ABC and Vancouver Liberals Disagree on Involuntary Care Plebiscite

On October 17, voters are asked whether the city should ask the province to convert the old St. Paul's Hospital, or a similar site, into a secure medical facility providing acute voluntary and 100-plus involuntary care beds for people posing a serious risk to themselves or others due to severe substance use and mental health disorders. The plebiscite is non-binding, meaning a yes vote is a request to the province rather than a decision. ABC Vancouver held the majority on city council and voted to add two plebiscite questions to the ballot; adding them will cost about $500,000, according to an ABC Vancouver spokesperson quoted by The Tyee.

Kareem Allam, the Vancouver Liberals mayoral candidate, told The Tyee he opposes the plebiscite for three reasons. He says it is non-binding, so placing it on the ballot wastes money. He also says detaining people because of drug use alone would be illegal under B.C.'s Mental Health Act. And he says renovation of the old St. Paul's would likely cost hundreds of millions of dollars, given that the building is not seismically sound, contains asbestos, and is not designed for individual patient rooms. He told The Tyee that money would be better spent revitalizing the Davie Village neighbourhood.

B.C.'s Mental Health Act allows involuntary detention only when someone is in a state of impairment that prevents them from seeking care and makes them a risk to themselves or others. Dr. Daniel Vigo, B.C.'s chief scientific adviser for psychiatry, toxic drugs and concurrent disorders, has told The Tyee the Act does not apply to someone simply because they use drugs. A person in drug-induced psychosis could be held, but only until they come out of psychosis, at which point they can choose to leave even if that means using drugs again. Therefore, Allam told The Tyee, a facility designed to hold people due to drug use alone would not be legal.

ABC Coun. Lisa Dominato told The Tyee she is shocked to hear the plan described as a prison or a bailout for the developer. She says she has heard consistently from the public that people's needs are not being met on the streets, and that a yes vote would give the city a clear endorsement to take to the province when advocating for more mental health resources. She acknowledged that health care falls under provincial jurisdiction but said municipalities have a role in pushing for services, as they do when mayors speak out against emergency department closures.

Allam told The Tyee he would push the province to expand voluntary treatment services. His platform proposes a six-pillar approach, adding housing and youth mental health to the existing four-pillar drug strategy of prevention, treatment, harm reduction and enforcement. He also proposes a meth response program, a plan to end homeless encampments by providing stable housing and supports, and reversing what he calls ABC's freeze on building supportive housing. He said the freeze delayed the pipeline of supportive-housing projects by a generation, affecting people with complex health needs who often cycle through hospital care.

Allam told The Tyee the building is not seismically sound, contains asbestos, and does not provide individual rooms for patients. The site would also need rezoning because current city bylaws classify it as a treatment facility rather than a detention facility, The Tyee previously reported. Allam said renovation would likely cost hundreds of millions of dollars. Coun. Dominato said a city can advocate for services it needs and it would then be up to the province to fund construction and operations. She said St. Paul's seemed like a natural location because it is a medical site about to be emptied and has willing partners among the property owners.

Allam told The Tyee 2,715 Vancouverites are currently unhoused and that only a small fraction of them would qualify for involuntary care under the Mental Health Act. He also said Vancouver's homeless count has increased by 12 per cent under ABC. Coun. Dominato said ABC has been calling for a plan to convert single-room occupancy units to apartment units with individual bathrooms, kitchens and living spaces, while also providing supports that help people access treatment and recovery.

Coun. Dominato told The Tyee the city has worked with Vancouver Coastal Health to integrate mental health professionals into police dispatch and response. Last year those programs diverted 2,500 people toward health services instead of police. The province's goal is to place someone in a detox bed within 48 hours of asking for treatment, but Allam told The Tyee the province falls well short of that target and lacks follow-on treatment beds for people who complete detox. Allam said this gap leaves a large number of people who want voluntary treatment unable to access it.

The plebiscite appears on your ballot at advance voting stations and on election day, October 17. Advance voting runs until October 16. You can read the full Tyee article by Michelle Gamage at thetyee.ca/News/2026/10/09/ABC-Wants-More-Involuntary-Care. Candidate profiles for the two candidates quoted in this article are at /candidates/kareem-allam and /candidates/lisa-dominato. Information on where to vote is at /where-to-vote.