Victoria – A new BC Ombudsperson report finds that too often key legal safeguards for involuntary patients under BC’s Mental Health Act are still not being applied across the province, despite improvement since the office’s 2019 Committed to Change investigation.
Audit results show key safeguards are still missed
The report draws on the Ministry of Health and health authorities’ quarterly audit results for July to September 2024, which show that required documentation was missing in a significant number of patient files, including forms outlining the reasons for admission, documenting treatment decisions and consent, and confirming that patients have been informed of their rights.
While steady progress is being made to protect the legal rights of people involuntarily admitted – audit results show higher form completion rates in 2024, compared to 2020 and 2017 – health care staff continue to admit patients against their will without completing the required paperwork.
“Involuntary admission under the Mental Health Act is an extraordinary power,” said BC Ombudsperson Jay Chalke. “I recognize the health care system is under strain. However, the required safeguards are not simply administrative paperwork. They are the legal protections that help ensure decisions to admit and treat someone are lawful, accountable, and rights-respecting. They must be completed 100 per cent of the time, in each and every case.”
Form 5 remains a key concern
The report highlights continued concerns with completion rates of Form 5, which documents a proposed course of psychiatric treatment and requires a physician to assess a patient’s capacity to consent.
The Ombudsperson emphasizes that this safeguard has become even more important following the passage of Bill 32, which repealed the Mental Health Act’s “deemed consent” provision in December 2025.
Compliance varies across BC
The report also identifies significant variation across health authorities, and notes that several health authorities were missing required forms in more than half of audited patient files. Provincial Health Services Authority reported the highest completion rate of 92 per cent. Among regional health authorities, Vancouver Coastal reported the highest completion rate of 81 per cent while Northern Health reported the lowest completion rate of 34 per cent.
The Ombudsperson is calling on the Ministry of Health and health authorities to continue strengthening compliance efforts to ensure safeguards are applied consistently in every designated facility.
Independent rights advice is a key safeguard
Notably, while an Independent Rights Advice Service is now available across BC, it is not yet implemented in a way that consistently ensures involuntary patients receive timely, independent rights advice when they are admitted.
Currently, the service is available on a by-request basis, meaning a patient generally must ask, and facility staff help initiate the request. The Ombudsperson notes that automatic notification – which would ensure rights advisors are proactively connected with patients unless they decline – has not yet been implemented.
“Independent rights advice is one of the most important safeguards for involuntary patients,” said Chalke. “But it can’t depend on whether someone knows to ask for it, or whether busy hospital staff have time to connect them. It needs to be built in, so people get timely, independent, support when they need it most.”
The monitoring report is part of the Ombudsperson’s ongoing oversight following the Committed to Change investigation, which examined systemic issues affecting involuntary patients under the Mental Health Act and made recommendations to strengthen safeguards and accountability.
