Manitoba’s Mental Health Act Flashcards
Who is not covered under the MMHA
Persons experiencing:
- Intellectual disability
- Substance abuse & dependence
- Neurocognitive disorders
- Personality disorders
Unless the person also has a mental disorder or has been assessed as a imminent risk to self or others
Vulnerable Person’s Act
Persons experiencing intellectual disability
Persons living in a personal care home or other care faculty
3 types of competency under the MMHA
- Competence to consent to or refuse admission
- Competence to consent to or refuse treatment
- Levels of competence to manage own affairs
Form 1
Application for an Order of Involuntary Medical Examination
4 things that need to be in place for form 1 to happen
1) Has a mental disorder
2) Is likely to cause harm to self or others
3) Needs to be examined by a physician
3) Refuses to be medically examined
Form 2
Order for Involuntary Medical Examination
- Justice of the peace (Judge) may complete a form 2
- The police now take the person involuntarily for medical examination
- Form 2 lasts for 7 days. If the police can’t find the person after 7 days that form expires
Form 3
Notice to Person in Custody
- Police must inform the person in writing as to where they are being taken
- That it is for an involuntary medical examination
- That they have a right to legal counsel
- Person must be examined asap (within 24hrs or less of pickup).
- They have the right to refuse treatment, and silence but not the right to refuse assessment
Form 4
Application by Physician for Involuntary Assessment
- Any physician can complete this form if they have examined the person with the last 2 days.
- Person can now be admitted involuntarily to a psychiatric facility for assessment.
- Allows for a 72 hour assessment period.
- Within the 72hrs of form 4 a psychiatrist needs to assess them. They need to bring in collateral info. They need to see them multiple tiems, look at nursing assessment, etc.
- In that 72hrs they need to complete the form 6.
- The doc that completes the form 4/5 CAN NOT be the same doctor that completes form 6
Criteria for a form 4 to work: 4 points
1) Believed or known to have a mental disorder
2) Because of the mental disorder is at risk:
For serious harm to self
Serious harm to others
And/or at risk of substantial deterioration if untreated
3) Would benefit from treatment at a psychiatric facility
4) Refuses voluntary admission or is not competent to consent
Form 6
Involuntary Admission Certificate
Valid for 21 days
Form 7
Renewal Certificate
Valid for 3 months
Form 5
Application by Attending Physician for Change of Client’s Status from Voluntary to Involuntary
- Client must be examined by a psychiatrist within 72 hours of Form 5 being signed
- If client has already been in hospital 72 hours when Form 5 signed, client must be examined within 24 hours
Form 9
Certificate of Incompetence to make Treatment Decisions
- If assessed as unable (incompetent) to make treatment decisions:
- Usually a family member will be asked to act as a legal proxy (substitute decision maker) for client & give their consent for treatment
- Clients must be informed of status, right to appeal & right to a lawyer
- The proxy must have had contact with the person in the last 12 months
- Doctor should contact the proxy within 72hrs
- Doctor doesn’t need to inquire about if they have a substitute decision maker
- Needs to be provided in writing what their rights are (informed/appeal/laywer)
Form 8
Certificate of Change of Status to Voluntary Client
- Status is also changed:
- Automatically when discharged
MMHA forms (4 or 5, 6, & 7) are allowed to lapse – not renewed - Client must be informed of change of status to voluntary
Form 13
Request for Discharge by Voluntary Client
- A person may voluntarily be admitted to a psychiatric faculty and then change their mind and request to leave
- To leave against medical advice, the person must complete a Form 13
- Client must be assessed by physician within 24 hours
After examination by the physician in Form 13 several options are possible:
1) Client changes their mind & stays voluntarily
2) Client is discharged
Either against advise
Or is doing good
3) Physician applies to change client status to involuntary (form 5)
Form 15
Leave Certificate or Extension of Leave
- Allows for least restrictive care in the community while still involuntary
- Technucally still a patient of the facility but living in the community
Leave certificate qualificaitions
- Been in hospital for 60 days in 2 years
- Had 3 or more admissions in 2 years
- Had a pervious leave certificate
The psychiatrist is legally responsible to inform a client in writing about:
Status under the MMHA
Right to appeal to Mental Health Review Board
Right to a lawyer
Form 18
Client’s Application to Mental Health Review Board
Client’s have a right to appeal anything in the MMHA that’s infringing their rights.
-can challenge their involuntary status
-can challenge their incompetence status
Mental Health Review Board consists of (4)
lawyer, psychiatrist, physician, and a member of the public
Form 14
Order for return of patient absent without permission
If any client leaves the hospital or does not return after a pass, the psychiatrist can complete a Form 14 and ask the police to return the client to facility
Treatment or restraint by force must be recorded in detail in client’s clinical record:
(a)Medication used route, dosage, frequency
(b)Force or mechanical means:
(i)means of restraint,
(ii)period of time during which the client was or is expected to be restrained, and
(iii)a description of the behaviour that required the client to be restrained or to continue to be restrained.
Client’s Rights - 3
- Status under MMHA
- Right to appeal to review board
- Right to a lawyer
