Text in graphic blocks along the left that reads “The Mental Health Review Board has released its latest Annual Report. This report provides us with some insights into how people detained under the Mental Health Act are accessing detention reviews. How did this year compare?” To the right of the text is an image of a man who has his head buzzed and is wearing headphones, facing away from the camera. There are trees in the background.

The Mental Health Review Board is a specialized tribunal that can review a person’s detention under the Mental Health Act and decide whether to discharge that person. While there is no way to review many aspects of involuntary treatment, the Mental Health Review Board is one of the safeguards in the Mental Health Act, providing oversight by ensuring that detentions are reviewable by independent decision-makers. It can be a lower-barrier option than making an application in court.

The Mental Health Review Board recently released its 2024/25 Annual Report, which provides us with some insights into how people detained under the Mental Health Act are accessing detention reviews. It also provides a window into how well this particular safeguard is working. When laws and policies authorize such significant restrictions on a person’s rights like how the Mental Health Act does, it is critical that we understand what safeguards exist and how they’re working. To learn more about oversight and accountability in BC’s mental health and substance use system, click here.

How does this year compare to previous years?

1. There is still no review of most detentions

Access to a Mental Health Review Board review panel hearing is not automatic. Individuals detained under the Mental Health Act in BC must request a hearing using a Form 7. Putting the onus on an involuntary patient to request review of their detention results in significant access barriers. We frequently hear from folks with lived and living experience that they were never told about their right to a review panel, and even those that are told and successfully submit a request for a hearing also face numerous barriers to actually going through with the hearing, which we will touch on later.

A safeguard cannot perform its function if it isn’t being accessed. Making detentions reviewable with no automatic access has resulted in a safeguard that is inaccessible in practice. Combining recent data on the annual number of involuntary admissions with the number of review panel hearings, we learned that just under 5% of adult detentions under the Mental Health Act last year involved a review panel hearing (1). For children and youth, the numbers shrink drastically. Out of 2,447 involuntary hospitalizations of children and youth in 2024/25, there were only 12 review panel hearings, meaning less than 1% of child and youth hospitalizations involved a review panel hearing. Additionally, only roughly 1% of the total review panel hearings in 2024/25 involved a young person—the lowest it has been in the past 8 years (2).

2. Application withdrawal rate continues to increase

Both the number of applications and the number of actual hearings increased slightly this year, but the gap between applications and hearings has remained roughly the same, with only 37% of applications actually resulting in a review panel hearing. In fact, more applications were withdrawn (38%) than actually went ahead to a hearing last year. This continues the trend over the past five years of increasing withdrawal rates of review panel hearing applications.

The withdrawal rate is significant because it does not include involuntary patients who were ineligible for a hearing or who were discharged from involuntary status before their hearing took place. 38% of patients who applied for a hearing withdrew their application while they were still certified as an involuntary patient.

Increasing withdrawal rates and continually limited occurrences of actual hearings reflects our ongoing concerns about the accessibility of this fundamental safeguard in the Mental Health Act and its vulnerability to coercive practices within the health care system. As we have written about previously, research has demonstrated that patients are often pressured to cancel their hearings, threatened if they wish to proceed, or offered inducements to encourage them to withdraw.

3. Significant Decrease in Rate of Decertification

The percentage of patients “winning” their review panels is shrinking. This year marked a sharp decline in the rate of review panels where a patient was discharged from involuntary status or “decertified”. There was a decrease from 12% last year to 9%, the lowest it has ever been according to available data. As recently as 2022/23, the decertification rate was 16%, meaning that the number of review panels resulting in decertification has almost halved in just 4 years.

It also means that the vast majority of review panels (91%) last year decided that a patient’s detention under the Mental Health Act should continue. We know this percentage is impacted by the number of patients attending their hearings without legal representation as decertification rates are typically lower when a patient is not represented. However, this year, more patients had legal representation than ever before. This is an alarming trend that raises serious concerns about whether the accessibility of the review panel process for patients may have changed over time, or whether there is another explanation for why hearing outcomes are trending in this way.

Other important information from the Mental Health Review Board Annual Report

Observations from Reasons Analysis Project

This year, the Mental Health Review Board shared their conclusions from a Reasons Analysis Project where they analyzed 70% of the written reasons from the 990 hearings that took place. Given the steep decline in decertification decisions, this may have been an opportunity for board staff and members to better understand how the Review Board is functioning and how decisions are being made by observing themes or trends across decisions. Instead, the conclusions shared in the Annual Report draw broad conclusions about the people seeking review panels, and the themes drawn from the analysis take a very limited and narrow perspective on those who are most impacted by the decisions of the Mental Health Review Board.

We will be taking a closer look at this piece of the Annual Report in a separate blog post on the topic. Don’t want to miss a blog post from us? Sign up for our email list!

Absence of Data by Health Authority

In previous years, the Mental Health Review Board’s annual report has included application rates broken down by regional health authority. This is important information because, as the Ombudsperson’s Committed to Change report and two systemic updates have shown, compliance with the procedural safeguards in the Mental Health Act varies significantly by health authority.

For example, one health authority may have done significant work to ensure patients are consistently informed about their right to apply for a review panel, resulting in their application rate going up. At the same time, another health authority might have significant cultural barriers to consistently informing patients of this right and supporting them to apply for a review. Without transparency related to Mental Health Review Board application rates by health authority, these kinds of access to justice issues cannot be identified and addressed.

Absence of Reporting on Children and Youth

In 2021, the Representative for Children and Youth released Detained: Rights of children and youth under the Mental Health Act. A follow up, Putting Children and Youth at the Centre: Reforming and Modernizing the Mental Health Act for Children and Youth was released in January 2026. Both reports documented several concerns about the rights of young people impacted by the Mental Health Act, including that children and youth were accessing review panel hearings at much lower rates than the general population. The Representative has shared that youth have comprised an average of roughly 2% of all hearings since 2017/18.

In May 2023 the MHRB hired a specialized Navigator to support the review panel applications of patients under 25 years old, based on a recommendation from Detained. The role is meant to support youth throughout the hearing process, including accessing legal representation and cultural supports. It is our hope that this role would go a long way to improving accessibility of the review panel process.

Last year, the Mental Health Review Board shared limited insights on how many applications and hearings involved children and youth that year. This year, the Annual Report is regrettably silent when it comes to children and youth. There is no information on the number of applications or hearings involving children and youth or how the Navigator position is impacting the accessibility of the hearing process. We strongly encourage the Mental Health Review Board to improve its transparency on this critical work.

The importance of transparency

The Mental Health Act authorizes significant restrictions on a person's rights so we need ways to be sure that people will be treated with respect and dignity. We also need ways to track and address improper use of power. The Mental Health Review Board annual report allows us to see how this particular safeguard is working. This year’s report suggests that few Mental Health Act detentions include a review panel and of those, very few have a successful outcome. This Annual Report was also notably less transparent than previous years, lacking data specific to regional health authorities or the number of children and youth accessing review panels. Transparency is a necessary piece of oversight and accountability. To learn more about what oversight and accountability should look like in a mental health system, check out our Oversight and Accountability page.

Sources:

Total number of involuntary hospitalizations for 2024/25 divided by the total number of review panel hearings (990/21,380). Figure 4 in BC Ombudsperson’s Committed to Change 2026 Update at page 13. https://bcombudsperson.ca/wp-content/uploads/2026/01/OMB_Committed-to-Change_Report_Update_2026-WEB.pdf
Representative for Children and Youth follow up to Detained titled Putting Children and Youth at the Centre at page 14-15. https://rcybc.ca/wp-content/uploads/2026/01/RCY-Mental-Health-Act-Reform-Jan2026.pdf

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The Mental Health Review Board has released its Annual Report