Critics slam B.C. premier's involuntary care announcement, cite lack of evidence

The B.C. premier’s announcement to introduce involuntary care for people with serious addiction and mental health issues is being met with pushback from critics who say the decision isn’t evidence-based and will cause more harm.

Dr. Kora DeBeck, a professor at the school of public policy at Simon Fraser University, said there is no evidence this approach works.

“Forced treatment doesn’t have the promise we hope that it does, and it sets us up for so much risk,” she said.

DeBeck said some of those risks include further eroding connections and trusting relationships in the health-care system, as well as increasing the risk of overdose.

“Addiction treatment is not a linear journey,” she said. “People often relapse and end up using drugs again. When they have these periods of not using drugs they’re much more likely to overdose and so when people are being forced into either stabilization or addiction treatment, when they get out, they’re at a very high risk of death.”

Designated units

At a news conference Sunday, David Eby said the decision was in response to the current system “struggling” to respond to people with three overlapping issues: mental illness, brain injuries and addiction to synthetic opioids or stimulants.

According to the premier, the province will create facilities where people can be held after being apprehended and detained under the Mental Health Act. Instead of releasing a person into the community, Eby said there will now be the option of moving them into one of these facilities without their consent. One of the first designated units is set to open on the grounds of the Allouette Correctional Centre.

DeBeck said the province’s new direction is missing the mark when it comes to addiction treatment, particularly in the midst of a toxic drug crisis.

“Addiction treatment, whether it’s voluntary or involuntary, is not addressing the toxic supply of drugs and that is what we know is killing people,” she said.

‘Very problematic’

Mercedes Eng, a writer who teaches at Emily Carr University, called the premier’s announcement maddening. As a person who accessed substance use treatment on her own terms, she said she doesn't understand how this policy will unfold.

“I feel confused as to how that’s going to work and why we haven’t been able to address the needs of folks who want care,” Eng said.

Eng added the program she accessed in the 90s taught her about relapse prevention strategies and the underlying issues of addiction.

“That program and being able to access methadone were pivotal for me in recovery, as was secure housing, so something like a forced detox would not work for me,” Eng said. “Yes, there are times, absolutely where interventions are required and where supervision is required but the mandatory care they’re talking about – I don’t think is going to work and is very problematic in terms of civil liberties.”

Civil liberties

Safiyya Ahmad, staff counsel with the B.C. Civil Liberties Association, said the organization was concerned about the announcement.

“We’ve spoken out in the past about the idea of the use of involuntary treatment particularly for people who use drugs,” she said. “We think it’s infringing on people’s rights in a way that’s not acceptable and that could possibly cause a lot of harm to people as well.”

Ahmad said individuals’ charter rights could be affected by this legislation. In particular, Section 7, which is the right to life, liberty and security in person.

“There’s evidence to show involuntary treatment is quite harmful to people,” she said. “There is simultaneously evidence to show that things like harm reduction services are beneficial for people to use drugs and yet we’re seeing harm reduction services shut down and taken away steadily.” 

The premier did not provide a specific timeline for when the facilities will open, but said the plan is to move forward quickly.