Why B.C.’s secure involuntary treatment may be more ethical than the status quo

Eighteen beds are opening in Metro Vancouver, expanding of involuntary care for people with drug addiction, mental illness and brain injuries.

The issue of secure and involuntary treatment for a small number of struggling British Columbians has been extremely controversial, but as the first batch of permanent housing for them is unveiled, it may be that the new approach is more ethical than the status quo.

CTV News spoke with several service providers of the new Alouette Homes facility in Maple Ridge, where two vacant government-built group homes have been refurbished with secured doors, panic buttons, and heavy furniture with rounded edges to avoid self harm.

They believe months of planning and careful consideration has culminated in a dignified, dorm-like setting, where those with specific overlapping needs can find some semblance of a normal life.

Dr. Daniel Vigo, a scientific advisor hired by the premier to recommend a path forward on people grappling with drug use, mental illness, and brain injuries, told reporters that the 18 people who’d be living at the two houses have been in and out of treatment, “stuck for years in a high security limbo of hospital units.”

Later, he emphasized that the tenants of Alouette Homes – and future, similar secured facilities with wraparound services – were those with long-term and repeated interactions with the health-care system.

Already locked up

Vancouver Coastal Health’s director of mental health and substance use told CTV News that while the rooms may appear sparse and spartan compared to a typical home, they’ll be adding artwork and providing services for people who’ve essentially been living in locked hospital rooms.

“A hospital is not a place where you want to be living, per se,” said Dr. JJ Sidhu. “This is a step in the right direction in terms of the environment being an upgrade.”

Sidhu is a frontline clinician himself, and has often encountered patients who begin to lose hope after spending so much time in the hospital, but he says that time and appropriate treatment can greatly improve their health and well-being.

While VCH is providing the clinical oversight, medical, and psychiatric treatment on-site, Connective Support Society is providing non-clinical supports to residents.

“That includes a constellation of supports, including things like art therapy, music therapy, connection to individuals’ culture,” said the organization’s chief operating officer, Liz Vick Sandha, who says her team has been meeting with the incoming residents.

“We’re supporting them to make choices around what their room looks like and how they want to choose to spend their day,” she said.

While the rooms are private, there are communal bathrooms and other common areas for socializing. A “family room” provides a sequestered area for residents to visit with loved ones in an area separate from their bedroom and communal living space.

The bigger picture

While the Surrey Pre-Trial Centre saw the first batch of secured, involuntary treatment beds for inmates with the three concurrent disorders, those are for temporary stays for individuals facing criminal charges. The Alouette Homes are intended as long-term or even permanent housing for those who are deemed unable to safely live on their own.

And while there are no bars on the windows and the homes are surrounded by trees and fresh landscaping, the high fences and locked doors are a reminder the residents cannot leave the property unescorted.

When CTV News asked who was providing oversight of the use of the Mental Health Act and the implementation of involuntary care provisions – whether secured or not – Vigo insisted that there is a system of education and oversight in place.

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“My office is working very closely with physicians across the province so that we use the Mental Health Act correctly in a therapeutic manner, which is what is intended,” he said. “The province has a very robust system of safeguards to ensure that people are receiving care under the Act, have their rights protected and are not receiving care that is inappropriate or unwarranted.”

Health Minister Josie Osborne says there are currently 21,000 beds staffed in B.C. for treatment of those with mental illnesses, and they’re working to add more.

“We are continuing the work of voluntary treatment and recovery, the work of early intervention,” she said. “The work of ensuring that people have access to the treatment and recovery service that they need to not be in a situation like this in the first place.”