Patient Advocacy

Over the past 20 years, Riverview Hospital (RVH) and BC Mental Health and Addiction Services have developed a number of advocacy services, policies and practices to ensure that individual concerns and systemic issues are addressed.

In 1994 RVH developed its Charter of Patient Rights – a first for  Canada – which been used as a template in other jurisdictions.

Policies are in place which outline patient rights for treatment consent, change of physician, non physician care giver and care environment.

Patients are also involved as an active participants in developing their care plans (dependant on their ability) and have the opportunity to raise concerns or make suggestions, e.g. activities, and menu preferences at regularly scheduled unit meetings.

RVH has also developed a formal service feedback process through which patients and family can raise and identify either individual or systemic concerns.

External Advocacy Services

Formal external advocacy services were initiated at RVH in 1997, and continue to evolve to address changing patient needs. Currently, these are provided by two experienced non-profit agencies via “arms length” contracts. A budget of $170,000 is spent annually to provide legal, individual and systemic advocacy services for RVH patients.

In late 1996, with the support of the Ministry, Riverview Hospital went to tender for an external patient advocacy service provider. The successful bid was won by the Motivation, Power and Achievement Society (MPA); previously known as the Mental Patients Association. Since 1997 the MPA has provided an arms length systemic advocacy service at Riverview Hospital. In 1998, RVH expanded the contract to include individual advocacy service for patients. This non profit agency has a long history of providing advocacy for individuals with a mental illness in the community and in health care settings.

MPA employs 2.5 full time equivalent positions who provide the following services:

• Proactively identify potential systemic issues at RVH
• Determine current systemic patient issues and develop strategies and actions to address them
• Provide education and support to patients to help them learn skills to self-advocate, including how to access available resource people and services
• Participate in discussions to resolve issues arising between patients and other organizations – e.g. TransLink, BCBC
• Monitor and report on issues and trends through the use of a data tracking base
• Conduct patient satisfaction surveys with patients transferred from Riverview under the Mental Health Plan
• Demonstrate accountability to the RVH patients whom they serve
• Pursue patient issues as long as the patient desires
• Ensure the patient seeking advocacy is the active participant who articulates the problem and defines the action taken

As well, RVH contracts with the Community Legal Advice Society (CLAS) to provide legal advice and assistance for patients. CLAS advises and provides support in relation to the Canadian Charter of Rights, & sections 23, 24, 28, 29, 42 of the Mental Health Act. A service contract with CLAS is also extended to the patient population at the Forensic Psychiatric Hospital (FPH) adjacent to Riverview, on the Colony Farm Lands.

FPH does not contract with an external agency for patient advocacy services, but there is a well developed in-house program available. Issues of a systemic nature, for example, the smoking policy, are brought forward to the Patient Advisory Committee, whose membership is a mix of patients and staff. A second body, the Patient Concerns Committee investigates and addresses issues pertaining to individual patients. These advocacy channels are well communicated to forensic psychiatric patients who make use of them as needed.