Sept 21 - Mental Health Law in Canada

Question 1

Mental health legislation in Canada attempts to balance three factors, what are they?

Hint - civil, society saf, society choi

Answer 1

1.the civil liberties of individuals to live as they choose

2.the responsibility of society to ensure the safety and well-being of individuals who cannot understand the consequences of their choices because of diminished capacity

3.the responsibility of a society to ensure that the choices and behaviour of one individual do not compromise the safety and security of others

Question 2

From the History of Involuntary Commitment in Ontario, what year does this fit into:

Medical supervisor and courts (no expectation of recovery

1808
1871
1935
1967
1978
2015

Answer 2

*1808

Question 3

From the History of Involuntary Commitment in Ontario, what year does this fit into:

Lieutenant Governor and three doctors

1808
1871
1935
1967
1978
2015

Answer 3

1871

Question 4

From the History of Involuntary Commitment in Ontario, what year does this fit into:

Two doctors, and the person might recover (time limited)

1808
1871
1935
1967
1978
2015

Answer 4

1935

Question 5

From the History of Involuntary Commitment in Ontario, what year does this fit into:

Safety of self or others

1808
1871
1935
1967
1978
2015

Answer 5

1967

Question 6

From the History of Involuntary Commitment in Ontario, what year does this fit into:

Imminent and serious bodily harm

1808
1871
1935
1967
1978
2015

Answer 6

1978

Question 7

From the History of Involuntary Commitment in Ontario, what year does this fit into:

Consent and Capacity Board oversee long term patients

1808
1871
1935
1967
1978
2015

Answer 7

2015

Question 8

Was it the mental health legislation in Ontario enacted in 1871 OR Ontario Mental Hospitals Act 1935 OR Revisions in the 1967 Mental Health Act that…

was entitled “An Act respecting Asylums for the Insane.”

Answer 8

the mental health legislation in Ontario enacted in 1871

Question 9

Was it the mental health legislation in Ontario enacted in 1871 OR Ontario Mental Hospitals Act 1935 OR Revisions in the 1967 Mental Health Act that…

indicated that no person could be confined in an asylum except under an order of the lieutenant-governor and a certificate of three medical professionals verified by the mayor or reeve.

Answer 9

the mental health legislation in Ontario enacted in 1871

Question 10

Was it the mental health legislation in Ontario enacted in 1871 OR Ontario Mental Hospitals Act 1935 OR Revisions in the 1967 Mental Health Act that…

removed the courts from the decision regarding admission, which then allowed involuntary admission based on the authorization of two physicians.

Answer 10

Ontario Mental Hospitals Act 1935

Question 11

Was it the mental health legislation in Ontario enacted in 1871 OR Ontario Mental Hospitals Act 1935 OR Revisions in the 1967 Mental Health Act that…

Was the first Act to allow for the fact that a patient may recover be released from hospital.

Answer 11

Ontario Mental Hospitals Act 1935

Question 12

Was it the mental health legislation in Ontario enacted in 1871 OR Ontario Mental Hospitals Act 1935 OR Revisions in the 1967 Mental Health Act that…

sought to limit the role of medicine

Answer 12

Revisions in the 1967 Mental Health Act

Question 13

Was it the mental health legislation in Ontario enacted in 1871 OR Ontario Mental Hospitals Act 1935 OR Revisions in the 1967 Mental Health Act that…

reduced the grounds for involuntary admission to any person who would not enter a hospital voluntarily and who was living with a “mental disorder of a nature or degree so as to require hospitalization in the interests of his own safety or the safety of others.”

Answer 13

Revisions in the 1967 Mental Health Act

Question 14

T/F - A central issue related to mental health legislation has been involuntary hospitalization and treatment

Answer 14

true

Question 15

Generally, WHAT is the primary criterion for involuntary admission

Answer 15

danger, the term for “danger” varies across provinces

Question 16

Throughout Canada, a person can be admitted involuntarily to a psychiatric facility by 4 different ways which are?

Answer 16

• A physician may complete an application for psychiatric assessment and the individual will then be transported to the psychiatric facility for assessment, if necessary by the police.
• A judge can order a person with an apparent mental health disorder to be taken by the police to a mental health facility for psychiatric assessment.
• Family members or concerned community mental health workers can swear before a justice of the peace that a person with an apparent mental disorder is behaving in a manner that may meet the criteria for harm or danger. The justice of the peace may then issue an order that instructs the police to assist with transporting the individual to a psychiatric facility where a physician can complete an application for psychiatric assessment.
• A police officer may apprehend a person who is believed to meet the criteria under mental health legislation and transport them to a psychiatric facility for assessment. Police have specific guidelines for action depending on the circumstances.

Question 17

T/F - Involuntary admission at law occurs before the psychiatric assessment is completed

Answer 17

false, occurs after the assessment

Question 18

Under the Canadian Charter of Rights and Freedoms, involuntary patients must what 3 things?

Answer 18

(1)be informed promptly of the reasons for detention

(2)be given the opportunity to retain counsel without delay

(3)have the validity of the detention reviewed and determined.

Question 19

Perceptions of control for involuntary patients include what 3 things?

Answer 19

• Supportive professionals who listen, respect the individual and maximize choice
• Gaining perspective on their illness and treatment through information provided
• Learning to manage their own mental health

Question 20

Every province now has consent legislation which means treatment first THEN consent

Answer 20

false, consent first THEN treatment

Question 21

T/F - Prior to the 1960s, any person admitted to hospital against their will could be treated without consent

Answer 21

true

Question 22

What type of consent is the oral or written expression of consent, for example, by the patient stating, “I would like you to remove this wart from my finger.”

Answer 22

express

Question 23

What type of consent is derived from the action or inaction of an individual. For example, consent for obtaining a blood sample is implied by the action of rolling up one’s sleeve and presenting one’s arm

Answer 23

implied

Question 24

What are the 3 elements of consent?

Answer 24

*A person must have the capacity to consent (cannot be impeded by mental health, health, or maturation)

*Consent must be informed (information must be available about all risks and benefits of treatment and info about risks of no treatment)

*Consent must be voluntary (it must be free of overt or implied consequences for consent or non-consent)

Question 25

T/F - Treatment can never be provided without consent even in an emergency if a person for whom the treatment is proposed is incapable of consenting and the delay in consulting with a substitute decision-maker would result in prolonged suffering

Answer 25

false

Question 26

What term describes - Legal document whereby wishes of person are recorded when competent

Answer 26

An advance directive, ex. acceptance/refusal of specific medications, ECT administration, hospitalization preferences, use of restraints

Question 27

which term describes the legislation that binds the substitute decision-maker to following the directive unless the expressed wishes endanger the physical or mental health or safety of the patient or another person

Answer 27

An advance directive

Question 28

Is it an advance directive or ulysses contract where a person may request detainment or restraint and may waive the right of appeal of involuntary admission and treatment

Answer 28

ulysses contract, it’s a freely made decision about one’s own future that sets out the person’s preference in case of medical or other incapacitation

Question 29

What is:
-Designated by the person in advance

-Bound by advance directives unless wishes endanger health or safety.

-Specified by law if not designated by the person.

Answer 29

Substitute decision-makers

Question 30

You may designate a WHAT (person granted authority to act on behalf of the grantor) for personal care prior to becoming incapable of consenting

Answer 30

power of attorney

Question 31

Ontario has community treatment orders (ctos) by which a person may choose to comply with treatment in the community instead of being involuntarily admitted to a hospital

This is known as WHAT

Answer 31

“leash laws” by opposition

Question 32

T/F - A power of attorney for personal care does encompass financial matters

Answer 32

false

Question 33

T/F - In Ontario, the test for financial competence includes

• the ability to understand the nature of the financial decision and the choices available;
• the ability to understand their relationship to the parties to and potential beneficiaries of the transactions; and
• the ability to appreciate the consequences of making the decision.

Answer 33

true

Question 34

What term describes an office that operates under legislation and works on behalf of a charitable or public group or individual to guide or make financial decisions.

Answer 34

Public Trustee

Question 35

professional duties to warn and protect exists when what 3 things happen

Answer 35

• there is risk to a clearly identified person or group of persons is determined
• the risk of harm includes bodily injury, death, or serious psychological harm; and
• there is an element of imminence, creating a sense of urgency.

Question 36

Client may access records that pertain to their care unless WHAT

Answer 36

Unless access might result in harm to self or others well beyond the merely possible or speculative