I believe your bill is a great idea even if the only thing it does is force the doctors to fully acknowledge the consequences of administering specific drugs. These amendments will make it far more effective. I. In the U.S. doctors need a court order to not only confine someone, but also to administer specific treatments against their will e.g. antipsychotics, electroshock therapy, etc. This is due to a 1989 U.S. Supreme Court decision. Is the same true in Canada? I know in Canada those detained get a hearing, but do doctors also require a court order to administer a specific treatment against the will of an inpatient? If doctors do not require an order (or if not required in all provinces) then I recommend adding this amendment to your bill in SECTION 5 - EXPEDIENCE AND EMERGENCIES. The doctor would have to explain to the mental health judge the purpose of the drugs, all plausible side effects with the monograph present and alternative treatments if any. Then the judge could make an informed decision approving the drugs AND the dosage. This is also a solution for the liability explained in SECTION 6.2 because the treatment would only be recommended by the doctor while it would be ORDERED by a mental health judge. The judge’s job is to decide if the treatment is appropriate after considering the side effects and alternatives. II. Your bill should mandate the psychiatrist rule out ALL medical causes that can have symptoms similar to those of a severe mental disorder before prescribing any treatment. Examples include Hashimoto’s disease for clinical depression, lime disease and a brain cyst/tumor for psychosis. For the latter two, there are documented cases of people being hospitalized for schizophrenia. III. Your bill should mandate doctors discuss specific alternative treatments so they can comply with Ontario’s Health Care Consent Act. If doctors would find it challenging to summarize a fifty-page monograph of the drugs they are prescribing, then imagine how much more challenging it would be for them to summarize alternative treatments not found in the monograph and some of which they likely never heard of. This is also challenging because nowadays there is supposed to be a pill for everything. Presently, most psychiatrists are unaware of most of the alternatives on this list below. a. Alternative treatments for stress and depression (the primary sources of relapses in those with severe mental disorders): physical exercise, guided or active meditation (including hypnotherapy), music therapy, cuddle therapy (platonic cuddling techniques with a partner) and massage therapy. b. Alternative treatment for coping with any mental disorder: psychotherapy. Your level of happiness depends little on your circumstances and almost entirely on how you feel about them and how effectively you deal with them. Psychotherapy is the practice of skill-based mental techniques for reversing negative thought patterns that lead to depression and self-defeating behaviors and then for handling life’s problems in an emotionally healthier way. Psychotherapy is wisdom and when taught properly has been the most effective part of standard mental health treatment since the late 1970s. Effective psychotherapy is intense emotional and intellectual work, but patients that do the exercises usually benefit more than from medication. Think of it more as taking a high-school course than conversing with a therapist. Anyone can significantly improve their mental health by mastering techniques in mindfulness-based cognitive therapy (CBT / MBCT), acceptance commitment therapy (ACT), or dialectical behavioral therapy (DBT), if not in person, then through books. Side effects are practically nonexistent and benefits are permanent. c. Alternative treatment for auditory hallucinations (hearing voices): specialized psychotherapy for coping with the voices. The Hearing Voices Network (HVN) is an international organization started in the Netherlands around 1990, has launched support groups worldwide, and has come up with a variety of cognitive exercises for coping with voices such as how to talk back to your voices. Some of their volunteers even visit mental hospitals and teach the exercises to patients. Patients that master the exercises tend to have greater acceptance of their voices or decreased frequency or severity of them. For more on this, you can visit their website. You can also contact Bower Thomas, the HVN representative at NAMI of Collier County in Naples, Florida at +1-239-260-7300 <Bower@namicollier.org>. d. Alternative treatment for autism and ADHD: biofeedback training (including neurofeedback). Preliminary research shows neurofeedback can treat other mental disorders including bipolar. It cannot be used to treat schizophrenia. I hope my post encourages others to read Roxanne's proposal for the bill and post their feedback here. I also hope my post generates discussion, including ideas to improve on these amendments.