Seclusion as a Reportable Restriction Pursuant to Part XX.1 of the Code
On November 30, 2012, the Ontario Review Board held that
Melville Ince, a man detained at the Centre for Addiction and Mental Health
(CAMH) and secluded for over eleven weeks, was unlawfully confined for at least a two-week
period. In so doing, the Board
criticized the CAMH team for summary descriptions of events rather than a
detailed description of the critical thinking around events, a failure to
document the rationale for the on-going isolation in seclusion, the lack of attention
to detail by those at CAMH responsible for protection the rights of vulnerable
people and unilateral decision making by CAMH staff which, if not opposed, would effectively deny Mr.
Ince his statutorily mandated hearing.
The Board is charged with reviewing significant restrictions
of the liberty of a person found not criminally responsible when that
significant restriction exceeds seven days.
In those circumstances, the hospital is obliged to notify the Board of
the restriction pursuant to section 672.56 of the Criminal Code and the Board
is required to hold a hearing to review the restriction of liberty.
Astonishingly, CAMH staff only notified the Board of the
restriction of liberties (without providing that notice to Mr. Ince’s lawyer)
almost seven weeks after the restriction occurred but the letter did not
actually get transmitted to the Board until another three weeks. If matters could not get worse for Mr. Ince,
CAMH then purported to withdraw its notification saying that the letter
notifying the Board of the restriction had been sent in error.
In a carefully reasoned decision, the Board confirms the
obligation to notify the Board of a significant restriction of liberty where
that restriction continues past seven days, that seclusion is a reportable
restriction and that the hospital must provide evidence for the reason for the
placement and continued placement in seclusion.
The decision is a must read for anyone whose practices touches Part XX.1 of the Code. It also validates the anecdotal evidence we here from people in the facilities that hospitals do not consistently notify the Board when their liberty is restricted as a result of being placed in seclusion. I've posted the decision here.