My son, a kind-hearted 43-year-old, experienced a troubling period before his involuntary treatment under the BC Mental Health Act. He faced serious challenges, including an incident where he attacked a neighbour, another incident, a family member, and was at one point charged with assault with a deadly weapon. His deep paranoia and declining health made him a danger to himself and others—meeting the critical criteria for involuntary treatment.

Thanks to his “right” to involuntary treatment, under the BC Mental Health Act, he is now thriving in supported housing, holds a part-time job, and has meaningful relationships with friends and family. Although the road to recovery was difficult, the involuntary treatment provided by the BC Mental Health Act was a lifeline.

On behalf of countless families, I want to emphasize that schizophrenia is not just a mental health issue; it is a debilitating illness, much like Alzheimer, which strips individuals of their ability to grasp reality. It erases memories, diminishes recognition of loved ones, and can overwhelm individuals with profound paranoia.

In light of the deeply disturbing recent events in Vancouver, including the tragic death of an elderly man due to an attack by an untreated individual suffering from addiction and mental illness, it is imperative that we advocate for effective treatment.  I recently finished reading “Malady of the Mind” by Dr. Jeffrey A. Lieberman” and wanted to share an impactful chapter which speaks to the heart of recent events, with our subscribers, Pathways members, and the wider community. 

Chapter: Civil Commitment and the Right to (Refuse) Treatment

The Fruits of Bad Policy – Jeffrey A. Lieberman, MD.

“Over the centuries, as civilizations progressed and our knowledge of medicine and disease increased, a consensus emerged that health care should be available to citizens to the extent that medical capacity allowed. In general, limitations on care have been determined by the level of knowledge we have about an illness. The effectiveness of treatments, and people’s access to services.  Whether governments should provide some or all of the health care people need is a question answered differently in different countries but what is hardly debatable is the notion that governments should not institute policies that inhibit or undermine the care of the sick.  Sadly although it is not intentional, that’s the situation we have in the United States, (and in Canada) when it comes to mental illness.  In the case of people with schizophrenia, the limiting factor is not our level of knowledge – our understanding of the illness is admittedly imperfect, but it has not prevented us from developing effective treatments – but of ACCESS TO HIGH-QUALITY CARE and the POLICIES GOVERNING HEALTH CARE.  

In the past, when mentally ill people were viewed as pariahs and considered a nuisance to society, the policy and preferred form of treatment was consigning them to prisons, almshouses, or asylums – and laws facilities this.  But then the appalling conditions in the asylums and the lack of effective treatment offered eventually gave rise to public outrage, policies changed, limiting the circumstance under which patients cold be put in institutions.  

If Wendell Williamson (Lieberman’s patient) had developed schizophrenia sixty years earlier, he would have been subject to a different set of laws, which may have led to a different treatment outcome.  But changes in the mental health policy afforded him the freedom to terminate treatment, permitting his symptoms to recur, which compelled him to murder two people.  Sadly, Williamson’s story – one of untreated mental illness that resulted in violent tragedy – is not unique.  Untreated, symptomatic schizophrenia patients are at increased risk of violence or harm to themselves or others. 

Mental health advocates point out valiantly that mentally ill people are not more dangerous than the general population.  While it is true that less than 4 percent of all violent crimes in the United States are committed by the mentally ill, this figure includes both treated and those who aren’t.  If we consider only mass violence incidents (usually defined as involving four or more victims), between 20 percent and 30 percent are perpetrated by people with mental illness.  Almost every mentally ill perpetrator of mass violence has been symptomatic and untreated for lengthy periods prior to his crime, either because he (or his family) did not seek treatment or because the ill person refused it.  Even in cases where family members or doctors invoked civil commitment procedures, patients could be released within seventy-two hours – without a requirement in place that they continue treatment – if mental health lawyers convinced a judge that they weren’t dangerous.”

In light of the deeply disturbing recent events in Vancouver, including the tragic death of an elderly man due to an attack by an untreated individual suffering from addiction and mental illness, it is imperative that we advocate for effective treatment. 

Nancy Ford, 
Retired ED for Pathways Serious Mental Illness Society
Advocate and Parent

More information

Malady of the Mind – Schizophrenia and the Path to Prevention – Jeffrey A. Lieberman, MD Chair in Psychiatry at Columbia University. Over his 40 year- career he has treated thousands of patients with mental disorder. His research has elucidated the pathological basis for schizophrenia and improved treatment for the disease. Elected to the National Academy of Medicine in 2000 he also served as a president of the American Psychiatric Association from 2013-2014 publishing more than several hundred articles in leading scientific journals.

Disclaimer: As an Amazon Associate, Pathways SMIS earns a commission from qualifying purchases.