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.