In 2013, former Vancouver police chief Jim Chu and former mayor Gregor Robertson sat side by side at a news conference and called attention to a “growing crisis” of severe mental illnesses.
Section 28 apprehensions under the B.C. Mental Health Act—a law that lets police take a person into custody if an officer deems them a threat to themselves or others—had increased 16 percent from 2010 to 2012.
“There are hundreds of people with severe but untreated mental illnesses that are a high risk to both themselves and residents of the city,” Robertson said in September 2013.
In the years following that declaration, the crisis intensified. By 2015, Section 28 apprehensions were 34 percent above where they were in 2010.
Now, new data obtained by the Straight reveals that after five years on the rise, the numbers finally plateaued.
In 2010, there were 2,276 VPD apprehensions under Section 28 of the act. In 2015, there were 3,050. Then 2,851 in 2017 and then a projected 2,929 in 2019 (based on the year’s first nine month’s of data).
The numbers have declined, but only marginally. And they remain high above where they were in 2013, when the mayor and police chief described the issue with such alarm.
Does Vancouver’s collective mental health remain in a state of crisis?
“We certainly do still see a significant number of admissions to the hospital which involve mental health, and that is a crisis for everybody,” Staff Sgt. Randy Fincham, a member of the VPD’s mental-health unit, told the Straight.
“Compound that now with the opioid crisis and addictions concerns,” he said in a telephone interview. “We know there are a lot of people living in the community with a mental illness who also have a concurrent disorder, living with an addictions concern, whether drugs or alcohol. Now the challenge is treating, not just the mental illness, but also treating the concurrent disorder. That creates significant challenges.”
Section 28 apprehensions only tell half the story.
A police officer can also take a person into custody under the B.C. Mental Health Act using what are called forms. There are primarily two categories of forms used by police: Form 4 and Form 21.
In contrast to a Section 28, which is deployed when someone is experiencing a mental-health emergency, Form 4s and Form 10s are used in a proactive manner.
A Form 4 allows a physician to order a person detained involuntarily and a police officer to apprehend that individual for the purpose of bringing them to a care facility. A Form 21 is used when a person who has been committed to a care facility—and then given—leave fails to return by a scheduled deadline.
Like Section 28 apprehensions, the Vancouver Police Department’s use of Form 4s and Form 10s has similarly plateaued, but after an even steeper climb.
From 2012 (the year the VPD began counting Forms) to 2019, the VPD’s Form 4 and Form 21 apprehensions climbed from 679 to a projected 1,851—an increase of 173 percent.
Fincham described this as a good thing, emphasizing that the rise in Form 4s and 10s has meant relatively fewer Section 28s, in which apprehensions can involve the use of force and physical restraint.
“A lot of what we’re seeing is different partnership programs between health [care] and the police having a positive impact,” he said. “We see the proactive efforts of health authorities reaching out to clients in the community.”
In a telephone interview, Laura Johnston, a lawyer with Vancouver’s Community Legal Assistance Society, cautioned that mental-health services forced on people can produce the opposite of their intended effect.
“All of these extremely coercive tactics create their own measure of harm or trauma, which can then deter people from accessing mental health and addiction services when they need it,” Johnston told the Straight. “Then it becomes a crisis situation.
“So you’re perpetuating a cycle,” she continued. “People don’t feel safe accessing the system on a voluntary basis, then it becomes a crisis, then there is an involuntary apprehension, and then they feel even less safe [to access services voluntarily]. It’s a downward spiral.”
Johnston emphasized that this is not just a Vancouver issue, but one the entire province grapples with. She pointed to a March 2019 report by the B.C. Office of the Ombudsperson that found between 2005-06 and 2016-17, involuntary mental-health admissions in B.C. increased 71 percent. Meanwhile, the province’s population only grew by 15 percent.
“What that indicates,” Johnston said, “is that our mental health and addictions system is primarily interacting with people in an involuntary or coercive way, rather than providing voluntary-based services.”
Thomas Kerr is senior scientist at the B.C. Centre on Substance Use (BCCSU) and a professor in UBC’s department of medicine. In 2015, he coauthored a paper that called into question the accuracy of the VPD’s claim of a mental-health crisis.
“The VPD reports contribute to a widening net of social control, rather than to the betterment of the lives of people living with mental illness,” it reads.
Four years later, Kerr took a different tone, telling the Straight he’s surprised the VPD’s Section 28 numbers for recent years aren’t even higher than the plateau at which they appear to have settled. He explained that while an epidemic of drug-overdose deaths has kept authorities preoccupied with opioids like heroin and fentanyl, Vancouver has quietly seen a sharp rise in the use of crystal meth.
According to preliminary data Kerr shared with the Straight, the percentage of BCCSU study participants who used crystal methamphetamine during the preceding six months increased from 19.3 percent in 2006 to 36.5 percent in 2016.
“We know that with a lot of crystal meth use comes a lot of mental-health challenges,” Kerr said.
He, however, cautioned that should not mean that someone on methamphetamine should automatically be involuntarily committed to a hospital.
“This is one of those areas that we’re concerned about, where people are in an acute-psychotic state, it’s drug related, and then they get apprehended and processed under the mental-health system,” he said.
Kerr argued that while some people may need to be admitted to a mental-health care facility against their will, there are usually larger underlying problems that institutionalization will leave unaddressed.
“It’s easier to say, ‘We have a mental-health crisis and we have to get people in care’, than it is to say, ‘We have to deal with poverty, the long-term effects of colonialism, and substandard housing,’ ” he explained.
“It’s always a concern when we turn to these quick medical diagnoses and solutions in the absence of meaningful social change.”