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While a voluntary patient may be admitted to any hospital with psychiatric services, involuntary patients can be admitted only to certain hospitals in BC. If a hospital doesn’t have a bed available, they may not be able to admit a person. In that case, the person would be sent, under supervision, to another hospital that has room.
===1. Doctor’s certificate===
This is the most common way people are hospitalized against their will. A doctor who believes a person has a mental disorder, as defined in the Mental Health Act, can complete a certificate to admit the person to hospital, even if the person doesn’t want to be hospitalized or treated. The doctor must believe the person needs to be hospitalized for psychiatric treatment, to prevent substantial mental or physical decline, or to protect the person or other people. The mental disorder must seriously impair the person’s ability to react appropriately to their environment or to get along with others. The person does not have to be dangerous to be admitted involuntarily.
===2. Court order===
Anyone, including family members and neighbours, who reasonably believes a person has a mental disorder and needs to be hospitalized can apply to court. The court can issue a warrant that allows the police to take the person to hospital, where they will be assessed.
===3. Police action in an emergency===
The police can act in an emergency when family members or health professionals need help getting a person to see a doctor. If the police believe a person has a mental disorder and their behaviour is likely to endanger their own safety or the safety of others, the police can immediately take the person to a doctor—usually in a hospital. If the person needs to be hospitalized, a doctor will complete a certificate to admit them.
==How long can involuntarily patients be kept in hospital?== A doctor’s certificate to send a mentally ill person to hospital is valid for up to 14 days prior to admission. Involuntary patients can be kept in hospital for only 48 hours after they are admitted, based on one doctor’s certificate. To keep the patient longer, the hospital must get a second doctor to examine the patient and produce a second certificate within the 48 hours. The patient is then certified and can be kept for up to one month. That term may be renewed for another month, then three months, then six months, and then every six months—each time with a doctor’s certificate based on an examination and written report. The examination must conclude that the criteria for involuntary admission continue to be met.
The hospital director must give the patient written and oral notice that they are being hospitalized—at the start of the hospitalization and at each renewal of it. If the director believes that the patient does not understand the notice, the director must give the notices again as soon as they think the patient can understand it. The written notice must also go to the patient’s near relative (which includes a representative). If there’s no information available on a relative, then the notice must go to the Public Guardian and Trustee.
==Can involuntary patients be treated without their consent?== Yes, because they may not understand or realize that they need psychiatric treatment. If they refuse treatment or are incapable of consenting, the hospital director consents to treatment for them. The patient (or a family member or someone else acting for them) can ask for a second medical opinion on whether the treatment is appropriate.
==Can involuntary patients leave the hospital on their own?== No—an involuntary patient cannot leave the hospital unless their doctor discharges them (lets them go) permanently or on extended leave, or changes their status to voluntary. If they want to leave the hospital and their doctor won’t discharge them, they (or someone acting for them) can ask a panel of the Mental Health Review Board (the Board) to review the decision (panels and reviews are explained in the next section). The Board is independent of government in making its decisions.
Some involuntary patients leave the hospital on extended leave and still have involuntary outpatient treatment that the hospital director authorizes. These patients have the right to periodic hearings by a panel—as if they had stayed in the hospital as involuntary patients.
[updated September 2013]
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