B.C. children's advocate says youth with mental illness retraumatized by involuntary hospitalizations

British Columbia's representative for children and youth says she has heard harrowing stories from those who were involuntarily hospitalized for a mental illness without access to legal advice.

Jennifer Charlesworth has released a report with input from youth who say they were restrained, medicated and secluded against their will.

Charlesworth is calling on the B.C. government to amend the Mental Health Act to allow youth to have access to a legal advocate while they're in care.

She says that while the Health Ministry believes Indigenous youth are overrepresented when it comes to being detained in hospital, it lacks data on how many youth are being affected.

Charlesworth says that's troubling because young people are being retraumatized when what they need is care that is culturally appropriate.

162% increase in number of children held under act

She says over a decade, the number of children held under the Mental Health Act has increased an alarming 162 per cent, bringing into question the voluntary system of care and treatment.

The province paused legislation last July to amend the act after Charlesworth and some First Nations groups said youth worried about being detained would fear asking for help.

B.C. Minister of Mental Health and Addictions Sheila Malcolmson said Monday the province accepts "the recommendations in principle" and committed to a new plan moving forward.

"We will be working with our partner ministries to review and develop a plan with Indigenous partners to address the recommendations and reflect them in ongoing work as we continue building a co-ordinated mental health and addictions system from the ground up," she wrote in the statement.

"Our main focus continues to be on boosting the voluntary system of care so young people can get help early on, before smaller problems become larger ones."

Safeguards need to be strengthened

B.C.'s social work association issued a statement in support of Charlesworth's recommendations on Monday, saying the province needs to "strengthen safeguards in the involuntary detention and treatment of youth within the mental health system [and] enhance opportunities for young people to have a say in their treatment."

"Some protections of individual rights exist in the mental health system however these are not always made available to young people detained for mental health treatment" wrote Michael Crawford, president of the B.C. Association of Social Workers.

"The strength of the Representative's report is in the attention paid to the experiences of youth detained for treatment as well as the careful and thorough review of data including the files of 116 youth," Crawford continued. "For too many young people, the lack of adequate and culturally appropriate community supports, means readmission to an in-patient facility.

More involuntary than voluntary services

The B.C. Civil Liberties Association also expressed its support for the report. Harsha Walia, the association's executive director, said one of the most stark findings in the report is that more children and youth were receiving involuntary services than voluntary services. 

"We know that any time someone seeks mental health support, if it is coerced, then that will have adverse effects in the long run," said Walia.

"There's ripple effects to that kind of adversarial approach to health care rather than a supportive voluntary approach to health care."

Walia says it is important to focus funding on these voluntary, evidence-based approaches in order to protect the fundamental rights to liberty and procedural fairness of children and youth.

"We really are taking a long-term approach to ensuring the health and safety of young people are protected and that has to be centred around voluntary services that are culturally relevant, that are specific for communities, and that is centred around the needs of young people to ensure their long-term wellbeing," she said.