New reforms must retain involuntary admission and treatment
Released on the Friday before the August long weekend, BC Supreme Court Justice Blake ruled on the Charter challenge: Council of Canadians with Disabilities v. British Columbia (2026 BCSC 1416). The decision rules on “whether BC’s legislative approach to psychiatric treatment for involuntarily admitted patients — the deemed consent regime — is constitutional,” and found that British Columbia’s approach is not. The ruling strikes down several sections of law related to involuntary admission.
More importantly, it does not rule on whether BC “should have an involuntary admission regime for those individuals who are unable to recognize that their mental illness is impeding their ability to appreciate their need for treatment.”
Stating instead that “it must.”
With only six months, the issue ahead for the BC government is to act quickly to reform these sections to ensure that an involuntary treatment regime is constitutional.
I serve as the volunteer president of the BC Schizophrenia Society (BCSS), an organization that supports families of those impacted by severe and persistent mental illness. We have long advocated for better family involvement in the treatment of mental illness—a process that increases the effectiveness and longevity of treatment and reduces costs on the system.
The BCSS has maintained ongoing support for the judicious use of involuntary treatment for severe mental illness. While the judge found some aspects of BC laws to be unconstitutional, she also discussed other provinces that could be a model.
For example, the Saskatchewan model mentioned by the Court could address each of the Court’s concerns: 1) Only admits patients who are not fully capable of making a treatment decision. Admitting only incapable patients would address widespread concerns about involuntarily admitting and detaining people who could not be treated.
2) The physician provides consent. Includes input from family members, but a mental health professional makes the treatment decision. BCSS strongly recommends that families be consulted when decisions are made about involuntary admission.
To be clear, the situations that lead to being involuntarily treated are extremely challenging for the person and their family. A common condition of schizophrenia is anosognosia, a neurological condition where a person is unable to perceive or recognize their own mental illness or impairment. This makes accepting treatment voluntarily challenging. In some cases, family members increasingly face confusing behaviour and even violence. Involuntary treatment is not something implemented lightly, but when applied, it saves lives.
What cannot be allowed to happen is a system whereby mentally ill people are detained, but not able to access treatment because they or their substitute decision makers are allowed to refuse treatment. This is the treatment necessary for their release from detention. Delaying treatment leads to continued suffering and detention, restraint and seclusion, as well as potential injuries to fellow patients and nurses.
Families are impacted, and the system loses beds occupied by untreatable patients. This now happens in Ontario. We don’t want it to happen in BC. This is akin to criminalizing mental illness and is both inhumane and deeply problematic.
As the Province considers legislative reform, it is essential to achieve a balanced approach that protects the constitutional rights of people living with mental illness while also ensuring that involuntary patients are not detained and left untreated.
Meeting the challenges set out by the courts is an immediate need. Still, it is an opportunity for the government and health authorities to work to modernize the Mental Health Act in ways that protect vulnerable individuals, support families, and improve mental health outcomes across British Columbia.
Changes to the Act are not the only effort required. Funding facilities, support, and training for doctors and nurses are desperately needed. This is something governments at all levels have a role in.
In fact, this coming municipal election provides an opportunity to see which leaders are willing to talk about and champion policy ideas around mental illness that are much needed.
This is not an easy issue, but it’s both an important and timely one. We hope that the government will act quickly and bring forward tested solutions that maintain treatment while looking to a broader package of measures to support people and families living with mental illness in every corner of our province.
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Jack Middleton is president of the BC Schizophrenia Society Board and a public affairs and government relations professional. He is a dedicated advocate for people and families affected by severe and persistent mental illness across British Columbia.