Two lesser-known provisions of the B.C. Mental Health Act are being used with increasing regularity, underscoring the extent to which Vancouver continues to struggle with—and involve police in—care for people with a mental illness.
The powers of the act are applied via what’s called a Form 4 and a Form 21.
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. The measure is largely proactive in nature. A hypothetical example of when a Form 4 might be used is when a person with schizophrenia expresses intent to harm themselves. A family member could alert that person’s physician, who could then complete a Form 4 to see police take them into custody and transport them to a hospital.
A Form 21 works in a similar manner but is used when a person who has been committed to a care facility and then given leave fails to return by a scheduled deadline.
During the first six months of 2016, Form 4s and Form 21s accounted for 859 Vancouver Police Department apprehensions, on track for a projected 1,718 by the end of the year.
That compares to 679 such apprehensions during 2012, marking a projected 253-percent increase in just four years (the period for which the VPD provided statistics). There were 1,064 Form 4 and 21 apprehensions in 2013, 1,396 in 2014, and 1,663 in 2015.
The data only cover cases involving the VPD, and many Form 4s are resolved without the involvement of law enforcement, meaning those statistics are smaller than the total numbers of forms that doctors issued.
In a telephone interview, VPD spokesperson Const. Brian Montague placed the data in the context of what former police chief Jim Chu described as a “mental-health crisis”.
Montague maintained that more Form 4 and Form 21 apprehensions shouldn’t be viewed in a negative light. He noted they usually originate within the care system and with the goal of connecting a person with the help that a doctor says they need.
Doug King, a lawyer with Pivot Legal Society, called attention to the sharp climb evident in the numbers.
“What has changed?” he asked. “It could point to more collaboration between the police and the health-care system.”
King told the Straight that this sort of cooperation might have positive implications but also raises “serious concerns”. Areas where that is the case, he continued, include record-sharing and unintended implications of police having more access to data about people’s health.
“Getting a tag or notation on your file that says you have a mental illness could be negative in terms of how police are going to treat you in the future,” King said. He also raised questions about which other agencies might have access to that information.
The increase in use of Form 4 and Form 21s mirrors a similar rise in VPD incidents involving another section of the Mental Health Act, known as Section 28. That provision allows police to take a person into custody if an officer deems them to constitute a threat to themselves or others. It differs from the application of Form 4 and Form 21s in that a Section 28 usually involves a person experiencing an acute mental-health crisis.
From 2010 to 2014, VPD apprehensions under Section 28 of the act increased between five and 10 percent each year, from 2,278 to 3,010. They then levelled off when there were 3,050 apprehensions in 2015 and 3,026 projected for 2016 (based on data covering the first six months of this year).
Montague again stressed that the increasing frequency with which police have come to use this section of the act does not constitute bad news.
"In most of those cases, no crime has been committed," he explained. "But it’s an apprehension under the act because a medical professional or a police officer has felt it is for the best interest of the person for their safety and the best interest of the public for their safety to do that.”
Jonny Morris, director of public policy for the Canadian Mental Health Association’s B.C. division, said the Form 4 and Form 21 statistics are further evidence of insufficient attention to preventive care.
“Whenever you are talking about a mental-health apprehension—whether the police are involved or not—we are talking about a point in someone’s trajectory where they are at a crisis,” he explained. “What are the opportunities before you need to exercise legislative authority where the health system could have intervened?”