11/12/2013 12:15 EST | Updated 01/23/2014 06:58 EST

Maybe What Rob Ford Needs is Proper Treatment -- And Compassion

All too often in recent years, we see headlines of those with mental health issues (real or alleged) paired with violent outcomes. Without knowing Toronto Mayor Rob Ford's mental state, the mounting signs of volatility paired with poor judgment are troubling.

In light of recent developments, Ford's over-the-top response to his visit from This Hour Has 22 Minutes' Mary Walsh, in the guise of Marg Delahunty, her intrepid reporter character isn't quite so funny any more. As a guest on the George Stroumboulopoulos Tonight show, Walsh told Strombo her brush with Ford had been "alarming". She added that she'd been so shaken up by the encounter she didn't know what she was saying. In all the years she'd confronted politicians in her comedic character Delahunty, said Walsh, this was the first time that had happened. In hindsight, maybe Ford's reaction wasn't that surprising, given that he later described bona fide journalists as "a bunch of maggots."

Ford has admitted to being inebriated and in a "drunken stupor" more than once while in office, and was ousted from a Toronto gala just last month because of concerns that he was impaired. He's admitted using crack cocaine, a drug which research has clearly shown is associated with anger and violence. And we've seen ample evidence of both anger and a violent temper, most recently in the video where he appears agitated as he paces back and forth, ranting and threatening to kill someone.

As Ford turns denials of his drug and alcohol use into admissions, it's impossible for the public to judge to what extent withdrawal symptoms may or may not be adding to the mounting stressors in his life.

What we do know is that there's a growing consensus that he's in denial as to the impact of his alcohol use on his ability to fulfill his role as Mayor of Canada's largest city. To date, he appears reluctant to willingly remove himself from office.

When we add intensified public, police, and media scrutiny to Ford's admitted substance abuse, we have a man under an incredible amount of pressure. Under such circumstances, whose mental health wouldn't be negatively affected? Is a mental meltdown ahead, if things continue along their current trajectory?

Pushing even closer to a possible tipping point, last week Ford's most constant, staunchly loyal supporter - his brother Doug - disappeared from his side. He resurfaced, chiming in with those calling for the Mayor to take a break from the job he claims to love.

Ford has told us he's not addicted to crack cocaine. Even it that's the case, research shows all substance use associated with the inability to inhibit hostile and aggressive impulses, alcohol (a common trigger for cocaine use) included.

Over the past several years, an alarming number of stories involving mental health issues and violent clashes have appeared in the media. Six years ago, Polish immigrant Robert Dziekanski was tasered by police who felt endangered by Dziekanski's agitated mental state. Dziekanski's subsequent death was deemed a homicide. More recently, the deaths of Toronto area residents Michael Eligon, Sylvia Klibingaitis and Reyal Jardine-Douglas and others continue to raise questions about how frontline officers deal with situations where mental health issues are at play.

The current crisis in Toronto's city hall might well serve as a reminder that as a society, we have a long way to go in understanding the impact of mental health when lives go awry on the public stage. We also have yet to achieve consensus as to what might constitute a compassionate, pragmatic response in such cases.

Let's hope Ford succumbs to the pleas for him to remove himself from office and get appropriate treatment. The last thing we need is one more story with the words tragic, mental health, or confrontation in the same headline.

If you're interested in learning about how to respond in a mental health emergency, there's a program in Canada called Mental Health First Aid (MHFA). You can read more about it at my blog post "Mental Health First Aid (MHFA) in Canada".


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