Lecture 5.1 - Ethical and Legal Framework Flashcards
Concerning psychiatric legal requirements, the law seeks to find a balance between:
The right to autonomy, self-determination, care and treatment - and the safety of the public.
What is the mental health act? What are its purposes?
Originally written in 1967, last revisions made in 1990. It is a law that gives certain power and sets of conditions for those powers, to stipulated health care professionals and institutions regarding admission and treatment of individuals with mental disorders
Purpose it to protect and health and rights of persons with mental illness, and also the rights of the community
What is an informal admission?
A person found incapable and admitted to a hospital with the consent of the person authorized to make his or her treatment decisions.
What are the three ways in which a person is admitted involuntarily to a hospital?
Under the Involuntary Mental Health Evaluations and Admissions (forms 1-5), Informal admission, and under the criminal code
What is form 1? Who signs it?
Signed by a physician who has examined the person for the involuntary admission (and police detaining) of a person for up to 72 hours at a psychiatric facility for the purpose of assessment. Expires after 7 days.
Form 42 must be provided to the patient. Without form 42, 1 is invalid.
What is form 42?
A notice to the patient that form 1 was enacted - is signed by physician.
Informs that patient that there is no right to appeal.
What is the nurse’s role when a form 1 + 42 have been signed in a facility?
To help the patient cope and support them emotionally, and to explain what the forms mean.
What is form 2?
A request for psychiatric assessment that can be filled out by anyone and needs to be signed by a justice of the peace, does not allow for any hold. Also expires after 7 days.
If the physician determines that the person requires further assessment, a form 1 is then signed.
What is form 2 section 17?
Allows police to detain an individual and bring them to the ER to be assessed by a physician at the officer’s discretion
What is form 3? Who signs it? How long it is valid? What must it be given with?
A certificate of involuntary admission filled out by a different physician than the one who completed form 1. It must be completed 72 hours from the start of the detention period under form 1.
Valid 2 weeks from and including the date it was signed.
What is a form 4? What must it be given with?
A certificate of renewal for involuntary admission after initial 2 week hold.
1st - valid 30 days
2nd - valid 60 days
3rd - valid 90 days
Every time it is renewed it can be appealed.
Must be given with a form 30
What is form 30?
A notice to patient letting them know who will visit, the situation, and their right to appeal and obtain legal services alongside an involuntary admission (3 +4)
What is a form 5?
Initiated by attending physician to change from an involuntary to informal or voluntary admission. No expiration or renewal.
What are the three kinds of involuntary assessments of individuals accused of criminal acts?
Psychiatric Assessment: when a judge believes a person that has committed a criminal act suffers from a psychiatric disorder. Involves section 22 + 21.
Under Criminal Code:
Fitness assessment: Judge believes a person may be unfit to stand trial (5 day hold)
Criminal Responsibility Assessment: Judge believes a person may or may not be criminally responsible on account of mental disorder for criminal acts committed (30-60 day)
What are sections 22 + 21 of a psychiatric assessment?
22: order for inpatient assessment
21: order for outpatient assessment
