Involuntary care is a legal procedure that has been in existence for a considerable period but has recently gained prominence in British Columbia due to efforts to expand treatment options for individuals grappling with mental health issues and addiction.
Last fall, involuntary care garnered attention during the provincial election campaign when Premier David Eby unveiled intentions to broaden such care for individuals with addiction concerns. Additionally, the B.C. Conservative Party included legislation on involuntary care in its platform.
In March, the newly appointed chief scientific adviser for psychiatry in the province issued guidance to clinicians regarding involuntary care for adults with substance-use disorder in British Columbia.
In a recent development, the province announced the establishment of 18 new long-term involuntary care beds at a mental health facility in Maple Ridge, offering a novel solution to the current scenario where patients often remain indefinitely confined in high-security hospital units due to limited alternatives.
Furthermore, new involuntary care facilities were disclosed for Surrey and Prince George, introducing an additional 100 beds to improve public safety measures.
Involuntary care caters to individuals experiencing severe mental illness that endangers their safety or that of others, and who are unable or unwilling to seek voluntary treatment.
To qualify for involuntary care, individuals must meet specific criteria outlined by the province, including the necessity for treatment due to a mental disorder, impairment in functioning within their environment, the need for care to prevent deterioration, and the inability to seek voluntary admission.
Patients can be admitted into involuntary care by authorities, often involving police intervention if there are concerns about self-harm or harm to others. The Mental Health Act allows for a 48-hour detention period for assessment and treatment based on medical certification.
Individuals under involuntary care can be detained for up to a month or longer if deemed essential by their healthcare provider. Appeals against certification under the Mental Health Act can be made to the Mental Health Review Board.
Involuntary care encompasses personalized treatments, including medication, counseling, sleep management, nutrition, and physical exercise. Treatment decisions are typically made by a team of experts rather than by the patients themselves.
Patients admitted to involuntary care are not permitted to leave the facility until they are discharged based on the criteria outlined in the Mental Health Act.
A variety of healthcare professionals, including nurses, physicians, mental health workers, therapists, and support staff, are responsible for caring for individuals under involuntary treatment.
Health authorities oversee facilities providing involuntary care, while facility directors manage the day-to-day operations and treatment.
Upon meeting discharge criteria, individuals are released from involuntary care, and ongoing care is detailed in a discharge plan, often involving family and healthcare providers.
Concerns regarding involuntary care include its effectiveness and ethical considerations, with advocates emphasizing the need for improved voluntary services to address the rising demand for mental health support.
Involuntary care is intended to safeguard individuals from harm, as highlighted by the B.C. Ombudsperson in 2019, who described it as a “life-saving power” when appropriately applied.
