Part 4: Systemic Abuse — Unsafe Treatment Practices and Financial Exploitation in BC's Youth Mental Health System

⚠️ Part 4: Systemic Abuse — Unsafe Treatment Practices and Financial Exploitation in BC's Youth Mental Health System

The experiences of youth in British Columbia's mental health system during the COVID-19 pandemic have highlighted significant issues, including systemic abuse, unsafe treatment practices, and financial exploitation. These concerns have raised questions about the adequacy and accountability of the services provided to vulnerable youth.

🛑 Unsafe Treatment Practices

Reports have surfaced detailing concerning treatment practices within psychiatric facilities:

• Use of Restraints and Seclusion: There have been accounts of inappropriate use of restraints and seclusion rooms in psychiatric wards, raising concerns about the safety and dignity of patients. Source
• Coercive Use of Sedation: Disturbing accounts have emerged regarding the coercive use of sedation, particularly in cases involving gender-based violence, highlighting a need for trauma-informed care. Source
• Lack of Trauma-Informed Care: The absence of trauma-informed care has led to further trauma for patients, emphasizing the need for compassionate and informed treatment approaches. Source

💰 Financial Exploitation Concerns

Financial exploitation within the system has also been a point of concern:

• Billing Practices: There have been instances where families were billed for services not rendered or for extended stays that were not medically necessary, raising ethical questions about billing practices. Source
• Resource Allocation: The allocation of resources has sometimes favored institutional care over community-based services, potentially leading to unnecessary institutionalization and associated costs. Source

📣 Calls for Reform

In response to these issues, several reforms have been proposed:

• Policy Reforms: Advocating for changes in policies to better address the needs of youth, particularly in times of crisis. Source
• Resource Allocation: Ensuring adequate funding and resources are directed towards youth mental health and substance use services. Source
• Community Engagement: Encouraging community involvement and support to create a network of care for vulnerable youth. Source

By addressing these areas, we can begin to heal the wounds left by the pandemic and build a more resilient support system for future generations.

Stay tuned for Part 5, where we delve into Accountability and Transparency in BC's youth mental health system. 🔍

Note from the author:

The issues raised in this post draw upon publicly‑available investigations, reports and advocacy commentary that highlight systemic vulnerabilities in youth mental‑health services in British Columbia. For example:

The office of the Representative for Children and Youth (BC) (RCY) has issued reports such as Detained: Rights of Children and Youth under the Mental Health Act (2021) and its subsequent monitoring updates, which point out significant concerns in how young people under the Mental Health Act (BC) are treated, including issues of rights‑awareness, appropriate data collection (including for age, Indigenous identity, length of stay, seclusion and restraint) and the quality of involuntary care. 

A blog by Health Justice titled “Seclusion and Restraints in BC” documents that the provincial legislation and policy framework allow for seclusion and restraint without clear safeguards, and that the available data is incomplete (for example, only tracking use in the first three days of hospitalisation) and lacking demographic breakdowns. 

The Child Health BC “Provincial Least Restraint Guideline” sets out definitions and protocols for seclusion, chemical, physical and mechanical restraint in children/youth care settings, establishing that restraint should be a last‑resort option and must be documented and regularly reviewed. 

Because of this context:

While there is firm, documented basis for concerns about unsafe treatment practices (e.g., seclusion, restraint, gaps in trauma‑informed care) for children and youth in BC’s mental‑health system, some of the specific claims in this post (for example, “families were billed for services not rendered” or “extended stays that were not medically necessary”) are less fully documented in publicly‑accessible reports—they reflect patterns and concerns raised by advocates rather than confirmed large‑scale audits or government disclosures.

Similarly, the allocation of resources favouring institutional over community‑based care is indicated by monitoring reports that show uneven progress and unmet recommendations, but may not yet be entirely quantified in all jurisdictions or sub‑populations.

For accuracy and transparency: readers are invited to review the linked reports and documents themselves. Where full data or definitive studies are absent, language such as “reports indicate”, “advocate concerns”, or “emerging evidence” is more appropriate than asserting absolute certainty.

This post does not capture every nuance of local policy, regional variation among health authorities, or every demographic group affected. One of the most critical findings of RCY and other bodies is that youth from Indigenous communities are disproportionately impacted, and that the “one‑size‑fits‑all” model does not reflect culturally safe, trauma‑informed practice. 

The intention of this post is not to ascribe individual blame to frontline workers, many of whom do their best under pressure, but rather to highlight systemic failures: gaps in oversight, data transparency, accountability, resource allocation and youth/Indigenous‑led, trauma‑informed models of care.

I encourage anyone with lived experience in British Columbia’s child and youth mental‑health system, or families of those who have been affected, to continue to share their stories, join advocacy efforts, and demand improved practice, transparency and reform. This post is part of a broader project aimed at raising awareness and calling for change in how vulnerable youth are served.

Thank you for engaging with this critically important topic. — 

Tina Winterlik (Zipolita)