Highlights from the Mental Health Review Board’s 2017–2018 annual report

The Mental Health Review Board conducts review panel hearings that decide if someone who is an involuntary patient should continue to be certified. (Our rights materials have some information about how involuntary patients can apply for a review panel hearing and what a hearing may involve.)

This past year, the Mental Health Review Board moved from the Ministry of Health to the Ministry of the Attorney General. Under the Ministry of Health, the board hadn’t been regularly reporting on its activities (See Operating in Darkness, p. 18). Now, under the Ministry of the Attorney General, the Mental Health Review Board is subject to the Administrative Tribunals Act, which requires that the board publish an annual report. In June, the Mental Health Review Board issued its 2017–2018 report, giving the public a glimpse into its operations for the first time in years.

Cover of the Mental Health Review Board Annual Report from 2017 to 2018

The report is only 19 pages long, so it’s not too onerous to read, but here are a few highlights:

Initiatives

Page 6 of the report summarizes the Mental Health Review Board’s initiatives in 2017–2018, some of which are ongoing:

  • •Restructuring the Board to ensure effective service delivery;
  • •Improving the Form 7 to simplify the application process for patients;
  • •Seeking feedback from stakeholders and government to modernize the Rules of Practice and Procedure;
  • •Implementing appropriate measures to reduce the budget deficit;
  • •Creating a new remuneration policy in accordance with the Treasury Board Directive 1/17 and the Ministry of Attorney General remuneration policy framework;
  • •Utilizing the appropriate technological solutions to improve Board operations;
  • •Proactively responding to the Community Legal Assistance Society report, entitled, “Operating in Darkness: BC’s Mental Health Act Detention System”, released to the public in November 2017;
  • •Working with the Ministry of Attorney General on the tribunal co-location project; and
  • •Creating and implementing a new Code of Conduct for Board members. (p. 6)

Many of these items are worth exploring in more detail in future blog posts, including:

  • how Form 7, the form patients (and people acting on patients’ behalf) use to apply for a review panel hearing, changed in May 2018,
  • what’s in the Rules of Practice and Procedure and how people can give their feedback,
  • what “appropriate technological solutions” might mean for patients’ access to review panel hearings, and
  • what’s in the new Code of Conduct and how it might affect patients’ rights.

Metrics

The report says:

Going forward, we will establish and monitor a set of key performance measures that objectively measure and demonstrate to the public how well we are fulfilling our mandate. Our focus will be on ensuring the procedural fairness of hearings and the highest standards of adjudicative integrity. (p. 7)

It goes on to summarize some metrics it hopes to collect and report:

To improve transparency and accountability, the Board aims to generate statistics about the following:

•Cost per hearing by geographic location

•Number of applications/hearings per capita of involuntary patient population

•Hearing cancellation rate by facility

•Patient reasons for cancellation

•Patient discharge rate by facility

•Length of time to hearing and resolution for cases that proceed

•Legal representation on outcome of cases heard

The Board does not yet have the capacity to record and report on this information. With a new case management system, the Board will endeavor to report on such data in future years. Together, these future metrics will hold us accountable to the public and assist our Board in identifying opportunities for continuing innovation and improvements. (p. 13)

I’m hopeful these statistics will shed some light on where we might want to focus efforts to raise awareness of patients’ Mental Health Act rights.

Mandatory reviews

Most review panel hearings rely on the patients or someone acting on their behalf to apply to the Mental Health Review Board. But the Mental Health Act’s section 25(1.1) is supposed to ensure that people who’ve been certified for more than a year have the chance to have their involuntary status reviewed automatically:

The Board is required by statute to review the treatment records of any patient who has been involuntarily detained for more than twelve months, and who has not requested or had a review panel hearing. The Board Chair conducts a mandatory review of the patient’s records to determine if there is a reasonable likelihood that the patient would be discharged following a review panel hearing. In such circumstances, the Board Chair must order that a hearing be held. This provides a statutory guarantee that the file of each involuntary patient will be reviewed on an annual basis.

There has been a steady increase in the number of mandatory reviews over the past three years. The Board has been improving the screening process for mandatory reviews. This includes creating safeguards to ensure that all mandatory review files are received, reviewed in a timely manner, and that adequate reasons are provided for the decision of whether to order a hearing in the circumstances. (p. 9)

I’m keen to learn more about what the screening process involves and what the safeguards might include. If I find out more, I’ll share what I’ve learned in a future post.

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I hope this annual report marks the beginning of a new era of transparency. The more we know about how the Mental Health Review Board works, the better involuntary patients can prepare themselves to exercise their right to a review panel hearing.

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