By John Besley
When Queen’s Park next sits, Ottawa Centre MPP Richard Patten is planning to re-introduce a private member’s bill that would allow doctors to force mentally ill patients they think could be dangerous to get treatment.
Supporters hope this will ensure that troubled individuals, such as some paranoid schizophrenics whose sickness may cause them to refuse treatment out of fear, to get the treatment vital to their well-being.
Detractors say human rights could be threatened or that the current Mental Health Act could work if only health officials would interpret it properly.
Currently, for a psychiatrist or doctor to force someone into treatment they must determine there’s an “imminent” risk to themselves or others. Many have interpreted that to mean immediate but the courts have said it can be as long as several weeks.
The issue has continued to attract attention since the coroner’s inquest into the death of CJOH-TV sportscaster Brian Smith. Smith died after Jeffrey Arenburg, a paranoid schizophrenic, gunned him down.
Centretown News: What’s in this legislation?
Richard Patten: The intention was to not do a complete re-write (of the Mental Health Act) but to take a very important area that has caused a lot of contention and a lot of tragedies around the province — that’s the part that allows for people to be assessed and to ensure those who need treatment get it.
CTN: Is the Act flawed or is it the interpretation of the Act that’s confusing people?
RP:It’s probably safe to say that it’s the interpretation but if such an Act leads to such misinterpretation, even for experts, then there’s a problem. And the fact is there’s confusion out there. And that confusion has led to tragedies. We should go back and simplify the Act and take out a word that’s causing problems.
First, I still think we should remove the word imminent (from the Act).
Number two, we should define that we’re talking about a very small group of people who are known to have continuing difficulties. We should be able to define it so that these people can be taken for (involuntary psychiatric) assessment.
The third dimension is adding a community treatment order which gives people the opportunity to be treated outside of a hospital once they’ve been stabilized. They may have been brought to a general hospital or a psych hospital, assessed and it was agreed that they need some treatment. But they need not be there for an indefinite period of time.
CTN: The wording of this Act was re-written in 1979 and it was done to protect individual rights. That wording is apparently causing confusion. What danger is there that we’ll go back to a time when legislators felt individual rights were being overridden?
RP: My bill doesn’t touch any checks and balances in the system that are still there and are quite stringent.
Doctors have to document what they do. The Consent and Capacity Board has to oversee this and there can be a hearing (if action is taken against a person’s will). There’s an advocate at the hospital that is there for the patients. There are so many things now for the rights of the patient that taking out the word imminent will not affect anyone’s rights.
CTN: One article in the Toronto Star said this legislation could face a Charter of Rights and Freedoms challenge.
RP: I know the (person who said that) and he feels that human rights is the absolute supreme. I disagree with him.
He’s making a mountain of a mole hill. The question isn’t taking away rights, it’s providing the opportunity to treat people who just aren’t getting the treatment they need, period.
Especially when, after the fact, people who have gone off the deep-end realize what they’ve done (once treated) and say ‘imagine that, I killed my mother or daughter’ and feel just terrible. But (when they were untreated) they actually felt their mother or daughter were in cahoots with the devil.
CTN: The courts have said imminent can mean several weeks.
RP: That’s right. That’s what the courts say but that’s not how it’s being interpreted by psychiatrists and others. If that’s happening — if there’s confusion all the way around — then take out the word.
My view is the that (the Act) takes away rights if there’s confusion with it. It means that those who have a right to treatment and the right to health are not getting it when they need it. I think the intent (of the Act) is to show respect for people and to support the rights of individuals but what it ends up doing is erring on the side of individual rights and then the individual ends up doing themselves or someone else in.
CTN: We understand the Minister of Health has said she supports your bill. Why hasn’t the Health Department moved on this, leaving you to do it by yourself?
RP: I’m not moving by myself. I have the support of a lot of people. But we also don’t know what the government is going to do.
They haven’t said they’re going to review the (Mental Health) Act though I think they should given all the inquiries and the recommendations that have emerged.
The function of my bill is to enable the government to move immediately on one small aspect (of bigger problems).
They could begin implementing this as they go ahead. It could be two or three years before they go ahead with a full review. I’m saying here’s something that might at least in the interim, deal with something that has a allowed tragedies to occur.
CTN: It seems it’s taking an inordinate amount of time to get this through the (legislature) when it could be cleared up by getting people to understand the court’s interpretation of the Act.
RP: Every single member has the opportunity for a private member’s bill. So it’s not more expensive — if it wasn’t this bill I would have chosen something else. All 130 members have their day to put forward a bill that they think will make a difference and it has always been thus.
CTN: What about looking at in terms of time. You could be raising public awareness instead of bringing it to Queen’s Park. Could you have gotten more done by trying to raise awareness outside of the legislature?
RP: I don’t think so. These things take a lot of time. It took six years for the last review of the Mental Health Act. Last session, I introduced my bill, then we had debate and it went to committee.
The government never moved it from committee to have hearings and propose some amendments. That could have all happened in a short period of time but government is cumbersome and this isn’t the only issue it’s working on.
CTN: But isn’t there something non-legislative that would have been quicker?
RP: Such as?
CTN: Teaching people how to properly interpret the act as the courts have interpreted.
RP: I doubt it. People have been trying to get that for a long time. First of all, I have no credibility to go around (telling people what to do). I’m not a lawyer, I’m not a psychiatrist, I’m not a medical practitioner. The only credibility I have is as a legislator and here’s something I can do to advance an issue. If I just went off on my own and said you people are mis-interpreting this I’d have no credibility.
CTN: Do you have any worries about this legislation?
RP: In terms of getting it through, yes. But it doesn’t have to get through (and become law) to be effective.
If the government wants to overtake it, which may happen, then that’s okay. I just want to keep pressure on them.
There’s not enough funding for the mental-health area. Money has not been placed in this area for a long time.
But am I worried about people rights? No, not with my bill. I think it will enhance people’s right to treatment. I think it’s clear that this is addressed to treatment and this is not touching human rights.