Involuntary psychiatric treatment and the erosion of consent: A critical discourse analysis of mental health legislation in British Columbia, Canada
Open accessAbstract
The Mental Health Act (1996) is legislation that directs voluntary and involuntary psychiatric treatment for people experiencing mental health issues in British Columbia (BC), Canada. This critical discursive analysis explores how BC's Mental Health Act (1996) and the Guide to the Mental Health Act (2005) structure involuntary psychiatric treatment and illustrates how the discourses within these texts constitute people experiencing mental health issues as passive recipients of care. Understandings of people experiencing mental health issues as pathological, incapable, vulnerable and dangerous justify their need for protection and the protection of others. Protection is identified as a central legitimising discourse in the use of involuntary psychiatric treatment. Further, these texts define the roles and responsibilities of police, physicians and nurses in authorising and implementing involuntary psychiatric treatment. This analysis describes how this legislation erodes consent and entrenches social marginalisation. Alternatively, discourses of equity have potential to transform health care practices and structures that reproduce discourses of deficit, vulnerability and dangerousness, shifting towards promotion of the rights and safety of people experiencing mental health issues and crises.
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British Columbia's Mental Health Act operates on a "deemed consent" model: once a person is detained involuntarily, they are deemed to have consented to any psychiatric treatment that follows.
“Unlike most other jurisdictions in Canada, the BC MH Act operates on a “deemed consent” model, which assumes that once a person is detained involuntarily under the MH Act, they are deemed to have consented to any psychiatric treatment that follows [3].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [3]
The Introduction (page unavailable) explicitly describes BC’s approach as ‘deemed consent’ and says consent to any psychiatric treatment the treating physician deems appropriate is assumed during involuntary treatment. The section ‘Constitutions of the “Involuntary Patient”’ links this treatment authority to involuntary-patient status. The paper does not establish the citing sentence’s additional comparison that most other Canadian jurisdictions use a different model. (LLM, conf=0.82)
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Self-citation
- Authors
- Kolar, M., Varcoe, C., Brown, H., & Einboden, R.
- Affiliations
- University of British Columbia (CA)
- The University of Sydney (AU)
- Corresponding author
- Kolar, Maja
- Venue
- Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine
- Publisher
- SAGE Publications
- Published
- 2022-05-09
- Volume
- 27
- Issue
- 6
- Pages
- 1076-1095
- ISSN
- 1363-4593 (ISSN-L)
- 1461-7196
- PMC
- PMC10588262
- OpenAlex
- W4229368545
- Cited by
- 10
- References
- 36
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2022: 1
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- involuntary psychiatric treatment, mental health law, informed consent, deficit discourse, dangerousness, social marginalisation, equity in mental health care, British Columbia
- MeSH terms
- Mental Disorders, British Columbia, Commitment of Persons with Psychiatric Disorders, Humans, Informed Consent, Mental Health
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