[DATE]

CURRENT MENTAL HEALTH LAWS ARE IMPEDING ACCESS TO CARE

Dear Hons. Doug Ford, Sylvia Jones, Michael Tibollo, Marit Stiles, France Gelinas, Lisa Gretzky, Bonnie Crombie, Adil Shamji, Doug Downey and Kristyn Wong-Tam,

Ontario’s current mental health laws prevent my family member from accessing inpatient psychiatric treatment because my family member does not have a history of past response to treatment or/and they contested a Consent and Capacity Board’s finding of incapacity to the Superior Court and have not been able to access treatment while they wait.

My family member’s symptoms have included:

• Hallucinations  
• Delusions – fixed false beliefs
• Disorganized speech or behaviors
• Social withdrawal and reduced motivation
• Emotional lability or dysregulation
• Grandiosity
• Impulsive behaviors

My family member does not have insight into their symptoms or the consequences of their mental illness. They declined treatment with psychiatric medications, but they are incapable of making such decisions. The only way to improve their health is through an involuntary admission where treatment can be provided with the consent of a legal Substitute Decision Maker. 

Because my family member has never had psychiatric treatment, they cannot demonstrate a history of their health improving in response to treatment. Consequently, despite suffering substantial mental or/and physical deterioration, they do not meet the Ontario Mental Health Act’s criteria for involuntary admission to a psychiatric facility (Form 3, Box B criteria). The current Mental Health Act would otherwise only permit involuntary admission if my family member is dangerous to themself or others, or suffers a physical impairment (Form 3, Box A criteria). This creates a gap in care for those who are significantly mentally unwell, yet not an acute physical safety risk, despite their likely risk for other forms of serious harm and what is in their best interest or their previously-expressed capable wish for treatment.

Another problem my family member has faced, or I am worried will happen, is even when they meet the requirements for an involuntary admission and are found to be incapable of consenting to treatment, they will be detained in hospital without treatment. This would happen if my family member challenges a review board’s finding of incapacity and has to wait for a Superior Court hearing.

As a result, my family member remains unwell and untreated, with no appreciation of their situation and is suffering the following consequences:

• Causing physical harm to others
• Causing physical harm to self
• Cognitive, memory, or thinking impairments
• Educational impairment or loss
• Relationship problems or loss, or social isolation
• Family estrangement
• Financial insecurity  e.g. financial loss, bankruptcy, not qualifying for ODSP
• Food insecurity
• Housing insecurity  e.g. eviction, transience, homelessness
•  Interference with physical health, or accessing physical health services
• Being physically assaulted
•  Legal or forensic involvement
• Lack of, or loss of vocation or work/employment

The following is my story of the consequences suffered because my loved one did not access inpatient psychiatric treatment:  [    ] 

I urge you to change the Ontario Mental Health Act so that involuntary admission is accessible to people suffering from a mental disorder needing treatment that can only be provided in a psychiatric facility, when they are at likely risk of substantial mental or physical deterioration, are incapable to consent to psychiatric treatment and consent from their legal Substitute Decision Maker has been obtained, and without need to demonstrate past response to treatment. I urge you to change the Health Care Consent Act so that treatment can be given during lengthy court appeals.

Please see the attached Ontario Psychiatric Association’s (OPA) proposed Mental Health Act and Health Care Consent Act changes. I support the views in this document. Where do you stand on the issues identified by the OPA and what do you propose to address and remove these barriers to care? What can you do to make these legislative changes happen?

Sincerely,

[YOUR FIRST + LAST NAME

ADDRESS WITH POSTAL CODE]