The Hon. Judy Darcy
Minister of Mental Health and Addictions, BC

Neilane Mayhew
Deputy Minister of Mental Health and Addictions, BC

Via Email July 27, 2020

Dear Minister Darcy,

The BC Schizophrenia Society (BCSS) would like to commend you on the new legislation (Bill 22) you have proposed that would allow youth aged 18 and under who have had a life-threatening drug overdose to remain involuntarily in a hospital psychiatric or observational unit for up to seven days. This will provide the much-needed opportunity for these youth to receive appropriate treatment and a thorough assessment including mental health issues. The legislation also makes it clear that the goal is for the person to be discharged with a treatment and support plan.

We know from the families that we serve that youth with undiagnosed/untreated serious mental illnesses often turn to street drugs to self-medicate. This legislation would provide an opportunity for the health care system to determine if an underlying mental illness is present and requires treatment.

We have noticed the pushback that this proposed legislation is receiving. None of this pushback seems to take the population with serious mental illnesses into account. We are seeing repeated references to the idea that involuntary treatment does not work and when someone receives involuntary care they will not agree to future treatment. This has not been the experience of many families in our community. Indeed, research shows that while 100% oppose being involuntarily admitted, after discharge a majority (around 60% but as high as 86%)[1] say the decision to admit them involuntarily was the right decision. As well, if involuntary treatment did not work, we would not see almost all people discharged with an average stay of 15 days.

In the complaints about this proposed legislation we do not see any recommendations on how the needs of youth with previously undiagnosed mental illnesses who have overdosed should be addressed. The critics of your legislation ague that “rights” are being violated. They seem to forget that, without this legislation, the “right to health” and the “right to life” protected by the Canadian Charter of Rights and Freedoms are being violated by these illnesses and addictions that preclude voluntary treatment.

In support of your legislation, we note that Saskatchewan, through their “Youth Drug Detoxification and Stabilization Act,” have a similar response. The Saskatchewan Act permits up to a 15-day involuntary hospitalization limit whereas BC is 7 days. Saskatchewan also allows for compulsory community treatment. Other jurisdictions, especially in Europe, have somewhat similar legislation to help addicted youth.

Although BCSS does not focus on people who are primarily dealing with substance use disorders, we sympathize with the families who are and who support this legislation. They, like BCSS members, are trying to cope with mental illness or addiction where the person does not seek help voluntarily. Without intervention with good services, compulsory if necessary, the results can be disastrous or deadly.

BCSS supports Bill 22.

Regarding the Mental Health Act, BCSS would like to also thank you and your government for two other initiatives: defense of the MacLaren Charter Challenge, and the Attorney General’s (AG’s) response to our concerns on the UN Convention on the Rights of Persons with Disabilities (CRPD).

BCSS fully supports the AG’s defense of the Mental Health Act challenge and have offered any assistance the AG may require in terms of witnesses who have relevant lived experience. The Community Legal Assistance Society (CLAS) with the Canadian Council on Disabilities have initiated this challenge. They assert that people who have been involuntarily admitted for the purpose of treatment should be able to refuse the treatment necessary for their recovery and release. Ontario uses this system being advocated by CLAS. It resulted in Mr. Sevels being kept in solitary confinement for 404 days because he could not be treated, severely injuring a staff member. On being treated involuntarily, he recovered and was discharged. Professor Starson was untreated for 7 years and nearly died because of delusional induced starvation. He greatly improved when treated against his will.

BCSS does not want BC hospitals turned into jails and wants CLAS and others to recognize that the right to health must be included in balancing the rights of persons with brain illnesses that make them deny they have a treatable illness.

BCSS appreciates your government’s response to our concerns about the CRPD. The AG assured us that his understanding was that Canada would not be withdrawing its reservation, which would have prohibited substitute decision-making in most Canadian guardianship and mental health laws. BCSS was particularly concerned because the UN had ruled that “Committal of individuals to detention in mental health facilities, or imposition of Community Treatment Orders contravene the convention and must be eliminated.”[2] The Mental Health Act would be completely abolished, as would the Not Criminally Responsible defense. If implemented in BC, this would mean that approximately 15,000 people per year, some of them dangerous to others, would have to be turned away from receiving hospital treatment. All would be untreated and many would end up on the streets, in the criminal justice system or in stressed families. BCSS strongly opposes this position and would ask that our position be advanced since some “rights” groups want the UN requirement implemented.

Again, we want to thank you for your courage in providing an additional tool through Bill 22 to address the too-often catastrophic consequences for youth struggling with addictions, and for their families.

Dave Halikowski
President, British Columbia Schizophrenia Society

[1] Gabriel, A. (2016). Perceptions and Attitudes towards Involuntary Hospital Admissions of Psychiatric Patients. Jacobs Journal of Psychiatry and Behavioral Science, 2(1), 13.

[2] (CRPD 2013) UN Committee on the Rights of Persons with Disabilities. Concluding observations on the initial report of Australia [Internet]. Adopted by the Committee at its10th session, [Cited 2013 September 2-13].