Involuntary care, a legal procedure with a long history, is gaining prominence in British Columbia due to the province’s efforts to enhance treatment for individuals grappling with mental health issues and addiction.
Last fall, involuntary care was thrust into the limelight during the provincial election campaign, with Premier David Eby unveiling plans to expand this form of care for those facing addiction challenges. The B.C. Conservative Party also integrated involuntary care legislation into its agenda.
In March, the province’s newly appointed chief scientific advisor for psychiatry offered guidance to clinicians on making decisions about involuntary care for adults in B.C. with substance use disorder.
In early June, British Columbia announced the establishment of 18 new long-term involuntary care beds at a mental health facility in Maple Ridge, B.C. These beds are touted as a groundbreaking alternative to the existing scenario where patients are indefinitely confined in high-security hospital units due to limited options.
Recently, Eby disclosed plans for new involuntary care facilities in Surrey and Prince George, introducing an additional 100 beds to bolster public safety measures.
In essence, involuntary care entails care and treatment for individuals facing severe mental health conditions that jeopardize their safety or that of others, and who are unable or unwilling to seek treatment voluntarily.
To qualify for involuntary care, individuals must meet specific criteria laid out by the province, including having a mental disorder requiring treatment, impairment in functioning, and the need for care to prevent deterioration or ensure protection.
Admittance into involuntary care can occur through police intervention if the individual poses a risk of harm, as stipulated in the Mental Health Act. Patients may be detained for up to 48 hours for assessment and treatment following certification by a medical professional.
Patients in involuntary care can be retained for a month or longer if deemed necessary by their healthcare provider. Challenges to certification under the Mental Health Act can be addressed through the Mental Health Review Board.
Treatment in involuntary care is individualized and may encompass medication, counseling, and holistic care practices to promote well-being.
Patients in involuntary care do not have a say in their treatment choices, as decisions are made by a team of experts overseeing their care.
Once admitted into involuntary care, patients cannot leave until discharged based on the criteria outlined in the Mental Health Act.
A multidisciplinary team, including nurses, physicians, mental health workers, and therapists, is responsible for caring for individuals in involuntary care.
Health authorities supervise facilities providing involuntary treatment, while facility directors oversee the day-to-day operations.
Discharge from involuntary care occurs when patients no longer meet the criteria for continued treatment, with ongoing care detailed in a discharge plan involving family and healthcare providers.
Advocates have expressed concerns about the effectiveness and ethical implications of involuntary care, highlighting issues with evidence on its efficacy and documentation inconsistencies in some facilities.
Involuntary care is aimed at safeguarding individuals from harm, serving as a potentially life-saving intervention when appropriately administered.