Tag: involuntary patient
This past fall, the Minister of Health and Long-Term Care introduced Bill 122, The Mental Health Statute Amendment Act, to the Ontario legislature. It received Royal Assent on December 10, 2015 and officially came into force on December 21, 2015.
By way of background, the bill’s purpose was primarily to make changes to the Mental Health Act (“MHA”) in order to provide the Consent and Capacity Board with new powers with respect to the criteria under which a patient can be held involuntarily in a psychiatric facility as well as to address the length of time under which a patient can be involuntarily held.
The bill emerged as a response to the Ontario Court of Appeal’s 2014 decision in P.S v Ontario in which the court declared provisions in the MHA which allowed indefinite renewals of fourth certificates of involuntary admission, to be unconstitutional. The legislature was provided with one year to amend the MHA in light of the decision.
A brief summary of some of the most significant changes is as follows:
1- The new class of “certificate of continuation” is created.
Under a certificate of continuation, involuntary patients can only be detained for three additional months under a first and subsequent certificate of continuation.
The process for the first three certificates of renewal remains the same. This means that involuntary patients can still be detained for one additional month under a first certificate of renewal, two additional months under a second certificate of renewal, and three additional months under a third certificate of renewal. However, the process now ends after the third certificate of renewal. At this point, the detention can only continue under the new certificate of continuation.
2- The Consent and Capacity Board is granted new order-making powers that can be exercised at hearings with respect to the new class of certificates of continuation (for patients who have been detained for periods longer than six months).
3- The officer in charge of the psychiatric facility is now to be made a party to any hearing where a certificate of continuation is at issue.
There are, of course, further changes as a result of Bill 122 which can be read about in more detail here. These include the transition provisions which will undoubtedly be an important part of the implementation as this new legislation goes into effect.
Thank you for reading.
Under the Ontario Mental Health Act, a Form 1 refers to an Application by Physician for Psychiatric Assessment, or APA. A Form 1 allows a doctor to hold a patient in a hospital or psychiatric facility for up to 72 hours in order to complete a psychiatric assessment. In order to sign a Form 1, the doctor must have examined the patient within the 7 day period prior to the Form 1 being signed, after which the Form 1 expires. In addition, the doctor must find that the patient meets one of two sets of criteria, depending on whether or not they are deemed capable of consenting to treatment in a psychiatric facility within the meaning of the Health Care Consent Act.
The physician’s clinical opinion can, in consideration of what is appropriate in the circumstances, be based on their own observations, or in combination with facts communicated to the physician by others (e.g. family members, friends).
Once the Form 1 has been signed, anyone can bring (or force) the person into a psychiatric facility for assessment within the 7 day period before the Form 1 expires. Upon completion of the psychiatric assessment, the patient must either be released, or admitted as an involuntary patient, a voluntary patient or an informal patient. Tomorrow’s blog posting will explore these options in greater detail.
Jennifer Hartman, Guest Blogger