B.C. offers rights advisers for mentally ill patients who are involuntarily detained

British Columbia has introduced legislation that would allow people to get independent advice about their rights after they've been involuntarily detained for treatment of a severe mental health disorder.

The province's Mental Health Act allows those in crisis to be treated for their own protection, or the protection of others.

Mental Health and Addictions Minister Sheila Malcolmson said Thursday the rights-advice service is aimed at assuring people will be treated fairly.

The service is expected to be available early next year, but patients must request it, the Attorney General's ministry said.

"Patients will be notified of the option to speak with a mental health rights adviser upon admission, transfer or renewal of involuntary status by a staff person," it said in a written statement.

The rights-advice service will later be automatically notified, though a timeline for when that could happen has not been set, the ministry said of the service, which will mostly be available by video conferencing and phone.

It said in-person appointments may be available in some circumstances, including for patients with a disability or other health condition that could make virtual communication difficult.

The number of patients admitted involuntarily in B.C. has risen significantly in recent years, with increases in mental health and substance use disorders contributing significantly to that trend, the ministries of Mental Health and Addictions and Attorney General said in a release.

Services should be independent, advocate says

Laura Johnston, legal director of Health Justice, an advocacy group promoting human rights in mental health and substance use care in the province, said a legal advice service that is not automatically triggered from the start would end up being inaccessible.

It should also remain independent from health authorities because the bill introduced Thursday does not define independence, she said.

"I'm not saying that this will lack independence, but that's something we'll be keeping an eye on."

Johnston also said many people experiencing a mental health crisis may need personal contact with an adviser on a ward in order to provide the most benefit from the service that many patients themselves have long lobbied for.

"That means that the person actually gets to sit down with their rights adviser and have a meaningful connection and contact with them," she said. "It also means that we're really opening up the doors on the detaining facilities because now there will be independent eyes on the ward about the practices that are taking place."

Those who struggle with technology, don't speak English or may be suffering to the point that they think they're under surveillance when going online would also need to have a legal adviser visit them, Johnston said.

She called the provision a positive step, but said other updates are needed because the Mental Health Act has not been changed since it was introduced in the 1960s and needs a major overhaul, especially during an overdose crisis.

"We've seen consistently that our province has fallen far behind other places in Canada when it comes to making sure our mental health laws and policies and practices are evidence-based," Johnston said.

An over-reliance on involuntary practices that some consider coercive can create harmful interactions in the health-care system, she said, adding the use of seclusion rooms and mechanical restraints in some cases have caused long-lasting trauma.

Patients currently sign a rights-advice form, but British Columbia's ombudsperson, Jay Chalke, has criticized the province for failing to ensure it does get signed.

He said in a 2019 report that a month-long audit of all provincial psychiatric facilities showed the form was not found in 51 per cent of patient files.

Chalke's report highlighted the need for facilities to have all legally required forms completed and ensure patients, who are at significant risk because of their illness, know about their right to speak to a lawyer.

Alberta, Saskatchewan, Ontario, New Brunswick, Nova Scotia, and Newfoundland and Labrador already offer rights-advice services for people who are involuntarily admitted under mental health legislation.