VANCOUVER – A peer-support worker who helps youth with mental health challenges says being involuntarily detained in a psychiatric facility half a dozen times has given him insight into the lack of legal protections for vulnerable patients in British Columbia.
Rory Higgs said he first sought treatment in hospital at age 18 during a difficult time in his life, but did not know he could be kept there, medicated against his will and placed in a seclusion room.
“It was a very jarring experience. I was not really told what was going on. And I was freaking out quite a lot because it was a shock to me,” he said, adding a second psychiatrist reassessed and discharged him the following day.
B.C. is the only province where the Mental Health Act allows for so-called deemed consent to treatment.
The legislation states that anyone with involuntary status under the law is presumed to have agreed to psychiatric treatment. Family members and other advocates are also barred from challenging prescribed treatments.
Higgs, now 25, is among advocates for the mentally ill who say the law must be changed for patients who need more support in the community.
After his first detention, Higgs was held at a psychiatric facility about five more times over the next three years with a diagnoses of psychosis.
Higgs said he was never formally advised that he could apply for a review of his detention and only learned more about his right to a hearing toward the end of his hospitalizations. He felt powerless to argue against involuntary detention, even with the help of an advocate through a legal aid program for patients, he added.
A major challenge of the system is that reviews are not mandatory, Higgs said.
Unlike in Ontario, B.C. has no independent advisory agency that informs patients of their right to a lawyer.
Patients at B.C. facilities are entitled to a hearing within 14 days of their request.
But the Mental Health Review Board, which conducts the hearings, said in a recent report that it is “concerned” about the number of applications that do not proceed to a hearing.
The report found that only 37 per cent of patients who applied for a hearing had one. It said 54 per cent of scheduled proceedings did not go ahead because the patient withdrew their application, sometimes when they were discharged from hospital and placed on so-called extended leave in the community where they are connected to a mental health team.
“The number of withdrawals may or may not raise an access to justice issue,” the report said.
About a third of hearings did not proceed because patients were decertified after they requested a hearing.
“A decertification may show that treating physicians are being responsive to the needs of their patients,” the report reads. “A decertification may also indicate an abuse of process. The board would like to measure whether a patient is decertified and recertified in order to avoid a review panel hearing.”
Lisa Wong, a lawyer who sits on review board panels, said a lack of funding for legal representation through the provincially funded Mental Health Law Program is a big issue for patients who sometimes show up at hearings without an attorney.
Patients who are on extended leave in the community can also apply for a hearing, but lawyers may not be able to reach those who are living in a single-room occupancy hotel, for example, where phone messages are not always be relayed or received, she said.
Wong said applications are withdrawn in nearly half the cases when lawyers said they did not get instructions from patients, which could also mean there was no contact with the applicant. She noted no reasons have to be provided due to lawyer-client privilege.
Mental health laws across Canada allow people to be detained if they are a danger to themselves or others.
Marina Morrow, a professor at the school of health policy and management at York University in Toronto, said B.C.’s laws are “uniquely problematic” because psychiatric treatment becomes compulsory but there is no oversight of the law, which is considered discriminatory against those with a disability and no mechanism for automatic review.
However, mental health systems across the country are “crisis driven” because psychiatry and acute care are funded while many other mental health supports are not, so ending up in the emergency department before being detained becomes a route to accessing care in the community for many patients, Morrow said.
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“It makes sense to me that a psychiatrist will say ‘Go to emergency and maybe you’ll get some help that way.’ ” she said, adding patients in B.C. could be forcibly administered medications and electroconvulsive therapy.
“There’s been frustration in B.C. for many, many years, with people raising concerns about the act and really little governmental response.”
Jay Chalke, the ombudsperson in British Columbia, said in March 2019 that a month-long audit of all provincial psychiatric facilities revealed a rights-advice form that patients should have signed was not found in 51 per cent of files.
Chalke’s recommendations were accepted by the ministries of Health, Mental Health and Addictions as well as the Attorney General though Chalke, who is expected to issue a followup report in the spring, said some promised timelines for action had passed.
The ministries of Health and Mental Health and Addictions did not respond to requests for comment on whether they would consider dropping the deemed-consent aspect of the Mental Health Act.
The Health Ministry issued a statement saying it established standards last month to support compliance involving the completion of forms as well as auditing requirements to be reported on a quarterly basis.
The Attorney General’s Ministry, which committed in January 2019 to providing a mandate for an independent rights body by November of that year, said such an agency requires “research and consultation with many groups who may be impacted by the delivery of the service.”
The ministry says it has begun consultations including with experts and other provinces.
In 2016, the Council of Canadians with Disabilities and two patients who had involuntary treatment challenged the deemed-consent aspect of the Mental Health Act in B.C. Supreme Court, arguing their constitutional rights were violated under the Charter of Rights and Freedoms.
The B.C. government stopped the case from going to trial, saying the council did not have public standing as a non-profit society. The province is now asking the Supreme Court of Canada to hear the case after the B.C. Court of Appeal issued a decision on standing.
Laura Johnston, legal director of Health Justice, said the underlying issue is that the law does not promote the dignity of patients, who are often injected with medication and placed in restraints as well as solitary confinement.
“People with mental disabilities, including mental illnesses, end up having negative experiences when they interact with our health-care system, sometimes even traumatic experiences,” she said.
She said that prevents them from accessing care or social services in the future.
This report by The Canadian Press was first published Feb. 7, 2021.
OTTAWA – Prime Minister Justin Trudeau says the NDP is caving to political pressure from Conservative Leader Pierre Poilievre when it comes to their stance on the consumer carbon price.
Trudeau says he believes Jagmeet Singh and the NDP care about the environment, but it’s “increasingly obvious” that they have “no idea” what to do about climate change.
On Thursday, Singh said the NDP is working on a plan that wouldn’t put the burden of fighting climate change on the backs of workers, but wouldn’t say if that plan would include a consumer carbon price.
Singh’s noncommittal position comes as the NDP tries to frame itself as a credible alternative to the Conservatives in the next federal election.
Poilievre responded to that by releasing a video, pointing out that the NDP has voted time and again in favour of the Liberals’ carbon price.
British Columbia Premier David Eby also changed his tune on Thursday, promising that a re-elected NDP government would scrap the long-standing carbon tax and shift the burden to “big polluters,” if the federal government dropped its requirements.
This report by The Canadian Press was first published Sept. 13, 2024.
Simon Jolin-Barrette, minister responsible for consumer protection, has tabled a bill to force merchants to calculate tips based on the price before tax.
That means on a restaurant bill of $100, suggested tips would be calculated based on $100, not on $114.98 after provincial and federal sales taxes are added.
The bill would also increase the rebate offered to consumers when the price of an item at the cash register is higher than the shelf price, to $15 from $10.
And it would force grocery stores offering a discounted price for several items to clearly list the unit price as well.
Businesses would also have to indicate whether taxes will be added to the price of food products.
This report by The Canadian Press was first published Sept. 12, 2024.
Quebec legislature member Youri Chassin has announced he’s leaving the Coalition Avenir Québec government to sit as an Independent.
He announced the decision shortly after writing an open letter criticizing Premier François Legault’s government for abandoning its principles of smaller government.
In the letter published in Le Journal de Montréal and Le Journal de Québec, Chassin accused the party of falling back on what he called the old formula of throwing money at problems instead of looking to do things differently.
Chassin says public services are more fragile than ever, despite rising spending that pushed the province to a record $11-billion deficit projected in the last budget.
He is the second CAQ member to leave the party in a little more than one week, after economy and energy minister Pierre Fitzgibbon announced Sept. 4 he would leave because he lost motivation to do his job.
Chassin says he has no intention of joining another party and will instead sit as an Independent until the end of his term.
He has represented the Saint-Jérôme riding since the CAQ rose to power in 2018, but has not served in cabinet.
This report by The Canadian Press was first published Sept. 12, 2024.
