Investigation Needed of Involuntary Commitment at Canadian Psychiatric Hospital
Citizens Commission on Human Rights (CCHR) says the practice of involuntarily detaining individuals labeled as “mentally ill,” depriving them of their rights and forcing them to undergo treatments that can harm them is a worldwide problem, including in the U.S. An estimated 907,000 individuals are involuntarily committed annually to psychiatric facilities across the U.S., Europe, Australia, New Zealand the United Kingdom–or about two people every minute.[1] Recently, Canada exemplified just how wrong involuntary hospitalizations can be. Among British Columbians ages 15 and older, forced detainment rose by 65.7% between 2008/2009 and 2017/2018. There was a 162% increase in involuntary commitments among children and youth.[2] In 2019, over 10,000 people were certified, incarcerated, and treated against their will under British Columbia’s Mental Health Act.[3]
One of the most vocal critics of one infamous psychiatric hospital in British Columbia is Dr. Anna Sylwestrowicz, a retired Clinical Assistant Professor of Anesthesiology Pharmacology and Therapeutics at the University of British Columbia. Since 2020, she has liberally exposed her concerns on Twitter and wants to see a thorough investigation of the hospital’s practices.[4]
Families have been outspoken about involuntary commitment and patient abuse at the facility. One man committed suicide less than three weeks after being released from it. His family’s concerns came as the mental health system faces continued scrutiny for alleged mistreatment of patients, according to Capital Daily. “It’s a situation that has left the hospital on the receiving end of hundreds of online horror stories and repeated calls to overhaul both the hospital’s psychiatric services and the way mental-health patients are cared for in the province,” said Capital Daily.[5]
British Columbia Ombudsperson, Jay Chalke, found regular violations of the Mental Health Act in the province’s psychiatric hospitals and health institutions. A 2019 report by the Ombudsman revealed that more than half of involuntarily admitted patients had not been informed of their rights, as required by law, in a single month. Additionally, a significant number of patient files lacked Consent for Treatment forms, and less than a third recorded any notification to patients’ relatives regarding their commitment.[6]
Georgette McBain, 75, after being held against her will for four months, won her case for discharge from involuntary commitment in 2014. She described being heavily medicated during her stay and was forcibly returned to the hospital by the police after leaving following her initial admission. The British Columbia Mental Health Review Board ruled that her involuntary commitment did not meet the requirements of the Mental Health Act, leading to her discharge.[7]
Former patients of a psychiatric emergency service (PES) shared stories of being patronized and belittled in 2016. Ella Hale, 18, voluntarily admitted herself in June 2020, staying overnight and seeing a dismissive psychiatrist the next morning. While in college, Hale connected with Emma Epp, 19, another former patient, and together, they formed a Facebook group called “PES: A Pathetic Excuse for Support” in February 2021. The group, with 513+ members and 89 posts by March 15, 2021, exposed allegations of shaming, victim-blaming, emotional abuse, and premature dismissal during medicated treatment.[8]
Dr. Sylwestrowicz criticized mental health care in British Columbia, expressing concerns about the use of pseudoscience and various medications. She also raised concerns about the use of Electroconvulsive “Therapy” on some patients, often administered over 70 times in conjunction with drugs and long-acting antipsychotics. She called for independent and random audits of those prescribing these treatments.
In 2022, the British Columbia Ombudsperson revisited the recommendations made in 2019 to protect the legal rights of people involuntarily detained, finding rights still lacking. In some cases, he said, “facilities used standard rubber stamps to purport to authorize treatment for individual patients instead of describing the actual treatment proposed for that specific patient. In other cases, physicians failed to explain why a person met the criteria for involuntary admission yet the patient was nonetheless admitted.”[9]
Jan Eastgate, president of CCHR International, based in Los Angeles, said CCHR supports the call, but says the investigation is needed in the U.S. as well.
Involuntary psychiatric hospitalizations violate the UN Convention on the Rights of Persons with Disabilities, a convention adopted by both the U.S. and Canada, and ratified as law in Canada. The UN High Commissioner for Human Rights has called for the abolition of forced psychiatric treatment, emphasizing the importance of respecting individuals’ autonomy, will, and preferences. The UN Committee on the Rights of Persons with Disabilities has also urged the elimination of forced treatment, including various forms of restraint, due to their inconsistency with the prohibition of torture.
The UN Committee has also repeatedly called for the elimination of forced seclusion and restraint methods, as these practices constitute torture and infringe on individuals’ rights to autonomy and freedom from involuntary detention and treatment.
Health Justice, a non-profit organization in British Columbia, released a report in June 2023 titled “Coercive mental health and substance use treatment is part of BC’s problem, not the solution.” The report highlighted a lack of accountability and regulation in the use of seclusion and restraints.[10]
Dr. Peter Gtzsche, a physician and respected international medical researcher says: “Forced treatment in psychiatry cannot be defended, neither on ethical, legal or scientific grounds. It has never been shown that forced treatment does more good than harm, and it is highly likely that the opposite is true.”
He continues: “The evidence we have tells us that forced treatment increases the harm done not only to patients but also to others. Violence breeds violence….”
“We need to abolish our laws about this, in accordance with the United Nations Convention on the Rights of Persons with Disabilities,” says Gtzsche.[11]
CCHR concurs and says that it should not be limited to the Royal Jubilee Hospital in Canada but to all psychiatric facilities in Canada, the U.S., and around the world.
[1] www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(19)30090-2.pdf; ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201900477
[2] journals.sagepub.com/doi/full/10.1177/07067437221128477
[3] www.focusonvictoria.ca/investigations/the-case-for-electroshocking-mia-r18/
[4] twitter.com/annasylwestrowi/status/1672266278449610753
[5] www.capitaldaily.ca/news/royal-jubilees-psychiatric-emergency-services-mental-health-act
[6] www.capitaldaily.ca/news/royal-jubilees-psychiatric-emergency-services-mental-health-act; bcombudsperson.ca/assets/media/Committed-to-Change_Report-Update_July21-2022.pdf
[7] www.timescolonist.com/local-news/woman-confined-in-psychiatric-unit-for-4-months-wins-release-4611915
[8] www.vicnews.com/news/belittled-and-dismissed-former-patients-of-victoria-psychiatric-emergency-services-call-for-change/
[9] bcombudsperson.ca/news_release/ombudsperson-finds-only-one-third-of-recommendations-are-implemented-three-years-after-report-calling-for-improved-safeguards-for-people-involuntarily-detained-in-b-c-psychiatric-facilities/
[10] www.healthjustice.ca/blog/coercive-mhsu-treatment
[11] www.madinamerica.com/2016/06/abolishing-forced-treatment-in-psychiatry-is-an-ethical-imperative/
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