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Hospitalizing a Mentally Ill Person (view source)
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{{REVIEWEDPLS | reviewer = Diana Juricevic, Mental Health Review Board |date= October 2017}} {{Dial-A-Law TOC|expanded = health}} | {{REVIEWEDPLS | reviewer = Diana Juricevic, Mental Health Review Board |date= October 2017}} {{Dial-A-Law TOC|expanded = health}} | ||
Anyone who wants help with a mental illness can ask to be admitted to a facility for treatment. The law also allows people to be | Anyone who wants help with a mental illness can ask to be admitted to a facility for treatment. The law also allows people to be involuntarily admitted in certain situations. | ||
== | ==What you should know== | ||
===If someone asks to be admitted to a mental health facility=== | ===If someone asks to be admitted to a mental health facility=== | ||
In BC, | In BC, [https://www.canlii.org/en/bc/laws/stat/rsbc-1996-c-288/latest/rsbc-1996-c-288.html#sec20_smooth the ''Mental Health Act''] is the law that describes what happens when someone who is living with a mental illness needs treatment and protection for themselves or others. Under this law, anyone aged 16 or older can ask to be admitted to a “designated mental health facility.” There are several dozen treatment centres and hospital psychiatric units in the province designated under this law. | ||
If a doctor who examines the person believes they have a mental disorder requiring treatment, the person can be admitted to hospital. People under the age of 16 need a parent or guardian to apply on their behalf. | If a doctor who examines the person believes they have a mental disorder requiring treatment, the person can be admitted to hospital. People under the age of 16 need a parent or guardian to apply on their behalf. | ||
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Mental health facilities can treat voluntary patients only if the patient consents to the specific treatment. If the patient is incapable of consenting, someone else can act as a '''temporary substitute decision maker''' (TSDM) to consent for them. In order of priority, a TSDM could be their spouse, child, parent, brother, sister, grandparent, grandchild, any other person related to them by birth or adoption, a close friend, or a person immediately related to them by marriage. The TSDM must be at least 19 years old, must get along with the patient, and must have been in contact with the patient in the past 12 months. | Mental health facilities can treat voluntary patients only if the patient consents to the specific treatment. If the patient is incapable of consenting, someone else can act as a '''temporary substitute decision maker''' (TSDM) to consent for them. In order of priority, a TSDM could be their spouse, child, parent, brother, sister, grandparent, grandchild, any other person related to them by birth or adoption, a close friend, or a person immediately related to them by marriage. The TSDM must be at least 19 years old, must get along with the patient, and must have been in contact with the patient in the past 12 months. | ||
The TSDM could also be the adult’s '''representative''' (appointed under a representation agreement) or '''committee''' (appointed by the court to make personal, medical, legal and financial decisions). | The TSDM could also be the adult’s '''representative''' (appointed under a representation agreement) or '''committee''' (appointed by the court to make personal, medical, legal and financial decisions). We have information on [[Adults and Consent to Health Care|consent to medical treatment and substitute consent]]. We also explain [[Powers of Attorney and Representation Agreements|what is a representative]] and [[Committeeship|a committee]]. | ||
====If a voluntary patient wants to leave the facility==== | ====If a voluntary patient wants to leave the facility==== | ||
To leave a mental health facility, a voluntary patient need only inform the facility staff they want to be discharged. In most cases the patient will be free to leave. The facility may ask them to sign a | To leave a mental health facility, a voluntary patient need only inform the facility staff they want to be discharged. In most cases the patient will be free to leave. The facility may ask them to sign a '''discharge against medical advice''' form. | ||
===To admit someone to a hospital against their will=== | ===To admit someone to a hospital against their will=== | ||
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====Through a doctor’s certificate==== | ====Through a doctor’s certificate==== | ||
The most common way people are hospitalized against their will is through a '''doctor’s certificate'''. A doctor who believes a person has a '''mental disorder''', | The most common way people are hospitalized against their will is through a '''doctor’s certificate'''. A doctor who believes a person has a '''mental disorder''', [https://www.canlii.org/en/bc/laws/stat/rsbc-1996-c-288/latest/rsbc-1996-c-288.html#sec22_smooth as defined in the ''Mental Health Act''], can complete a certificate to admit the person to hospital, even if they don’t want to be hospitalized or treated. The doctor must believe the person: | ||
*Is suffering from a mental disorder that seriously impairs their ability to react appropriately to their environment or to associate with others. | |||
*Requires psychiatric treatment in a designated facility. | * Is suffering from a mental disorder that seriously impairs their ability to react appropriately to their environment or to associate with others. | ||
*Requires care and supervision in a facility to prevent the person’s substantial mental or physical deterioration or to protect themselves or others. | * Requires psychiatric treatment in a designated facility. | ||
*Is not suitable to be a voluntary patient. | * Requires care and supervision in a facility to prevent the person’s substantial mental or physical deterioration or to protect themselves or others. | ||
* Is not suitable to be a voluntary patient. | |||
The person does not have to be dangerous to others to be admitted involuntarily. | The person does not have to be dangerous to others to be admitted involuntarily. | ||
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===How long involuntary patients can be kept in hospital=== | ===How long involuntary patients can be kept in hospital=== | ||
A doctor’s certificate to keep a person with a mental disorder in hospital is valid for up to 14 days before admission. Involuntary patients can be kept in hospital for '''only 48 hours''' after they are admitted, based on one doctor’s certificate. | A doctor’s certificate to keep a person with a mental disorder in hospital is valid for up to 14 days before 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 doctor’s certificate within the 48 hours. The patient can then be kept for up to '''one month'''. | To keep the patient longer, the hospital must get a second doctor to examine the patient and produce a second doctor’s certificate within the 48 hours. The patient can then be kept for up to '''one month'''. | ||
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===Involuntary patients can be treated without their consent=== | ===Involuntary patients can be treated without their consent=== | ||
If an involuntary patient refuses treatment or is incapable of consenting, the hospital director can consent to treatment for them. The director must complete a consent for treatment form. | If an involuntary patient refuses treatment or is incapable of consenting, the hospital director can consent to treatment for them. The director must complete a consent for treatment form. | ||
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. | 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. | ||
===Involuntary patients cannot leave the hospital on their own=== | ===Involuntary patients cannot leave the hospital on their own=== | ||
An involuntary patient cannot leave a hospital unless a doctor discharges them either permanently or on extended leave. | An involuntary patient cannot leave a hospital unless a doctor discharges them either permanently or on extended leave. | ||
A doctor can change an involuntary patient’s status to voluntary, allowing the patient to leave as they please. | A doctor can change an involuntary patient’s status to voluntary, allowing the patient to leave as they please. | ||
If an involuntarily admitted patient wants to leave the hospital and their doctor won’t discharge them, the patient (or someone acting for them) can ask for a review of the decision to keep them in hospital. We explain this process next. | If an involuntarily admitted patient wants to leave the hospital and their doctor won’t discharge them, the patient (or someone acting for them) can ask for a review of the decision to keep them in hospital. We explain this process next. | ||
===Involuntary patients can request a review of their hospitalization=== | ===Involuntary patients can request a review of their hospitalization=== | ||
Involuntary patients have the right to have a panel of the Mental Health Review Board '''review''' | Involuntary patients have the right to have a panel of the Mental Health Review Board '''review their hospitalization''' after they are involuntarily admitted and after each renewal of their hospitalization. The patient (or someone acting for them) must request the review by completing an application form, [https://www.bcmhrb.ca/ available on the Review Board website], from the Review Board office (phone 604-660-2325), or at the hospital. | ||
The Mental Health Review Board is independent of government in making its decisions. A panel of three people (including a medical doctor, a lawyer, and a person who is not a doctor or lawyer) performs the review. The panel must hold a hearing within 14 to 28 days after the Review Board receives the application, depending on how long the person is being hospitalized for. A patient has the right to have a lawyer, friend, or advocate speak for them. After the hearing, the Review Board panel makes a decision on whether the hospital should keep or release the patient. | The Mental Health Review Board is independent of government in making its decisions. A panel of three people (including a medical doctor, a lawyer, and a person who is not a doctor or lawyer) performs the review. The panel must hold a hearing within 14 to 28 days after the Review Board receives the application, depending on how long the person is being hospitalized for. A patient has the right to have a lawyer, friend, or advocate speak for them. After the hearing, the Review Board panel makes a decision on whether the hospital should keep or release the patient. | ||
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===Applying to court to be discharged from a hospital=== | ===Applying to court to be discharged from a hospital=== | ||
[https://www.canlii.org/en/bc/laws/stat/rsbc-1996-c-288/latest/rsbc-1996-c-288.html#sec33_smooth Under section 33 of the ''Mental Health Act''], a patient or a person acting for them can apply to court for an order that the patient be discharged from a mental health facility. The application is brought to BC Supreme Court. This is a complicated area of law and patients should get legal advice if they want to do this. | |||
== | ==Who can help== | ||
===With your case=== | ===With your case=== | ||
The '''Community Legal Assistance Society''' (CLAS), through their Mental Health Law Program, provides representation to people who have applied to review their involuntary detention under the ''Mental Health Act'' at a hearing before the Mental Health Review Board. | The '''Community Legal Assistance Society''' (CLAS), through their Mental Health Law Program, provides representation to people who have applied to review their involuntary detention under the ''Mental Health Act'' at a hearing before the Mental Health Review Board. | ||
* Call 604-685-3425 (Lower Mainland) or 1-888-685-6222 (toll-free) | |||
* [https://clasbc.net/ Visit website] | |||
===More information=== | ===More information=== | ||
The '''Mental Health Review Board''' conducts reviews of hospitalizations after a person is involuntarily admitted and after each renewal of their hospitalization. | |||
* Call 604-660-2325 | |||
* [https://www.bcmhrb.ca/ Visit website] | |||
The '''BC government'''’s website includes information and options for support on mental health issues. | The '''BC government'''’s website includes information and options for support on mental health issues. | ||
* [http://gov.bc.ca/mentalhealth Visit website] | |||
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{{Dial-A-Law Copyright}} | {{Dial-A-Law Copyright}} | ||