The Mental Health Act allows for people to be treated by a mental health facility on an informal voluntary basis, or on a formal basis as a patient who has been committed to the facility. As a patient in a mental health facility, you may lose the right to make medical treatment decisions for yourself if a doctor finds that you do not have the mental capacity to make such decisions. In such a situation you might want to be sure that you have arranged for someone you trust to make such decisions for you, such as an agent under a personal directive.

Committal as a formal patient in a mental health facility can happen in one of the following ways:

• The doctor issues an admission certificate after examining you and concludes that you are suffering from a mental disorder, and you are in a condition whereby you are likely to be a danger to yourself or others and cannot be treated except as a formal patient. The certificate allows for you to be taken to a mental health facility where you can be watched, examined, treated, detained, and controlled for twenty-four hours. If a doctor does not issue another certificate after twenty-four hours, you must be released.
• Other people can apply to a provincial court judge for a warrant to have you taken to a mental health facility for an initial assessment. A judge will consider the warrant if you are shown to be suffering from a mental disorder, are in a condition whereby you are likely to be a danger to yourself or others, and cannot be treated except as a formal patient. The application can be made by telephone. The warrant is effective for up to seven days and can be extended once only for another seven days.
• A police officer takes you to a mental health facility if there are reasonable grounds to suggest that you are suffering from a mental disorder and are in a condition whereby you are likely to be a danger to yourself or others, and there is no time to apply for a warrant from the court.

Review of decision not to receive treatment

It is possible to be a formal patient in a mental health facility, but to retain decision-making authority about medical treatment.

As a formal patient who is mentally competent, you (or your agent, guardian, or nearest relative if you are mentally incompetent) can refuse medical treatment. The doctor cannot then administer the treatment unless he or she has an order from a review panel. The panel hears evidence on the issue and considers what is in your best interests.

Psychosurgery can never be performed on a formal patient without an order from a review panel.

Review of decision of incapacity to make decisions about medical treatment

When you are formally admitted to a mental health facility, a doctor may issue a certificate confirming that you are not mentally competent to make treatment decisions. The test is whether or not you are able to understand the subject matter relating to the decisions and the consequences of the decisions. You can apply for a review of this decision. The board of the mental health facility has the onus to prove that the decision of the doctor is correct. The review panel can cancel or uphold the certificate. There is a right of appeal to Court of Queen's Bench within fourteen days of the decision.

If you are a patient formally admitted to a mental health facility and if a doctor has issued a certificate of incapacity to make treatment decisions, a guardian or an agent under a personal directive can make decisions about your medical treatment.

If there is no guardian or agent, or they are not willing to make the decision about treatment, your nearest relative can make the decision, or any adult person that the board of the medical facility can direct will act as your nearest relative. The relative or the agent must have had personal contact with you over the last year and be willing to be responsible for your treatment decisions. Any decisions must be made in your best interests. In cases where there is no one to make treatment decisions, the Public Guardian can act.

If you disagree with a decision, the treatment will not be given even if the guardian, agent, or relative designated to make the decision agrees. A second doctor must then confirm your inability to make treatment decisions.

Return to Treatment under the Mental Health Act

Updated: October 9, 2003
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