BC needs guiding principles in its mental health law
Many reports have found problems with BC’s Mental Health Act and the way it is being used. Our publication, A Path Forward: Human rights-based guiding principles for BC’s mental health law and services, goes through some of those problems and why BC needs a new approach. In the creation of this publication, we identified eight guiding principles that can help improve BC’s mental health law. They are rooted in the human rights of the people who access mental health and substance use services. We’ve summarized these eight principles below, but you can also read more about each of these principles here.
1. Recognize human rights
“Behind every issue, whatever your issue is, there is an entire person. There is a human being and they have human rights.”
— Lived Experience Expert
Stating in the law that human rights are important can help improve BC’s system. This is needed because the problems that have been identified in BC’s mental health system stem from a failure to respect human rights.
2. A holistic approach to mental wellness
“Hospitalization and medication didn’t bring back the friends I had lost. It didn’t fill the gaps that were in my resume. It didn’t repair my confidence which had been shattered. It didn’t instantly make me feel comfortable being around other people. I had lost my comfort with others because I had been paranoid for a long time (but never violent). So, my recovery journey involved a lot of rebuilding. I did the rebuilding mostly through volunteering. Medication was not the whole answer. As for the hospital, I had to do my rebuilding in the community, not in an institution.”
— Lived Experience Expert
BC’s mental health law should recognize that we need many things to be well. This includes health and social services, and things like housing, income, relationships and belonging.
3. Access to quality health services
“I don’t actually ever remember getting treatment. I got medicated against my will… I didn’t get any therapy, just medication and being held.”
— Lived Experience Expert
BC needs more voluntary mental health and substance use services that are accessible and safe for all people. This means being timely, close to home, ethical, and centered on the needs of the person accessing the service. We should ensure the law prioritizes access to quality services.
4. Nothing about us without us – participation in law, policy and services
“The involvement of the patient, like, since it’s your mental wellness plan, you should probably be involved in it. But they don’t involve you at all. Like, they don’t ask you.”
— Lived Experience Expert
BC’s mental health law should acknowledge that people are experts in their own lives. This means including people in decisions that impact them, and it means recognizing the expertise of people with lived and living experience to shape the mental health and substance use system.
5. Comply with the UN Declaration on the Rights of Indigenous People (UNDRIP)
“What is cultural safety in this context? It means being cognizant of historical and intergenerational trauma, and the impacts of colonization while recognizing that, the systems in place that have inflicted trauma are still in active existence – one of the ways that this system exists is through the Mental Health Act.”
— Indigenous Leadership Group Member
BC’s mental health law impacts Indigenous people and it should be developed in consultation and with the consent of Indigenous people and communities. This will also meet BC’s commitment to ensure its laws comply with UNDRIP.
6. Prioritize intersectional equity and respect the different elements of a person’s identity
“In other countries, they have mother baby units for people that are experiencing that mental health crisis. Where I could have kept [my baby with me]. Maybe not in the initial stages when I was really unwell, but 3-4 days later, I was doing so much better. I could have been spending so much more time bonding, soaking up those moments that you’re supposed to be soaking up.”
— Lived Experience Expert
Every person who is impacted by BC’s mental health law has their own unique and complex identity. BC’s mental health and substance use services should respect and accommodate the different aspects of a person’s identity. We should prioritize ensuring that services meet the needs of the people who experience the most inequity.
7. Promote self-determination at every opportunity
“When we are treated involuntarily, choice is often taken away from us at many levels and about many things. It’s important to remember that even when someone is unwell and perhaps not able to make the same decisions they would normally make in some areas because their perception of reality is different, it doesn’t mean that they can’t make decisions in every area. People can still have opportunities to exercise choice. Many of the choices I would have liked to make when I was hospitalized were the same then as they would be now, when I am well.”
— Lived Experience Expert
People with mental health and substance use-related disabilities are often stereotyped as unable to make decisions or choices in their own lives. BC’s mental health law should ensure people have every opportunity possible to exercise choice about their own lives and health, whether or not they are an involuntary patient.
8. Accountability and oversight make services better
“It should have to be justified each time they override a person’s choice. Not just making them involuntary, but all the little choices too. It would be onerous, but that’s transparency.”
— Lived Experience Expert
We can only improve BC’s mental health and substance use services if we track how they are working and if they are transparent about the results. Independent oversight of the use of BC’s mental health law and mental health and substance use services can help ensure they continue to improve and that they are not repeating past human rights violations.
Guiding principles can help build a mental health and substance use health system that respects and supports human rights. This is something desperately needed in BC’s mental health system in order to support wellbeing.