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2 For example, could less restrictive alternatives have been used? Ultimately, the lack of documentation raises questions about whether individuals at their most vulnerable have been detained lawfully and fairly

3 the health authorities and the Ministries of Health and Mental Health and Addictions, have not taken sufficient steps to uphold patient rights by implementing external oversight and internal management practices sufficient to ensure statutory compliance

The independent rights advisory service we recommend would have legislated powers to assist involuntary patients upon admission to a psychiatric facility. This new service would complement existing legal advocacy services provided by the Community Legal Assistance Society and others before the Mental Health Review Board. I am further recommending that the health authorities establish account

13 Schedule B and C facilities are public hospitals, or parts of the hospital, that have been designated as a psychiatric units (Schedule B) or observation units (Schedule C). Of the 75 facilities, most are located in public hospitals. Schedule B facilities account for 37 of the 75 facilities that can involuntarily admit patients and are responsible for a significant majority of involuntary admissions.

14 The 20,483 discharges involved 14,980 unique patients – meaning that many individuals were involuntarily admitted more than once. During the same year, there were 17,656 voluntary psychiatric discharges from Schedule B and C facilities, involving 11,683 unique patients.11 Figures 1 and 2 indicate that involuntary admissions, as reflected in the number of discharges, have increased steadily since 2006/07, while voluntary admissions have stayed relatively static over the same period.

15 Between 2005/06 and 2016/17, when the population of British Columbia increased by 15 percent, the number of involuntarily admitted patients increased at a significantly higher rate. The discharge data indicates a growth in involuntary admissions of approximately 71 percent over the same period. In contrast, voluntary admissions have remained fairly consistent [decreased on a per capita basis when population growth taken into account].