Fifteen years after shelving legislation that would have allowed youth to be detained in treatment against their will, British Columbia is preparing to take another look at "secure care" – in which children and youth can be forced into detox and treatment programs.
That's a relief to secure-care proponents such as Diane Sowden, who championed the push for secure-care facilities in the 1990s and remains convinced they are a necessary piece of the child-welfare puzzle.
"I am a strong believer that [secure care] is a tool we need for extremely high-risk kids," Ms. Sowden said in a recent interview, adding she favours a case-by-case approach that could provide for longer stays than the short stints typical of most secure-care programs.
"It took years for these kids to get where we are – we're not going to fix it with a Band-Aid," said Ms. Sowden, who is executive director of Children of the Street Society, a Coquitlam group that works with vulnerable youth, and who raised a daughter who struggled with drug and alcohol abuse.
But the concerns that revolved around B.C.'s proposed Secure Care Act – which was shelved after the Liberals swept to victory in 2001 – still exist, with organizations that opposed the bill ready to dust off their concerns for a new round of legislators.
"We'll have to see what the province proposes, but we definitely have concerns about it," Josh Patterson, executive director of the B.C. Civil Liberties Association, said in a recent interview.
"We have concerns about any proposals … that go beyond the immediate protection of a minor from some sort of harm – or that go beyond a short-term assessment geared toward getting someone into voluntary treatment."
The pledge to review secure care came as part of the government's response to a report about a young woman named Paige.
That report – Paige's Story: Abuse, Indifference and a Young Life Discarded – was released in May by B.C. Child and Youth Representative Mary Ellen Turpel-Lafond and described how Paige was repeatedly returned to her mother despite her mother's instabilty and alcoholism. Paige died at 19 of a drug overdose, after having been the subject of 30 child-protection reports. Ms. Turpel-Lafond's report included six main recommendations to address what she called a pattern of professional indifference.
The recommendations include looking at what other jurisdictions are doing to help youth as they "age out" of care.
As part of one of those six recommendations, the representative calls for the Ministry of Children and Family Development to "explore the creation of a form of secure care, with all appropriate legal safeguards, that would allow for the apprehension of vulnerable children and youth whose situation places them at an unacceptable level of risk and the subsequent safe placement of these children in a service that will respond to their trauma and high risk of self-harm."
Currently, seven provinces – Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick and Nova Scotia – have some form of secure care.
Saskatchewan, for example, in 2006 passed the Youth Drug Detoxification and Stabilization Act, which enables involuntary treatment of children up to the age of 18, following an order from two doctors, for up to five days and for two, five-day extensions.
Secure care is considered a last resort and would, if introduced, affect only a small percentage of the hundreds of children who come into contact with the child-care system each year. But even the prospect of such a model tends to raise big worries.
NDP child-care critic Doug Donaldson said secure care – if introduced – would have to be undertaken under limited conditions and with sufficient resources to help youth once they are released.
"Asking front-line social workers and ministry workers to do more and more without putting in any additional funds is a recipe for disaster," he said. "What ball are they juggling now that they are going to have to drop?"
The prospect of being "locked up" might make troubled youth less likely to seek help and result in more trauma for children who have likely already faced violence or sexual abuse, said Michael Krausz, an addictions researcher at the University of British Columbia.
It is widely agreed that voluntary services – such as detox, residential treatment and outpatient addictions and/or mental-health counselling – are the most effective means of addressing addiction issues, which are often concurrent with mental-health problems, a Ministry of Children and Family Development spokesperson said in an e-mail.
Going beyond currently available options "would require the enactment of specialized legislation authorizing the involuntary detainment of youth," the spokesperson said. "This would require establishing specialized and expensive new facilities and programs. The potential costs and benefits of such an approach must be carefully considered."
Responsibility for child and youth mental health overlaps between the Health, Education and Children and Family Development ministries – all of which are expected to bring recommendations for improved services to cabinet by June of next year.