Mental Health Patient Admission (14:V)
Admissions to mental health facilities under the MHA may be either voluntary under s 20 or involuntary under s 22 (see Section VII). Admission can also occur due to a verdict of “Not Criminally Responsible by reason of Mental Disorder” for criminal charges; this is not considered an “involuntary” admission but rather an “NCRMD” admission.
It should be noted that patients who are initially admitted voluntarily may later have their status changed to involuntary, using the admission procedure for involuntary patients described later in this chapter.
A. Charges for Mental Health Services
Section 4 of the Mental Health Regulations (BC Reg 233/99) provides a formula for calculating the charges for care of persons admitted voluntarily (under s 20 of the MHA) to a mental health facility. It does not authorize or mention any charges for care to be paid by those persons who are admitted involuntarily (under s 22 of the MHA). According to Director of Riverview Hospital v Andrzejewski (1983), 150 DLR. (3d) 535 (BC County Court), s 11 of the MHA does not authorize any charges for mental health services where an individual is admitted involuntarily. Check for any changes to the Mental Health Regulations to determine the authorized charges for different classes of patients.
B. Consent to Treatment
Psychiatric treatment is legally considered a type of medical treatment. The Health Care (Consent) and Care Facility (Admission) Act, RSBC 1996, c 181 [HCCFA] sets out the requirements for consent from the patient before a health care provider can legally provide health care. Generally, adults are presumed to be capable of consenting to treatment, and they have the right to give or refuse consent to treatment. However, there are significant exceptions in the realm of mental health.
The HCCFA does not apply to the provision of psychiatric treatment where an individual is involuntarily detained under the MHA and/or is on leave from a psychiatric facility or has been transferred to an approved home (HCCFA s 2). For those individuals, the director of the relevant psychiatric facility has the right to consent to health care on the patient’s behalf (see Section VII). Additionally, for patients not involuntarily admitted, s 12(1) of the HCCFA allows an adult to be treated without their consent in an emergency situation in order to preserve that adult’s life, or to prevent serious mental or physical harm, or to alleviate severe pain, if certain other conditions are also met.
In the absence of specific provisions under the HCCFA, the common law continues to apply.
