Episode 18: Involuntary Care

Presented by: Beam Credit Union
Host: Jessica Samuels
Guest: Mike Gawliuk, CEO, CMHA Kelowna

Episode Overview

In this episode, Jessica Samuels speaks with CMHA Kelowna CEO Mike Gawliuk about the complex and often divisive topic of involuntary care in British Columbia’s mental health system. Together, they unpack what involuntary care means under the BC Mental Health Act, explore how and when it’s used, and discuss why it continues to spark debate around human rights, compassion, and the need for a stronger voluntary care system.

Mike offers insight into the legal framework, current practices, and the growing conversation around compassionate mandated care—especially in the context of the province’s drug poisoning crisis and rising homelessness. The conversation also touches on concerns about overrepresentation of marginalized groups and what safeguards and accountability measures exist within the system.

Key Takeaways

Understanding the Mental Health Act: The Act defines how involuntary and voluntary mental health treatment occurs in BC, with four key criteria determining if someone can be certified for involuntary care.
Checks and balances: Certification requires medical assessment and multiple approvals, but review mechanisms like the Mental Health Review Board are underused.
Human rights and consent: BC is the only province with a “deemed consent” clause, meaning individuals certified under the Act are considered to have consented to treatment decisions made by their care team.
The role of the drug crisis: Rising substance use and homelessness have led to increased use of involuntary care as a response to complex community issues.
Need for stronger voluntary care: A lack of accessible, early, and voluntary mental health services may be driving reliance on involuntary interventions.
Evidence and evaluation: Research on involuntary care shows mixed results, underscoring the need for better data on outcomes and long-term support.
Equity and representation: There is concern about disproportionate impacts on Indigenous and marginalized communities.
A last resort: CMHA Kelowna supports involuntary care as a necessary but last-resort option, emphasizing that it must exist alongside a robust voluntary care system.

Resources Mentioned:

What is involuntary care

https://www2.gov.bc.ca/gov/content/health/managing-your-health/mental-health-substance-use/mental-health-act

https://www.healthjustice.ca/fast-facts-mha

https://static1.squarespace.com/static/5e34ed207332cf46d561c2da/t/66f5e892880abb36086f9736/1727391891785/GetTheFactsAboutInvoluntaryTreatment_2024_HealthJustice.pdf

https://bc.cmha.ca/news/charter-challenge-on-bcs-mental-health-act/

https://www.youtube.com/watch?v=1pEp16qiCGE - Mayor Krog’s comment at the end is interesting.

How it works

https://www.bcmhsus.ca/about-us/who-we-are/governance/mental-health-act

https://thetyee.ca/News/2021/11/23/BC-Forced-Mental-Health-Treatment-Spikes/
https://vancouversun.com/health/does-involuntary-care-work-three-bc-residents-share-their-personal-stories

Your Rights under BC's Mental Health Act | Here to Help

Does It work

https://bc.cmha.ca/news/involuntary-care-in-bc/
https://thetyee.ca/Opinion/2024/09/24/Involuntary-Care-What-BC-Should-Do-Instead/

https://vancouversun.com/health/does-involuntary-care-work-three-bc-residents-share-their-personal-stories

https://www.youtube.com/watch?v=lSTFDuVnvHk

Appealing

https://www.bcmhrb.ca/

https://www.heretohelp.bc.ca/infosheet/your-rights-under-bcs-mental-health-act

Recent developments

Charter Challenge

Eby’s expansion of involuntary care

https://www.cbc.ca/news/canada/british-columbia/new-involuntary-care-guidelines-1.7482295

Health first vs Housing First

Kamloops Council wants in prisons

About the Podcast

A Way Forward: Conversations on Mental Health, presented by Beem Credit Union, explores timely and complex mental health topics with local experts, sharing insights that help build healthier, more compassionate communities.