'Jarring experience' in B.C. psych wards because of 'uniquely problematic' law
Abbotsford NewsFeb 08, 2021
A peer-support worker who helps youth with mental health challenges says being involuntarily detained in a psychiatric facility half a dozen times has given him insight into the lack of legal protections for vulnerable patients in
"It was a very jarring experience. I was not really told what was going on. And I was freaking out quite a lot because it was a shock to me," he said, adding a second psychiatrist reassessed and discharged him the following day.
B.C. is the only province where the Mental Health Act allows for so-called deemed consent to treatment.
The legislation states that anyone with involuntary status under the law is presumed to have agreed to psychiatric treatment. Family members and other advocates are also barred from challenging prescribed treatments.
Higgs, now 25, is among advocates for the mentally ill who say the law must be changed for patients who need more support in the community.
After his first detention, Higgs was held at a psychiatric facility about five more times over the next three years with a diagnoses of psychosis.
Higgs said he was never formally advised that he could apply for a review of his detention and only learned more about his right to a hearing toward the end of his hospitalizations. He felt powerless to argue against involuntary detention, even with the help of an advocate through a legal aid program for patients, he added.
A major challenge of the system is that reviews are not mandatory, Higgs said.
Unlike in
Patients at B.C. facilities are entitled to a hearing within 14 days of their request.
But the
The report found that only 37 per cent of patients who applied for a hearing had one. It said 54 per cent of scheduled proceedings did not go ahead because the patient withdrew their application, sometimes when they were discharged from hospital and placed on so-called extended leave in the community where they are connected to a mental health team.
"The number of withdrawals may or may not raise an access to justice issue," the report said.
About a third of hearings did not proceed because patients were decertified after they requested a hearing.
"A decertification may show that treating physicians are being responsive to the needs of their patients," the report reads. "A decertification may also indicate an abuse of process. The board would like to measure whether a patient is decertified and recertified in order to avoid a review panel hearing."
Patients who are on extended leave in the community can also apply for a hearing, but lawyers may not be able to reach those who are living in a single-room occupancy hotel, for example, where phone messages are not always be relayed or received, she said.
Wong said applications are withdrawn in nearly half the cases when lawyers said they did not get instructions from patients, which could also mean there was no contact with the applicant. She noted no reasons have to be provided due to lawyer-client privilege.
Mental health laws across
However, mental health systems across the country are "crisis driven" because psychiatry and acute care are funded while many other mental health supports are not, so ending up in the emergency department before being detained becomes a route to accessing care in the community for many patients, Morrow said.
"It makes sense to me that a psychiatrist will say 'Go to emergency and maybe you'll get some help that way.' " she said, adding patients in B.C. could be forcibly administered medications and electroconvulsive therapy.
"There's been frustration in B.C. for many, many years, with people raising concerns about the act and really little governmental response."
Chalke's recommendations were accepted by the ministries of Health, Mental Health and Addictions as well as the Attorney General though Chalke, who is expected to issue a followup report in the spring, said some promised timelines for action had passed.
The ministries of Health and Mental Health and Addictions did not respond to requests for comment on whether they would consider dropping the deemed-consent aspect of the Mental Health Act.
The Attorney General's Ministry, which committed in
The ministry says it has begun consultations including with experts and other provinces.
In 2016, the
The B.C. government stopped the case from going to trial, saying the council did not have public standing as a non-profit society. The province is now asking the
"People with mental disabilities, including mental illnesses, end up having negative experiences when they interact with our health-care system, sometimes even traumatic experiences," she said.
She said that prevents them from accessing care or social services in the future.
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