Part 3: Oversight of services ensures safety and equality

To mark Mental Health Week 2020, Health Justice is doing a 3-part series on lessons we can learn from COVID-19 that can inform improvements to our mental health laws.

In the last few weeks, we have seen the role that oversight bodies can play in helping to monitor and hold public bodies and service providers accountable to support the health and safety of groups that are more vulnerable in a pandemic. The BC’s Seniors Advocate has played a role in monitoring and ensuring accountability with respect to long-term care facilities for older adults. The Representative for Children and Youth has spoken about concerns for youth who might be aging out of care and potentially losing the resources and supports they have counted on during this uncertain time. The Corrections Investigator of Canada has played a key role in identifying failures on the part of Corrections Services Canada to protecting incarcerated people from COVID-19 outbreaks.

Unfortunately, while people with serious mental health concerns are more vulnerable to the impacts of a virus like COVID-19 and psychiatric wards and facilities have been a documented source of outbreaks across the world, there is no oversight body in BC for mental health and substance use. And while there has been regular information published about the numbers and locations of COVID-19 outbreaks in high risk settings like care facilities and prisons, any numbers and information about outbreaks in psychiatric wards and facilities in BC is conspicuously absent.

While several organizations that provide much-needed mental health services have done their best to raise attention about negative impacts of the BC Mental Health Act among many other demands on their time, BC doesn’t have an independent provincial Mental Health Advocate like Alberta. We don’t have a requirement in our mental health legislation that independent reviews take place at five year intervals like Newfoundland and Labrador and Ontario. We haven’t commissioned former Supreme Court of Canada judges to conduct independent reviews of our legislation like Nova Scotia.

BC used to have a provincial Mental Health Advocate that was responsible for independent monitoring of the mental health system in the province, but the office was eliminated in 2001. As a result, in a time when transparency, monitoring, and oversight are needed more than ever, people being subject to coercive health care under the Mental Health Act have no external body monitoring their well-being or their rights.

Oversight is necessary to ensure safety and equality. For example, monitoring infection rates has underscored racialized health inequities: people of colour and Indigenous people have been disproportionately hit by COVID-19. Oversight mechanisms in other jurisdictions similarly shows that racialized people are involuntarily detained under mental health legislation at disproportionately higher rates.[1] But BC does not track or monitor this data, which prevents us from understanding and addressing racialized health inequities in the application of our mental health law.

Health Justice is working to transform our Mental Health Act into a law that is evidence-based and promotes human rights principles – a law that BC can be proud of. As this pandemic highlights, we have to make sure that oversight is built into our mental health laws to ensure equality and safety.

[1] See for example, Care Quality Commission, "Count Me In: Results of the 2010 national census of inpatients and patients on supervised community treatment in mental health and learning disability services in England and Wales” (April 2011).