Involuntary care as a solution to mental health crisis is a political distraction: Observations from the front lines
'Why are we talking about locking people up when we haven’t even come close to providing people with voluntary-care services?'
The topic of involuntary care for people suffering from serious mental health illness on the streets of British Columbia has been in the news a lot in recent months.
In September 2024, the provincial government announced a plan to increase involuntary care, first with a correctional site at the Surrey Pretrial Services Centre, which opened with 10 beds in April 2025. The second is a housing facility on the grounds of the Alouette Correctional Centre in Maple Ridge, which hasn't opened yet.
"All of the facilities will provide involuntary care under the B.C. Mental Health Act for people certified as requiring that care," according to a government news release from September.
Premier David Eby said this was B.C.'s start of a new phase in response to the addiction crisis.
"We’re going to respond to people struggling like any family member would," Eby said. "We are taking action to get them the care they need to keep them safe, and in doing so, keep our communities safe, too.”
An ongoing Globe and Mail investigative series about Pandora Street, Victoria's Downtown Eastside, spends considerable time focusing on involuntary care.
Julian Daly, CEO of Our Place, a Pandora shelter and support services provider, is quoted in the series saying it is long past time B.C. opens it's first long-term, involuntary care facility: “I make no apology for saying that. That’s what my experience has shown me. There is a small group of people who are so unwell they are not able to make an informed choice about their health care. If they do not get help, they will die.”
But maybe focusing on involuntary care while voluntary care services are lacking is a little like fixing a broken leg with amputation.
Some advocates, frontline workers, and family members of those suffering with mental disorder and/or addiction say hold on, let's make sure there is enough voluntary care long before we start locking people up against their will.
Jody Paterson is a board member at SOLID Outreach, a non-profit that provides street support services in Victoria.
Here is Paterson's response to the recent focus on involuntary care in a commentary in the Victoria Times Colonist, followed by a supportive response from the mother of a man suffering with mental health and addiction as posted on the Facebook page for the group Moms Stop the Harm.
Most importantly, Paterson calls the talk of involuntary care "a political distraction that will make minimal difference to the visibility of homelessness, substance use and suffering on our streets."
Jody Paterson, May 31 2025:
"I’m a board member with SOLID Outreach Society, which has provided diverse services for more than 20 years supporting the people who the Globe and Mail is writing about (though, so far, not actually talking to) in its coverage of the public-health crisis playing out in full view in Victoria’s downtown.
"Involuntary care is a prominent theme in this coverage, including in the Times Colonist’s own story May 28 on the Globe series.
"Decades of insufficient response to growing social crises and the dramatic rise of fentanyl as a dominant and deadly component of the illicit drug supply have created a terrible situation. Involuntary care does have a small role to play in addressing the complex and multi-layered problems that have resulted, though most of the people the public assumes will be helped will not actually meet current criteria.
"But why are we talking about locking people up when we haven’t even come close to providing people with voluntary-care services? More supportive housing, low-barrier detox/treatment, Indigenous-led recovery services, a regulated drug supply – that’s where the hope lies.
"So many people framed as 'the problem' are desperate for services that would help them detox from harmful substances, get treatment, access medical care, get help with their mental health, find a place to get stable for a few weeks or months while they look for permanent housing. SOLID sees that every day at our access hub, which bridges people from crisis to stability and supports them in accessing a range of recovery options.
"But walk a mile in the shoes of people on Pandora and you will quickly see how many barriers they face in seeking voluntary care. Systems designed to help them are vastly oversubscribed and overwhelmed, or buried behind requirements that are far too demanding for anyone dealing with the kinds of health challenges, trauma, poverty and lack of access to routine care that people are facing.
"So yes, involuntary care may be needed for some people once all voluntary options have been tried. But we haven’t even come close – in Victoria or anywhere in B.C. – to providing enough services to meet the vast need.
"As long as that remains the case, this push for involuntary care is a political distraction that will make minimal difference to the visibility of homelessness, substance use and suffering on our streets."
So what about family members? Christine Moore is a mother turned advocate because of her son Christopher Newton who suffers from mental illness and uses substances to cope. She replied to Paterson's commentary with her first-hand perspective:
"Thank you for this, Jody. You’ve captured what so many of us with lived experience – as family members, frontline workers, and advocates – have been trying to say for years.
"My son, Christopher, is one of the people this debate directly impacts. He’s been missing since December. He lives with schizophrenia, has used substances to cope, and has tried again and again to access help – only to be met with long waitlists, red tape, and a system that too often shuts families out, even when we’re the ones still searching, still fighting to keep our loved ones alive.
"The idea that involuntary care is the answer — when we haven’t even come close to offering proper voluntary supports — is heartbreaking. We talk about locking people up before we’ve ever met them where they’re at. Before offering them a place to stabilize, to feel safe, to be seen.
"We need wraparound services that meet people as they are – with no strings attached – and that include family members in care when it’s safe and appropriate to do so. Not everyone has safe or supportive family, and we need to recognize that. But for those who do, families can be vital. The system should not default to shutting us out.
"And involving police in forced treatment – especially when many people have already been deeply traumatized by past interactions with law enforcement – only causes further harm. Even with better training, it doesn’t make sense to default to police-led intervention. What’s the plan after that? A short hospital stay followed by a release with no co-ordinated, ongoing care? No housing, no support system, no follow-up?
"That’s not treatment – that’s a revolving door.
"SOLID and so many others working on the ground know what’s actually needed.
"Until we address that, this push for forced care is nothing more than a political distraction — one that will not reduce harm, and will only deepen the suffering of those already struggling to survive.
"Thank you for continuing to speak the truth. These conversations matter. Because behind every headline is a real person. Someone’s child. Like my son."
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Paul J. Henderson
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