by Francesca Simpson

If what we in British Columbia euphemistically call Extended Leave (known in the US as “Assisted” Outpatient Treatment) were truly Extended Leave, there would be an empty hospital bed held for each patient in the community on Extended Leave. And that, of course, would be fiscally impossible. Thus Extended Leave isn't “leave” at all; it's merely a transfer from one system to another. It throws patients out of the expensive hospital and enrols them in a much cheaper program – one in which they are coercively drugged in their own homes, often living a life of brutal isolation in which the only people with whom they interact are paid to “treat” them.

Such an arrangement is much easier for psychiatrists, as they can expand their diagnostic net. (Hundreds of people are on Extended Leave who would not meet the criteria for being involuntarily hospitalized.) It also eases the conscience of the public, who erroneously believe that the mad are able to live outside the hospital only due to the wonders of modern medicine. There are bonuses for the bureaucrats coming in under budget. It's a win for everybody – except for the poor sap actually on Extended Leave. You're declared ill enough to require involuntary treatment. And yet, if you want hospital care, what’s on offer is days on end sleeping in a chair at Psychiatric Emergency Services, with no more claim to a hospital bed than someone walking in off the street.

Coercive Community Care

A Reckoning

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Advance Directives

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Extended Leave

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After Her Brain Broke - Book Review

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