First Session, 43rd Parliament

Official Report

of Debates

( Hansard )

Tuesday, November 25, 2025

Afternoon Sitting

Issue No. 106

The Honourable Raj Chouhan , Speaker

ISSN 1499-2175

The HTML transcript is provided for informational purposes only.

The PDF transcript remains the official digital version.

Contents

Orders of the Day

Second Reading of Bills

Bill 32 — Mental Health Amendment Act (N o . 2), 2025 (continued)

Claire Rattée

Jeremy Valeriote

Elenore Sturko

Hon. Sheila Malcolmson

Anna Kindy

Jordan Kealy

Peter Milobar

Reann Gasper

Macklin McCall

Hon. Josie Osborne

Committee of the Whole

Bill 29 — Child, Family and Community Service Amendment Act, 2025

Hon. Jodie Wickens

Rosalyn Bird

Reporting of Bills

Bill 30 — Employment Standards (Serious Illness or Injury Leave) Amendment Act, 2025

Third Reading of Bills

Bill 30 — Employment Standards (Serious Illness or Injury Leave) Amendment Act, 2025

Proceedings in the Douglas Fir Room

Committee of the Whole

Bill 24 — Vaping Product Damages and Health Care Costs Recovery Act (continued)

Brennan Day

Hon. Niki Sharma

Anna Kindy

Steve Kooner

Elenore Sturko

Sheldon Clare

Proceedings in the Birch Room

Committee of the Whole

Bill 30 — Employment Standards (Serious Illness or Injury Leave) Amendment Act, 2025

(continued)

Kiel Giddens

Hon. Jennifer Whiteside

Gavin Dew

Tuesday, November 25, 2025

The House met at 1:32 p.m.

[The Speaker in the chair.]

Orders of the Day

Hon. Lisa Beare : In this House, I call Committee of the Whole, Bill 29, the Child, Family and Community

Service Amendment Act.

In the Douglas Fir Room, Committee of the Whole, Bill 24, Vaping Product Damages and

Health Care Costs Recovery Act.

In

Section C, the Birch Room, Committee of the Whole, Bill 30, Employment Standards

Amendment Act.

Sorry, Mr. Speaker. In this House, first it is continued second reading on Bill 32,

the Mental Health Amendment Act. My apologies.

Second Reading of Bills

Bill 32 — Mental Health

Amendment Act ( N o . 2), 2025

(continued)

[Lorne Doerkson in the chair.]

Deputy Speaker : Thank you, Members. We are continuing debate on Bill 32, the Mental Health Amendment

Act (No. 2), 2025.

Claire Rattée : I hope that you will indulge me. I had to get cut off earlier for lunch, so I’m just

going to go back one paragraph so that I don’t confuse myself here.

If the deemed consent provision is removed, the Mental Health Act contains no framework

for how treatment decisions are to be made for involuntary patients who refuse care.

In that situation, the system defaults back to the general law of consent in British

Columbia, the Health Care (Consent) and Care Facility (Admission) Act.

That act says that every adult is presumed capable unless proven otherwise, that a

capable patient has the right to refuse treatment and that the only time treatment

can proceed without consent is in a narrowly defined emergency or through a substitute

decision-maker if the patient is incapable. That sounds reasonable in theory, but

it does not reflect the clinical reality of the people who are most often certified

under the Mental Health Act.

[1:35 p.m.]

Many involuntary patients are not incapable in the narrow legal sense. They can understand

information. They can repeat back risks and benefits. They can explain side effects.

But they cannot appreciate the consequences of refusing treatment because of a condition

called anosognosia, the lack of awareness of one’s own illness.

When we talk about consent and capacity in the context of severe psychiatric illness,

we must recognize that British Columbia’s existing legal framework was never designed

to address the realities of conditions like schizophrenia, bipolar disorder with psychosis,

psychotic depression or the increasingly common toxic-drug-related brain injuries

we are seeing today.

Capacity law in the Health Care (Consent) and Care Facility (Admission) Act sets out

a narrow test: whether someone can understand information and appreciate the reasonably

foreseeable consequences of a decision. That test may work when someone is deciding

whether to have a surgery or a medical procedure, but it does not capture the fragmented,

inconsistent and often fluctuating insight that characterizes many severe psychiatric

disorders.

People can often articulate information clearly while being completely unable to appreciate

its personal relevance, because their illness prevents them from recognizing the illness

itself. That is the clinical reality of anosognosia, and it is a reality our laws

have not even attempted to describe, let alone regulate.

It is not denial; it is a symptom of severe mental illness. It affects a significant

percentage of people with schizophrenia, bipolar disorder with psychosis and psychotic

depression. It also affects people with traumatic and toxic-drug-related brain injuries

as well as people with Alzheimer’s and dementia and things of that nature — a population

that is now growing rapidly in British Columbia.

When someone has this they genuinely believe that there is nothing wrong with them.

They may insist that their hallucinations are real, that their paranoid beliefs are

justified or that their family is conspiring against them. They may also, once stabilized,

appear articulate, logical and coherent, which leads clinicians to find them capable

under the general legal test, but because they lack insight, they will often refuse

further treatment.

This produces the tragic cycle that we all recognize. The person deteriorates, becomes

a danger to themselves or to others, is detained, receives treatment over objection,

begins to recover, becomes capable in the legal sense, refuses continued treatment,

is discharged, stops medication and relapses, overdoses or returns to the hospital

in a worse state. Families are left grieving. Communities are left unsafe. And the

individual’s brain injury deepens each time.

Without clear statutory guidance on how capacity should be assessed specifically for

psychiatric decisions, clinicians are forced to make extremely high-stakes judgments

in a legal vacuum. Some may interpret capacity broadly and conclude a patient is capable

simply because they can repeat information back to them. Others may take a more nuanced

approach, incorporating insight, history, pattern of illness and risk.

In rural and northern communities, including mine, where psychiatric coverage is limited,

these assessments may be made by clinicians meeting the patient for the very first

time, under pressure in a chaotic emergency department or, worse yet and commonly

the case, virtually rather than in person.

None of this inconsistency is the fault of the clinicians. It is the direct result

of a legislative framework that has failed to define what capacity should mean in

the context of severe psychiatric illness. The outcome is a system where two patients

with the same conditions may have completely different rights, outcomes and protections,

depending on who assesses them that day.

What’s particularly troubling is that not only is the situation that I just described

very common in northern rural B.C., where we’re looking at the lack of access to psychiatrists,

but…. Very recently, the Health Minister and I were touring a facility in my riding

where we were told that it’s better for the patients that they can’t see a psychiatrist

in person and just virtually. That bothers me greatly.

I don’t think that you can replace face-to-face interaction with a health care provider

with virtual. I understand that we have to fill gaps, but it’s quite alarming that

we’re now making excuses for why we can’t actually allow patients to be seen in person.

And I think, specifically when it comes to psychiatric assessments, being able to

diagnose somebody in person is incredibly important.

[1:40 p.m.]

If the government removes deemed consent without establishing a modernized capacity

framework, these inconsistencies will only deepen. Many severely unwell patients,

especially those with anosognosia, will be deemed capable in a legal sense and therefore

allowed to refuse all treatment, even when their lives are at risk, or others’ lives.

Others may be labelled incapable based on subjective judgment. Families may suddenly

become responsible for treatment decisions that they are unprepared to make, in situations

that are emotionally fraught and medically complex. And clinicians will be put in

the impossible position of guessing whether treating someone without clear statutory

authority could expose them to complaints or litigation. This does not create safety

or clarity. It creates uncertainty and potential harm.

The government may argue that substitute decision-makers can simply fill the gap when

a patient is found incapable, but that assumption overlooks the very real complications.

Substitute decision-making only works when there are clear statutory rules guiding

it.

At present, British Columbia has no legislative process detailing when a family member

can authorize or refuse psychiatric medication on behalf of a loved one. There is

no oversight mechanism to ensure that the substitute decision-maker is acting according

to the patient’s values, best interests or stated wishes. There is no tribunal process

to resolve disputes between clinicians and families when opinions differ, and there

are no safeguards to protect patients from family conflict, coercion, estrangement

or even well-meaning but harmful decisions made in moments of crisis.

It’s because this piece of legislation doesn’t actually replace anything. It’s looking

to remove a

section without providing any kinds of guidelines or framework.

If we’re going to go to a situation where, essentially, we’re going to be relying,

for the most part, on these substitute decision-makers that are primarily going to

be family or close loved ones, why is there no framework here about how that person

is determined, which person it’s going to be in the family, safeguards to ensure that

they’re not going to abuse that family member?

It’s impossible for a clinician to know every single time what the family history

is or how this patient has interacted with that person in the past. So we’re going

into very dangerous territory by doing this without any kinds of clear frameworks.

These risks are not theoretical. Families across the province are already stretched

to their breaking point, caring for loved ones with severe and persistent mental illness,

substance use disorders or brain injuries. Many are exhausted, traumatized and desperate.

Asking them to shoulder legal responsibility for forced psychiatric interventions

without clear guidance, support or safeguards is unfair to them and unsafe for patients.

There are also situations where estranged or abusive relatives attempt to insert themselves

into care decisions.

Without a legislated framework, the system risks enabling further harm rather than

preventing it. And again, that’s not to say that I don’t want to see more family involvement

in care decisions, because I think that’s important. But what we do need are guidelines,

because not everybody is going to act in the best interest of people in their family.

A modern mental health law must recognize these complexities. It must define capacity

in a way that reflects psychiatric reality, including impaired insight. It must set

out a clear and consistent process for involving substitute decision-makers, backed

by safeguards, oversight and the ability to challenge decisions. It must ensure that

clinicians, patients and families all understand their roles, rights and responsibilities.

Removing deemed consent without addressing any of these issues does not modernize

the system. It destabilizes it. It leaves clinicians without guidance, families without

support and patients without the protections that they deserve.

This issue is even more concerning when we consider youth. Young people experience

mental illness and substance use disorders differently from adults. Their insight

fluctuates more rapidly. Their decision-making capacity is more vulnerable to peer

influence, trauma and developmental factors. Yet British Columbia has no youth-specific

involuntary treatment framework, no capacity-based youth model and no clear legal

standard for when parents can override a youth’s refusal of psychiatric treatment.

This is a really big issue that has been consistently seen. I get tons of casework

to my office about this because there is no ability for a parent to intervene in those

decisions, even when the child may have other disorders, not just psychiatric disorders,

that impact their ability to make these decisions. But the parents aren’t allowed

to intervene.

The government once recognized this gap when they introduced Bill 22 in 2020, which

would have allowed involuntary stabilization for youth after an overdose. They paused

that bill due to a lack of consultation, promised to come back with something better,

then abandoned the issue entirely.

[1:45 p.m.]

This is alarming, because it’s similar to what we are seeing right now with no consultation

and a bill being brought forward. So it will be interesting to see how this plays

out.

Now, in the middle of the most severe youth overdose crisis in Canadian history, they

bring forward a bill that could make it even harder to treat high-risk youth who lack

insight into their condition.

One of the most serious consequences of removing deemed consent without replacing

it is that we risk creating a system that detains people without actually treating

them. This is not only medically irresponsible but also ethically indefensible.

Detention under the Mental Health Act is supposed to have a therapeutic purpose. It

is justified because treatment is necessary to prevent serious deterioration or harm.

If clinicians are legally unable to provide that treatment, then the detention itself

becomes punitive rather than therapeutic, something this government has said multiple

times that they don’t want to do. It becomes confinement for the sake of confinement.

That is the opposite of what involuntary care is supposed to achieve.

Imagine a person in acute psychosis — paranoid, terrified, disorganized, unable to

recognize their own needs. Imagine telling that person: “We can hold you here against

your will, but we cannot give you the treatment that would actually help you become

well.” That is not compassionate care, that is not trauma-informed care, and it is

certainly not recovery-oriented care. It is a failure of the system and a violation

of the principles that this government claims to uphold.

If this bill proceeds without a replacement framework, that is exactly the situation

British Columbia will be placing clinicians and patients into. If Bill 32 passes without

a replacement framework, that cycle will become more entrenched, not less. Clinicians

will still be able to detain a person, but without the deemed consent provision, they

will likely be unable to treat them, unless they go through the formal process of

declaring them incapable and locating a substitute decision-maker.

Because the legal test for incapacity is narrow, many people with anosognosia will

be labelled capable. That will mean that the very group of people who most desperately

need stabilizing treatment, the people with the least insight into their conditions

and the highest risk of fatal outcomes, will be the ones who are now allowed to refuse

care.

This is not a hypothetical concern. The government itself has acknowledged that drug-related

brain injuries are now a widespread and growing problem. The Premier has spoken publicly

on multiple occasions about people overdosing twice in a day, being revived in emergency

and being sent back out onto the street to overdose a third time. He called it bizarre.

He spoke about the need for involuntary care in those situations.

The government then appointed a chief scientific adviser, Dr. Daniel Vigo, who confirmed

that involuntary care for this population could be delivered under the Mental Health

Act, and that’s under the existing Mental Health Act. This was eight months ago that

he said that. So again, I can’t help but wonder why this is being couched as a necessary

part of being able to move forward on involuntary care. Why are we not listening to

the expert here?

What really concerns me about this is that when I had a briefing on this bill with

the government staff about it, I asked about how much consultation had been done about

bringing this piece of legislation forward. I was told that Dr. Vigo — now, bear in

mind Dr. Vigo is the one that said that these changes were not necessary — has done

consultation with psychiatrists. But the staff admitted to me that no consultation

beyond that has been done on bringing forward this piece of legislation.

Again, I am concerned that this is just about shielding the government because of

this Charter challenge. I understand the desire to do that, but don’t couch it as

being something that’s necessary to bring forward involuntary care when the wording

itself makes it seem as though it’s actively working against that goal.

Despite recognizing this, the government has made almost no progress in actually implementing

involuntary care. So I must ask: how does it make sense to talk about using the Mental

Health Act as a tool for involuntary care in the toxic drug crisis while, at the same

time, removing the very legal mechanism that allows you to treat people whose illness

stops them from recognizing that they are ill?

For years, experts, advocates, families and clinicians have been calling for expanded

psychiatric beds, expanded long-term treatment capacity and vastly more community

supports. The government has ignored those calls.

We still have emergency departments functioning as psychiatric wards. We still have

people admitted to medical surgical floors because there is nowhere else to place

them. We still have hundreds of people discharged prematurely due to bed shortages.

We still have Indigenous communities with no psychiatric services at all. We still

have youth waiting months or years for a psychiatric consultation.

[1:50 p.m.]

A modern mental health law cannot function if there are no psychiatrists to assess

people, no beds to stabilize them and no community teams to support them after discharge.

That infrastructure does not exist, and this bill does absolutely nothing to fix that.

Even the scarce detox and treatment beds that do exist outside of the Red Fish Healing

Centre are not designed for stabilizing long-term psychiatric or cognitive impairment

caused by toxic drug exposure. They are not designed for the people cycling repeatedly

through acute psychosis with no insight. They are not designed for people who need

weeks or months of structured in-patient care to regain stability.

Another glaring problem with this bill is that it assumes the province has the capacity

to operationalize a modern consent system when it simply does not.

Capacity-based legislation only works when the entire system is built around accurate,

timely and consistent capacity assessments. That means having trained psychiatric

staff available around the clock. It means having clinicians who are capable of assessing

acute psychosis, disorganized thinking, brain injury or impaired insight in a reliable

and standardized way. It means having specialized in-patient units ready to receive

patients when capacity is lost and treatment is necessary. None of those conditions

exist today in British Columbia.

Another serious issue is that lack of capacity exposes clinicians to enormous legal

and professional risk. Under this bill, a nurse or doctor who decides a severely unwell

patient is incapable could be accused of violating their rights. Meanwhile, a clinician

who decides they are capable could be blamed when that patient deteriorates, harms

themselves or harms someone else.

These decisions cannot be left to guesswork, but that is exactly what will happen

without the resources needed to make proper assessments. We are setting clinicians

up for failure, and the government knows it. Giving them liability protection does

not solve the problem. It merely shifts the risk. A modern system would give clinicians

the tools that they need, not leave them to improvise in a crisis.

The government also refuses to acknowledge that modernizing mental health law requires

capacity not just to assess and treat but to follow up. People with severe psychiatric

illness need continuity of care. They need intensive case management, assertive outreach,

structured housing supports and long-term stabilization.

British Columbia does not have those systems in place. People are discharged with

no follow-up, no plan, no appointment and no support. We know what happens next: relapse,

psychosis, overdose, hospitalization, sometimes death. A rights-based framework without

a care-based infrastructure is an illusion.

One of the most overlooked problems with this bill is that it deepens the inequality

between rural and urban care. In Vancouver or Victoria, a patient refusing medication

under a capacity-based system might at least be seen quickly by a psychiatrist. In

the North, that same patient could wait days or longer for an assessment. In some

cases, the assessment might not happen at all.

The law will be the same across the province, but the outcomes will not be. The regions

with the least capacity will see the worst results. People in rural and northern communities,

my communities, will be left without timely assessments, without timely treatment

and without the protections a modernized framework is supposed to provide. This is

not equity. It is regionally entrenched injustice.

In northern communities, including Skeena, we often have limited or no access to psychiatrists

on site. We have emergency departments that are overwhelmed, rotations that are inconsistent

and designated psychiatric beds that are insufficient.

This government has known for years that psychiatric capacity is dangerously low,

yet they have not meaningfully increased staffing, expanded in-patient facilities

or developed community-based psychiatric services for communities. Instead, they now

introduce a bill that will remove the only legal tool that clinicians currently have

to provide timely treatment in high-risk situations, and they’re not providing anything

to replace it with.

The government is legislating as though we have a fully staffed, modern psychiatric

infrastructure. We do not. We are nowhere close, and the consequences of pretending

otherwise will be borne by the most vulnerable people in the system.

The irony is almost unbelievable. The government is trying to legislate a capacity-based

model while refusing to invest in capacity. It is like trying to build a skyscraper

on a foundation of sand. The structure looks neat on paper, but it collapses as soon

as it is used.

[1:55 p.m.]

If the government truly believed in a capacity-based approach, the first step would

be investment in psychiatric beds, in detox beds, in long-term treatment, in community

outreach, in northern services, in forensic stabilization and in specialized brain

injury units. Instead, they are moving backward. They are making it harder to treat

people, not easier. They are making it harder to intervene in a crisis, not easier.

It must be said plainly. This government has known for years that British Columbia’s

mental health system does not have the capacity to meet even basic needs.

Deputy Speaker : Thank you, Member.

Claire Rattée : I was told that I had two hours.

Deputy Speaker : Oh, you are the designated speaker?

Claire Rattée : Yes, I will be the designated speaker.

Every coroner’s report, every Auditor General review, every Ombudsperson report….

Deputy Speaker : Member, I hate to interrupt. I just need to recognize our Minister of Education and

Child Care.

Hon. Lisa Beare : Excellent, thank you.

Sorry, we were waiting till you were done there.

I seek leave to make an introduction.

Leave granted.

Introductions by Members

Hon. Lisa Beare : In the gallery, we have 40 people from Lift Auto Group, which has 67 locations, including

one here in Victoria, and is headquartered out of Kelowna. They do collision repairs

all across the province.

Will the House please make them feel very welcome.

Deputy Speaker : Indeed, welcome to everybody in the chamber today.

Debate Continued

Claire Rattée : It must be said plainly. This government has known for years that British Columbia’s

mental health system does not have the capacity to meet even basic needs. Every coroner’s

report, every Auditor General review, every Ombudsperson report, every expert panel,

every clinician, every grieving family has said the same thing.

We do not have enough psychiatric capacity. We do not have enough treatment beds.

We do not have enough staff. We do not have enough support for people after discharge.

Despite knowing all of this, the government brings forward a bill that assumes the

system is fully functional. It is not, and their failure to act is costing lives.

What makes this bill even more alarming is the glaring contradiction between the government’s

public messaging and their legislative actions. This Premier has repeatedly stated

that involuntary care must be available for people who overdose multiple times a day.

He has stated publicly that allowing someone to be revived in the morning, only to

die in the evening, is unacceptable.

The government’s own chief scientific adviser has stated unequivocally that repeated

overdoses cause profound brain injury, that insight is impaired and that involuntary

care is sometimes necessary as

an act of compassion, yet at the very moment when the

government should be strengthening the legal framework to support those interventions,

they are dismantling the only statutory mechanism that currently allows treatment

in these high-risk situations.

This raises a serious question. Was the government ever actually committed to involuntary

care, or were those statements simply made to respond to public outrage? When a government’s

words and actions contradict each other this dramatically, British Columbians notice.

They have every right to question whether this bill reflects sound policy or political

self-preservation in the face of a Charter challenge.

In April of this year, following a mass casualty event at a public festival that involved

a person with untreated mental illness, the government announced a review of the Mental

Health Act. They held press conferences. They talked about modernization. They talked

about protecting the public. They talked about building a better system. But since

then, we have seen absolutely no evidence of that review. There has been no consultation

paper, no terms of reference, no interim findings, no public engagement, no outreach

to families, no evidence that the review has progressed at all.

What is particularly troubling is that instead of bringing forward a comprehensive

reform package informed by that review, the government is now moving this small, reactive

bill in the final days of the sitting. It is difficult to avoid the conclusion that

this bill is not about modernizing mental health law or improving care. It is about

legal positioning. It is about the looming Charter case. It is about shielding the

government and health authorities from liability, without doing the work of building

a functioning, compassionate and accountable system.

Again, I have to ask: why are we rushing through a narrow, technical change to one

of the most controversial sections of the act before that review is complete? Why

are we legislating to manage a court case, instead of legislating to fix a broken

system? It feels premature, it feels backward, and it raises real questions about

what the government’s true agenda is here.

I want to acknowledge that the bill does contain provisions to protect clinicians

from liability when they provide treatment authorized by the director. I understand

why many nurses, doctors and allied health workers welcome that protection. They are

working on the front lines of an extraordinarily complex and underresourced system,

and they deserve support, but legal immunity for clinicians does not fix the underlying

problem.

[2:00 p.m.]

They still will not have a clear statutory framework to guide their decisions when

an involuntary patient refuses care. They will still be forced to navigate a patchwork

of internal health authority policies, ad hoc capacity assessments and unclear legal

obligations.

Patients, especially those with anosognosia or toxic-drug-related brain injury, will

receive inconsistent and insufficient care. British Columbians deserve better than

this. They deserve a government that does the difficult work of drafting a modern

capacity-based mental health law that recognizes autonomy where possible, protects

the right to be well where necessary and builds in robust safeguards, oversight and

accountability.

They deserve a system where families are part of the process, where rural and northern

realities are recognized, where Indigenous communities are engaged with respect and

where clinicians are properly supported. They deserve more than a two-clause amendment

introduced at the last minute because the government is anxious about its position

in court.

In principle, I support modernizing the Mental Health Act. I support strengthening

rights and creating a fair, transparent consent framework. But I cannot support a

bill that removes a major legal mechanism while offering nothing in its place.

Doing so risks worsening outcomes for the people who need the most help. It risks

creating a situation where we detain people without treating them, a scenario that

is unethical, unsafe and inhumane. And it risks further eroding public confidence

at a time when the system is already under immense strain.

What is most troubling is the government’s refusal to grapple with the full context.

This bill is being introduced in a province that has the highest overdose death rate

in Canadian history, the highest rate of drug-induced brain injury ever recorded,

a collapsing psychiatric system, chronic staffing shortages, emergency departments

functioning as psychiatric stabilization units, long-term-care needs that are completely

unmet and no coherent strategy for involuntary treatment, despite promising it repeatedly.

This bill does not exist in a vacuum. It exists inside a system that is fundamentally

broken. And instead of fixing the system, the government is removing one of the only

tools that it has.

Rights matter. But that includes the right to be well. We can move towards a modern

capacity-based model that respects autonomy whenever possible, explicitly recognizes

situations where illness destroys insight, provides strong safeguards and still allows

clinicians to act in a transparent and accountable way when doing nothing would mean

death or serious harm.

If the government were serious about modernizing the Mental Health Act, this bill

would not be two clauses long. At minimum, it would include a statutory definition

of “capacity” tailored to psychiatric decision-making. It would require regular documented

capacity assessments. It would establish a clear process for authorizing treatment

in cases where a patient is capable but at extreme risk due to impaired insight, patterned

overdose or severe psychosis.

It would strengthen rights advice and legal advocacy. It would create oversight mechanisms

— whether through the review board, an independent tribunal or another body — so that

treatment decisions could be challenged fairly. It would provide a structured role

for families, with clear limits, safeguards and accountability. And it would be accompanied

by a commitment to increased psychiatric capacity, community care options and stabilizing

treatment facilities across the province. None of that appears in this bill.

British Columbia cannot build a rights-based mental health framework on a system that

is structurally incapable of delivering the most basic psychiatric care. The government

knows that psychiatry vacancies remain unfilled across Northern Health, Interior Health

and Vancouver Island. They know that some communities have no permanent psychiatrists

at all.

They know that emergency departments are so overwhelmed that psychiatric consults

are often delayed for days or done virtually by providers who have never met the patient

in person. They know that burnout among clinicians is at an all-time high.

Yet they still bring forward a bill that hinges entirely on the assumption that clinicians

have the time, training and capacity to carry out nuanced legal assessments in the

middle of a collapsing system. That is not modernization; it is magical thinking.

British Columbians do not need a bill that protects the government from liability.

They need a bill that protects people from dying. They need a mental health law that

recognizes modern clinical realities, that balances autonomy with safety, that supports

clinicians in making the right decisions and that gives families a framework that

they can trust.

Instead, they are being offered a last-minute, legally driven amendment that does

nothing to improve care, nothing to expand access to treatment and nothing to address

the devastating gaps that this government has acknowledged for years but failed to

act upon.

[2:05 p.m.]

British Columbians deserve leadership, not legal manoeuvring. They deserve a government

willing to confront the hardest issues in mental health and addiction with honesty,

courage and a genuine commitment to saving lives. This bill falls far short of that

standard, and the people of British Columbia deserve far better.

I want to take a little bit of time now to talk about some of the timeline here and

why I have a lot of concerns about the way that this bill is being brought forward.

I’ve touched on them already, but just to put it in perspective.

We know that eight months ago Dr. Daniel Vigo, who is the expert on these matters,

the expert that we were told we needed to have…. This government needed to have him

hired on so that he could give advice. He said eight months ago that for us to enact

involuntary care, we did not need to make any changes to the Mental Health Act whatsoever.

He’s supposed to be the authority on this, he’s supposed to be the expert, and now,

for some reason, we’re going against his advice.

We know that back after the Lapu-Lapu Day tragedy, the Premier stood up and announced

that we were going to get a review of the Mental Health Act, something that many people

have been calling for, for a very long time. That was announced, and I’ve heard crickets

ever since.

Now we’ve got this bill coming forward. We haven’t done a review. We haven’t done

consultation, as I mentioned. Ministry staff told me as much yesterday, that no consultation

has been done on this. So all I have left to assume is that this is just about shielding

the government from the results of this Charter case.

Again, I understand why they may want to do that. I understand that there is some

concern there. I’m certainly not against us providing more protections to health care

workers. I don’t want them to be facing liability for doing the right thing and making

the right medical choices. That’s important. They need to feel confident that they

can make those medical choices.

But the fact still remains that this government agreed that we needed involuntary

treatment. I’ve pored over this document and tried to find any other way to interpret

it other than the fact that it is now going to be more difficult for us to be able

to implement involuntary treatment in this province. That concerns me greatly.

I’ve spoken about it in this House before. I’m somebody that has lived experience

with this. I went to treatment. I was a drug addict for a number of years, and I went

to treatment. I got psychiatric help as well. I did suffer from psychosis. I have

been through that pattern. I understand this very keenly. I have the lived experience

on it, and that’s why I advocate for it. That is also why I know, as somebody with

lived experience, as somebody that was a youth when I was struggling, that involuntary

treatment would have saved me.

Obviously, I’m still alive. I’m still here today. I made it through, but I did a lot

of really irreparable harm to my body and my health during that time. I was a young

person. Obviously, I regret it now. I wish I hadn’t done that, but I did.

My parents cared about me immensely. They wanted to do everything they could to try

and save me, but there wasn’t any mechanism for them to do so. I have the clarity

now that I need, as an adult, to be able to look back, and I recognize that despite

my parents being excellent parents and caring about me a lot, I wanted them to pay

attention to me. I felt like they didn’t pay attention.

If they would have forced me into treatment, if they had had a mechanism when I was

16 or 17 years old, I guarantee you it would have worked. I know it won’t work for

everybody, but I can look back, and I can see that now. I know it would have worked.

It would have saved me. I went through a lot of things that I shouldn’t have gone

through as a young child, as a teenager, that I wish, obviously, I didn’t have to

go through.

We need involuntary treatment in this province. We can’t continue to wait. There has

to be a mechanism. There are a lot of lives that could potentially be saved if we

found a way to do that.

Unfortunately, I am now going to spend the time to try and figure out some amendments

that I can bring forward to this piece of legislation that will allow us to enact

that. I’m hoping that I can do a good job of it, because I do not have a legal background,

nor do I have a medical background. I’m hoping that I can figure out a way to do that

in a way that both sides of the House can agree on so that we can actually start enacting

that framework.

But the government still needs to take on the responsibility of building out that

capacity to allow us to be able to take on that challenge. What concerns me is, again,

that this is a government that insisted we had to hire this special expert in Dr.

Vigo. We had to have him. He was the expert on this matter. He would be able to figure

out what we needed to do to be able to solve the problems that we’re facing right

now. And we’re actively going against advice that was given to us from him.

There hasn’t been consultation done on this. Again, I am not a legal expert, nor do

I have a health care background.

[2:10 p.m.]

I have concerns about the fact that this is now legislation that is likely going to

get changed. That’s why I will bring forward the amendments, because I know that the

government has more votes than the opposition and that this will move. I’m hoping

that the amendments will be ones that the government can agree to, to try and make

this a bit safer and to ensure that it’s actually going to achieve the outcome that

we want it to.

This is really work that should be being done by people like Dr. Vigo. I thought that’s

why we were spending tax dollars on having him consult. I have a lot of concern over

the fact that this is actively going against what he originally had said that we needed

to do.

I do not think that this bill is actually going to do anything for the intended purpose

of strengthening involuntary treatment care. I think that it is definitely going to

help shield the government from any potential legal battles that they might have with

this Charter challenge, but it doesn’t do anything to improve access to care in this

province. That concerns me. This is being brought forward as a health care bill, but

it’s feeling like it’s more of a legal bill.

I don’t know where it came from that the government got the recommendation for removing

deemed consent and not replacing it with anything else, but I have concerns around

that. Was there any consultation done with other provinces? Again, we are the only

province left in Canada that still has these provisions.

Yes, our Mental Health Act is incredibly outdated. I’m not saying that I’m against

looking at updating it and making some improvements, but if there wasn’t consultation

being done, if we didn’t consult with other provinces that have gone through this

— learn best practices, understand what works and what doesn’t — that this feels incredibly

premature.

The problem is that once you remove something like that, you can’t just bring it back.

There needs to be some kind of structure, some kind of framework that is brought in,

in place of that to ensure that we are actually going to have a system that is going

to be functioning that can help to treat people that are suffering.

Again, if anybody listening to this hasn’t experienced either themselves dealing with

significant psychiatric illness or having someone in their family that struggles with

it…. I think probably most have experienced that at some point, being around somebody

that does struggle like that.

If you haven’t, it’s very difficult to understand just how common it is for someone

if they finally get diagnosed and they finally get the help that they need. They finally

get treatment. They finally get medications, and they start to feel better…. It doesn’t

take very long for them to start to think: “I’m better now. I don’t need the medication

anymore. I don’t need the treatment anymore. I’m feeling great.”

At that point, by any kind of legal capacity test, they would be considered capable

of making that decision for themselves. They would be considered capable of determining

whether or not they need to continue with treatment or if they can discontinue the

treatment and be fine. The problem is I’d think that the clinicians would know that

as well. They’d be very cognizant of that. They would recognize this is a person that

has struggled with severe psychiatric illness for a long time.

Once the medications wear off, they’ll be right back where they started, and they’ll

have no legal recourse to stop them from getting off of those medications. That’s

incredibly concerning. I don’t think that the average British Columbian recognizes

— although they may now because of things that have happened recently — just how many

people are living in community under the Mental Health Act that are mandated to get

medications, usually by an injection, every couple of weeks.

I’m not saying this to disparage those people, because I think it’s incredibly important

that they have this opportunity so that they can feel well, so that they can live

a normal life. But if they have the ability, whenever they feel like it, to just get

off their medications because they’re feeling well at that moment, we could see things

like what happened at the Lapu-Lapu Day festival again.

We could see more tragedies, and I don’t feel like we’ve worked in any kind of safeguards

here to ensure that that doesn’t happen again. Psychiatric illnesses like schizophrenia

don’t go away. There’s no cure for that. You can medicate it, and that’s about all

you can do. You can treat, but there’s no way to completely stop it from coming back.

If we don’t have some kind of a safeguard in place to make sure that doesn’t happen,

I’m worried that we’re going to make this system worse, not better.

Another piece of that is definitely people that suffer from delusions, people that

are living on the street. It’s a very common situation that you’ll come across with

people that are unhoused that are struggling with substance use. It’s really common

that they will also have some kind of a psychiatric condition. Typically people will

self-medicate in those situations, and they’ll end up on the street.

I spend a lot of time doing outreach work with people in those situations. I would

say you get to know somebody fairly well. You can have a conversation with that person

one day and they seem fairly coherent and capable of making decisions for themselves,

and the next day they’re not. This is not something that’s just going to be the exact

same every day.

[2:15 p.m.]

Again, if that person presents to a psychiatrist and they’re having a particularly

lucid moment, a lucid day where everything seems fine and they don’t feel like they’re

going to need any more help, they could then be released and end up doing more damage

to themselves.

Another part of this is that when psychiatric patients aren’t getting properly treated,

again, like I said, they tend to turn to self-medicating. It’s incredibly difficult

dealing with psychiatric illness. For the person that’s experiencing it, for what

it does to your mind, it’s incredibly difficult.

As somebody that has experienced this and has experienced using illegal substances

to try and self-medicate it, it’s a very simple trap to fall into. You don’t feel

well. Something doesn’t feel right. You feel like your brain doesn’t function like

everybody else’s, so you find a way to self-medicate and to deal with it another way.

We know what happens. We know what the outcomes are there. You either end up overdosing

and dying or overdosing and ending up with a permanent acquired brain injury. And

that brain injury gets worse every single time that you overdose.

Again, this is not something that is treatable. It’s not something that’s reversible,

but it is preventable. That’s where I get frustrated that this government isn’t doing

something more to prevent that from happening, to build out the capacity that we need

to be able to treat people early on, to be able to ensure that they don’t end up in

a place with an acquired brain injury.

I mentioned it to the Health Minister very recently when she visited my riding — about

the need for us to be able to take a look at this epidemic that we have now of people

with acquired brain injuries as a result of repeated overdoses. Why are we not looking

at legislation that brings forward better education for people, on what repeated overdoses

can do to you — can do to your brain?

Many people think that naloxone exists now, and it’s okay because you can be revived

and there won’t be any real consequences, but there are. Every single overdose means

that you aren’t getting oxygen to your brain, and you are ending up with a brain injury.

You keep repeating that over and over again, and unfortunately, you end up with people

that have lost all function and ability to care for themselves.

Even further to that, why don’t we have any kind of a facility for people that are

in that position, to be able to give them some dignity and some care? Why are we okay

with just leaving them on the street?

I don’t know how to fix all of these problems, because it doesn’t seem like the government

wants to fix many of them, but I am hoping that we can at least work across the aisle

on this piece of legislation in committee stage and make some amendments that need

to be made to ensure that it’s going to actually work for British Columbians, that

it’s going to address the problems that it needs to address. Hopefully, it can address

the problems that government is seeing right now and the potential of this Charter

challenge at the same time.

I’m willing to work across the aisle and try and make sure that that happens, but

what I’m not willing to do is risk that we move forward on a piece of legislation

that may handicap us later from being able to implement involuntary care properly.

I’m not willing to do that. I will do everything in my power to ensure that doesn’t

happen, because involuntary treatment is absolutely necessary at this point. We cannot

wait any longer.

When I began my speech, I did mention that at this point, without bringing forward

legislation in this session that allows for involuntary treatment, we will likely

lose another 450 British Columbians by the time we show up here again for another

session to potentially be able to bring forward that legislation.

It’s 450 people that will most likely die in this province if we don’t make sure that

we do something now to prevent that from happening; to give our health care system

the tools it needs to be able to treat people when they’re dealing with those concurrent

disorders; to be able to ensure that even when they don’t want that treatment, if

we can tell that it is in their best interest, that they will have no standard of

living, no dignity if we don’t or that they may potentially die, we can then implement

that care.

That is compassionate. That is important. It’s not something that we can continue

to ignore any longer, so I really hope that both sides of the House are willing to

work on that in committee stage and work on some amendments to be able to make this

legislation something that we can support. But at this point in time, I cannot support

handicapping ourselves and not allowing ourselves to move forward on involuntary care.

[2:20 p.m.]

Jeremy Valeriote : I just want to start by appreciating the member for Skeena relaying personal lived

experience, recounting it, and how important that is in this discussion.

Thank you.

I’m pleased to rise to speak to Bill 32. I’m still getting up to speed when it comes

to being an effective critic for health and mental health in this Legislature, but

I am inheriting an immense amount of work and expertise on this file from my predecessors

Sonia Furstenau, Adam Olsen and the many caucus staff that have supported elected

Greens.

For years, the B.C. Green caucus has been calling on this government to reform the

outdated and archaic Mental Health Act. My colleagues have worked closely with health

professionals, people with lived and living experience and disability, justice and

human rights advocates to gain a comprehensive understanding of mental health legislation

in B.C. We’ve seen countless reports detailing the inadequacy of the current mental

health regime and all the ways it must be reformed to meet basic standards of human

rights and dignity.

This legislation hasn’t been substantially updated in almost 30 years, and it contains

much of the same wording from when it was first devised in 1964. After more than 60

years of tinkering around the edges, I was expecting to stand to celebrate the long-awaited

overhaul of the Mental Health Act. Instead, I’m standing to speak to a minor shuffle

of two clauses. To say I’m disappointed is an understatement.

B.C.’s Mental Health Act, last substantially updated in 1998, still authorizes coercive

health measures and is out of step with modern evidence-based understandings of mental

health and illness. It’s time for the act to be overhauled and oriented toward creating

the conditions for all people to be well, informed by those who are or have been directly

impacted by this legislation.

It is somewhat suspect that this government is making minor changes to an outdated

piece of legislation for the sole purpose of defending itself in a Charter challenge.

I’ll dive deeper into these concerns throughout this debate, on which I will be the

designated speaker.

In 2016, the Council of Canadians with Disabilities and two individuals challenged

the constitutionality of B.C.’s mental health legislation. The plaintiffs argue that

B.C.’s Mental Health Act violates sections 7 and 15(1) of the Charter of Rights and

Freedoms.

For the record, these sections read:

Section 7: “Everyone has the right to life, liberty and security of the person and

the right not to be deprived thereof, except in accordance with the principles of

fundamental justice.”

Section 15(1): “Every individual is equal before and under the law and has the right

to the equal protection and equal benefit of the law without discrimination and, in

particular, without discrimination based on race, national or ethnic origin, colour,

religion, sex, age or mental or physical disability.”

Although the two individuals dropped out of the case, the Council of Canadians with

Disabilities continued the Charter challenge.

In 2022, the Supreme Court of Canada unanimously determined this case did pass the

test to be considered in the public interest. The legal case, known as the British

Columbia Mental Health Act Charter challenge, began earlier this year, on May 29.

The final arguments took place between October 28 and November 6.

The Council of Canadians with Disabilities, which I’ll refer to as CCD from here on,

argued that they are not seeking to eliminate involuntary treatment nor change who

can be detained or how long or the legal criteria for admissions. With this Charter

challenge, they’re seeking to ensure that when psychiatric treatment is forced, it

is done so with dignity, oversight and involvement of the patient’s trusted supporters.

As many experts and advocates have so astutely identified, we do not have to choose

between public safety and individual rights. We can have both.

That starts with creating a Mental Health Act that wasn’t drafted during the same

time when residential schools were operating, whose non-consensual medical experiments

continue to harm Indigenous survivors today; during a time when involuntary sterilization

against people who were declared mentally defective was common practice; and when

being queer was determined to be a mental disorder. We can do so much better than

a 60-year-old piece of legislation that has barely been updated in the past 30 years.

[2:25 p.m.]

Anne Levesque, co-chair of the disability justice litigation initiative of the CCD,

writes:

“Waiting for the courts to force change wastes precious time and public resources

that could be better spent on designing a new Charter-compliant mental health system

in collaboration with experts, service providers, families and people with lived experiences.

“Meanwhile, substantial public funds are being spent on government lawyers to fight

a legal battle defending a regime that is clearly unconstitutional and fails both

patients and public safety. That money would be far better spent consulting with experts,

families and people with lived experiences and developing legislation that upholds

constitutional rights and keeps communities safe.

“The time for delay is over. The B.C. government must act now to rewrite the Mental

Health Act in order to protect the public and respect Charter rights.”

The piece of this legislation that has faced particular scrutiny in this trial is

the very

section that is being repackaged in these proposed changes.

The heading for

section 31 reads: “Deemed consent to treatment and request for a second

opinion.” Subsection (1) reads: “If a patient is detained in a designated facility

under

section 22, 28, 29, 30 or 42 or is released on leave or is transferred to an

approved home under

section 37 or 38, treatment authorized by the director is deemed

to be given with the consent of the patient.”

The government says that

section 31(1) was added in 1980 in response to a Supreme

Court of Canada decision. This court decision found that involuntary treatment could

be constituted as battery. This

section was added to protect health workers from being

liable in a tort of battery.

Let me read into the record a guidance document prepared by and for the government

of Canada in 1981, titled “Legal Aid for Mental Patients”:

“Civil commitment must be seen as an extreme form of state intervention, representing

as it does the deprivation of our most fundamental rights, and particularly the right

of autonomy over physical self.

“Given the loss of liberty, privacy and self-determination and the dramatic consequences

of hospitalization, it is not surprising that many have begun to ask basic questions

about involuntary commitment. When is it justified, and how best can one achieve a

balance between freedom and protection of the individual and society?

“The difficulties in psychiatric assessment and diagnosis are not surprising. Mental

illness is a complex phenomenon which cuts across medical, normative, cultural and

ethical considerations. This, then, is not a criticism of psychiatry or psychiatrists,

only a further indication of the need to deal with the inevitable ambiguities in all

mental health legislation and to protect the individual from the uncertainties in

the consequential diagnostic process.

“In short, unsure diagnosis can be successively qualified and modified in an ongoing

voluntary treatment relationship, but it must be subject to close scrutiny and challenge

when it is the basis for committal.”

As I highlight in these quotes from 1981, this country has recognized the complexities

that arise from involuntary treatment. Why, then, I wonder, has it taken the B.C.

government so long to address the outstanding concerns of its outdated Mental Health

Act? And why is this B.C. NDP government only just now tinkering around the edges?

When asked to provide commentary on this government’s review of the Mental Health

Act, the Premier said this:

“Our reluctance to enter into this modernization of the act before the trial was complete

is we’re going to get a judgment from the court, and it’s going to tell us about the

direction to go in terms of being compliant with rights. Also, it presents a risk

to our trial and to the case to suddenly change the law in the middle of the case,

but I think the moment that we’re now in requires that we move ahead regardless and

accept that risk.”

So why, I ask again, are these changes coming before the court case has concluded?

We’ve heard two justifications from this government. They’ve argued that they need

to provide certain protections from liability for health care workers, particularly

in a tort of battery when providing involuntary treatment. The second justification

is that health care workers are afraid of providing treatment to involuntary patients

because protection from liability is unclear in the existing legislation. Some argue

that provincial health authorities are, therefore, not forcibly treating enough people.

I’ll say this. We aren’t aware of any health care worker groups that have said they

are concerned about liability when delivering treatment involuntarily under the Mental

Health Act. This government says that they’re seeking to enhance the protection of

liability for health care workers while also saying that this protection from liability

is baked into the existing legislation and that these amendments don’t actually change

the function of the act.

I come back to my initial questions. Why this, and why right now?

The intent of

section 31(1) doesn’t matter. We must face reality and be honest about

the ways deemed consent has caused harm. This clause was added in the 1980s. Why hasn’t

this changed since then?

[2:30 p.m.]

As identified by the Office of the Ombudsperson, more people are being involuntarily

detained under the Mental Health Act than ever before. Each year in B.C., the Mental

Health Act is used 30,000 times to involuntarily detain individuals experiencing mental

health and/or substance use challenges. This number is over double what it was ten

years ago. I’ll add that the 20,000 people this involves amount to about half a percent

of B.C.’s population. That’s one in 200 people.

The Ombudsperson’s first report in 2019, called Committed to Change: Protecting the Rights of Involuntary Patients Under the Mental

Health Act , found a striking lack of compliance with the legal documentation required on involuntary

admissions under the Mental Health Act. “A detailed analysis of mandatory admission

forms found that across the province, all of the required forms were completed in

only 28 percent of involuntary patient admissions.”

In the 2022 Committed to Change report update, the Ombudsperson wrote: “We are encouraged by the fact that government

and the health authorities have made substantial progress in developing auditing systems

to increase oversight and accountability for form completion and to improve training

for staff and physicians since Committed to Change was issued. As this report highlights, however, there is significant work ahead to

ensure that the systemic issues we identified in those areas in our report, particularly

related to independent rights advice, are fully addressed.”

We must recognize that being involuntarily detained and forcibly treated can be an

extremely traumatizing experience. Many people say they fear being detained again,

so they will avoid seeking help from health professionals.

We continue to see the horror stories coming out of each report that analyzes the

system of involuntary treatment in B.C. People have been forcibly injected with medication

and sedatives, physically restrained and given electroconvulsive therapy. These experiences

have created a culture of avoidant care, meaning that if there is a risk of harmful

apprehension, people are less likely to seek care in the system. This applies to the

police, health and mental health systems.

I’ll read some of the concerns about the current Mental Health Act, as identified

by Health Justice.

“The Mental Health Act authorizes detaining hospitals and facilities to ‘discipline’

patients. This means that patients can be solitarily confined in seclusion rooms,

mechanically restrained with straps that tie them to their beds or otherwise punished

during their time in hospital. There are no limits on when, how, why or how long someone

can be disciplined, and no review process.

“The Mental Health Act removes health care consent rights for involuntary patients.

All involuntary patients can be administered any form of psychiatric treatment the

facility chooses, without consent from the patient or their families or personal supporters

who know them best.

“Finally, the Mental Health Act fails to address many important aspects of daily living

conditions that could support recovery. There are no patient rights to access phones

or computers, to receive visitors, to protections during clothing removal or to grounds

passes to get exercise or fresh air. The result is that many involuntary patients

experience unnecessary trauma, isolation and alienation from the health care system.”

Yesterday an

article was published in the Canadian Medical Association Journal titled “Involuntary Treatment for Substance Use: Application of Kass’s Ethical Framework

to Alberta’s Compassionate Intervention Act.”

In the concluding sentences, the authors write: “Resourcing evidence-based, community-led

voluntary services would likely yield better substance use and mental health outcomes

than involuntary care. Instead of instituting ethically fraught interventions with

weak evidentiary support, Alberta and other provinces should strengthen and evaluate

a full spectrum of patient-centred, evidence-based services, including supportive

housing and community resources for patients who already require care under the existing

Mental Health Act or are seeking trusted care on their own terms.”

I’ve heard this time and time again. Many involuntary admissions are people who sought

voluntarily care days, months or even years before being admitted but were unable

to get connected with the right care at the right time. To me, this speaks to a fundamental

flaw with our health system and something this government has a particularly difficult

time reckoning with.

The least restrictive care is also the least costly, both in terms of financial costs

and societal costs. Yet here we are debating the merits of minor changes to an outdated

act instead of talking about the systemic reforms that must happen to improve the

well-being, health and safety of our entire province. A mental health legislation

framework can protect both human rights and public safety. It’s not one or the other.

But this government continues to operate as if it were 1981.

[2:35 p.m.]

In our current system, involuntary treatment can play a role in a comprehensive mental

health system, but it must be used responsibly, with proper supports after discharge.

Alongside this, we urgently need a strong, preventative approach and substantial investment

in mental health services.

When people are involuntarily admitted and treated in B.C., they are often discharged

from hospital with little continuing support. They may be discharged into conditions

that are not appropriate for full and ongoing recovery or care. This government fails

to identify an involuntary treatment regime that ensures that people have safe housing

when they’re discharged or ongoing counselling and mental health supports.

People will not magically get better after being detained for a few weeks or months.

Mental health and substance use management are long processes. We’ve already heard

about the dangerous impacts of involuntary treatment without long-term-care plans.

People will be released with no safe place to go. For people with substance use issues,

the rate of relapse, sometimes fatal relapse, is incredibly high.

Housing, nutrition, community-based counselling and mental health care are all fundamental

to creating the conditions to be well and thrive.

In their position paper titled Involuntary Care: Criminalization by Another Name, Pivot Legal Society writes:

“Rather than supporting expanded involuntary or carceral treatment, we endorse supports

and services that directly meet people’s material needs, built on a framework of consent,

capacity, cultural safety and peer leadership.

“We call on all levels of government to invest in robust access to voluntary treatment

options, including primary care, detox, treatment programs, publicly funded counselling

services, residential mental health services, harm reduction programming, safe supply,

family programming, culturally affirming options, and treatment modalities that reflect

the intersecting identities of all those who seek and/or desire mental health and

substance use support and care.”

As I voice my criticism for this government’s reactionary approach toward mental health

reform, I will identify all the things that must be done to build a system of mental

health care that truly meets the moment we’re in.

Firstly, as mentioned, we need a comprehensive overhaul of the Mental Health Act to

bring it in line with human rights. B.C.’s Mental Health Act has been criticized for

non-compliance with the United Nations convention on the rights of persons with disabilities

by the special rapporteur, following an inspection of Canada, who found that: “The

Mental Health Act of British Columbia contains very broad criteria for involuntary

admissions and, once detained, a person can be forcibly treated without their free

and informed consent, including forced medication and electroconvulsive therapy.”

This legislation provides little to no oversight or accountability. Where does liability

then lie if and when harms occur? Experts and advocates have been calling on this

government to create an independent office of the mental health advocate that would

provide individual and systemic advocacy aimed at improving mental health care systems

in B.C. If there’s no process for addressing concerns, systemic reform will never

happen.

We also need to improve the emergency response system. Far too often, police are the

first to respond to people experiencing a mental health or substance use–related crisis.

Experts, advocates, people with lived and living experience and those working on the

front lines have stated that police are not an appropriate response to mental health

crises.

Crisis Centre of B.C. has called for an equally strong investment in prevention, crisis

response, post-discharge supports and the dignity and autonomy of people in distress.

Our priorities for emergency mental health response include: (1) integrating mental

health as a fourth option in 911; (2) increasing crisis line funding to enhance capacity

to manage diverted 911 calls and create consistent protocols for 911 operators, emergency

responders and mobile crisis teams to ensure coordinated and effective mental health

crisis responses; (3) expand the PACT, peer assisted care team — now rebranded as

CRCL, crisis response, community led — that has been highly effective in three communities;

partner with local organizations to introduce these teams in more communities and

extend the service hours of existing teams.

Gaps in the mental health system can result in very poor outcomes for those who are

not being served. There’s currently a glaring gap between the pediatric and adult

mental health system. Our priorities include addressing the abrupt transition between

pediatric and adult mental health care by ensuring seamless and effective connections

to support services at all stages of life.

There should be psychologists, counsellors and social workers in every school, based

on a per-student ratio. All students should have access to mental health professionals

in their learning environments. Voluntary trauma-informed mental health services must

be available and accessible when people seek help. Currently it can take months or

years to get connected with the mental health care people need.

[2:40 p.m.]

The public system is failing to deliver the level of services needed, and many people

seek support in the private system. The private system is unregulated and extremely

expensive. For those who don’t have the funds, they need to seek private care. People

are simply not able to access any level of mental health support. This can escalate

and create conditions of crisis.

The Charter challenge has been proceeding since 2016, and the government could have

introduced these amendments at any time. Why is it choosing now to make these changes?

It appears the Attorney General and the Minister of Health know that they will lose

this case as it currently stands and are seeking to make a Hail Mary.

More than 20 years ago the Supreme Court of Canada found that the right to refuse

unwanted medical treatment is fundamental to a person’s dignity and autonomy. The

right is equally important in the context of treatment for mental illness.

The CCD stated in 2022 that the B.C. government could simply stop its campaign to

preserve B.C.’s outdated and unconstitutional forced psychiatric treatment laws and

instead get to work building a mental health system that provides top-notch health

care without trampling people’s rights.

B.C. is an outlier in Canada. It’s the only province where people detained under mental

health laws are automatically deemed to consent to any treatment authorized by the

facility, regardless of their wishes or capacity, with no right to name a substitute

decision-maker, no ability to appeal a treatment decision, no independent oversight.

Treatment is often imposed through isolation, physical restraint or security force.

In

summary, the Third Party caucus is concerned that this is a small-scale reaction

to a long-standing court case that overshadows the need for systemic reform, including

better access to voluntary treatment and improving mental-health-oriented emergency

response. We will be closely involved with scrutinizing this bill through the committee

stage if it passes second reading.

Elenore Sturko : I’m pleased to be able to rise to speak to Bill 32, Mental Health Amendment Act (No.

2), 2025.

I’ve been putting a lot of thought into this over the last 24 hours, and I’ve been

thinking about my reasons why I came from my policing career to become a politician

and to represent my community. The number one reason was because I wanted to see change

in the way that we treat people with mental illness in B.C.

As a police officer, I had a lot of experience apprehending people under the Mental

Health Act, intervening with families in crisis, and there’s a lot of work to do.

I would say that the biggest piece of the puzzle that’s missing is just a lack of

services.

Knowing how much of my own personal life, even, I have put aside to try to advocate

for more for British Columbians, and seeing this bill come forward, Bill 32, and what

it’s missing for British Columbians, is one of the biggest disappointments that I’ve

had since coming to this place. It really does not even get to the core of what I

think are the most fundamental issues regarding our mental health crisis that we have

in British Columbia.

Before I get into more of my speech, there is something that I want to address that

was said by my colleague from the Third Party. He characterized using chemical restraints

and using seclusion as a punishment. While it could be viewed, perhaps, by some as

a punishment, in reality, these are treatments that are sometimes medically necessary.

For example, if a person is in psychosis and violent and actively trying to harm other

people, harming health care workers, harming themselves actively, trying to hurt other

patients or inmates in the forensic system, sometimes, though they might seem harsh,

these are required treatments that are engaged to protect people from violent and

harmful behaviour on themselves or others, even homicidal behaviour.

While I can understand that for some British Columbians, some of the procedures and

means of care that get used to help restrain or to help isolate people in an extreme

crisis where violence and danger are a reality…. These are the realities of what sometimes

has to happen.

[2:45 p.m.]

We need to be careful, as people in this place. To characterize these types of sometimes,

in exigent circumstances, required treatments as somehow being a punishment or something

that we need to never do…. Unfortunately and sadly, there are sometimes circumstances

that we have to use things like that to keep others and keep people within our system

safe.

Like my colleagues, I do have concerns about Bill 32 appearing to just be a response

to the Charter challenge that has been launched, particularly with respect to

section

31 of the Mental Health Act, the

section which speaks to deemed consent. I just find

that the timing is incredibly suspect.

Of all the things that we could do to modernize this act, why, coincidentally, is

it this particular

section that this government is looking at when it happens to also

be the subject of a Charter challenge, a court challenge? As many of my colleagues

in here have already pointed out, it seems like the government is on the losing end,

at this point, of that court challenge.

I also have questions, to be honest, about the

section 16 amendments that are being

proposed, and I wonder if these are related to other recent lawsuits.

Even when I was the critic for Mental Health and Addictions from 2022 until 2024,

I can’t think of any circumstances where anyone had come to me — a health care worker,

a doctor or someone in the health care system, or a family — that talked to me about

taking civil action, launching a lawsuit against the health authority or a specific

health care worker with respect to treatments that were given in good faith, to a

loved one or to themselves, under the Mental Health Act.

Coincidentally, recently there were two civil suits, notices of civil claim launched

in B.C. Supreme Court, one being in relation to the Lapu-Lapu tragedy, and the other

being in relation to a young man that died on the grounds of a hospital in Vancouver.

He was apprehended and certified under the Mental Health Act, was receiving treatment,

died on a bench and wasn’t found for several days.

He was considered to be AWOL, and this person had actually died. Although staff had

said that they had been searching for this individual and security had been searching

for them, they never found them on the grounds of their own hospital — someone in

the care of the government. We’re supposed to be looking after people like this who

are vulnerable.

I will be really looking to the government to confirm that the aim of this bill is

to inoculate community care teams and the province from civil liability for claims

related to forced treatment or involuntary care for people with comorbid mental health

and substance issues that represent dangers to themselves and to the public and not

to inoculate the government, specifically the Vancouver Coastal Health Authority,

for any civil liability arising out of the Lapu-Lapu festival tragedy.

The allegation is that VCHA knew or ought to have known that defendant motorist Kai-Ji

Adam Lo represented an imminent danger to himself and to the public, and that he should

have been committed to involuntary care at the time of the Lapu-Lapu festival tragedy.

It wouldn’t surprise me. That’s the thing. It wouldn’t surprise me, with this government,

if that were the intent, but it’s hard to know, because this bill is so incredibly

flimsy. Given the scope of the challenge that we have in this province, to see two

sections…. One of them is a complete repeal of deemed consent, and there are lots

to consider with deemed consent.

I think that the conversation and the debate, as it continues talking about looking

at ways to get consent from individuals under the Mental Health Act, to have them

participate with consent in their treatments, is a good debate to have, but what will

the impact be of repealing that? Are there going to be consequences? For example,

will this delay care?

We have the Red Fish Healing Centre in the Lower Mainland. It services all of British

Columbia for people with complex mental health and addictions concurrently, and there’s

at least a three-month waiting list to get in there.

[2:50 p.m.]

We have people who are certified and are receiving care at places like Red Fish or

any other hospital. If they don’t consent, or, let’s say, they don’t have the cognitive

ability — if they have been assessed, and they can’t make that decision — and someone

who is their substitute decision-maker does not consent to the treatment, will it

prolong the period of time that they’re going to be kept in the hospital for? They

don’t have the support, in terms of medication or a treatment plan, that they need

to then be discharged. Will it make the wait longer?

Like my colleagues, I’m really concerned, to be honest, also about the fact that we

have a repeal of

section 31, deemed consent, but I don’t see anything else inside,

in terms of a framework within the Mental Health Act.

If we default then to the Health Care (Consent) and Care Facility (Admission) Act

and we look at the exception to getting consent from an adult…. The exception under

section 12(1) of the Health Care (Consent) and Care Facility (Admission) Act is: “A

health care provider may provide health care to an adult without the adult’s consent

if it is necessary to provide health care without delay in order to preserve the adult’s

life, to prevent serious physical or mental harm or to alleviate severe pain.”

Sub (

b) is: “the adult is apparently impaired by drugs or alcohol or is unconscious

or semi-conscious for any reason or is, in the health care provider’s opinion, otherwise

incapable of giving or refusing consent.” Perhaps this is something that should be

added to the Mental Health Act. Why is it left out? Why are we leaving these gaps?

Since 2017, this government has been in power and has had the power. As my colleague

from the Third Party pointed out, this Charter challenge has been going on since 2016.

There was plenty of time in nearly a decade to have found more language to put into

section 31.

What happens, then, if the substitute decision-maker refuses the treatment plan for

a person? Under the Mental Health Act, will they be able to go and apply for a court

application to get a court order to give court-mandated treatment to someone? What

if that person is posing a risk to public safety? Will this delay care?

There’s just not enough in this bill that tells us what’s next, which is why I have

such a hard time believing that this isn’t simply a reaction to a court case the government

is losing. Otherwise, you would have more details here. This is far too important

for our province not to have something more.

Apart from the glaring omission, I would say, of not having a framework in place in

the Mental Health Act, even to specifically talk about the other parts of other legislation

that would then apply after the deemed consent would be repealed from our Mental Health

Act, is a complete lack of a plan….

What’s the plan for British Columbia? This is a government that’s overseen the deadliest

overdose crisis in the history of not just British Columbia, of Canada. We have so

many people with acquired brain injuries. We have people with concurrent disorders

languishing on the street. We have an absolutely out-of-control crisis with people

with untreated illnesses, mental illnesses, on the streets, unhoused.

And this is the bill. Since 2017, this is what they have been working on. They should

be ashamed. This government should be ashamed of itself.

Deputy Speaker : Sorry to interrupt, Member.

Peter Milobar : I seek leave to make an introduction.

Leave granted.

Introductions by Members

Peter Milobar : Thank you to the member. I was waiting for a pause, so that worked out well there.

Thank you for that.

[2:55 p.m.]

We have a group here from the Abbotsford Christian School and their teacher, Lindsay

McGrail. It’s 20 grade 11s and four grade 12s.

We’re currently debating a bill in front of the Legislature that would make some changes

to our Mental Health Act and access to care or how health workers provide that care

or not. Hopefully, you find this interesting and you hear various speeches, depending

on how long you are here.

Will the House please make them welcome.

Deputy Speaker : Glad to have you join us, class.

Now we are turning back to Surrey-Cloverdale.

Debate Continued

Elenore Sturko : Welcome to the schools that are coming in here to learn about our Mental Health Act

today.

So many things have happened just in the last three years that I think have been absolutely

horrific for British Columbians. So many of the most significant and devastating tragedies

that have ever happened in the history of our province have happened under the watch

of this government and have a nexus to untreated mental illness and a lack of community

services to support people who are in contact with our Mental Health Act.

I’m going to read through a few of the significant ones that have happened, because

I think that in terms of this bill and highlighting just what a complete missed opportunity

that this bill really represents, I want to read these into the record. These are

examples of mental health system failures leading to violent acts in British Columbia

from 2020 to 2025.

Unprovoked attack, September 2024, downtown Vancouver. A young man, 34 years old,

from White Rock randomly assaulted two strangers. He fatally attacked a 70-year-old

man near West Georgia and Hamilton streets, severed the hand of another victim, which

was later reattached. He attacked that person near Richards and Dunsmuir streets.

The suspect had a long history of mental illness, substance use disorders and over

60 police interactions for mental health crises in Metro Vancouver.

The system failures were that despite a September 2023 assault conviction that this

individual had, he was released with quite light probation conditions and minimal

oversights. Experts who gave their opinion on this cited chronic issues like long

wait-lists for psychiatric treatment, a lack of early diagnosis programs, inadequate

mental health services in jails and unheeded government review recommendations for

better housing and community care following the Riverview Hospital closure.

Of course, this year, April 2025 in Vancouver, a 30-year-old man drove into large

crowds at the Lapu-Lapu festival, killing 11 people, including a five-year-old child,

and injured more than two dozen others. The perpetrator of this, the accused person,

was profoundly ill with severe mental health issues and a history of more than 50

police contacts related to crises.

Hours before the attack, the family member contacted the psychiatric ward about his

deteriorating condition. Police had interacted with him the day prior. No immediate

intervention occurred. Despite the province’s recent launch of ten involuntary treatment

beds and other announcements, this case highlighted the lack of mandatory care pathways

for severe cases, leaving families and police powerless to enforce treatment.

April 2025 in the Coal Harbour area of Vancouver, a man brutally attacked a female

tourist from Toronto, causing a broken nose, black eyes, cuts and severe bruising

to her face in a random stranger attack. This individual was agitated, off his medications,

and he had had a severe mental health crisis the previous year. He had been arrested

two days earlier. This individual had been arrested and despite the family’s pleas

for hospitalization, he was granted bail and then later diverted to a hospital rather

than jail.

Chinatown festival stabbings. This was just a conviction that happened where a 66-year-old

stabbed three people at the Light Up Chinatown festival. Festival-goers were injured

in random attacks. This individual had schizophrenia. He was told by God to commit

these acts, previously found not criminally responsible due to a mental disorder for

the fatal stabbing of his 16-year-old daughter. He had been on an unescorted day pass.

[3:00 p.m.]

We know from the recent B.C. Review Board annual report that the review board talks

about the lack of adequate supports under the forensic system where this individual

was a part of.

After the Lapu-Lapu tragedy, the Premier stood on the steps of this place. The first

thing he did was order a review into the bollards to find out if we have enough security

at events like festivals. We’re in a province that did the Olympics. We have FIFA

coming. And the first course of action is to find out how to do security. Are you

kidding me?

You know how to do security. What you don’t apparently know how to do is fix the mental

health system. And Bill 32 isn’t fixing it, after nearly a decade. It’s outrageous.

Instead of looking so narrowly at the Mental Health Act, which…. There’s no doubt.

As my colleagues have brought up, there are historic issues with even the context

in different times of the Mental Health Act, involuntary treatment. There are many

things that we could modernize and look at here. But it’s not just the Mental Health

Act. It’s the system that supports the Mental Health Act.

With Bill 32, as my colleague from Skeena had pointed out, we’re talking about repealing

deemed consent, allowing for doing assessments of people’s ability to make decisions

or allowing a substitute decision-maker to be brought in, perhaps having to go to

a tribunal or to the courts to seek a court order to treat people — all of which is

not actually defined now, after

section 31 of the Mental Health Act is repealed —

but no context in terms of even how this is going to enhance the supports that people

need.

The government has not committed to a fulsome review of the mental health care system.

They don’t have a plan that we can look to, that we can point to. This is a government

that loves plans as a way of showing that they’re doing something.

They put out these plans, and they love to have a press conference. They have one

for sexual violence. Very good. These are good plans. They have ones for addressing

post-secondary. They have lots of different kinds of plans that you can point to but

none for this. One of the most significant issues that our province is currently facing

and there is no plan.

In their news release, where they were announcing Bill 32, they gave themselves credit

for the number of beds that they have built over the last almost decade, since 2017.

It’s less than 100 beds a year.

Interjection.

Elenore Sturko : Pardon me?

She said she started from scratch, Mr. Speaker.

Deputy Speaker : Members, if we could focus on our Bill 32 this afternoon.

Elenore Sturko : Well, I wouldn’t expect a government that’s failing this spectacularly at mental

health to heckle me while I’m giving a speech on their failures in mental health.

I just read from a bunch of examples of how this government’s failure has killed British

Columbians. Are you kidding me? You’ve got to be kidding me. And to be heckled when

you’re trying to point out the fact that this government, since 2017, has developed

no plan….

I get it. You don’t agree with the way that the previous government implemented and

designed Red Fish Healing Centre, that started Foundry, which you took over as a government.

Thank goodness for the previous government, because then you didn’t really start from

scratch, did you? You had a foundation on which you could build something. But instead,

you’ve been without a plan. And Bill 32 is not a plan.

There have been so many opportunities, so many reports, B.C. Review Board annual reports

pointing to worsening outcomes, worsening numbers of beds, supports for people with

mental illness.

[3:05 p.m.]

What is missing from Bill 32 is a whole lot. And I do not believe that this is anything

more than a response to litigation, as a means of trying to skirt their own responsibility

to the community, to the public.

I’m going to conclude my statements on Bill 32 for now, but I will participate in

the committee stage if it passes second reading.

I would expect the government to do better. If you counted the speeches that were

given in here, not just for bills — private members’ bills, two-minute statements,

five-minute statements, mental health debates — this has been one of the most significantly

spoken about issues in the entire province. The fact that what the government introduces

after nearly a decade in power is repealing one

section and one amendment is a disgrace.

Hon. Sheila Malcolmson : Let me first say, as clearly as possible, in response to comments from both the member

for Skeena and the member for Surrey-Cloverdale — and I appreciate greatly the voices

that both of those members bring to this debate and to this chamber; it is important

— these amendments are unrelated entirely to the tragic events at the Lapu-Lapu festival

in April. This is about protecting health care workers and supporting them while they

provide the crucial front-line care to vulnerable populations.

I’ll also say…. I’m so glad we’ve got so many people in the chamber listening to this

really important debate. I’m going to talk for a little bit. But just in case you’re

going to leave soon, this is an amendment that is about protecting a service that

we already have in the face of a court case. This is not the review of the Mental

Health Act. That work is entirely ahead of us.

This is the smallest amendment, because it’s the amendment that we need right now,

in this time, providing some needed clarity in the operation of the Mental Health

Act, confirming that doctors and nurses and others cannot be sued for doing their

jobs in good faith and with reasonable care and, honestly, making sure that we keep

the tool that we have right now, before we then do the work that is already underway

of reviewing the Mental Health Act and working together.

We can’t predict what the courts will decide, but in the meantime, we are doing everything

we can right now to protect involuntary care in the province so that people who require

it can continue to receive treatment under the Mental Health Act and, also, so that

the brave and dedicated people who provide this essential care are not put in jeopardy

for doing so.

That’s the part of my speech that is just really trying to correct the record. I’ll

now speak in more detail to this very limited amendment, not the last amendment to

the Mental Health Act that this government will be bringing.

Big picture: when adults and young people are in crisis, we want them to be met with

compassion and care. That’s why we have been working to build up a comprehensive system

of mental health and substance use care. It is described in the plan that was adopted

in 2019, Pathway to Hope, and we’ve been building it out — child and youth mental

health care, harm reduction, addiction treatment, recovery services.

Some of the pieces, many of them, are voluntary — the early psychosis intervention

that we stood up, the Foundry centres, the integrated child and youth mental health

teams that break the silos between the health authority and the school district and

MCFD and community service providers. All of these are meeting people where they are

and really recognizing that if we invest early in young people’s mental health, we

can set them up for a lifetime of more success.

[3:10 p.m.]

Bed-based treatment and recovery beds. Red Fish Healing Centre has been mentioned

a couple of times in this debate, a 105-bed site that has a lot of voluntary treatment.

It does have some involuntary beds and floors as well. But it finally broke the logjam

between a health system that said concurrent….

Interjections.

Hon. Sheila Malcolmson : Well, I opened it when I was the minister, and I was so glad to see it open in 2021.

Deputy Speaker : Let’s stay focused on 32, folks.

Hon. Sheila Malcolmson : Yeah.

Road to Recovery. First Nations addiction treatment centres in my own riding, both

the Orca Lelum Youth Treatment Centre…. It’s actually in the riding of my colleague.

I believe it’s my colleague Nanaimo-Lantzville, in his riding. And the Tsow-Tun Le

Lum addiction treatment centre, which is in the riding of my colleague from Cowichan

Valley, both state-of-the-art, brand-new addiction treatment centres.

Assertive community treatment teams that operate 24-7 in a bunch of communities, including

mine in Nanaimo, Gabriola Island. Mobile integrated crisis response programs, pairing

police along with mental health professionals to respond to mental health–related

crisis calls.

All of these voluntary supports have been really important to build up. They continue

to open, and we continue to find new ways to tackle some of the really wicked problems

that are in front of us.

Those are all voluntary supports, but when someone is so unwell that they can’t make

decisions about their own safety and their own health care, we have a responsibility

to step in with compassion and with care. When used correctly and consistently, the

Mental Health Act ensures people suffering from severe mental disorders get the timely

care and protection that they need, even if they are unable to seek it themselves.

I have a quote from a patient who received involuntary care. Initials are E.W.

“My experience with involuntary treatment provides a huge sense of relief, and it’s

the only reason I’m able to function, knowing that if I fall down, something’s there

to catch me. I won’t agree with it at the time, because I’m in a different state of

reality, but it catches me before I make a decision I can’t come back from, like using

hard drugs, committing suicide or harming someone else. I just have confidence that

professionals who’ve worked their whole lives are there to fix my brain, or at least

stabilize it, so I can pick up the pieces again.”

That’s why involuntary care is necessary and important.

The Mental Health Act states that a patient can only be involuntarily admitted if

all of the following four criteria are in place: the person suffers from mental disorder

that seriously impairs their ability to react appropriately to their environment or

to associate with others; the person requires psychiatric treatment in or through

a designated facility; third, the person requires care, supervision and control, in

or through a designated facility, to prevent their substantial mental or physical

deterioration or for their own protection or the protection of others; and finally,

the person is not suitable as a voluntary patient.

Physicians and nurse practitioners apply their clinical assessment to determine the

appropriateness of involuntary admission. The vast majority of people with mental

health conditions are effectively treated on an out-patient basis, but the Mental

Health Act ensures access to care in situations where the person is unable to seek

care themselves due to a state of severe mental impairment.

Right now Mental Health Act admissions occur at 75 designated facilities, including

37 hospitals that are designated as psychiatric units; 13 hospitals that are observation

units, which allow shorter-term admissions; and 25 provincial mental health facilities.

Those are in-patient facilities. And as I mentioned earlier, some of these beds are

at Red Fish.

There are more than….

[The bells were rung.]

Deputy Speaker : Just pause for a moment, Minister.

Sorry for that interruption, Minister.

[3:15 p.m.]

Hon. Sheila Malcolmson : Thank you, Mr. Speaker.

I was listing the Mental Health Act admission locations, 75 different designated facilities.

There are more than 2,000 mental health beds across the province, and 17,000 individuals

were admitted involuntarily last year, some of them admitted repeatedly, so some of

the numbers you see are higher than 17,000, but those are individual pieces.

I read these numbers out hoping that my friend Nanaimo mayor Leonard Krog is listening

in, because as we have had debates over the years about whether there are facilities

and whether we need to build additional facilities, I will often remind the mayor

that we do have, notwithstanding the closure of Riverview…. This, admittedly, was

done very poorly, so far as not having in place the kind of community care and the

more decentralized facilities that had been committed to at that time.

Notwithstanding that failure, there are right now many, many people that are held

against their will within our existing medical system. In addition, there are 18 involuntary

care beds at Alouette Homes in Maple Ridge and ten beds at Surrey Pretrial Services

Centre that opened in the spring of 2025. These are both under the trial we’re doing

around secure care.

Work is also underway to open an additional 100 involuntary care beds in Surrey and

Prince George facilities. We’re also building more than 400 acute care mental health

beds at new and expanded hospitals throughout the province. Whenever you see a new

hospital opening, we have psychiatric facilities built into them. They will be available

to people as these hospital projects are completed.

One recent example is the new Seven Sisters facility in Terrace, with five new mental

health and substance use beds, replacing an old, outdated facility.

I’m going to read another quote, this time from a parent whose daughter received involuntary

treatment. She said: “My daughter would likely be dead or in prison if she had not

been treated in a timely manner when hospitalized for threatening and bizarre behaviour

when in psychosis from schizophrenia. We are grateful that the Premier is amending

the B.C. Mental Health Act to affirm treatment of involuntary patients upon hospitalization.

Treatment stabilizes and enables someone with a serious mental illness to regain judgment

and begin to heal.”

That’s Shirley Chan, the past president of Pathways Serious Mental Illness Society.

So for all these reasons, I support Bill 32 and its amendments to

section 31(1) of

the Mental Health Act to replace the dated language of the existing

section with very

clear language that exists in other health laws in the province that say that health

care workers are protected when they are delivering this involuntary care in our province.

We are in court right now defending the involuntary care provisions of the Mental

Health Act. We think it’s important that these provisions exist and that they remain.

We think it gives people an opportunity to rebuild their lives after facing catastrophic

mental health challenges. It’s important that this tool remains, and we’re in court

making these arguments right now.

This change we’re introducing in the Legislature doesn’t make that court challenge

irrelevant. It doesn’t have an impact on whether or not the court is able to grapple

with this really important question about what limits are on involuntary care or treatment.

I recognize, for the reason that the House Leader of the Green Party outlined, that

involuntary treatment and the conditions which patients experience inside the health

care system are not uncontroversial. It’s vital that care be delivered in the most

dignified and careful and human rights–based framework. It’s important that the courts

are grappling with this question of involuntary care or treatment.

This amendment in Bill 32 just provides health care workers with the certainty that

regardless of the outcome of that court case, those workers will be protected in delivering

care. We need to be very clear that regardless of the outcome of the court case, health

care workers will be protected in the work that they do.

The outcome of this provision passing is that it protects the health care workers

involved in delivering involuntary care so that they know with certainty that they’re

protected in the work that they do and that frankly, for families and for patients,

the tool is protected.

[3:20 p.m.]

That’s why this is such a short bill, because it’s very narrow.

We are updating the language to reflect other health laws in this province that say

very clearly that the health care workers who administer this care under these other

sections of the act are protected from being sued.

It doesn’t talk about patients having deemed to have consented. If this amendment

passes, it just states that the law is standing behind these health care workers who

deliver this care and that they are protected from being sued.

We know involuntary health care is essential, and we know that it saves lives. If

Bill 32 passes, then the amendments will reduce confusion that has emerged about the

authority within the act to authorize involuntary treatment and to better protect

health care workers providing involuntary mental health care to patients. We want

health care workers to be able to focus on providing quality care to their patients.

These amendments won’t have an impact on the way that health care is provided under

the act.

This is status quo, carrying on, while we do the other work of reviewing the Mental

Health Act and bringing in the amendments that other members opposite have described.

Together these changes will help clarify and protect the purpose of the act, which

is to provide treatment to people who require it.

This is not the first time that we’ve amended the Mental Health Act recently in this

Legislature. You’ll remember that during the spring 2022 legislative session, we introduced

legislation to amend the Mental Health Act so that people involuntarily admitted under

the act could access support from an independent rights adviser.

You’ll remember that those changes were introduced by the Attorney General, because

the Mental Health Act’s responsibility is split between multiple ministers. I certainly

experienced this when I was Minister of Mental Health and Addictions. The rights-based

part of the legislation sits with the Attorney General, and it was the AG that brought

that forward.

That was embraced by the Legislature, and it moved forward, and we now have an independent

rights adviser who talks with patients at the point of their involuntary admission

about what their rights are and lets them know that they have the ability to get a

second opinion, for example.

And no, this legislation is not part of the Mental Health Act review that is underway.

That is work that we are committed to doing. This is just another small step along

the way, as was the spring 2022 legislative change.

I’m now going to leave the mechanics of the health worker protection provisions of

Bill 32 and just speak for a couple of minutes about some of the associated work that

is also supporting people on their journey towards full mental health. These are commitments

and actions that have been identified in the poverty reduction strategy that I am

responsible for, where, with inputs from tens of thousands of people across British

Columbia, we developed a vision of British Columbia where people find meaningful and

rewarding work, employment services and other tools and supports that can help them

out of poverty.

These are relevant in a number of ways. We’ve been integrating employment services

into bed-based addiction treatment so that people, while they’re…. They have this

built into their counselling programs. People get jobs and connections that they need

to build a better life, and when they exit the residential bed-based treatment, they

already have a new set of responsibilities, a new set of friends and some more connection

and a purpose in community.

My ministry granted, in 2023, $5 million to the B.C. Canadian Mental Health Association,

and it is using that to pilot this program that I’ve described, integrating employment

services with addiction treatment, in recovery centres in five different communities

— for example, Nanaimo. We just have been really encouraged to see how many people

are exiting treatment with a plan, with a job and with supports in order to be able

to retain that job.

[3:25 p.m.]

In another area, we’ve been working with the National Institute of Disability Management

and Research, NIDMAR, to help people recovering from a physical injury or mental health

challenge to safely return to work. We don’t want people to end up on disability assistance

and not have the supports to lift them back up to a place that they can return to

their jobs.

We’ve had really encouraging outcomes already, showing that early health care and

ergonomic and job coaching interventions can mean that British Columbians with disabilities,

including mental health disabilities, can continue to thrive in the workforce. Again,

that connection of employment is a real protector against mental illness.

We’ve also been so encouraged to have been able to adopt a provincial peer-support

training curriculum, created by Here4Peers, to integrate the valuable contributions

of peer workers and to help people with mental health recover. We’ve also developed

together another British Columbia first, an employer’s guide to supporting and engaging

peer workers.

We’ve also been co-developing and facilitating Indigenous-led programs and support

for Elders, so that people get the care that they need in their own home communities,

supported and surrounded by cultural teachings, again as a way to buffer against mental

illness.

Finally, through our work with Community Living B.C., which is the provincial Crown

that provides community inclusion supports for adults with developmental disabilities,

we’ve been creating new housing options for Community Living B.C. participants who

have particularly complex needs.

Grosvenor House in Surrey is a place that five Indigenous men with mental health and

substance use challenges and behavioural challenges, who had been caught in a cycle

of homelessness, are able to get supports. We’re very grateful to the health authority

for being one of the partners on that.

We have construction starting next year in Prince George, a ten-unit complex care

housing, the first of its kind — a cooperation between B.C. Housing, Northern Health

and Community Living B.C. — for adults with developmental disabilities who have mental

health challenges.

I will close by saying the combination of poverty reduction and employment supports

for vulnerable people that I described at the end of my speech; the standing up of

new, voluntary mental health treatment supports that I described at the beginning

of my speech; and then, at the middle part, the substantial facilities that we have

to house people within the medical system when, because of their mental health challenges

or psychosis in the moment, they are not able to make good decisions about their own

health care….

I offer, again, my support for Bill 32 and its amendment to protect the ability of

mental health workers to be able to administer involuntary mental health care, knowing

how essential it is in certain situations to save lives and ensure that people get

the treatment that they need.

Anna Kindy : I’m here to add my two cents on the Mental Health Amendment Act, 2025. Listening

to the other speakers and hearing that this is the first bill brought by this government

since they’ve been in power for eight years….

When I look at what’s happening on the ground…. I’m going to bring that perspective

a little bit, the context of what’s on the ground, because it’s sometimes easy to

make amendments, and they sometimes sound good on paper, but when you intend to actually

implement them, what does it mean on the ground? Before even knowing what it means,

you have to understand the context of what’s happening on the ground.

I’ve been practising for a long time. Part of my practice was addiction and, obviously,

the dual diagnosis of addiction and mental health…. Often people have that dual diagnosis.

I’ve also been a GP, trying to help people navigate who have mental health issues.

[Mable Elmore in the chair.]

So the context is that sometimes making amendments is meaningless, when you hear the

other side mentioning the number of beds opened and the number of programs they’ve

started or are implementing, when what I’m seeing on the ground is a worsening condition.

[3:30 p.m.]

If you look at talking about the safety issue of our cities…. People from around the

world travel. They come to Vancouver, and they’re shocked when they walk down East

Hastings, and they fear for their safety. That’s real. That has changed. That was

not there 15 years ago to the extent that it is now, and it’s worsening.

Obviously, there’s a safety issue, and part of the safety issue is because people

doing illicit substances get to be brain-injured, and drug use can cause psychosis

and precipitate schizophrenia as well. So we’re dealing with a real epidemic of overdoses

and mental health issues.

If you’re looking at the access to mental health beds, if we’re talking about a patient

coming into the emergency department in terms of the safety of the front lines…. Basically,

section 31 removes a provision that deems patients to have consented to treatment

if the director has authorized treatment.

My concern with this is when other provinces…. There’s a Charter claim against the

province regarding that statement. The other provinces don’t have the same legislation,

but they do have other legislation that allows certification or treatment without

consent in an emergency department. So if we’re concerned about safety, what is the

backdrop of what’s going to happen if we remove that?

If a patient…. I mean, you can’t chemically sedate a patient unless they’re certified.

If you need their consent, well, they’re not going to give you their consent if they’re

in active psychosis, so what options do you have then? Is it physical restraint? Is

it putting a patient in what I call a padded room? That is what happens, right? If

a patient cannot give consent, where will they end up?

The issue, as well, is that you have to play the tape of what our psychiatric world

is like now. Even if you are, at some point, certified, it’s difficult to chemically

sedate a person to the point that you want to sedate them sometimes.

If they’re in a padded room — I’ve mentioned that before in this House — that means

that they need to, hopefully, move into a psychiatric bed. But the issue is that there

are no psychiatric beds. They’re very hard to come by. Patients can stay in the emergency

department for days and weeks in what I would call inhumane conditions.

I’m kind of wondering where we’re going in all of health care, including psychiatric

care, when we can’t access the basics of a hospital bed. I think we need to address

that context to start off with. That’s throughout the province.

In the north Island, we don’t have a psychiatrist. When you’re rural, good luck ever

getting into triage from your own hospital into a psychiatric bed. It’s very difficult.

Then it leaves the safety portion for the health care workers having to deal with….

Also, the inhumane conditions of some of these patients — what they have to go through.

So the context is real.

It was a little bit disappointing, as well, when one of our members here was talking

about…. She views it from more of a legal aspect, having been an RCMP officer. She’s

talking about real deaths of people.

I mean, we do have to show some compassion here. It’s one thing having legislation,

but we also need to have compassion for what’s happening on the ground and what people

go through when somebody has died. I think we need to be respectful of that, and I’m

just going to reiterate that.

[3:35 p.m.]

Coming back to clause 2, of removing the provision that deems patients to have consented

to treatment if the director has authorized treatment, again, other provinces without

deemed consent legislation can treat patients with medication in the ER under their

respective mental health acts.

Do we have that here? Do we have a backup? Because if we’re going to be removing that,

we need a backup. I’m a little bit worried about just having this

section without

having a backup in an urgent situation. I think it needs to be looked at seriously,

because that is an issue.

I also want to say that in medicine, it’s always a balancing act, because you have

to balance the right of the patients as well as medicating or treating the patient

and keeping the health care workers safe. We have to also remember that as health

care workers, we’re not perfect, and we do make mistakes — all of us. As a health

care worker, I’m liable for my mistakes, because I’m not perfect. That’s why we all

get insurance. We know that, potentially, at some point, a mistake will be made.

I find it a little bit concerning, clause 1, which extends liability protection of

providers of authorized professional services, care and treatment. Is there a mechanism

for liability if you do wrong? Because we have to look at the reality on the ground.

Most times it’s very rare that it can happen, but sometimes something can be done

to the detriment of the patient, even in the psychiatric world. It happens. As a GP,

I can prescribe the wrong medication, and a patient gets harm from it. As a surgeon,

I can make a mistake while I operate, and I’m liable. I need a bit of clarification

there, personally, as to what this means — the extension of liability protection to

providers of authorized professional services, care and treatment. It seems very broad.

This is where you start thinking about Lapu-Lapu. Was this a response to Lapu-Lapu?

Was this a response to…?

I have to go and be honest here. It’s not the first time I’ve heard in this House

about the government being liable or the health authorities being liable. That should

be the least of the concerns. It should be the patient’s safety, patients being able

to get timely care, patient safety and front-line safety. But we seem to be more worried

about liability. I think that’s maybe a dangerous precedent to set if that’s what

this clause is saying.

I just think that should be discussed, because like I said, we have to balance the

needs of, obviously, the medical community as well as the needs of the patients. I

think this clause 1 seems to favour one side over the other.

Again, being on the front line…. We’ve all heard about mistakes being done in the

medical field. It happens. You hear about the doctor being sued. It happens. Again,

this is why we have insurance for that. In terms of liability, is it liability for

health authorities? Is this what the concern is? Do people one day…? I’m not a lawyer.

One day, people, if a mistake was done….

Sometimes I think the way lawyers proceed, they sue everybody, as far as I know. They

sue the nurse present, the doctor present, the hospital and maybe the health authority.

Maybe this is what this is about. Is this about protecting the health authorities?

We have to look at if that’s the intent of that clause. I think, again, it’s a dangerous

precedent.

[3:40 p.m.]

We need to look at, again, the balance of keeping patients safe. Health care should

be patient-centred. It’s about outcomes for patients. That’s what we should look at,

outcomes. How do we improve outcomes here? How do we improve the safety of the patient,

the safety of the community?

I think those two clauses, as far as I see it, don’t improve the situation at all

on the ground — especially clause 2, not having a backup to removing a provision that

deems patients to have consented to treatment if the director has authorized treatment.

I’m a bit concerned about that, about the thoughts. I think that needs to be discussed

again.

We go back to how to keep the community safe, and part of how to keep the community

safe, if we’re dealing with psychiatric issues, is access to timely care. Right now

we don’t have that. There are numerous stories we can talk about.

A previous MLA talked about, actually, a physician whose son was certified in hospital

and left on a day pass or left for a smoke and was called AWOL, and he was found four

days later on hospital grounds. Is that patient-centred? Are we thinking about the

patients? Is anybody liable in this case where somebody doesn’t even bother to look

around the hospital grounds to find a young man’s body that was there for four days?

I came across a story recently. A very reputable forensic psychiatrist contacted this

family and told them that their son is one of the worst cases he’s ever seen. This

young fellow is certified but at this point stable because he’s compliant with his

medications. He would be called stable, but he has this sort of explosive way of reacting

to things. His forensic psychiatrist is saying that he worries for the safety of the

community.

Because this young man has also addiction issues, there are not very many places that

can accept people with dual diagnosis. There’s the diagnosis of psychiatric diagnosis

of schizophrenia and also the diagnosis of substance use disorder. There’s Red Fish

right now. One place, Red Fish. The wait time for this patient to get into Red Fish

— again, he’s been identified as “one of the worst cases I’ve ever seen” — is three

months to get into care.

We’re failing in provision of the basic psychiatric care. It snowballs from there.

We can do as many legislations as we want. We put two clauses, but on the ground,

will that change anything? No. It protects the providers, maybe, from liability.

There’s a case in front of the court regarding a Charter for consent. Is that the

reason this is happening? If that’s the case it’s, again, not a solution to w