One flew east, one flew west,
One flew over the cuckoo’s nest.
~ children’s poem
By MPP Toby Barrett
Just before Christmas a law was passed, Bill 122, providing more protection for psychiatric hospital patients detained for more than six months.
This bill, the Mental Health Statute Law Amendment Act was debated and became law as a result of a judge’s ruling that Ontario’s Mental Health Act violates the Charter of Rights and Freedoms.
During debate, I pointed out the lack of media or public input, or public consultation, with respect to the issue – the judge had ruled and the changes to the Act seemed to be a fait accompli. As a society, we seem to give little thought to the approximately 330 people detained in our province’s psychiatric facilities.
For many, life in a psychiatric institution is exemplified by the Jack Nicholson film, One Flew Over the Cuckoo’s Nest — based on the book of the same name by Ken Kesey. The book, written in 1962 and the release of the film in 1975 had a significant impact on people’s perception of what goes on behind closed doors.
And just last November, a new film on the topic was released based on an 1887 first-hand account, written by reporter Nellie Bly. Ten Days in a Mad House chronicles her undercover journey through Blackwell Island in New York City. What she did, as a journalist, was feign insanity, had herself committed, and found out that sometimes it’s harder to get out than it is to get in.
By way of background, involuntary patients are detained in psychiatric facilities because they have a mental illness or there’s a risk of harming themselves or harming other people. The majority of the people who are detained longer than six months, by and large, suffer a number of ailments: mood disorders, depression, bipolar, manic depression, and psychotic disorders like schizophrenia or psychogeriatric disorders.
Before Bill 122 received Royal Assent, a person could be detained involuntarily in a psychiatric facility for an initial two-week period. On first renewal of the involuntary admission they could be detained an additional month, an additional two months on a second renewal, three months on a third renewal, and so on. There was no mechanism for a civilly-detained patient to challenge the conditions of their treatment. Nellie Bly was only incarcerated for 10 days. She was able to get out in 10 days because she had a lawyer.
People have the right to retain a lawyer, to instruct a lawyer, and have access to a telephone. People have access to a rights adviser to let them know about any change in their legal status. They do have the right to challenge the doctor’s decision. As an involuntary patient they are not free to leave the hospital without permission.
Bill 122 clarifies the process of continual detention for patients in mental health facilities.
The Mental Health Act is based on consent and substitute decision-making. The ticket in is a Form 1. For that ticket out, I am heartened from a human rights perspective, that we now have legislation that will provide people with more options.