Mental Health Patient Admission (14:V)

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by the Law Students' Legal Advice Program on August 18, 2021.

Admissions to mental health facilities under the BC provincial MHA may be either voluntary under section 20 or involuntary under section 22 (see Section VII below). Involuntary admission under the MHA involves doctors renewing the patients' involuntary admittance status on a regular basis.

Admission can also occur due to a verdict of “Not Criminally Responsible by reason of Mental Disorder” or “Unfit to Stand Trial” for criminal charges, under the Mental Disorder provisions, Part XX.1, Criminal Code of Canada (CCC). This is not considered an “involuntary” admission under the MHA, but rather an “NCRMD” or “UST” admission, under the CCC. NCRMD and UST will see matters of treatment and release governed by a British Columbia Review Board (BCRB), governed by the Mental Disorder provisions, Part XX.1, CCC.

Part 3 of the Health Care (Consent) and Care Facility (Admission) Act, RSBC 1996, c 181 [HCCFA] came into force on November 4, 2019, and it outlines the regulations for admission to a care facility. No person is to be admitted unless they have given consent, substitute consent (by a personal guardian with authority or person otherwise designated by the act) has been given, or the person is admitted on an emergency basis under section 24. Section 25(1) of the HCCFA states that if a person in care is capable and expresses a desire to leave—or they are incapable and the person authorized to act as their substitute expresses a desire for them to leave—a manager must not prevent them from leaving.

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. This procedure is 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. The formula is calculated by adding the daily Old Age Security maximum to the daily Guaranteed Income Supplement and multiplying by 85%.

This provision does not authorize or identify any charges for care to be paid by those persons who are admitted involuntarily (MHA, s 22). According to Director of Riverview Hospital v Andrzejewski (1983), 150 DLR (3d) 535 (BC County Court), section 11 of the MHA does not authorize any charges for mental health services where an individual is admitted involuntarily. Please review the Mental Health Regulations to determine the authorized charges for different classes of patients (i.e. voluntary and involuntary).

B. Consent to Treatment

Psychiatric treatment is legally considered a type of medical treatment. The 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.

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