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October 1, 2007 Community Services CS-37 October 1, 2007 Community Services CS-37 Title: Monday, October 1, 2007Communitity Services Committee for all members and staff and presenters there’s no need to touch the Date: 07/10/01 microphone in front of you. The equipment is operated remotely by Time: 9:30 a.m. the Hansard staff. [Mr. Marz in the chair] Okay. Thanks, everyone, for your patience. Are there any The Chair: Good morning, everyone, and welcome to the public questions or comments from the members? hearings of the Standing Committee on Community Services. I’d Seeing none, we’ll move to our first presentation, a video like to start today’s hearing by thanking everyone here for their conference from the Canadian Civil Liberties Association in participation in this process. I know that we’re all looking forward Toronto. Good morning, Ms Mendelsohn Aviv. to a series of informative discussions today. Now, to begin, I’d like to invite the committee members and staff Canadian Civil Liberties Association at the table to introduce themselves. Starting with myself, my name Ms Mendelsohn Aviv: Good morning. This is a very interesting is Richard Marz. I’m the MLA for Olds-Didsbury-Three Hills and forum. Thanks for having me. I’d like to say, first of all, good acting chair of this committee. We’ll start by going with my deputy morning to you, Mr. Chair, and to members of this committee. My chair to the right. name is Noa Mendelsohn Aviv. I’m here on behalf of the Canadian Civil Liberties Association. Our organization has been involved in Mrs. Mather: Thank you. I’m Weslyn Mather, MLA for this issue, the issue of involuntary committal and forced treatment Edmonton-Mill Woods. for people who are mentally ill, for a number of decades, and I think there can be little doubt why this would interest our organization. Mr. Lukaszuk: Good morning. Tom Lukaszuk, Edmonton-Castle The bill that’s before this committee today contemplates denying Downs. people their most basic rights and freedoms; namely, the right to dignity, privacy, and most of all liberty. Mr. Lougheed: Good morning. Rob Lougheed, Strathcona. While it’s clear that in our Canadian society we are willing to contemplate depriving certain people in certain circumstances of Mr. Johnston: Good morning and welcome. Art Johnston, Calgary- their liberty – in the criminal justice system, for example, we do so Hays. – we take great care and great precautions to ensure that we do not do so arbitrarily. We seek to ensure that an offence has been Mr. Backs: Good morning. Dan Backs, Edmonton-Manning. committed and one that we cannot live with. Now, I don’t want to make any confusion here. I’m not suggest- Dr. Massolin: Good morning. Philip Massolin, committee research ing that mental illness is in any way linked to criminality. The realm co-ordinator, Legislative Assembly Office. that these two notions share is the realm of liberty and the question of when we in a free and democratic society are willing to take away Ms Dean: Shannon Dean, Senior Parliamentary Counsel. someone’s liberty. I’m here to suggest that in both contexts, the criminal justice system and the mental health system equally, we Mrs. Kamuchik: Louise Kamuchik, Clerk Assistant, director of need to exercise a very exacting degree of caution to make sure that House services. Good morning. we have not arbitrarily or unfairly deprived someone of their freedom. Mr. Flaherty: Jack Flaherty, MLA for St. Albert. Unfortunately, it is our opinion that while this bill may have the very best of intentions and may be all about attempting to help Dr. Pannu: Raj Pannu, MLA for Edmonton-Strathcona. Good people and even provides certain safeguards, it falls very far short of morning and welcome. the requisite level of caution when we are talking about taking away people’s liberty. If the bill is trying to help people, it is doing so by Mr. Johnson: Good morning. LeRoy Johnson, MLA for expanding the criteria under which a person can be taken and put in Wetaskiwin-Camrose. a psychiatric hospital, where there is a good possibility that they may be restrained, isolated, and quite likely forced to take medication, all Rev. Abbott: Good morning and welcome. Tony Abbott, the MLA of this against their will. for Drayton Valley-Calmar. Now, as you’re probably all aware, the current statute in Alberta, the Mental Health Act, provides that people who are a danger to Mrs. Dacyshyn: Corinne Dacyshyn, committee clerk. themselves or to others can have their freedom restricted in this way for reasons of dangerousness that some of us can understand. This The Chair: Thank you. bill goes much further than that. It seeks to expand the criteria for Now, before we get into the presentations, I’d like to make note involuntary committal and treatment to people merely because they of some important things that we need to remember. Each presenta- have a mental disorder and are likely to suffer substantial mental or tion should be 10 minutes, leaving 10 minutes for questions from the physical deterioration or serious physical impairment. The question committee members. We’ll have to stick to that because we have a I’d like to ask members of this committee is: what does that mean? full slate right till 9 o’clock tonight. At the end of the presentation The language is very vague and very broad. or even before it, when 10 minutes are up, the chair will thank the If we take the simple meaning of the words, we can get to some presenter, and we’ll go into questions. When 10 minutes are up in ridiculous results. What if a person is suffering from anxiety, a questions, then we’ll move on to the next presentation. I’d like to recognized mental disorder, and has leukemia? Does this coinci- ask everyone to ensure that any cellphone, BlackBerry, or whatever dence mean that this person should be a candidate for involuntary other electronic device you have is either turned off or in silent detention in a psychiatric facility? Well, you may say that that’s mode. For my colleagues at the table please do not leave your ridiculous and that would never happen, but in the murky area of BlackBerrys sitting on the table because the vibrations from mental health diagnoses it is clear that the net has been cast too wide incoming messages interfere with the Hansard recording. Finally, CS-38 Community Services October 1, 2007 when language could allow for such a situation. When we come to involuntary treatment, especially in the case of mind-altering and vulnerable people with mental illness, we cannot allow a net to be behaviour-altering drugs, is a prison of the mind. cast so wide that it would pull up people who shouldn’t be there. From the material that we have researched, there appear to be If we think that the answer lies in our psychiatric profession, that many good and logical and rational reasons for people refusing to our psychiatrists know the difference and will know who needs to be take psychiatric drugs. The side effects have been described in some detained and who not, that there are clinical definitions and diagno- cases as devastating. The effects have been extreme and permanent. ses for these things, I would suggest and the academic literature They have affected people’s ability to do work. They have made would suggest that that is not the case. The primary diagnostic tool people look strange and frightening. They’ve affected personal available to psychiatrics is the DSM, the Diagnostic and Statistical relationships. I won’t go on in this vein because I understand that Manual of Mental Disorders. What the DSM offers us is a long and you’re going to be here until 9 o’clock tonight, and I imagine that ever-changing repertoire of possible mental disorders, ranging from you will hear a lot more, but the details are important. If someone some that are very severe to some others such as insomnia, alcohol were to refuse to take drugs with this kind of side effect, it may seem intoxication – who’s never had that mental disorder? – voyeurism, perfectly rational and reasonable to object to receive such treatment. and male erectile disorder. From one version of the DSM to the next At least it may seem that way to everyone but the doctor and the hundreds of entries have been changed. family members who desperately want this person to get better, even if they think the drugs are worse. I just want to read to you a small bit from the Australian and New Well, some people will say that we cannot possibly attribute the Zealand Journal of Psychiatry, which, if you don’t want to take my same kind of rational thinking to people who by virtue of their word for it, will also verify that according to the academic literature illness may be unable to make those kinds of decisions. That is an diagnosis in psychiatry is not an exact science. It says: argument, but how do we know if the very refusal to take the First, the introduction of explicit diagnostic criteria and new classification categories in psychiatry took place in the context of a treatment is the measure by which we assess the person’s rationality? discipline that still lacks conceptual coherence and hence remains Members of the committee, I ask you: how can we know? easily influenced by ideological, political and market forces. Moving on to a slightly different topic, I understand that this bill Secondly, there are inherent shortcomings in the design of these was put forward in an attempt to bring Alberta into line with several classification systems which limit their usefulness and make them other provinces which have also expanded their criteria for coerced liable to misinterpretation or misuse.
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