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The guidelines also refer to certification under the Mental Health Act as implying a need for a high degree of sedation, but this too reflects a lack of understanding about the Mental Health Act and the role of certification.

Given how common psychiatric illness is, even among people reading this journal, the application of the term “psychiatric patient” and the implication that this is someone who can easily lose control in an aircraft is stigmatizing and of no value in determining risk.

Banerjee and colleagues[5] reviewed eight cases of sudden death in psychiatric patients in 1995 in the UK and concluded that “the risk of sudden cardiotoxic collapse in response to neuroleptic medication given during a period of high arousal should be widely publicized,” reminding us that there is risk with medications used to treat psychiatric patients and their use must be rational and guided by diagnosis and individual circumstance. A report—recommended standards for UK fixed wing medical transport systems and for patient management during transfer by fixed wing aircraft.

The unfortunate decision of the BC Ambulance Service (BCAS) to develop new guidelines for transportation of people with mental illness without consulting anyone with ex­pertise in mental illness has had several unfortunate consequences, the main one being that physicians who need to get help for their patients in another centre continue to feel forced into a blanket application of a medication policy that has no basis in evidence, does not take into account existing medications, puts their pa­tients at undue risk, and does not help with the difficult transfers that we do need to make.

At Hillside Centre, we provide tertiary psychiatric care in our PICU, adult, and geriatric programs for people from throughout the northern and southern interiors of BC.