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{{LSLAP Manual TOC|expanded = mentalhealth}}
Patients who are admitted to a mental health facility without their consent are admitted involuntarily. The MHA provides mechanisms for both short-term emergency admissions and for long-term admissions. '''The HCCFA and all of its requirements for consent to treatment do not apply to psychiatric treatment of involuntarily admitted patients.''' Involuntarily admitted patients therefore have few rights in this area by statute, although some parts of the MHA could potentially be challenged under the ''Charter'', such as the current CLAS challenge in BC to the “deemed consent” provisions of the BC Mental Health Act.
Such a challenge occurred in Ontario, in P.S. v. Ontario, 2014 ONCA 900, where the constitutionality of the provisions of the Mental Health Act, R.S.O. 1990, c. M.7 providing for involuntary committal as they apply to long-term detainees, was challenged and found to violate s.7 of the Charter. The judgement stated that the patient must be provided meaningful procedural avenues to seek the accommodation and treatment they need to be rehabilitated, while being involuntarily detained, and the province cannot wield the power to detain mental health patients indefinitely where such procedural protections are absent. This will likely change the role patients themselves play in determining the course and nature of their treatment in Ontario; however it is unclear as of now what effect this may have in British Columbia. The Mental Health Law Program (MHLP) at CLAS assists involuntarily admitted patients at review panel hearings. LSLAP clinicians should contact CLAS to see if a referral is appropriate. Access Pro Bono (APB) is also starting a Mental Health Program for clients who have been detained under the MHA and who are unable to obtain legal representation through CLAS. All referrals will first be made through the MHLP/CLAS. If CLAS is unavailable, they will refer the patient to APB. APB will then attempt to find volunteer lawyers and law students to legally represent the patient at his or her scheduled Mental Health Review Board Hearing (see [[Governing Legislation and Resources for Mental Health (14:II) | Resources section]] of this Chapter or [[General Legal Help Resources (22:I) | Chapter 22: Referrals]]).
Section 22 of the MHA provides that a person may be admitted involuntarily and detained for up to 48 hours. The person must first be examined by a doctor and the doctor must provide a medical certificate stating that he or she is of the opinion that the person has a mental disorder and requires treatment to prevent "the substantial mental or physical deterioration" of the person or to protect that person or others. A second doctor must provide a second certificate for the person to be detained longer than the initial 48 hours. ''Mullins v Levy'' 2009 BCCA 6, the leading case in this area, applied a broad definition of “examination” and stated that the MHA does not require a personal interview of the patient in every instance. However, a patient is entitled to request a review hearing according to certain prescribed periods that depend on the length of time the patient has been detained or that his or her detention has been renewed.
=== 2. Through a Review Panel Hearing ===
An involuntary patient is entitled to a hearing before a review panel. Generally, a patient may have a hearing once during each period of detention. The application for a review panel hearing may be made by the patient or by someone else on the patient’s behalf (s 25). The application is completed by filling out an Application for Review form contained in the MHA Regulations (the “Regulations”.) Section 6 of the Regulations describes the conduct of review panel hearings. Students are encouraged to contact the Mental Health Law Program at CLAS for advice and a possible referral.
A hearing takes place before a panel of three people, which must include a medical practitioner, a member in good standing with the Law Society of British Columbia (or a person with equivalent training) and a person who is not a medical practitioner or a lawyer. The Ministry of Health appoints all three members from a list of people previously accepted by Order in Council.