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Everything you need to know about involuntary care ahead of B.C.’s provincial election
About 20,000 British Columbians are involuntarily admitted each year, the highest rate in Canada.
As the B.C. provincial election enters its final stage, involuntary care continues to be a hot-button issue.
Over the last several years, the Mental Health Act has frequently made headlines as Premier David Eby expanded involuntary care in the province. At the same time, a major court decision in July ruled parts of the Act unconstitutional.
During the municipal election, involuntary care made it onto the ballot as the ABC’s plebiscite asked whether the city should ask the province to convert portions of the old St. Paul’s Hospital into a facility that would, among other things, provide 100-plus involuntary care beds. The results of the plebiscite will be announced on Wednesday, Oct. 21.
But beyond news headlines and political talking points, it’s worth exploring how involuntary care in B.C. works, who can be admitted and what the evidence shows.
What does the Mental Health Act currently allow?
Under B.C.’s existing Mental Health Act, individuals can be placed under involuntary care if they experience severe mental illness that impacts their ability to manage their lives safely. Four criteria must be met before someone can be "certified," or involuntarily admitted, under the Act.
First, they must suffer from a disorder that seriously impairs their ability to “react appropriately to the environment” or associate with others.
Second, that person requires psychiatric treatment through a designated facility. Third, they require care or supervision at that facility for their own protection or the protection of others; and, finally, they are unsuitable to be voluntary patients.
Generally, a person is brought to a hospital by friends or family, the police, or by a judge's order.
Kevin Love, the supervising lawyer for the Community Legal Assistance Society’s (CLAS) community law program, told Vancity Lookout that “[people are also certified] when they bring themselves to the hospital of their own accord,” he said. ”That happens more than people think.”
Normally, if someone is incapacitated, next of kin typically become the decision makers. However, when someone is certified under the Mental Health Act, the treating facility becomes the sole decision maker for psychiatric treatment.
There are currently nearly 80 facilities across B.C. where patients can be observed and detained involuntarily.
Who is being involuntarily detained?
Each year, an estimated 20,000 British Columbians experience involuntary admission, the highest rate in the country.
However, according to Health Justice, a non-profit that advocates for the transformation of mental health and substance use treatment in B.C., true rates of involuntary care are likely much higher.
Current reported numbers for those in involuntary care exclude a variety of circumstances, such as those detained by police under the Mental Health Act who are never admitted to an acute unit.
Involuntary care is not new, but over the last 20 years, the rate of those detained under the Mental Health Act has increased significantly, while rates of voluntary admission stagnated.
Youth detention under the Mental Health Act has climbed by 162 per cent over the same time period, and between 2008 and 2018, involuntary apprehensions involving the police increased 130 per cent.
Men and women are involuntarily treated at comparable rates (55.3 per cent and 44.7 per cent respectively). While data on race and Indigeneity in B.C.’s involuntary care regime is not widely tracked or publicly accessible, other jurisdictions (the U.K., Australia and New Zealand) have shown that racialized people are overrepresented in groups who experience seclusion and restraint while involuntarily admitted.
What is certification being used for?
It is a common misconception, Love said, that schizophrenia and similar disorders make up the majority of certifications – they only account for about 30 per cent of involuntary admissions.
He said that CLAS sees a “real range” of conditions, spanning various forms of cognitive disorders like dementia, as well as substance use disorder.
Under current laws, substance use disorder alone is not typically enough to justify certification. However, many of those admitted have multiple diagnoses which can complicate care. Further, an estimated 20 per cent of those who receive involuntary treatment have a primary diagnosis of substance use disorder.
“[There’s a lot of] assertions that we don’t currently detain people for substance use disorders, but we do… [the laws] are quite broad,” Love said.
What does the evidence show when it comes to involuntary care?
Jonathan Morris, the CEO of the Canadian Mental Health Association of B.C. (CMHA BC) told Vancity Lookout that the evidence surrounding the use of involuntary care for psychiatric illness is very “mixed,” and the conclusions that can be drawn from the data are highly variable.
“There isn’t a simple answer to the efficacy question for substance use disorders, concurrent disorders (mental health disorders alongside a substance use disorder) or a mental disorder alone,” he said, because it is not ethically possible to design randomized controlled trials where some people are detained and others are not, success “is really hard to measure.”
Some experts have referred to the existing research around forced treatment for drug use in particular as “an absolute dearth” of scientific evidence. While North America studies are limited, a handful of international studies suggest that involuntary drug treatment can increase risk of accidental fatal overdose upon release.
The UN has denounced involuntary drug rehabilitation programs in China and elsewhere in Asia for violating the human rights of detainees.
When it comes to involuntary treatment for other psychiatric conditions like bipolar disorder or psychotic disorders, Morris said some patients have said involuntary care “saved their life,” while others have called it “the most traumatizing and horrific experience.”
“There isn't a really widely available, approved quality framework for this form of care in British Columbia,” he said.
What do we know about transparency in B.C.’s involuntary care regime?
While some people benefit from involuntary care, the data surrounding who is being involuntarily admitted, what happens behind closed doors and following release have “concerning” gaps, that Love said “is not helpful when you’re trying to make decisions about public policy and what will work or not work.”
According to a series of Ombudsperson audits, required documentation was missing in a “significant number of patient files,” including forms outlining reasons for admission, treatment decisions, consent, and confirmation patients had been informed of their rights.
Regional health authority compliance varied significantly across the province. Vancouver Coastal Health reported the highest completion rate of required patient forms (81 per cent), but Northern Health completed just 34 per cent.
The Ombudsperson noted that the “investigation has shed light on a process often hidden from public scrutiny,” adding “even the health authorities were not aware of their facilities’ poor compliance with the Mental Health Act’s procedural safeguards.”
What was the recent Supreme Court decision on the Mental Health Act?
In July, a B.C. Supreme Court decision ruled that sections of the Mental Health Act on involuntary treatment were unconstitutional.
“There’s a difference between involuntary admission and involuntary treatment,” Love said. “This decision had nothing to do with who can be held in hospital. It has to do with what happens to them once they’re inside those walls.”
The judge found that depriving involuntary patients of their rights to consent to treatment in all circumstances resulted in unequal treatment under Section 15 of the Charter and violated Section 7 of the Charter.
While all provinces and territories have a law that authorizes involuntary psychiatric treatment, no other province grants a detaining facility unilateral power over psychiatric decision-making rights, particularly without independent oversight of a physician’s assessment of someone’s capacity.
The judge gave the province six months to remedy the constitutionality issues of the Mental Health Act. Should the government fail to do so, those sections of the Act will no longer be in effect.
“The judge didn’t say that involuntary treatment is always unconstitutional… or that involuntary treatment should never happen,” said Love. “But [it needs to happen] within constitutional boundaries.”
It will be up to the next provincial government to make those required changes.
What do experts recommend?
While Love and Morris agree that the Mental Health Act needs review, there have been some positive changes in the mental health space over the last several years.
The province opened 20 Foundry Centres, offering free mental health services to youth, Morris noted. A program at St. Paul’s Hospital significantly improved wait-times for drug detox.
Earlier this year, CMHA BC helped pioneer the Independent Rights Advice Service, a trauma-informed service that provides information to people in involuntary care to understand their legal rights.
“It helps people better understand what’s happening to them,” said Morris. “It's [also] useful to have advice service in wards so that the detaining force isn’t the same force educating you on your rights.”
Ahead of the election, the CMHA BC is calling for parties to increase investment in prevention, early intervention, and community-based support to help people before their condition reaches a crisis point.
“[The high rates of involuntary admission] is an indicator that more can be done to help people avoid getting into crisis in the first place,” said Morris.
He added that while in politics there is a temptation towards black-and-white thinking around treatment approaches, “the most valuable evidence is probably those people with lived experience with involuntary care. [We need to listen to] what they have to say about it too.”
Where do the parties stand on involuntary treatment?
BC NDP: Current Premier David Eby has moved to expand involuntary treatment capacity across the province since he was elected in 2022, including (but not limited to) opening additional involuntary care beds in Maple Ridge, Prince George and Surrey. He recently pledged to invest up to $90 million to establish involuntary care in the Okanagan.
In June 2024, Eby appointed Dr. Daniel Vigo as B.C.’s first chief scientific adviser for psychiatry, toxic drugs and concurrent disorders. Vigo released a clinical guidance document that, while not legally binding, clarified how physicians can use the Mental Health Act when treating patients with concurrent mental health and substance use disorders.
In 2020, the province attempted to amend the Mental Health Act to allow youth to be involuntarily treated following drug poisoning. However, those proposed amendments never went through due to concerns of putting youth at greater risk of overdose.
Conservative Party: The Conservative Party of B.C. has promised to expand psychiatric services, including involuntary treatment and “empower police to enforce the Mental Health Act” by amending the Act so that officers can “connect people with mandatory treatment.”
They promise to implement a “recovery-oriented system of care” focused on prevention, treatment, and recovery, and to expand detox, clinical treatment, recovery housing, and “aftercare” across B.C.
They propose to “strengthen upstream intervention for vulnerable children and youth,” through anti-drug education in schools, improved coordination between child and family services, mental health and addiction services and housing.
Finally, they promise to end what remains of B.C.’s safe supply program, deploy more police to “hardest-hit neighbourhoods,” add 500 RCMP officers and 150 civilian staff over five years in rural and regional communities and hire 50 new Crown prosecutors.
BC Green Party: The BC Green Party is the only major political party to oppose the expansion of involuntary care. It has pledged to act to bring the Mental Health Act into compliance with the Constitution, including “strengthening protections around consent, capacity, involuntary treatment and independent oversight.”
They have pledged to “examine and address disparities and any inequitable impacts of mental health legislation” based on identity and include six annual mental health professional visits under MSP.
They have proposed to integrate mental health as the fourth option in 911 emergency services to accommodate mental health crises that do not fall under traditional fire or police response options, and extend the Mobile Response Team’s psychosocial support and training.
OneBC: According to OneBC’s website, they plan to implement “involuntary drug rehab and housing for the severely addicted,” roll back all decriminalization programs, “crack down on open drug use… eliminate safe supply and drug consumption programs” and “cancel all new drug consumption sites and turn current consumption sites into drug recovery centres."
Copyright 2026, Vancity Lookout. All rights reserved.
Maddi Dellplain, Local Journalism Initiative Reporter, Vancity Lookout.
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Musical about genetic discovery conceived as way to process 'life-changing' family secret
Musical conceived as way to process family secret
THE CANADIAN PRESS/Nathan Denette
After Noam Tomaschoff's parents revealed to him that his dad — the man who raised him from birth — was not his biological father, his gut instinct wasn't to keep harbouring the secret they had kept for 31 years: It was to share it, and share it widely.
"My brain automatically told me, like, you need to make something out of this," he said of his reaction in the summer of 2022.
That intuition led the writer-actor to process the news through penning a one-man musical with his two childhood friends based on his real-life extraordinary genetic discovery.
Another aspect of the personal bombshell was the fact that the only child actually had more than 35 half-siblings.
"I've met people who have had similar experiences and when they don't have an outlet, whatever it may be, to wrangle it and make sense of it and own it, it can remain a big obstacle, something you never get past," he said. "I think it was my way of getting through it."
After successful runs at the Toronto and Edinburgh Fringe Festivals, a showcase in New York, and performances in other Canadian cities, "Our Little Secret: A True New Musical" is heading to the Off-Mirvish stage, giving the Toronto-born performer a special homecoming.
"It's everything. It's like the Olympics," he said of the show hitting the CAA Theatre for a nearly three-week run, beginning Nov. 3.
For Tomaschoff, the last four years have been a whirlwind.
He had a typical childhood and said he never had any reason to suspect his parents were keeping anything — let alone an identity-shaking secret — from him. But as detailed in a lengthy 2023 Toronto Life feature, when he was 31, a woman he was dating, who is now his fiancée, told him about direct-to-consumer genetic test kits. On a whim, he ordered one. When he told his mom about the impending DNA test, the series of life-shifting events unfolded.
Unable to conceive naturally, Tomaschoff's parents turned to sperm donation and decided to tell only a few family members. Tomaschoff said it wasn't in his nature to lash out at his parents. Intellectually, he said, he understood their reasons for not telling him.
"That was the general guidance at the time; it made sense," he said. "There wasn't as much of a support structure. There's a lot of shame around this type of thing, so I was never there being like, 'How could you do this?' I know why they did it."
After taking the DNA test, Tomaschoff connected with other people who were conceived via the same sperm donor. The man died before Tomaschoff learned of their relation, but he has since grown close to some of his half-siblings, he said.
While his parents wanted their son to keep the truth under wraps, Tomaschoff refused. Before learning about his true backstory, the 35-year-old artist had been living in Los Angeles, struggling to land auditions and feeling "creatively adrift" after wrapping up an independent feature film project, he said.
"I had never had such a stroke of inspiration about any other project I've done in my life" he said.
After receiving a slot in the 2023 Toronto Fringe Festival, Tomaschoff wrote the show with his best friends, composer Ryan Peters and producer Russell Citron, whom he had met in high school and, fittingly, bonded with over a love of musical theatre.
The show, then called "Our Little Secret: The 23andMe Musical," sold out all its performances and earned awards, including the Patron’s Pick and Best of Fringe.
Tomaschoff has since performed it at the Edinburgh Fringe in 2024 and later in Montreal. The show is currently playing at Edmonton's Citadel Theatre until Oct. 25. Ahead of its return to the Toronto stage, Tomaschoff said the show's rise has been "very amazing and humbling."
"Our Little Secret" has evolved since its original conception. Initially, Tomaschoff said, it focused on the fun, joyful and wow moments, but after receiving constructive feedback that it lacked emotional, vulnerable notes, he said the show now better balances the highs and lows of that time period.
"It would be unsatisfying for the general audience to see a show that's just kind of all happy. It certainly wouldn't be true if it was all sad," he said. "It's trying to have everything in there that was a key step along the way, whether it was a difficult moment or overcoming that."
The new production is directed by veteran stage performer Adam Pascal, best known for his role in the original Broadway and West End productions of "Rent." In "Our Little Secret," Tomaschoff speaks directly to the audience — referred to as breaking the fourth wall — and plays multiple roles, including his parents, Gideon Tomaschoff and Sylvie Leone-Tomaschoff.
When he was creating the musical, he kept his folks in the dark about its contents, a move he described as "my little payback." But when his parents first saw it performed, they really liked it, he said. With every new iteration of the script, he strives to represent them authentically, while not shying away from difficult moments.
"It's a negotiation, but we always strive to arrive at consensus around each new version of the script, which I think it must be the first musical in history where the parents essentially have an editorial role in the writing of it," Tomaschoff said. "But it's another way that we kind of keep each other honest."
Tomaschoff's story is specific, but he said the show deals with universal themes such as identity and family crisis. He wants audiences of all ages to walk out of the show inspired to embrace honesty in their relationships.
While he's had years to process the truth, Tomaschoff said during performances, he can still tap into the initial moment of shock.
"I think I will be able to forever because it was just such a life-changing moment."
This report by The Canadian Press was first published Oct. 21, 2026.
By Kaitlyn McGrath | Copyright 2026, The Canadian Press. All rights reserved.
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Ontario housing market set for modest rebound in 2027: Desjardins report
Ontario housing set for modest rebound: report
THE CANADIAN PRESS/Graeme Roy
A new report says Ontario's housing market is expected to improve "modestly" next year as favourable economic conditions help push buyers off the sidelines, though higher borrowing costs could dull the extent of the rebound.
Desjardins senior economist Kari Norman calls the province's housing sector "weak" despite improved affordability, greater buyer choice and easing rental conditions.
Her report predicts existing home sales would rise nearly five per cent in 2027 compared with this year, remaining well below long‑term norms, while balanced market conditions should lead to average price growth of 2.4 per cent next year.
The analysis also says the interest rate backdrop will "likely remaining challenging," with two rate hikes by the Bank of Canada expected in 2027 that would limit affordability gains from recent home price declines and rising disposable incomes.
That would also raise construction financing costs, as the report projects housing starts to rise around six per cent to nearly 65,000 units in 2027 — still more than 30 per cent below levels seen in 2021 and 2022.
The report says rental conditions should remain relatively balanced, as new condominium and purpose‑built rental completions add supply at a time when population growth is likely to be weak.
This report by The Canadian Press was first published Oct. 21, 2026.
By Sammy Hudes | Copyright 2026, The Canadian Press. All rights reserved.
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