What should oversight and accountability look like in a mental health system?

In recent months, the provincial government has been making many concerning and confusing statements about the Mental Health Act and involuntary treatment in BC. The exact plans for change are not clear. Some statements make it seem that the government believes the current Mental Health Act already provides legal authority for its plans and other statements hint at potentially proposing changes to the Mental Health Act. What is clear is that the provincial government has committed to further expanding involuntary mental health and substance use health treatment after many years of increasingly higher involuntary treatment rates. 

Regardless of what your opinion is on the effectiveness and ethics of involuntary treatment, any law that authorizes serious powers over people must be accompanied by accountability and oversight of those powers. The powers under the Mental Health Act are some of the most serious state powers authorized in Canadian law – powers to detain, to administer injections and electroconvulsive therapy without consent, to “discipline” patients in any way, to mechanically restrain, to confine alone in a seclusion room. When someone experiences detention and involuntary treatment, we need ways to be sure they will be treated with respect and dignity and that there are ways to address improper use of power.

BC’s Mental Health Act has some of the weakest oversight and accountability safeguards in Canada – for example, BC is the only province or territory in Canada that has no form of automatic review of detention built into its mental health legislation. Data is not collected about some of the most basic exercises of legal authority. There is no way to challenge the use of “discipline” or any other condition involuntary patients experience in a detaining facility. There are no accountability consequences for detaining facilities that violate legal requirements. There is no independent office that provides consistent and proactive monitoring of detaining facilities.  

If involuntary treatment is going to be even further expanded in BC, there needs to be a substantial expansion of the accountability and oversight of these powers. So what does that look like? 

We’ve outlined 5 types of oversight and accountability that should be built into all mental health systems in the following infographic. 

As we continue to research and engage on what good oversight and accountability can look like within the mental health system, check out our Oversight and Accountability page to see what we’ve found!