The PPAO must NOT become part of the CMHA
Ontario’s Psychiatric Patient Advocate Office (PPAO) is set to come under the umbrella of the Canadian Mental Health Association (CMHA). This is as big a conflict of interest as you are likely to encounter in Canadian health care.
When you are admitted to a psychiatric facility in Ontario — especially under a Form 1 (“Application by Physician for Psychiatric Assessment”; viz., involuntary admission) — you are pretty much at the mercy of staff save for the efforts of the PPAO. What does it do?
- It provides information to the patient on their rights concerning admissions under the Mental Health Act, the Criminal Code, and into long-term care facilities.
- It offers in-hospital patient advocacy on the above issues as well as in matters of complaint procedures, uses of personal health information, and treatment modalities.
- Outside the clinical sphere, it engages in systemic advocacy in a full range of vital areas, including appropriate use of force, the employment of restraints, police deployment of tasers, accessibility to elections, and consent and capacity issues.
In the larger sense, the PPAO is about guaranteeing human rights and civil liberties to inpatients. In the immediate sense, it is about preventing abject abuses to their persons and psyches.
Why must the PPAO not come under CMHA authority?
The CMHA is not an institution, but it is de facto the main provider for outpatient mental health services and allied psychiatric supports in many communities, often in conjunction with hospitals. In Grey and Bruce Counties (whose hub is Owen Sound), there are three(!) distinct mental health-related organizations, all designed to operate interdependently. In essence, Grey Bruce Health Services-Owen Sound (our Schedule 1 hospital — that is, hospital with psychiatric inpatient services), our branch of CMHA, and the Grey Bruce Community Health Corporation all function en bloc.
CMHA, then, is a significant part of the system no matter where you live, and has its own interests and aims. However, allow me to quote from PPAO’s official history:
“The intention of all political parties [in 1982, when the PPAO was founded] was that the Office would operate at an arm’s length relationship with the Ontario Government in the exercise of its mandate with only administrative accountability to the Ministry of Health.”
It doesn’t matter that the CMHA is a non-profit charity, answerable to a board of directors and not directly to the Ministry of Health and Long-Term Care. The same principle should hold. It is not reasonable to presume that a body whose mandate is to remain independent can function under the aegis of an organization which is an adjunct to inpatient facilities.
So, what can you do?
- Read up on the topic. Look at what we post in the Facebook group “Psychiatric Patient Advocacy Must Be Independent“. Consult the PPAO’s website, as well as the CMHA’s.
- Lobby lobbyists, like the Ontario Mental Health and Addictions Alliance, of which CMHA is a part. Their aim is to keep mental health issues on the front burner moving into the 2011 Provincial election. But because they speak principally from the point of view of service providers and not patients (though the Ontario Association of Patient Councils and the OPDI are represented), they must be made to know that this is unacceptable.
- Apply pressure through conventional and alternate media — rabble.ca, etc. Connect with socially conscious journalists. Write letters.
- Make use of Deb Matthews (the Minister of Health and Log-Term Care) and your MPP’s — write them!
This is not a mere administrative issue. Independent bodies are independent for a reason. They need the leeway to speak and act on behalf of vulnerable individuals. They must be free to hold institutions to account lest these summarily decide to curtail a person’s rights.
We Survivors have fought long and hard to define what constitutes institutional abuse. We can’t lose what we have gained.