“Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act
Bibliographic record
Abstract
British Columbia's Mental Health Act permits the involuntarily detention and treatment of individuals who meet specific criteria. Over the past 15 years, British Columbia has seen an increasing trend in the number of involuntary psychiatric admissions. This qualitative study explores the experiences of people receiving and providing involuntary psychiatric treatment within two health organizations in British Columbia, Canada. Five focus groups were conducted with 23 individuals who had previously received involuntary psychiatric treatment at a facility operated by one of the two health organizations. All sessions were facilitated by individuals with lived experience of involuntary psychiatric treatment. Additionally, semi-structured interviews were conducted with 11 clinical staff and 10 non-clinical support personnel involved in delivering involuntary psychiatric treatment or associated services. Data were analyzed using reflexive thematic analysis, guided by an equity-oriented care framework. Seven themes were generated, including the limited availability of voluntary care options, the compounding role of social determinants of health in mental health crises, the lack of conclusive evidence supporting involuntary psychiatric treatment, the negative impacts on both patients and providers, and the importance of peer support. Across themes, participants described involuntary psychiatric care as shaped by systemic constraints with limited access to upstream, voluntary and community-based alternatives. These findings highlight the need for system-level reform to reduce reliance on coercive practices and to expand access to voluntary, community-based mental health supports that address underlying social and structural factors contributing to mental health crises.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.027 | 0.030 |
| Scholarly communication | 0.008 | 0.004 |
| Open science | 0.003 | 0.009 |
| Research integrity | 0.003 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".