Premier David Eby says the province will provide involuntary care for people dealing with both mental illness and drug addiction, as well as severe brain injury caused by repeated drug overdoses.
“For people with these three overlapping conditions, we know that the current response that we offer is not adequate,” Eby said at a news conference in Vancouver on Sunday. “They are not safe and, increasingly, I’m concerned that the way that they are interacting in our communities is making everybody less safe.”
The involuntary care, being called secure care, will be made available in provincial corrections facilities starting in Surrey, highly secure housing starting in Maple Ridge, and in more hospitals starting in Northern Health.
“We’re going to respond to this situation as a family member would — with compassion and concern to ensure that the safety of these folks is protected and looked after, and by doing so, we’ll ensure our broader community is safe as well,” Eby said.
The premier’s promise comes as the provincial election campaign is set to launch this weekend, amid concerns about the toxic drug crisis, related street crime and stranger attacks.
Eby said the first secure housing and care facility for the most behaviourally challenged people will be “in the coming months” on the grounds of Alouette Correctional Centre (Monarch Homes), in Maple Ridge, and there are plans to expand throughout the province.
“Our goal is we will open facilities like this across British Columbia on a regional basis to ensure that people are able to stay in the communities where their family and friends are, while getting the support that they need in a highly secure environment,” said Eby.
The first secure psychiatric and addiction treatment inside correctional facilities under provincial jurisdiction will be 10 beds at the Surrey Pretrial Services Centre, “so we don’t have the situation of people being released back into the community in worse condition than they entered,” said Eby.
About 400 new mental-health beds at new and expanded hospitals are coming on line throughout the province. All will provide both voluntary and involuntary care under the Mental Health Act.
Nanaimo Mayor Leonard Krog said he’s pleased the premier has “finally listened” to him and others across the province “who have called for exactly this.”
Krog said there’s such a significant population now with brain injuries after overdosing on toxic drugs that, while 400 beds is a good start, much more is needed.
Julian Daly, executive director of Our Place Society, which provides food, shelter, support and advocacy for members of the street community, who are often struggling with mental-health challenges and addiction, said he has long advocated for more involuntary-care beds in the south Island.
Daly said his 25-year-old self might have rejected the idea of additional involuntary care for concurrent mental illness, brain injury and drug addiction, but after 17 years in Edmonton and Victoria working with the street population, he believes the need is critical.
Daly said over the years — particularly with the arrival of the drug fentanyl — he’s seen a small group of people with inextricably linked mental-health and addictions challenges who are regularly in crisis on the street and not getting the help they need.
“They are extremely vulnerable to exploitation, particularly women, and are utterly unable to make a rational, informed decision that’s in their own best interests and give informed consent at that moment,” he said.
“For their safety and for their well being — even in some circumstances to save their lives — I would suggest that in extreme circumstances and with all appropriate checks and balances, involuntary care is what is needed for them.”
Once stabilized, they can begin to make informed decisions about their care, he said.
Daly cautions, however, that he would only support involuntary care that is compassionate, informed and appropriate, and leads to recovery, adding it should never “become a licence or permission to clean our streets of people who are faced with addictions and mental-health challenges and carve them sort of wholesale into institutions.”
Victoria Police Chief Del Manak said he applauds the province for “stepping up” to provide more beds for involuntary care, calling it another tool to help keep the community safe.
“It can’t come soon enough,” Manak said in a phone interview. “I have long advocated for secure care or involuntary care for those that need it most, those that require intensive supervision and support.”
Manak said many of those who are mentally ill, addicted and brain-injured are in desperate need of care but are caught in a revolving door of crime and street entrenchment.
“Some of these individuals have a high propensity to violence, and we’re seeing some of these incidents play out across British Columbia,” said Manak.
The police chief said police only become involved in apprehending someone under the Mental Health Act if they are involved in violence, threats of violence to themselves or others, or if weapons or crime are involved.
Pender Island resident Leslie McBain of Moms Stop the Harm, who lost her son to a toxic drug poisoning, said while research has shown involuntary care not to be very successful “there are people who are in severe mental-health crisis who are a harm to themselves and others.”
Noting that involuntary care is already provided for under the Mental Health Act, McBain questioned who will decide who is admitted if more beds are made available.
“Are they actually skilled and trained enough to make this life-changing decision?” she asked. “We don’t know how much police will be involved. We don’t know what the treatment might look like. We don’t have enough beds for voluntary care, much less involuntary care. We need a lot more information and a lot more assurances.”
Eby said the decision is made by two physicians or a physician and a nurse practitioner.
McBain maintains the move by the NDP government is “political” in the face of the BC Conservatives surging in the polls.
BC Conservative leader John Rustad has promised involuntary care, saying he would use the notwithstanding clause to push past any legal challenges.
In a statement Sunday, Rustad said Eby was being inconsistent and “flip-flopping” after years of not acting on the issue.
B.C. Greens Leader Sonia Furstenau accused Eby in a separate statement of following “John Rustad off every reactionary cliff” and said she was concerned about an over-reliance on involuntary care.
Furstenau said the province already has thousands of people receiving some form of involuntary treatment annually.
After negative feedback from the province’s representative for children, the chief coroner, and Indigneous leaders, the NDP under former premier John Horgan in 2022 dropped an attempt to keep youth in hospital after overdoses until they could stabilize and until family or guardians could be contacted. After winning the leadership, Eby also backed off involuntary care the same year.
Eby said Sunday he understands the concern that youth might be less likely to ask for help if they fear being taken to treatment against their will.
“So these are the things we’re trying to balance as a society. It’s incredibly challenging, and our goal is to work with … the experts in this area, because I think that we need to keep revisiting these decisions and make sure that they’re taking us in the right direction.”
Jennifer Charlesworth, representative for children and youth in B.C., said her office has always thought that involuntary care may be a necessary part of the continuum of care.
“But our critique in the past has been that there weren’t sufficient safeguards,” Charlesworth said, adding “if we put in secure care or involuntary care, we have to make sure that we’ve got a strong voluntary system.”
She said more information about the involuntary care plan is needed.
“We still need to make sure that we don’t wait until a young person has a profound substance use disorder and a brain injury and multiple overdose events before we start to support and treat.”
— With files from The Canadian Press
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