In a landmark case that could reshape mental health care across British Columbia, seven plaintiffs have launched a constitutional challenge against provisions in the province’s Mental Health Act that permit involuntary treatment without patient consent. The lawsuit, filed Monday in B.C. Supreme Court, strikes at the heart of what advocates call a deeply problematic “deemed consent” provision that strips patients of fundamental rights when detained under the act.
“This isn’t about whether someone needs care—it’s about their right to have a say in that care,” said Laura Johnston, legal director for Health Justice, one of the organizations supporting the challenge. “Currently, when someone is involuntarily detained under the Mental Health Act, they automatically lose all decision-making authority over their psychiatric treatment.”
The legislation, which hasn’t seen substantial revision since 1964, allows physicians to administer treatment without obtaining consent once a person is certified under the act. This provision affects thousands of British Columbians annually, with involuntary admissions rising steadily over the past decade, reaching over 20,000 in recent years.
Among the plaintiffs is Louise Maurakis, who describes her experience with forced treatment as traumatizing. “Being held down and injected with medication while begging them to stop is something that stays with you,” Maurakis told CO24 News. “It breaks something fundamental in the relationship between patient and healthcare provider.”
The lawsuit argues that British Columbia stands virtually alone among Canadian provinces in its approach to patient consent. While other jurisdictions have moved toward more rights-respecting frameworks that recognize the capacity of people with mental health conditions to participate in treatment decisions, B.C.’s legislation remains notably restrictive.
Mark Iyengar, spokesperson for the Ministry of Mental Health and Addictions, acknowledged receipt of the lawsuit but declined detailed comment, noting, “As this matter is before the courts, it would be inappropriate to comment on specifics of the case.”
The legal challenge comes amid growing public scrutiny of mental health services across Canada. A 2022 report from the B.C. Ombudsperson found significant procedural failures in how the Mental Health Act was being implemented, including incomplete certification forms and inadequate rights notification.
“There’s a fundamental misconception that people experiencing mental health crises are incapable of making any decisions,” explained Dr. Marina Singh, a psychiatrist who supports the legal challenge. “Evidence shows that collaborative approaches to treatment lead to better outcomes and recovery.”
Disability rights organizations point to international human rights standards, including the UN Convention on the Rights of Persons with Disabilities, which Canada has ratified but not fully implemented. These standards emphasize supported decision-making rather than substitute decision-making.
The lawsuit does not seek to eliminate involuntary hospitalization in crisis situations but aims to separate detention from automatic loss of treatment decision-making. The plaintiffs propose alternatives such as advance directives, supported decision-making protocols, and second opinion mechanisms that have proven effective in other jurisdictions.
Legal experts suggest the case could have implications beyond British Columbia, potentially influencing mental health legislation across Canadian provinces. The challenge raises fundamental questions about the balance between providing necessary care and respecting individual autonomy.
As our society continues to evolve in its understanding of mental health, should our laws not evolve as well to recognize the dignity and decision-making capacity of all individuals, regardless of their mental health status?
