Involuntary mental health treatment for B.C. youth up 162% over 10 years: report

A new report from B.C.’s children’s rights watchdog has found the number of children and youth who are receiving involuntary mental health services has increased “alarmingly” over the past decade.

According to the report released by the Representative for Children and Youth on Tuesday, the number of young people admitted for involuntary mental health support rose from 973 to 2,545 – or 162 per cent – in the 10 years between 2008/09 and 2017/18.

“This raises troubling questions about the adequacy of the voluntary, community based system of care and treatment and its ability to avoid unnecessary involuntary detention,” the report, written by representative Jennifer Charlesworth, said.

“Clearly, the time has come for government to devote special attention to how the Mental Health Act can be improved in its operation and administration to better protect and respect the voice and the interests of children and youth it affects in such profound ways.”

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The report, titled Detained: Rights of children and youth under the Mental Health Act, looked at how the province is using its power under the Mental Health Act to admit young people into mental health treatment on the grounds that involuntary care is necessary in some cases to keep a person or others safe.

But the report also called mental health detentions among the most intrusive measures that a state can impose on people and that they result in the deprivation of liberty.

The report laid out 14 recommendations to improve the system.

Charlesworth found a lack of data on vulnerable young people leaves a gap in understanding the full effect of the Mental Health Act, and that the oversight of restraint and confinement measures is inadequate.

“Use of these practices demands rigorous oversight and accountability. It is concerning that legislation and regulation to guide the use of these measures does not exist – although there is legislation and regulation to govern the use of restraints in residential care facilities licensed under the Community Care and Assisted Living Act and the use of restraints and confinement in youth custody centres,” the report said.

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The recommendations also included identifying why involuntary mental health detention for children and youth is increasing and opportunities to reduce these admissions.

The findings rely heavily on the experience of young people who have been forced into mental health treatments, and said that First Nations, Métis, Inuit and urban Indigenous children are disproportionately impacted.

“It can be seen and experienced as another link in a long chain of oppression imposed by the state on Indigenous peoples,” the report said.

Additional recommendations:

• Standardize the collection and reporting of key data pertaining to children and youth admitted under the Mental Health Act
• Review and reconcile the section of the Mental Health Act that allows a child under 16 to be admitted on a voluntary basis at the request of their parent or guardian
• Develop a process to enable a First Nations, Métis or Inuit child or youth to notify their community or Nation of their involuntary admission
• Notify an independent body every time a child or youth is detained under the Mental Health Act and mandate this body to provide rights advice and advocacy
• Develop new informational materials provided to children and youth detained under the Mental Health Act that explain what is happening, their rights and options
• Ensure First Nations, Métis or Inuit children and youth who are detained under the Mental Health Act are offered services by staff who assist Indigenous patients
• Amend the Mental Health Act to ensure isolation and restraint are only used as a last resort and only in accordance with legislative or regulatory criteria
• Create mandatory periodic Mental Health Review Board reviews for involuntarily detained children and youth and children under 16 who are admitted at the request of their parents

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