Good morning.

A few years ago, there were almost 3,000 people in British Columbia on what’s called extended leave under the Mental Health Act.

That number has been steadily increasing: Data released under freedom-of-information laws show there were just 848 classified that way in 2008-2009.

Patients on extended leave have been certified and civilly detained under the act, but they have been released by a clinician from the treatment facility for supervised, mandatory care in the community.

They have not been accused of a crime.

The figures are important to keep in mind when considering whether there were red flags that, if heeded, might have prevented the horrific attack on the Lapu-Lapu festival just more than a week ago.

Globe reporters spent much of last week digging into the background of Adam Lo, the 30-year-old who has been charged with eight counts of second-degree murder. He is accused of driving his SUV through the crowded festival. Eleven were killed, more than a dozen injured and some remain in hospital in serious and critical condition. The youngest in hospital is a 22-month-old boy.

Lo was an involuntary outpatient in the care of a community mental-health team at the time of the attack. He was forced into hospital under the Mental Health Act in 2023 and 2024 and had recently been deemed a high risk for his mental health to decline, a source with knowledge of Lo’s history told The Globe.

His care team had concerns that Lo was unwilling to take his medication for schizophrenia and about two weeks before the attack, Lo’s psychiatrist suggested his dosage may be insufficient to be considered therapeutic.

Lo’s neighbours and childhood friends noticed he had become increasingly paranoid and delusional. He had had frequent interactions with police, but most of them had been at his own initiation.

“To the care team‘s knowledge, there was no recent change in his condition or non-compliance with his treatment plan that would’ve warranted him needing to be hospitalized involuntarily,” Vancouver Coastal Health said in a statement following the Globe’s reporting.

Premier David Eby said last week he wants a public inquiry to examine Lo’s care by the public health care system and how closely he was being monitored, though any inquiry will have to wait until the completion of the criminal proceedings.

Eby also said the province would proceed with overhauling its Mental Health Act to “moderinize” it, even though the act is subject to a long-running court challenge from groups arguing it is inhumane and reinforces harmful stereotypes about people with mental health issues.

Vancouver Mayor Ken Sim said the fact that Lo was on extended leave “is incredibly difficult to hear and even harder to accept because it points to a deeper failure in the mental health system.”

“The mental health crisis is not just a health crisis, it has become a public safety crisis,” he said.

Sim went on to lament the lack of resources for “compassionate mandatory care to resource secure treatment beds.”

It will be up to the courts and any resulting public inquiry to determine whether Lo’s mental illness should have been a warning about what he is accused of doing.

But Sim‘s leap to use the tragedy as a demand for more involuntary care seems premature at best.

Based on The Globe’s reporting, Lo was not among the many British Columbians without mental health care: He was under the care of a mental health team and had seen a psychiatrist just two weeks prior to the attack.

Lo had never been charged or convicted criminally. Based on what police have said, Lo is not in the same category as the repeat, often drug-addicted offenders who cycle through the justice system before being accused of something horrific.

With thousands of British Columbians on extended leave, whatever the answer will be to preventing another horror like the Lapu-Lapu attack, it surely can’t or shouldn’t include locking them all up.

As André Picard wrote last week, most people with mental illness are not violent. There’s an emerging consensus among policy makers across the spectrum – Eby’s NDP government in B.C. and Danielle Smith’s United Conservative government in Alberta – that there’s a place for involuntary treatment.

Whether Lo should have been detained is far from clear without the benefit of hindsight.

Sim was asked at his news conference if he had any indication that even if British Columbia had a thousand more mandatory care beds, this wouldn’t have happened.

“No,” Sim replied.

This is the weekly British Columbia newsletter written by B.C. Editor Wendy Cox. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.