B.C. hospitals fail to meet rights of mentally ill patients admitted involuntarily: report

Ombudsperson’s report says legal documents only completed in 28 per cent of cases

Hospitals are denying the legal rights of mentally ill patients involuntarily admitted to psychiatric facilities across the province, according to an investigation by the BC Ombudsperson.

The report, released Thursday by Ombudsperson Jay Chalke, looked at admission records of every involuntary admission in the province that took place in June 2017. Roughly 1,450 cases were reviewed.

Often missing from case files were legally required documents such as ones that outline why a person was involuntary detained, the description of treatment, and confirmation the patient was told their rights.

All required forms were found completed in just 28 per cent of the admission files reviewed. Vancouver Coastal Health, Northern Health and the Provincial Health Services Authority had the lowest overall compliance rates.

In some cases, facilities used “standard rubber stamps” to authorize treatment for a patient, instead of describing the specific treatment, the report said. In other cases, physicians didn’t include which criteria the person met to be involuntarily admitted in the first place. Some forms lacked the necessary signatures or dates.

Chalke said in a news release this kind of response to help mentally ill patients is a last resort for people who are at risk of harming themselves or others.

“Involuntary detention and treatment is the most intrusive form of mental health care available,” he said. “This is a failure to comply with the Mental Health Act, the law that allows people who are gravely ill – our friends, daughters, sons, parents and grandparents – to receive timely treatment while protecting their legal rights.”

The report highlights several personal cases, including one woman who was held in a seclusion room without being told she had been involuntarily admitted. She was not told why nor was she notified of her rights, the report said, and when she requested a copy of her file after she was discharged, she found no form notifying her of her legal rights.

Last month, the B.C. Supreme Court ruled the Fraser Health Authority violated a woman’s Charter rights by detaining her against her will for almost a year and denying her access to a lawyer.

The woman was placed in mechanical restraints, denied access to visitors and the use of a phone or internet, and was prohibited from leaving the facility for fresh air. Fraser Health had failed to tell her why she was being detained.

“Going through experiences like this is stressful enough,” Chalke said. “This lack of compliance with legal requirements naturally raises many questions for patients and their families.

“Without documentary evidence, reasons for detention and treatment as well as awareness of how to question decisions can be extremely unclear. Public confidence in the system at large is also put into doubt.”

Chalke’s report says the Ministry of Health and health authorities failed to adequately monitor, audit and address designated facilities’ compliance with legal forms.

He makes 24 recommendations, including increasing oversight and accountability, improving training for staff to know what forms are required, and developing an independent rights advisor to advise patients.

Mental Health Minister Judy Darcy said the report aligns with her office’s goals to improve mental health care.

She said the ministry is reviewing how cases are tracked in each region, as well as improving training among staff and physicians. A video is being developed to inform patients and their families of their legal rights during an involuntary admission. The ministry has also implemented weekly audits by the Provincial Health Services Authority’s psychiatrist-in-chief of all patients admitted involuntarily under the Mental Health Act at BC Children’s Hospital.


@ashwadhwani
ashley.wadhwani@bpdigital.ca

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