More documentation of human rights violations in BC’s involuntary treatment system
Text in graphic blocks along the left that read “More documentation of human rights violations in BC’s involuntary treatment system. These reports are the two latest thorough and independent reviews that show us the extent of human rights and quality of care gaps in BC’s involuntary treatment system.” To the right of the text is an image of a person sitting in a skatepark, facing away from the camera with their hood up.
Two more independent reports documenting violations under BC’s Mental Health Act have been released since December. These reports showed human rights violations and legal compliance violations.
New Report: Putting Children and Youth at the Centre
Of the two reports, the first was released in December. The Representative for Children and Youth released Putting Children and Youth at the Centre: Reforming and Modernizing the Mental Health Act for Children and Youth.
The report shows that:
The views of children and youth are dismissed and invalidated in the mental health system in a variety of ways.
The province has failed to make progress on the majority of recommendations made by the Representative’s office in their 2021 report Detained: Rights of children and youth under BC’s Mental Health Act.
The province lacks data on the overall numbers of children and youth detained and treated without their consent under the Mental Health Act.
Fourteen times more children and youth are detained under the Mental Health Act compared to the Youth Criminal Justice Act. This makes the Mental Health Act the main method for detaining children and youth by far.
The Mental Health Act is inadequate in addressing the unique needs and rights of children and youth compared to the Youth Criminal Justice Act.
There are concerns about the province’s current measures to expand involuntary treatment for youth administratively instead of amending the Act.
Expansion of involuntary treatment for children and youth in general should occur with:
adequate voluntary services
improved procedural safeguards
Indigenous consultation and support
a provincial commitment to research and evaluation to understand the efficacy of involuntary treatment
Report Update: Committed to Change
In January, the BC Ombudsperson released its second update on its systemic recommendations set out in 2019’s Committed to Change: Protecting the rights of involuntary patients under the Mental Health Act. The report documented wide-spread non-compliance with the basic procedures the Mental health Act requires to detain a person and administer involuntary treatment.
The Ombudsperson’s update shows that:
After 6 years of effort, there has been sustained improvement in compliance with the legal forms required under the Mental Health Act. However, there is still a significant rate of detentions where the forms are not filled out at all or are not filled out properly.
Compliance with the law varies significantly by health authority. Interior Health, Fraser Health, and Norther Health comply with the law in less than 50% of patient files.
Northern Health and Fraser Health are outliers, with significant legal violations in terms of ensuring that basic legal forms are completed when a person is detained and treated without their consent:
Form 4 documents the legal justification for detaining a person. It was not properly completed in 91% of files in Fraser Health and 65% of files in Northern Health.
Form 5 is the primary way that involuntary treatment is authorized after Bill 32 amended the Mental Health Act in December. It was not properly completed in 73% of files in Fraser Health and 54% of files in Northern Health. Without this form completed properly, the staff administering involuntary treatment may be accused of battery.
Provincial data shows a decrease in involuntary admissions, but it also changed how it collects data, so long-term trend comparisons cannot be made.
Independent review is important, but action must be taken on recommendations
These reports are the two latest thorough and independent reviews that show us the extent of human rights and quality of care gaps in BC’s involuntary treatment system. Progress made on these and past recommendations by the province is slow, uneven across the province, and in many cases non-existent. Independent reviews are an incredibly important step to make sure that people’s rights are respected and that they receive high-quality care. They confirm what people with lived and living experience have been consistently reporting.
However, without the provincial government’s commitment to act quickly and to fully implement the recommendations made by the Representative for Children and Youth and the Ombudsperson, BC’s involuntary treatment system will continue to cause harm. People in need of mental health supports deserve better.