In neighboring British Columbia, the provincial government is increasing the incentives to deliver this involuntary care. This initiative aims to help those people who are struggling with mental health concerns and addiction. Premier David Eby has announced plans to increase capacity for involuntary care. There’s strong interest across B.C. cities to back this kind of change. Many advocates contend that these initiatives will ultimately fall short of meeting the deeper needs of the growing challenges faced by this vulnerable population.
Involuntary care is a legal process that allows for treatment even when someone isn’t willing or able to give consent. Officials in B.C. are now trumpeting it as a way to better support those battling addiction and mental illness. In March, the province appointed a new chief scientific adviser in psychiatry. This authoritative expert provided critical direction to clinicians about how to approach decisions around involuntary treatment for adults with substance-use disorder. This framework would help to bring consistency to how these violations are treated and increase accountability by making sure decisions are made fairly and uniformly.
During the provincial election campaign, Premier Eby often talked about his commitment to involuntary care. To this end, he made building new facilities his top priority. In early June, the province released new plans. They will bring online an additional 18 long-term involuntary care beds at a new mental health facility in Maple Ridge. Eby made the equally exciting announcement of new, permanent care sites in Surrey and Prince George. Together, these sites will create an additional 100 beds to our overburdened healthcare system.
People in involuntary care need to remain a minimum of 30 days. Their medical professionals can then evaluate their condition and decide if further extensions are needed. Health Minister Josie Osborne made it clear that these people need to be willing to engage with treatment. This short statement opens up essential ethical discussions around patient autonomy, consent, and data use.
In her 2019 report, B.C. Ombudsperson Jay Chalke found a lack of consistency in the documentation of treatment across various facilities. The report’s findings were alarming and inconsistent when it came to answering if an individual would meet the definition of certified for involuntary care. This intense scrutiny has resulted in increased calls for protocol standardization and transparency in the treatment process.
The multidisciplinary team involved in caring for patients under involuntary care includes nurses, nurse practitioners, physicians, mental health workers, therapists, facility administrators, as well as Indigenous and vocational support workers. This motley crew of educators, artists, coders, and hip-hop dancers is looking to offer more holistic support that meets each person where they are.
Even after the provincial government has responded to advocacy by expanding involuntary care, advocates are still unconvinced that expanding involuntary care would be effective. Many argue that simply increasing bed availability does not address the systemic issues that contribute to mental health crises and addiction. Critics contend that people with mental illness only make repeated trips to high-security hospital units because they do not have enough community supportive services and rehabilitative facilities. Without viable alternatives, these folks have nowhere to go.
At the recent Union of B.C. Municipalities conference, Premier Eby put his foot down unequivocally. He pledged to create more involuntary care beds, expanding treatment for mental health and addictions. This announcement is an encouraging step that matches the province’s recent willingness to treat these challenges as public health issues.
The province recently opened new treatment centres in Surrey and Prince George. We are hopeful that this initiative will lead to wiser practices in pursuing quicker, more successful treatment pathways for people battling mental health challenges. The aim is to reduce instances where patients find themselves “stuck in high-security hospital units indeterminately” due to insufficient options.
