Advocates say the B.C. premier’s proposal to expand the scope of involuntary mental health treatment could further infringe on the rights of marginalized people.
Involuntary or mandatory treatment is among Premier David Eby’s proposals to expand mental health care support, which also includes funding more mental health emergency teams — a pillar of his public safety plan.
Involuntary treatment is allowed under B.C.’s Mental Health Act; a person can be detained in a psychiatric facility if a doctor deems it necessary for their health and safety, as well as the safety of others.
But Eby is proposing to expand the system further, including by beefing up information sharing arrangements between police and medical professionals.
“Part of this announcement … is a province-wide deployment of an app that allows police to contact directly those medical health professionals at the hospital to know how best to respond,” he said.
“So they’re not waiting there trying to explain to an emergency room physician or a nurse why this person needs to be held, that the information is shared seamlessly.”
Eby says the province would also work to expand involuntary treatment to the corrections system.
“This is an opportunity for us to get in there [and] provide medical support — so that when they’re released they’re actually in better shape than when they went in.”
The proposal follows months of complaints from police and B.C. mayors who have requested mandatory treatment especially for so-called prolific offenders.
Involuntary treatment doesn’t work: advocate
Civil rights advocates say forced treatment is not based on science and called on the province to move away from the approach.
“Coercing people or forcing them into carceral settings for care does not actually engender good results,” said Meenakshi Mannoe, a campaigner with Pivot Legal Society.
Experts have previously said that involuntary care often breeds a distrust of the medical system, due to its “coercive” structure, and that it can sever connections to family and community.
Mannoe adds that advocates have noticed B.C.’s increasing use of the Mental Health Act to detain people for years, and while investments in treatment are welcome, the province should work to make voluntary treatment more welcoming for anyone seeking care.
“What’s on offer is just unsafe,” she said. “They know that it jeopardizes their income, their housing, for example, if you have to go to a longer term treatment program.”
A spokesperson for the Mental Health and Addictions Ministry said the province’s “primary focus” is shoring up the voluntary care system.
“While involuntary treatment for psychiatric illness can be effective in some circumstances, voluntary services are the most effective, when possible,” they said in a statement.
Treating drug addiction
According to the government spokesperson, the province is also “currently reviewing” sections of the act, which currently does not cover “involuntary care for substance use disorder in the absence of a concurrent psychiatric disorder.”
In 2020, B.C. proposed mandatory treatment for youth who repeatedly overdose — a proposal they rescinded after significant criticism.
Later, during his leadership campaign, Eby told Postmedia that involuntary care should be an option to protect people who repeatedly overdose from serious brain injury.
But police are rarely judicious when it comes to detaining people under the Mental Health Act, according to Tyson Singh Kelsall, an outreach worker in the Downtown Eastside and a PhD student at Simon Fraser University,
Racialized drug users were most at risk, he added, saying in the context of a poisoned drug supply, research has shown people are at heightened risk of death after compulsory treatment for drug addiction.
“If you’re forced into treatment, and you’re released … your tolerance will be at an all-time low,” he said. “There’s a good chance you’re gonna feel compelled to access the poisoned drug supply.
“We see a huge association between discharge from incarceration and overdose risk. It would be the same for compulsory care.”
Singh Kelsall says the province is shying away from addressing the toxic drug supply by promising to shore up the treatment system instead.
“I believe the solution is having a regulated supply of drugs that people can do safely and not infringing further on people’s human rights.”