“Unlike most of country, B.C.’s legislation does not provide a lawyer for people with mental illness facing involuntary detention,” says Jay Chalke, B.C.’s ombudsperson (Globe and Mail, September 2, 2020)
Unlike other Canadian jurisdictions, mentally ill people can be held indefinitely -B.C. does not have an automatic review of ongoing detention.
That means that people, who may or may not be mentally ill, can be held endlessly.
Detention of people under the guise of mental illness can have political overtones. The Soviet Union misused psychiatry to get rid of political opponents. The term “philosophical intoxication,” a pseudo-scientific term for mental disorders, was applied to people who disagreed with the country’s Communist leaders.
I don’t mean to suggest that the government of B.C. is detaining political opponents under the Mental Health Act. But systemic paternalism and racism can play a role.
And I don’t deny that mentally ill people who are violent need be detained for their own safety and the safety of others. The forced detention of unstable persons under the Mental Health Act is not the issue.
Given the treatment of Indigenous people as wards of the state, the detention of First Nations persons presents a complicating layer.
Take the case of “A.H.,” a First Nations 39-year-old woman who was wrongfully detained for almost a year.
In a court case between A.H. and the Fraser Health Authority, the Supreme Court of B.C. learned that A.H. had been held against her will and that she was not even found to be mentally ill.
It wasn’t a simple case -A.H. suffers from cognitive impairments and mental health issues. She has a history of substance abuse, family violence and sexual abuse. She was also diagnosed with Fetal Alcohol Spectrum Disorder (FASD).
A.H.’s mother sexually exploited her by pressuring her to drink alcohol and take drugs to make her compliant to sexual abuse. She did not have clean clothes or sufficient food.
After she was detained, authorization to hold her longer than 48 hours under the Mental Health Act expired. Despite that, she remained captive. She asked staff to provide a lawyer but staff said they couldn’t help. She was not told why she was being detained and tried to escape. On at least one occasion, A.H. was physically restrained with mechanical restraints that tied her to the bed. She was forced to take medications, including sedatives.
In her ruling of the case in 2019, Honourable Madam Justice Warren said:
“However, the procedures for Mental Health Act certification were not followed and there is no evidence that A.H. was certifiable under that legislation.
“The detention decision deprived A.H. of her liberty, the most fundamental of her rights. The consequences could scarcely have been more serious. It is apparent that A.H. did not understand the basis for her detention or the reasons for it. She expressed, multiple times during the course of the detention, confusion about her ongoing detention, repeatedly asking why she could not go home.”
The detention of unstable mentally ill people under B.C.’ Mental Health Act is necessary for the protection of themselves and others. But the unjustified detention of people under the pretext of doing it for their own good smacks of paternalism, and in the case of First Nations people, colonialism.