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The Intersection of the Mental Health Crisis with Covid-19: "Injury on the tracks"

Swimmers. Betty Goodwin.

By Daniel Tarade

Note: Stories of suicide can be difficult to read. If you're dealing with mental-health concerns, help is available. If you're in crisis or in need of assistance, call 416-408-HELP, go to your nearest hospital or call 911.

Edit: The Toronto Star covered this topic on Aug 5.

The crisis of Covid-19 intersects with many other systemic issues. The Albertan government argued that now is the ideal time to build pipelines — because people can’t protest. Black neighbourhoods in Toronto have been hit the hardest just as black Americans die at three times the rate of white Americans. Migrant workers in Windsor-Essex die while working and living in crowded, dangerous conditions. As schools and workplaces close, unpaid work in the home disproportionately burdens girls and women. All of these systemic inequalities manifest in an unequal mental health burden. Just the increase in unemployment due to Covid-19 is predicted to result in between 400 and 2000 excess suicides in 2021.[i] This, of course, affects the poorest among us. But I am concerned that a burgeoning mental health crisis is being ignored, or worse, weaponized by those who want us to go back to work for their profit. Because, right now, there is evidence of increased suicide in Toronto subway system, and no one is talking about it.

In October of 2018, I wrote about suicide in the Toronto subway system (Toronto Transit Commission; TTC). My young blog seldom appeared in search engine queries. All of a sudden, at seemingly random intervals, website visits would spike. Looking through the visitor logs, it became clear that Torontonians looking up “injury at track level TTC” drove this trend. Stranded commuters confused by ambiguous TTC announcements turned to google for an answer about why they were late for work; they found my article.

Digging through the data, the landscape of a mental health crisis, its peaks and valleys backlit in flickering yellow light, emerged in sharp relief and then suddenly slunk back into the shadows.

Between March 20, 2019 and Mar 19, 2020, I find evidence for 28 injuries at track level. For most of these (Mar 20, Apr 18, May 30, Jun 2, Jun 13, Jun 27, Aug 1, Aug 6, Aug 23, Sep 3, Sep 26, Oct 12, Nov 24, Dec 27, 2019; Jan 8, Jan 16, Jan 25, Jan 30, Feb 1, Feb 16, Mar 5, Mar 15, and Mar 19, 2020, there is a correspondence between web traffic and TTC notices. In this window, all spikes of five of more clicks correspond to an “injury on the tracks.” The only exception was Sep 10, 2019, when the TTC launched a new anti-suicide initiative. Searching through @TTCnotices specifically for this phrase revealed five additional incidences (Jun 28, Jul 29, Oct 13, Oct 19, 2019; Jan 27, 2020), all of which occurred late at night or early in the morning, that did not generate web traffic.

But, since the government of Ontario declared a state of emergency on March 17, subway suicides became more common but less visible. There have been thirteen incidents between April 1 and July 10 (Apr 4, Apr 13, Apr 14 (x2), Apr 28, May 9, May 16, May 20, May 23, Jun 4, Jun 16, Jul 2, and Jul 9). None of these drew much attention except when subway suspension caused a crowded situation when we all ought to have been physically distancing. This isn’t surprising as subway ridership declined over 80% during the pandemic. But despite decreased ridership, these thirteen incidents are more than double the same period in 2019. Is Covid-19 also exacerbating a mental health crisis?

I trawled through all @TTCnotices tweets using the queries “personal injury at track level” and “injury on the tracks.” The Twitter account abruptly switched from using the former to the latter on June 18, 2019 amidst a spate of four injuries in three days. I wonder if their social media people grew frustrated with the Twitter threads clarifying that “personal injury at track level” euphemized suicide. Overall, I found 16 ‘personal injuries at track level’ in 2013, 29 in 2014, 19 in 2015, and 24 in 2016, which matches up well with the 17, 30,16, and 21 suicides reported by the Globe and Mail for those respective years. 30, 30, and 25 incidences were uncovered in 2017, 2018, and 2019, respectively. These numbers fall short of the 45 (2017) and 46 (2018) suicide-incidents reported in a CBC article; apparently, 2017 was “the only year for which the TTC was able to provide [an] up-to-date figure.” This is linked to a decision the TTC made in 2016 to pursue honesty because “not talking about [subway suicides] hasn’t worked.” As a result, the numbers reported for 2017 and 2018 seem to include “[t]ransit workers who have also intervened with dozens more people who seemed to be in distress.” But these don’t show up on Twitter.

When I took a 60-day rolling average of “injuries at track level,” the quarantine period clearly stood out compared with Spring months in previous years. The 9 incidents between April 4 and May 23 or April 13 and June 4 matches the highest 60-day total, confined entirely to one calendar year, in the last seven years (there was a sixty-day period with 10 incidents spanning Dec ‘17 to Feb ‘18). Despite the clear impact of Covid-19 on mental health, there is media silence on this uncomfortable topic.

The TTC claims to care deeply about the proliferation of suicide on subway tracks, but nothing they do seems to help. TTC's chief safety officer, John O’Grady, says in 2019 that “we’ve done many things, which have some effect. But still the numbers are high and going up. So we’re not doing enough.” While the TTC continues to mull over the financial costs associated with barriers, which would immediately prevent future suicides in the subway system, they instead ask “customers to look at their fellow citizens and just talk to them...that’s the next thing we can try until we get an engineered solution.” What fucking horseshit!

Articles on subway suicides are a perverse Toronto tradition. Every six months, like clockwork, another newspaper takes a crack at the eye-catching topic and some TTC official expresses their concern. There have been over 1000 suicide attempts since the subway was first built in the 50s. It’s not a novel concept. Subways all over Europe and Asia feature barriers. Clearly, this isn’t a real priority for the TTC or the city. Just admit it. How else do you explain the TTC’s request that commuters play therapist while they travel to their minimum wage job on a jam-packed subway that is 30-minutes delayed rather than invest in barriers or social workers. Instead, the TTC invests heavily in fare inspectors to issue $425 fines for not paying a $3 fare while phasing out the subway guard position, which actually helps prevents suicide and other tragedies. Instead, they force employees with PTSD back to work. This punitive and aggressive approach contrasts with the lovey-dovey image the TTC tries to portray. After all, fare inspectors, much like Canadian police, who themselves murdered five BIPOC during wellness checks in the last three months, are not equipped to handle mental health crises. Rather, they happily pepper spray mentally-ill folks and racially profile commuters. In capitalism, these are the only ‘solutions’ that exist.

Just like the installation of subway barriers, students at the University of Toronto pushed for barriers in certain buildings known to be suicide hotspots — within one eighteen-month period, three Toronto students died of suicide in the same building. But these are immediate demands. If installed, these barriers buy us time to intervene in a broken system. The same goes for expanding the public mental health care system in Ontario, which in its current form is woefully inadequate. We must ask, however, whether the mental health crisis can be effectively confronted in a capitalist society. As a socialist, I argue that it cannot.

Capitalists seek to maximize profit. The hoarding of wealth by the 1% drives the austerity confronting our societies. Money flows into the military and police to bomb brown people and protect private property while marginalized people fall through budgetary cracks. Private practices respond to the mental health crisis, but this is not affordable for many people. Because wealth can’t be extracted from the homeless and broke people living with schizophrenia, bipolar disorder, depression, anxiety, or addiction, those most vulnerable become invisible.

Instead, the bare minimum is invested towards hiding homelessness from the rest of the population. The Toronto police literally uses bulldozers to raze encampments of homeless people. The same perverse situation exists on campus. The administration, although a non-profit entity much like the TTC, runs the school like a business. Mental health services are pitiful despite a 2016 National College Health Assessment survey finding that 65% of Canadian students reported feeling overwhelming levels of anxiety and 44% reported difficulty functioning due to depression within the last twelve months. Most troubling, one in fifty students reported a suicide attempt in the previous year. With limited resources, the University of Toronto focuses on those students whose mental health struggles impact their studies. I myself was turned away by health resources on campus for this reason. As I wrote to U of T President Meric Gertler, “I took that to mean that if you can succeed despite anxiety, despite depression, the University of Toronto does not care. Only when graduates stop being successful in the community, when the U of T image is tarnished, will those who run this institution care.” It is clear that both the TTC and U of T care more about their revenue stream than the wellbeing of people. This is the reality when public institutions compete for funding amidst cutbacks.

The Covid-19 pandemic is just the most recent stress test that our society fails to pass. Capitalist greed drives corporations to rush people back to work in order to keep up profits even if it means workers must risk their lives. The wealth inequality endemic in capitalism means that even temporary layoffs threaten to leave thousands homeless. Austerity, ramped up since the 2009 financial crisis, left the healthcare system unable to deal with an influx of critically-ill patients. Privatized long term care facilities, which prioritize profit and not resident wellbeing, failed to even slow down Covid-19. While unemployed people must make do with only $2000 a month in Canada, massive corporations receive billions in bailouts. Combined with the need to quarantine, many fear a mental health crisis of pandemic proportions echoing for years to come. Capitalist forces seize upon this emergency to justify re-opening. But this is an obvious contradiction in the capitalist system — to control the pandemic, we need to shut down non-essential production, but this leaves many workers in dire straits. It is time to for workers to construct a society based on human need rather than capitalist greed! We must fight for a centralized economy under direct, democratic workers control. Workers make society run. We should run society!

[i] McIntyre, R. S., & Lee, Y. (2020). Projected increases in suicide in Canada as a consequence of COVID-19. Psychiatry research, 113104.