus money for their blue and white collar workers as a way of saying good job!

So my conclusion is that the fine people in charge of the Plan de développement de Montréal should accept our diversity, and let each borough council decide how to meet those standards with programmes specific to the needs in their own communities.
Please give me your feedback below.

Tel que souligné par la commission responsable du PPU des Grands jardins (pages 35 et 68 de leur rapport), nous considérons que la présence de lieux permettant la pratique d’activités sportives, de récréation et de détente est essentielle pour permettre l’émergence d’une vie de quartier et d’un sentiment d’appartenance au quartier. Il y a peu de parcs dans le district Peter-McGill et nous croyons qu’il faut faire tout en notre pouvoir pour tirer le plus de chacun d’entre eux et pour faire en sorte que les citoyens du quartier se les approprient et les fréquentent. L’aménagement de terrains de sports est une demande qui a été maintes fois répétée par nos membres, tout particulièrement par les jeunes familles qui finissent souvent par quitter le secteur parce qu’elles n’y trouvent pas ce genre d’infrastructures.

Les gens qui choisissent de vivre au centre-ville le font souvent en raison de la proximité de tous les services. Or, voici un besoin qui n’est pas comblé : les résidents doivent aller ailleurs pour pratiquer des sports ou carrément s’en passer. Nous croyons que l’aménagement d’un terrain multisports au Parc Rutherford favoriserait le développement de saines habitudes de vie et bénéficierait grandement à une population dont 45% des ménages vivent sous le seuil de la pauvreté. Ce lieu public serait de plus propice à la création de liens entre les résidents et à l’intégration des nouveaux arrivants.

Cependant, voici ce qu’un de nos membres, Robert Hajaly, souligne:

   Concerning planned sporting activities for Rutherford Park, my reaction is that while the emphasis on soccer and football is correct the remaining activities mentioned [rugby and ultimate frisbee] do not provide a sufficient variety of sports to promote the maximum use of the park by the public. Having regard to the many sporting activities provided in public parks in the eastern part of Ville-Marie borough I would suggest that at a minimum Rutherford Park, in addition to a properly developed soccer/football field, should provide tennis, basketball and possibly volleyball courts; and especially for older people a facility for playing bowls, and for younger people a skateboarding facility. In the winter there should be skating and ice hockey rinks. There is plenty of room for all these facilities in this park, and also for one mini-soccer field (or two of them, as proposed, if the meteorological apparatus now in the southwest corner of the park were transferred to the Mount Royal mountain). As for the suggestion of frisbee this is now played on the McGill University campus field above Sherbrooke Street which is open to the general public to use.

   However, let me emphasise that my suggestions are only those of one person. As I said at the last Ville-Marie borough meeting I think it highly desirable that the borough carry out a thorough public consultation on the use of Rutherford Park. This could be accomplished by mailing out a form to all households living within, say, a mile of the park, explaining the borough’s intention to develop the park and asking people what sports or other activities, if any, they would actually like to play in the park. People could choose from a comprehensive list of possible activities and mail in or email their answers. This survey could then be followed by a public meeting to discuss the results of this survey. As well as letting the borough administration know accurately what people would actually use the park for, this consultation would have the valuable funtion of letting the public know that there is a public park here that they can use. Right now most people that I have spoken to about Rutherford Park do not know that it is a public park open to the general public. They think it is only part of the Montreal waterworks or else owned by and part of McGill University. Therefore a public survey on the use of the park would correct people’s misperception of the park, and also create interest in its use by the public. This consultation would also give people the sense that it is their park, increase their sense of ’appartenance’ in regard to the park, so likely further increase their use of it. For all these reasons I strongly urge that the borough hold a real public consultation regarding the use of this park.

   One last point I would like to raise is the proposed use of synthetic grass for this park. I would like to suggest that the use of natural grass is preferable to that of synthetic grass. First, natural grass is more ecological–it absorbs and converts greenhouse gases from the atmosphere whereas synthetic grass doesn’t do this. Second, natural grass is cooler to play on, especially in the hot part of the summer. Further, third, when synthetic grass gets hot and is vigourously played on it can give off vapours and particles which are unhealthy for people playing on it to breathe into their lungs. There is some evidence that this absorption of these vapours and particles can be carcinogetic. For this reason the city of New York as well as our city of Westmount have stopped using synthetic grass in favour of natural grass. Therefore I would strongly urge the borough to reconsider the use of synthetic grass for Rutherford Park.

[...]

Robert Hajaly

Dear Mayor and Ville-Marie councillors,

Hello, this is Robert Hajaly. I am emailing you to put in writing the objections I expressed at the last Ville-Marie borough council meeting to the proposed Tour Avenue des Canadiens building. I am doing this because of the importance I perceive this project to have, because I was not able to express my objections to the consultation on this project, and in the hope that it is not too late for you to modify this proposed building.

According to the information I have on this building, at the southeast corner of de la Montagne Street and Avenue des Canadiens, it violates the applicable municipal by-laws in that it is 197.1 metres high rather than the permitted 176.3 metres, has 61 floors rather the permitted 44 floors, and its base of 14 floors exceeds the permissable height of a building on the street. Assuming these figures are correct, I have the following objections to this building:

First, this proposed building would greatly exceed the height of all the buildings immediately surrounding it, which are all low-rise buildings, and so overwhelm and diminish these buildings, including the Bell Centre.

Second, the height of this proposed tower does not create a gradual transition in height between the very high tower at 1250 Rene-Levesque, between Stanley and Drummond Streets, and the much lower towers of the City of Electronic Commerce between de la Montagne and Lucien-L’Allier Streets. This is contrary to the conception of the city’s urban plan, which calls for the city centre to have the profile of a gradual summit, parallel to that of Mount Royal. In fact, the height of the proposed building, 197.1 metres, is virtually the same as that of 1250 Rene-Levesque, which is 199 metres.

Third, the proposed number of residential units in this building, which I’m informed is 700 units, will absorb too much of the downtown residential market for one building. As you know, there are many vacant and underused parking lots downtown which need to be built on, but if you allow this many residential units to a single building this will make it that much harder to fill up all these other available sites. Moreover, if you allow these exemptions from the municipal by-laws for this project, how can you then deny this to any other developer that wishes to exceed the by-laws, making this problem even worse.

Finally, fourth, because the lot on which this building is to be built is rather narrow, its base of 14 floors will be built right up against de la Montagne Street, creating an overwhelming presence for pedestrians walking up and down this street. I presume this is why there is a by-law which would prevent this.

For these reasons I suggested that a much better project would have a tower which respected the applicable by-laws, while its base would have a height comparable to that of the adjacent Bell Centre, about 7 to 8 floors. Even then, this building would be higher than any existing residential tower in Montreal. And even if this change meant a slight delay in this project this would be better than living with a permanent mistake, and the precedent it created, for which you would be responsible by granting an exemption to the by-laws.

In conclusion, I hope that you will agree to make the changes I’ve suggested instead of passing a final adoption of the current proposal.

Yours sincerely, Robert Hajaly