Welcome to the BC Mental Health Rights blog!

This blog is an informal place to talk about patients’ Mental Health Act rights. Posts take a closer look at an issue related mental health rights, especially in BC, and are written by patients and people with lived experience, care partners, clinicians, legal experts, and researchers.

This content has not been reviewed for legal accuracy and should not be considered legal advice.

Highlights from the Mental Health Review Board’s 2018–2019 annual report

The Mental Health Review Board schedules and conducts review panel hearings for involuntary patients who want to challenge their certification. (If you want to learn more about what review panels do and how to apply for one, our rights materials may help.) Last year was the first time the board published an annual report, which I summarized in a blog post.

The board has seen tremendous shifts over the past couple of years, with a new chair implementing a restructuring plan, a move from the Ministry of Health to the Ministry of the Attorney General, and a corresponding physical move to a new office.

This year’s annual report offers a glimpse of the progress and effects of this restructuring. Here are a few highlights, along with some of my reactions.

Cover of the Mental Health Review Board's 2018–2019 annual report Continue reading “Highlights from the Mental Health Review Board’s 2018–2019 annual report”

Mental Health Act news roundup

The cover of the Government of BC's plan, A Pathway to Hope

BC’s Mental Health Act has been in the news a few times over the past several weeks. Here are some rights-related highlights:

Should the Mental Health Act be used to detain youth with substance use disorder?

At a BC coroner’s inquest into the overdose death of 16-year-old Elliot Eurchuk, pediatrician Dr. Tom Warshawski testified that he supports using the Mental Health Act to treat young people for substance use disorder against their will. Dr. Perry Kendall, B.C.’s former provincial health officer, told the inquest that there’s not enough evidence that involuntary treatment would prevent deaths and improve health outcomes. Continue readingMental Health Act news roundup”

New Mental Health Act video for youth in BC

Promotional poster for the youth video. The video's main character is shown, along with questions "Why do you need to be here?" "Do you have a say?" "What do you tell your friends?" The poster says that the video is available at bcyouthmentalhealthact.ca.

BC Children’s Hospital has launched an interactive video to help youth and their families better understand what it means to be certified under the Mental Health Act. The video explains:

  • what the Mental Health Act is,
  • what the criteria are for involuntary hospitalization,
  • what rights a young involuntary patient has under the Mental Health Act,
  • how long a young patient might stay in hospital,
  • what happens after decertification,
  • what roles various healthcare providers play in the young patient’s care and treatment, and
  • how a young patient can participate in their own recovery by expressing their opinions and asking their treatment team questions.

Continue reading “New Mental Health Act video for youth in BC”

Will forcing health authorities to complete all Mental Health Act forms help patients better understand their rights?

Poor form completion rates

In the recently released report, Committed to Change, the BC Office of the Ombudsperson detailed disturbing findings that involuntary patients aren’t consistently told about their rights under the Mental Health Act. Further, family care partners aren’t always told that their loved ones have been detained. These stories are appalling, but will enforcing better record keeping prevent these scenarios from happening?

According to the Mental Health Act, when a person is admitted as an involuntary patient under a medical certificate (Form 4):

  • They’re supposed to learn their rights by being read and given Form 13.
  • They’re supposed to nominate a near relative to notify about their hospitalization, using Form 15.
  • Their care team is supposed to send Form 16 to that near relative. Form 16 tells the near relative that the person (a) has been detained and (b) has rights under the Mental Health Act. This form is supposed to be sent or given to the near relative immediately after the person has been admitted.

The BC Office of the Ombudsperson found:

  • Form 13 in only 49% of patient files,
  • Form 15 in only 43% of patient files, and
  • Form 16 in only 32% of patient files.

In response to these poor compliance rates, the Office of the Ombudsperson issued this recommendation:

Recommendation 9: By June 30, 2019, the Ministry of Health and the Ministry of Mental Health and Addictions work together with the health authorities to establish clear and consistent provincial standards aimed at achieving 100 percent compliance with the involuntary admissions procedures under the Mental Health Act through the timely and appropriate completion of all required forms.

In other words, these three forms should appear in 100% of patient files. But will mandating 100% compliance solve the problem of patients and family care partners not knowing patients’ rights?

I don’t believe they will. Continue reading “Will forcing health authorities to complete all Mental Health Act forms help patients better understand their rights?”

Mental Health Act rights materials now available in eight languages other than English

The unmet need

In a series of focus groups, members of our research team asked clinicians about the barriers they face when giving involuntary patients rights information. One barrier participants mentioned over and over was that many of their patients didn’t understand English.

Form 13, the document clinicians use to to tell patients about their rights, seems to be available only in English.

Translated rights materials

To help fill the gap in availability of Mental Health Act rights information in other languages, we’ve translated:

into eight of BC’s most commonly spoken languages other than English:

  • Arabic
  • Chinese (Traditional and Simplified)
  • Farsi
  • French
  • Korean
  • Punjabi
  • Spanish
  • Vietnamese

Continue readingMental Health Act rights materials now available in eight languages other than English”

A chance to make a better Guide to the Mental Health Act

Cover of the 2005 edition of the Guide to the Mental Health Act

In Committed to Change, a report detailing the failure of the mental health system to uphold the rights of involuntary patients hospitalized under the Mental Health Act, the BC Ombudsperson issued 24 recommendations “to ensure the rights of people with serious mental illness are respected and public confidence in our mental health system is enhanced.” (BC Ombudsperson 2019, p. 3)

One of the recommendations is that, “By March 31, 2020, the Ministry of Health update and reissue the Guide to the Mental Health Act to incorporate the changes made arising from this report and other changes.” (BC Ombudsperson 2019, p. 98)

Continue reading “A chance to make a better Guide to the Mental Health Act

Committed to Change—the Ombudsperson’s critical new report about involuntary patients’ rights

Over 2017 and 2018, the BC Ombudsperson’s Office investigated whether hospitals in the province were meeting their Mental Health Act obligations to safeguard involuntary patients’ rights by filling out the required forms at admission. On March 7, 2019, the report of this investigation, Committed to Change, was made public.

Cover of the Ombudsperson's report "Committed to Change: Protecting the Rights of Involuntary Patients under the Mental Health Act" showing the title superimposed on a photo of a long hospital corridor.

Continue readingCommitted to Change—the Ombudsperson’s critical new report about involuntary patients’ rights”

The Mental Health Review Board’s website

Screen shot from the BC Mental Health Review Board website, taken January 9, 2019.

When I interviewed people who experienced involuntary hospitalization (certification) about their information needs, some of them told me that, when they choose to exercise their rights, they’d like more information about what comes next.

What happens after you hand in Form 7 to ask for a review panel hearing? Or what happens after you hand in Form 11 to ask for a second medical opinion?

Continue reading “The Mental Health Review Board’s website”

Second medical opinions under BC’s Mental Health Act

Involuntary patients over the age of 16 have the right to ask for a second medical opinion from a doctor who’s not on their treatment team. My interviews with former involuntary patients and with clinicians seem to show that both groups are confused about how this right works, so this post aims to answer some of the most common questions about it.

A cartoon showing a doctor examining a patient on a bed.
Continue reading “Second medical opinions under BC’s Mental Health Act

Clinicians: What questions do you have about Mental Health Act rights?

Cartoon of clinicians sitting around a table. One of them is talking. A researcher listens.

In response to clinician demand arising from our rights information sessions, some members of our team are working with clinical staff to develop a LearningHub module about Mental Health Act rights so that healthcare providers across BC will have access to our content.

To make sure we address clinicians’ most pressing questions about Mental Health Act rights, we’re reaching out!

Questions can be about:

  • the Mental Health Act rights themselves
  • your obligations under the Mental Health Act to give rights information
  • the rights-notification process
  • Forms 13 & 14 and other rights information tools

…or any other concerns related to Mental Health Act rights.

If you’re a nurse, social worker, physician, or other healthcare provider who works with the Mental Health Act and are wondering about any rights-related issues, please contact us with your questions by December 20, 2018.