B.C. directs physicians to notify parents if child shows up with mental health, drug use issues

The B.C. government is issuing new guidance for physicians when it comes to treating youth with overlapping cases of mental health and substance use challenges, clarifying the use of involuntary care in the process.

In a guidance document issued Friday, the province directs physicians to notify parents, and potentially involuntarily detain youth if they're unable or unwilling to seek care themselves.

It follows updated guidance of involuntary care for adults with severe cases of mental health and substance use disorders, issued earlier this year by Dr. Daniel Vigo, the province's chief adviser for psychiatry, toxic drugs and concurrent disorders.

At a press conference on Friday, Vigo, Premier David Eby and other officials were joined by parents who have lost their children to drug overdoses.

"To put it bluntly, we should only do this [involuntary care] if the brain or the life of the child is seriously at risk," Vigo said.

"But if that is the case, then we should not hesitate and we should always involve the parents or guardians in planning next steps."

Under the previous directions, Vigo explained that an articulate 15-year-old who's a drug user could have been assessed as a "mature minor." A mature minor is someone under 19 who makes their own health care decisions independent of their parents' or guardians' wishes.But that is no longer the case, he added.

Vigo says many of his physician colleagues interpreted the Mental Health Act — which allows for involuntary care — differently when it comes to whether they could admit a child against their will if the parent asks them to.

"Many of my colleagues ... sincerely thought that they couldn't use it at the request of the parent," the adviser said.

"And now I'm clarifying that yes, we can and yes, we should, when there's a medical indication for it — which is a kid who has developed a dependence to opioids and is at risk of, you know, death, brain damage."

While toxic drug deaths are trending downward in B.C. as a whole this year, the latest numbers from the B.C. Coroners Service show that 21 youth under 19 died from illicit drugs from January to October this year.

That's up from 17 youth who died in the same timespan last year.

Since 2016 — the year B.C. declared a public health emergency due to toxic drugs — 222 people under 19 have died to illicit drugs.

Among the parents who spoke at Friday's event were Brock Eurchuk and Dr. Rachel Staples, whose 16-year-old son Elliot Eurchuk died of an opioid overdose in April 2018.