New rules for Ontario mental health care

Last Friday, the Ontario government enacted "Brian's Law," a bill making changes to the Mental Health Act. The changes mean a different way of caring for the mentally ill in Ontario.

"Brian's Law" was named after Brian Smith, the popular sportscaster killed by Jeffrey Arenburg, a man suffering from a severe mental illness. It's a substantial change from the old Mental Health Act.

The new legislation makes it easier to commit allegedly dangerous patients to hospital and allows for something called community treatment orders.

"A community treatment order is a consent-based agreement where the patient, or the substitute decision maker, agrees to treatment in the community," says Brad Clark, an assistant to the Health Minister. He guided the development of the legislation.

"It's like a step down from the hospital to the community. In the community itself, there'd be assertive treatment teams there. There'd be supportive housing there."

In plain language, community treatment orders mean 'Take drugs to control your illness or you'll go back to hospital.'

But Clark says, as a consent-based system, if they say 'No' then "they go back to hospital."

Under Brian's Law, the word "imminent" would be removed from the act. Under the old act, "imminent" was a condition for getting a psychiatric assessment and other services. Now, if the psychiatrist feels the patient is a threat to himself or others they have the opportunity to take action.

Another of the changes involves the police. Under the old law the police had to directly observe disorderly conduct before they could take a person to hospital for assessment. Now they base that decision on discussions with family members or neighbours.

But there are concerns, even from those who support the law's increased level of community care. They fear community support teams aren't coming into place quickly enough. In short, the mental health system isn't ready for "Brian's Law."

Ontario's Mental Health Act was originally written in 1967, and has been amended three times since then.