Rob Wipond is an investigative journalist and author of Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships.
A researcher, scholar and gifted philosopher-poet, Erin Soros has garnered two National Magazine Awards, a CBC Literary Award, and a Simon Fraser University residency.
She also has a history of serious trauma.
This May, Ms. Soros won a Writers’ Union of Canada award for her account of seeking mental-health help in 2022, and then getting detained in a Vancouver psychiatric hospital, where she was threatened, stripped, tied down with four-point restraints, and forcibly tranquillized. She described this involuntary “care” as unnecessary, brutal, traumatizing, and like “institutionalized rape.”
During the research for my book, I interviewed hundreds of ordinary, intelligent people like Ms. Soros who have experienced forced psychiatric treatment – overstretched single parents, struggling university students, war refugees, sexual assault victims, and those who’d recently lost spouses or jobs – and many of them shared similar stories and perspectives. After being committed by apparently well-intentioned, risk-averse or overprotective psychiatric professionals, declining psychotropic drugs became evidence of “lack of insight” into their “need for treatment”; security guards, restraints and forced drugging often followed. I also found mental-health law powers being increasingly used in social or institutional management: Staff in schools, foster and group homes, workplaces and government agencies, housing, long-term care facilities, and mental-health hotlines often get disruptive, distressed or protesting people forcibly taken to psychiatric hospitals.
When politicians, pundits and others call for expanding involuntary commitment, is this what they are picturing?
Promoters of forced treatment push a well-known tale: Most large asylums were closed down by the 1980s, laws for committing people became strictly rights-protective, and legions of mentally ill people consequently became homeless. Thus we must broaden laws and coercively medicate more people “for their own good.”
But this story misrepresents reality. Studies tracking discharged asylum patients, including in Canada, found that very few actually became homeless. Most moved into long-term care facilities, group homes, and supportive housing. And Canadian pilot projects have shown that a subsidized home, with voluntary supports, can stabilize most people labelled with severe mental illnesses and addictions, and do so relatively inexpensively – making it clear that homelessness is primarily an affordable-housing problem.
Meanwhile, the numbers of people deemed mentally ill have long been rising dramatically. According to the Mental Health Commission of Canada and Toronto’s Centre for Addiction and Mental Health, 50 per cent of Canadians will have experienced a mental disorder by the age of 40. Criteria for detentions and forced interventions have similarly broadened, far beyond “danger to self or others.” Most provincial mental-health laws authorize forced interventions against those who might simply be experiencing “negative effects” or “mental or physical deterioration” owing to mental disorders.
These laws are paternalistic, aggressive, and arguably unconstitutional. The B.C. government is currently fighting a Charter challenge to its Mental Health Act, by which anyone with involuntary status is automatically “deemed” to be incapable of making reasonable decisions. And in 2019, a judge threw out Alberta’s laws as “overbroad,” noting that detentions had correspondingly “skyrocketed.” They’d similarly doubled in a decade in British Columbia and Ontario.
Wherever we find reliable data, the forced drugging of people living outside of hospitals, in their private homes or elsewhere in the community also appears to be rising. In Ontario, for instance, such outpatient commitments have climbed from a few hundred people in the early 2000s to 7,000 in 2019 – three times the per-capita rates in New York, which has a reputation for aggressive outpatient commitment.
An estimated 150,000 Canadians experience involuntary psychiatric interventions every year. Yet health authorities don’t track who they are, or whether their lives improve or worsen from forced treatments, which usually come in the form of tranquillizing drugs with potential long-term adverse effects that can include diabetes, motor dysfunction and cognitive impairment. And with so much political fear-mongering over dehumanizing caricatures of people with mental illness living on city streets, there’s little public awareness of the increasing uses of these expansive psychiatric powers against a wider spectrum of society.
What’s more, while some family members told me they fervently believed a loved one could be helped by forced treatment, that is sadly unlikely. As summarized by a 2019 review of the negligently scarce scientific research on coercive psychiatric care, there is “little evidence” that such interventions “confer any clinical benefits,” making it “paradoxical” that they “continue to be used extensively.” Worse, forced interventions are “often associated with negative outcomes” and experienced as “highly distressing and even traumatic.” That’s why the World Health Organization now advocates abolishing force and improving voluntary services and community supports.
Mental-health law powers already undermine too many Canadians’ basic rights and freedoms. We must resist expanding these laws further.