BC provides clarity on when substance users can be put into involuntary care

One of Premier David Eby’s campaign promises was to enable involuntary care as an option for those with substance-use and mental health issues. 

This week, he and Josie Osborne, Minister of Health announced how that would come about and when involuntary care can be forced upon someone. 

According to Osborne, the Mental Health Act is designed to help those in need of care, but the needs of the “voluntary population” have become increasingly complex, which is why involuntary care facilities are being utilized. 

To navigate the Mental Health Act’s new allowances for involuntary care, how it is used by clinicians and when it is called for, BC’s chief scientific officer for psychiatry, toxic drugs and concurrent disorders, Dr. Daniel Vigo has issued a guidance document. 

Dr. Vigo was appointed to his position in June 2024, and since that time, the Province says he has been working to analyze existing mental health and addictions treatment services in BC, review data and best practices and look to other jurisdictions for proven solutions that can be implemented in BC.

“Involuntary treatment can be a tool to preserve life and treat the source of impairment in people with combinations of mental disorders, substance use and acquired brain injuries from toxic-drug poisonings,” Vigo said. 

“Dispelling misconceptions about the use of the act is a first step to support this population, in addition to creating new services, including mental-health units in corrections, approved homes, in-patient beds and community teams supporting the most complex patients and under-served areas.”

Dr. Vigo’s document provides information for clinicians to determine when involuntary admission and treatment may be appropriate for people with concurrent mental-health and substance-use issues. 

The new guidelines in the Mental Health Act on involuntary care require two physicians or nurse practitioners to examine a patient in order to determine they have a mental health condition. 

Once examined, if they do have a mental health condition and are believed to use illicit drugs, an individual can be detained in involuntary care for anywhere between one month and six months, at the physicians’ discretion. 

According to the Mental Health Act, a patient can only be involuntarily admitted if specific criteria is met. 

The person must suffer from a mental disorder that seriously impairs them, require psychiatric treatment, need supervision and control for their own protection or the protection of others and they must not be willing to voluntarily admit themselves. 

Mental Health Act admissions occur at 75 designated facilities, including 37 hospitals, 13 hospitals as observation units and 25 provincial mental-health facilities.

The total number of beds for voluntary or involuntary admissions, within these facilities is around 2,000, according to the Province. 

Additionally, new involuntary care beds at the Alouette Homes in Maple Ridge and the Surrey Pretrial Services Centre will open in spring 2025.

The BC government says there are plans to open more beds for involuntary care in the coming months.