An open letter to Judy Darcy, British Columbia Minister for Mental Health and Addictions regarding Bill-22-2020 The Mental Health Amendement Act.

Moms Stop the Harm (MSTH), an organization of over 1,300 families in Canada who have all had close experiences with the crisis of overdose and drug-related death, does not support Bill 22, the proposed amendment to the BC Mental Health Act..

The amendment, Bill 22, the involuntary care of youth who present at a medical facility in an overdose state, is counterproductive. This amendment on involuntary care was drafted with little or no collaboration from stakeholders - families and youth - and will likely have serious negative, unintended consequences for the young people it aims to help.

In the experience of our families, involuntary care does not lead to successful recovery. In fact, we see that it is likely to break a youth’s trust in both the health system and the family - a harmful and devastating outcome that has resulted in the death of a child for a number of families in our community.

Involuntary care will have a destabilizing effect on youth, which may increase their risk of overdose upon release. For many youth who need our help the most, this amendment may have the opposite of its intended outcome. For instance, many marginalized youth who have experienced the health and social systems, including social services, have already lost faith in the state, given that such involvement has often resulted in a negative experience. Youth may perceive involuntary care as ‘incarceration’ which will exacerbate their lack of faith, thus leading to poor long-term outcomes.

A further unintended consequence of this amendment is that youth witnessing a friend’s overdose may avoid calling 911 if they know that the possibility exists that they or a friend might be held for up to seven days against their will.

There are too few health professionals in the province trained and skilled in addiction medicine, especially for youth. Given that most youth in B.C. have little to no immediate care after overdose, particularly those who live in rural and remote communities, how will they benefit from involuntary care when the infrastructure is simply absent? Removing them from their home communities, their families, is not the answer.

A further concern is the limited research done in this area; the scant research available does not support the Bill 22 model.

Where services for youth are urgently needed, but absent, is in harm reduction. This was identified by the Advocate for Children and Youth in a report released in November 2018:

The Representative firmly believes that B.C. should be building a comprehensive array of prevention, early intervention, care, treatment and post-treatment services for youth and that harm reduction must be a necessary part of this spectrum of services, especially for youth with significant and severe substance use issues (Advocate for Children and Youth, 2019, p. 1).

Of concern is that Bill 22 has little mention of the impact these changes will have on the family paradigm, nor does it outline the inclusion of families in the care of their loved ones. Families have an important role in supporting children and youth who experience challenges with substance use; families must be supported and involved in the care of their children whenever appropriate.

A further concern is the limited research done in this area, and the research that is available does not support this model.

Rather than implement involuntary approaches to substance use, the Province must instead focus on creating a provincial evidence-based, youth-focused system of care where one presently does not exist, as outlined in the above mentioned report by the Representative for Children and Youth

As the families of Moms Stop the Harm, we strongly object to Bill 22 in its current form, and urge the government to engage in meaningful dialogue with all stakeholders to develop services that actually will help, rather than harm our children.

Leslie McBain, Co-founder

For the British Columbia Members of Moms Stop the Harm, The Board of Directors of MSTH