The right to refuse wellness

Posted on August 30, 2010 in Health Debates

Source: Toronto Star — Authors: Editorial

On the streets, we see homeless men and women engrossed in soliloquies or flailing at their demons. Behind closed doors, the burden of mental illness can be more private but no less tormenting.

Now, a committee of MPPs studying mental health and addiction has called for major reforms that would get Ontarians talking again about how to help mental health patients who refuse to be treated.

The all-party committee heard from an anguished family trying to help a son who believed he could stop moving cars just by touching them; and it heard about the suicides of loved ones who did not receive the help they needed. Their report, released last week, concludes that provincial mental health legislation permits “excessive and unnecessary suffering.” That cannot continue.

Current laws place such a high value on consent that people cannot be involuntarily admitted to a psychiatric facility until they are so physically dangerous to themselves or others that they can be arrested for it. Even then, they can still refuse treatment.

Ontario rightly abandoned the routine practice of institutionalizing those with a mental illness and forcing invasive treatments on them decades ago. Now, we watch people deteriorate and harm themselves without being legally able to intervene at all.

Ontario must broaden its criteria for when people can be involuntarily admitted to a psychiatric facility and limit the right of patients to refuse treatment once they are there, the report states. “The right to autonomy must be balanced with the right to be well.”

Wisely, the MPPs refrained from proposing specific amendments to Ontario’s mental health legislation. Instead, they call for a new task force that includes patients and caregivers to recommend changes to involuntary admission and treatment policies.

This is a sensible way to proceed on a divisive and emotional issue. But as the committee points out, the legal framework is only part of the problem. Too many Ontarians with mental illnesses don’t get appropriate and timely care because there are insufficient hospital beds, programs and community supports. Even when people are well again, they won’t remain so without housing and proper services.

This thoughtful report suggests the pendulum has swung too far in favour of patients’ rights trumping patients’ health. We need a fuller debate on how mental health services are delivered in this province.

< http://www.thestar.com/opinion/editorials/article/854099–the-right-to-refuse-wellness >

Tags: Health, mental Health, rights

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