Running head: HEALTH POLICY ESSAY ASSIGNMENT PART B

Health Policy Essay Assignment Part B Dermot Connolly Stenberg College PSYN 204-3 K. Bagshaw August 2013

HEALTH POLICY ESSAY ASSIGNMENT PART B Health Policy Essay Assignment Part B In part A of this paper the changing roles of the police in Canada and their increased

interactions with the mental health community was analyzed. The reasons behind these increased interactions was also explored with a view to identifying the focusing events that led to the implementation of policy changes aimed at assisting the police and protecting societies vulnerable. The more pertinent of these policy changes was the introduction of emergency procedures under section 28 of the BC Mental Health Act. The target populations for section 28 are people with a mental disorder who are at risk of coming in contact with the Canadian criminal justice system. (British Columbia Ministry of Health 2005). The implications section 28 has on the mental health community and the police force is the primary focus of part b of this paper. Subsequent amendments to the act as they pertain to emergency procedures are also explored. A comparison is also made between the BC Mental Health Act and similar legislation introduced in other Canadian provinces. Special focus is given to the merits, implications and drawbacks to the section 28 while also making recommendations for improvement. The establishment of BC legislation on mental illness can be traced back to 1873 with the passing of the insane asylums act which allowed for the involuntary committal of a person deemed insane after examination by two doctors. (Vancouver Sun 2012). The BC mental health act as we know it today, came into effect in 1965. It was established to govern the admission and treatment of individual with mental disorders while also dictating the procedures needed to govern admittance and patient rights. (Early Psychosis Intervention n.d.). Section 28 of the act governs emergency procedures and was introduced under the Mental Health Amendment Act of 1998. (Priddy 1999). Section 28 provided clarifications around police interventions with the mentally ill at a time when lack of awareness and training resulted in the mentally ill being

HEALTH POLICY ESSAY ASSIGNMENT PART B discriminated against under BC legislation. Such discrimination culminated in the confrontation and subsequent deaths of several individuals suffering from mental illness.

Under section 28, police were now given the authority to apprehend a person they believe to be acting in a manner that endangers either their own safety or the safety of others. It also clarifies the role of the provincial magistrate in the issuance of warrants and detention of an individual suspected to be suffering from a mental illness. (Priddy 1999). In 2005, the BC Mental Health Act was amended to provide additional clarification on several sections including section 28. Central to these changes was the provision of additional clarification on police interventions under section 3.2 and appendix 5. In addition, an optional police triage guide was introduced to help police ascertain if a persons behavior is grounds for apprehension under the act. (Ministry of Health n.d.). The role of the police in the transporting a person to hospital is also detailed with the mental Health Act under appendix 5. This role centers on the legal transfer of ownership of a patient to hospital staff. Under section 28(1), the hospital cannot legally take responsibility of a patient until a medical certificate has being successfully completed. (British Columbia Ministry of Health 2005). In addition, no provision has being placed within the act to dictate when a police officer should assist hospital staff. Instead, such obligations fall under the police officers common law duties. (British Columbia Ministry of Health 2005). The addition of the police triage guide into the 2005 edition of the mental Health Act is a commendable attempt to aid police officers in the detection of a mental disorder with the potential of endangering safety. The triage provides examples to signs and symptoms to common mental disorders and likely endangerment such disorders can pose. (British Columbia Ministry

HEALTH POLICY ESSAY ASSIGNMENT PART B of Health 2005). The obvious problem with the use of the triage guide is its use of generic descriptions to describe each disorder. This allows for increased subjectivity between officers when attempting to make a determination about a persons mental health. Such subjectivity is a reflection of the generic descriptions and diagnoses commonly found within the DSM. While the mental health act has being implemented in every Canadian province, notable differences exist between each. There are many who suggest that the BC mental health act infringes on the rights of the patient. Involuntary admission for example is governed under an

imprecise and broad set of criteria that is open to interpretation. (Groves 2011). When compared to the Ontario mental health act, such misinterpretation is avoided through the provision of additional clarity surrounding criteria for involuntary admission. (Groves 2011). In fact it is argued that the Ontario mental health act is more cognizant of the rights of the patient where the BC mental health act leans heavily on the interpretations of the physician. (Groves 2011). This apparent disconnect is hampering the successful implementation of section 28, where ambiguity surrounding the criteria for involuntary admissions only causes confusion as to what constitutes circumstances for apprehension and admission by the police. It is the opinion of the writer that consideration should be given to the several proposals surrounding the policing of the mentally ill. Where necessary, such proposals should be included in an amendment to section 28 which has not being reviewed since 2005. Important proposals worth considering include the inclusion of mental health policy makers on the board of the criminal justice reform secretariat (Hall & Weaver 2008) and the amendment of use of force policies when confronted with a person exhibiting symptoms of mental illness. (Canadian Mental Health Association 2008). Such reforms can only serve to clarify the role of police in the apprehension of the mentally ill and strengthen section 28 of the BC mental Health Act.

HEALTH POLICY ESSAY ASSIGNMENT PART B The introduction of section 28 into the BC mental health act is a commendable piece of legislation designed to address the increasing levels of police interactions with the mentally ill. While the act helps to clarify conditions surrounding apprehension and detainment under the judicial system, it does little to address some of the underlying causes of such interactions. Lack of funding for community based programs; deinstitutionalization and changes in common law have all played fundamental roles in the breakdown of support services for the mentally ill. In the absence of such support systems, increased police interaction is inevitable. One of the more significant effects of section 28 has being the training it has provided police in the recognition and respect of mental illness. Such training has helped support the changing face of policing in BC which has seen a shift from institutionalized to community care policing to help protect the more vulnerable within our community. Discrepancies also exist between provincial Mental Health Acts within Canada where in BC; it is argued that the rights of the involuntary patient are infringed upon in favor of the

subjective diagnoses of the physician. While section 28 and its subsequent amendments go some way to clarifying the circumstances governing police interactions, more still needs to be done. Its time for the BC mental health act to undergo another amendment and when it does, section 28 and its amendments must be reviewed. Such a review must concentrate on addressing the underlying causes of police interactions without infringing on the rights of those it clams to protect.

HEALTH POLICY ESSAY ASSIGNMENT PART B References: British Columbia Ministry of Health (2005). Guide to Mental Health Act 2005 Edition. Canadian Mental Health Association (2008). Crisis intervention policy for police working with people with mental illness / concurrent disorders. Retrieved from: http://2010.cmha.bc.ca/files/policy_crisis_intervention.pdf Early Psychosis Intervention (n.d.). The mental health act of British Columbia. Retrieved from: http://www.hopevancouver.com/Mental_Health_Act_of_British_Columbia.html Groves, M. (2011). Suggested changes to BCs mental health s ystem regarding involuntary admission and treatment in non-criminal cases. Retrieved from: http://bccla.org/wpcontent/uploads/2013/01/2012-BCCLA-Paper-BC-Mental-Health-System.pdf

Hall, N. & Weaver, C. (2008). Keeping people with mental disorders out of trouble with the law. Canadian Mental Health Association. Retrieved from: http://2010.cmha.bc.ca/files/DiversionSummary.pdf Ministry of Health (n.d.). Mental health act. Retrieved from: http://www.health.gov.bc.ca/mhd/mentalhealthact.html

Priddy, P. (1999). Mental Health Amendment Act 1998. Retrieved from: http://www.leg.bc.ca/36th3rd/1st_read/gov22-1.htm

Vancouver Sun (2012). A brief history of the treatment of mental illness in BC. Retrieved from: http://www.canada.com/vancouversun/news/westcoastnews/story.html?id=5496270bbf1b-449e-9b81-fc1705224f76