Mayor Ken Sim is asking Premier David Eby for 100 new involuntary-care beds in Vancouver, but a recent court ruling has created confusion about what governments can and cannot do.
A recent B.C. Supreme Court ruling has reignited debate over involuntary care, just as Vancouver Mayor Ken Sim is pushing Premier David Eby to add 100 new involuntary-care beds in the city. But despite some of the political rhetoric surrounding the decision, the court did not rule that involuntary admission itself is unconstitutional.
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In Council of Canadians with Disabilities v. British Columbia (Attorney General), released July 28, Justice Lauren Blake wrote that the issue was not whether B.C. should have a system for involuntary admission. She said it must. The constitutional problem was how B.C. dealt with psychiatric treatment decisions after a person had been involuntarily admitted, an important distinction as Vancouver and the Province debate the issue.
What did the court actually decide?
Under B.C.’s system, involuntary status could allow psychiatric treatment to proceed without a legislated requirement to first determine whether a patient was capable of making that particular treatment decision. The court found that framework violated Charter protections.
B.C. was also an outlier in Canada. The judgment found it was the only province or territory without a statutory framework requiring assessment of an involuntary patient’s capacity to make psychiatric treatment decisions, while also allowing the detaining facility broad treatment authority without independent oversight. CityNews, reporting through The Canadian Press, also noted that other Canadian jurisdictions use less rights-infringing approaches.
However, none of that means a person can no longer be involuntarily admitted. The Mental Health Act continues to allow involuntary admission when the statutory criteria are met, including when a person with a mental disorder requires care and supervision for their protection or the protection of others and cannot suitably be admitted voluntarily. The court suspended its declarations for six months, giving the Legislature time to create a Charter-compliant treatment framework.
Sim wants 100 new beds in Vancouver
Against that backdrop, Sim wrote to Eby on Aug. 6 asking the Province to commit 100 new involuntary-care beds to Vancouver. Global News reported on the request and Eby’s defence of his government’s record on the file.
The request follows a significant provincial announcement nearly two years ago. In September 2024, Eby announced a secure-care strategy for people with severe mental-health, addiction and brain-injury challenges, with plans for secure regional facilities under the Mental Health Act.
Some of that capacity has since opened. Ten mental-health beds were established at Surrey Pretrial Services Centre and 18 long-term involuntary-care beds opened at what the Province now calls Spiritwood Homes in Maple Ridge.
This July, the Province announced another 132 dedicated beds in Surrey and Prince George. The first 24 of Prince George’s 72 beds are expected by December 2027, with the remainder by the end of 2028. A separate 60-bed Surrey facility is expected to open in spring 2028, while no equivalent new dedicated facility has yet been announced for Vancouver.
But doesn’t B.C. already have more than 2,000 beds?
Yes, the Province says B.C. already has 2,100 mental-health beds capable of providing involuntary care, including 930 acute psychiatric beds, 952 non-forensic tertiary beds, 190 forensic beds, the 10 Surrey Pretrial beds and 18 long-term approved-home beds. Business in Vancouver’s Rob Shaw reported that 455 of the roughly 2,000 existing beds are within Vancouver Coastal Health.
However, that is not the same as 2,100 newly created or purpose-built secure-care beds. Most are existing psychiatric beds that can accommodate people admitted involuntarily. Sim’s request is for 100 new dedicated beds in Vancouver for people with particularly severe and complex needs, similar to the specialized capacity the Province is building elsewhere.
Both numbers can therefore be true. Vancouver already has access to involuntary psychiatric care, while the city has not received the kind of new dedicated secure-care facility being developed in Surrey and Prince George.
Who actually has the power to act?
Vancouver deals with many visible consequences of the mental-health and addiction crisis through policing, fire services, streets and the public realm. The City, however, does not run B.C.’s health-care system or write the Mental Health Act.
Those responsibilities sit primarily with the provincial government and health authorities. Under B.C.’s Health Authorities Act, the Province establishes standards and can specify the level or extent of health services that must be provided, while regional health authorities deliver services within that framework.
There is also a broader question about where care should be located. In announcing the Prince George facility, the Province emphasized providing specialized treatment closer to home. That raises a legitimate question about whether people with complex needs should receive appropriate treatment in their own communities, with connections to family and local support networks, rather than concentrating services in a small number of regional hubs.
That conversation deserves its own examination. But on the immediate issue, the recent court ruling does not prevent B.C. from expanding involuntary care. It requires the Province to build a treatment system that protects patients’ constitutional rights while still allowing involuntary admission when the legal criteria are met.
Eby and Sim stood together in 2024 and agreed that the existing approach needed to change. Nearly two years later, the court has now provided clearer constitutional boundaries for what that change must look like, while the Province has begun building new specialized capacity outside Vancouver.
For Vancouverites, the question is becoming less about whether involuntary care is legally possible and more about what a workable, rights-respecting system should look like, how much capacity is needed and where it should go. Those are questions the City and Province will have to answer together, and Vancouverites likely care far less about which level of government wins the political argument than whether both can get on with the job.
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