“Do It or Die”: How Systems Use Trauma Against Us

By Daniel Hearn

In Saskatchewan, the safety net often feels more like a snare.

Support services designed to help people in crisis frequently operate through frameworks of control, surveillance, and conditional care. Whether it’s addiction recovery, income support, housing, or mental health services, the message vulnerable people receive is clear: comply, or lose access.

That reality becomes especially dangerous when trauma is involved. In a province where intergenerational violence, colonization, and systemic poverty are already present in so many lives, service systems can easily replicate the same dynamics they claim to treat. Instead of meeting people where they are, they often punish them for how they got there.

This article draws from lived and professional insights shared by Dr. Barb Fornssler (School of Public Health, USask) and Kayla Demong (Executive Director, Prairie Harm Reduction) to explore the deeper question: what happens when our systems use trauma against us?

The Illusion of Choice

Saskatchewan has legislation that enables involuntary admission to treatment or psychiatric care in some circumstances. But coercion often doesn’t come through formal orders. It comes through conditional offers: take treatment or lose your kids. Accept support, but only if you follow our rules. One wrong move, and your access to housing, services, or freedom disappears.

Many people describe this as “treatment under duress.” There is no real choice when the alternatives are incarceration, family separation, or homelessness. These dynamics are especially sharp in rural and remote communities, where options are few and stigma is high.

From Support to Surveillance

Multiple Saskatchewan systems, from SIS to probation to child welfare, operate on a model of behavioral compliance. People receiving help are placed under scrutiny, monitored for setbacks, and penalized for non-compliance. But this doesn’t create safety. It creates fear.

Research and advocacy groups, including CLASSIC, Legal Aid Saskatchewan, and Elizabeth Fry Society of Saskatchewan, continue to show how the line between help and harm is easily crossed when care is conditional on submission.

When Trauma is Pathologized

Instead of recognizing trauma as a root cause, many systems treat it as a red flag. A person with visible signs of trauma may be seen as “unstable,” “uncooperative,” or “at risk.” This labeling often leads to more restrictions, more supervision, and fewer opportunities to shape their own path.

In family services and criminal justice especially, trauma is treated less as context and more as a liability. The result is a cycle of containment: traumatized people are deemed unfit for autonomy, and so they’re further surveilled, disciplined, and disempowered.

The Cost of Non-Compliance

In Saskatchewan, “non-compliance” can mean anything from missing an appointment to challenging a worker’s tone. The cost? Loss of income support. Loss of housing. Apprehension of children. Even criminal charges.

For people already managing poverty, addiction, or mental illness, this creates a state of constant pressure. You must appear stable, grateful, and compliant at all times—or risk everything.

Barriers like these are not failures of the system—they are the system, functioning as designed.

Real Support Looks Different

Efforts like SURGE-SK are helping to map and strengthen the province’s response to substance use by promoting collaboration across sectors,

from harm reduction to recovery, from rural communities to urban centres.

So what does real support look like? According to advocates and lived experience experts, it starts with:

• Voluntary care that prioritizes relationship, not compliance

• Culturally grounded and community-based services across urban and rural communities

• Peer-led programs that honour lived experience and reduce stigma

• Harm reduction and housing-first models, like those practiced at Prairie Harm Reduction

• Youth- and Indigenous-led spaces, like Chokecherry Studios, where trust is earned, not assumed

• Community-driven supports like STR8 UP in Saskatoon and Prince Albert, which support individuals exiting gang life through relational, harm-reducing approaches

• Integrated mental health and housing supports offered by Phoenix Residential Society in Regina and CUMFI Wellness Centre in Saskatoon

• Crisis shelter and women-centered advocacy from the YWCA Saskatoon and Elizabeth Fry Society of Saskatchewan

• Holistic, Indigenous-led programming in places like Newo Yotina Friendship Centre in Regina

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These approaches shift the goal from obedience to healing. From containment to connection. And they remind us that real care isn’t a checklist—it’s a relationship.

These approaches shift the goal from obedience to healing. From containment to connection.

When Help Isn’t Safe

The systems discussed here are often staffed by people who care, but who are working inside policy environments shaped by risk management, not relationship-building. That disconnect is why so many people fear seeking help. They’ve learned that help comes with strings. That trauma might be used against them.

And that being vulnerable in Saskatchewan is still too often treated like a threat.

If you haven't checked out the Speakeasy episode that discusses this topic, watch it here.

Acknowledgment: This article is part of a research and knowledge mobilization project led by Dr. Barb Fornssler at the University of Saskatchewan’s School of Public Health, through SURGE Saskatchewan, which strives to be Saskatchewan's substance use information hub—connecting stakeholders and promoting intersectoral collaboration across the continuum of care to enhance programs and services for the people of Saskatchewan.