Welcome to the BC Mental Health Rights blog!

This blog is an informal place to talk about patients’ Mental Health Act rights. Posts take a closer look at an issue related mental health rights, especially in BC, and are written by patients and people with lived experience, care partners, clinicians, legal experts, and researchers.

This content has not been reviewed for legal accuracy and should not be considered legal advice.

Will forcing health authorities to complete all Mental Health Act forms help patients better understand their rights?

Poor form completion rates

In the recently released report, Committed to Change, the BC Office of the Ombudsperson detailed disturbing findings that involuntary patients aren’t consistently told about their rights under the Mental Health Act. Further, family care partners aren’t always told that their loved ones have been detained. These stories are appalling, but will enforcing better record keeping prevent these scenarios from happening?

According to the Mental Health Act, when a person is admitted as an involuntary patient under a medical certificate (Form 4):

  • They’re supposed to learn their rights by being read and given Form 13.
  • They’re supposed to nominate a near relative to notify about their hospitalization, using Form 15.
  • Their care team is supposed to send Form 16 to that near relative. Form 16 tells the near relative that the person (a) has been detained and (b) has rights under the Mental Health Act. This form is supposed to be sent or given to the near relative immediately after the person has been admitted.

The BC Office of the Ombudsperson found:

  • Form 13 in only 49% of patient files,
  • Form 15 in only 43% of patient files, and
  • Form 16 in only 32% of patient files.

In response to these poor compliance rates, the Office of the Ombudsperson issued this recommendation:

Recommendation 9: By June 30, 2019, the Ministry of Health and the Ministry of Mental Health and Addictions work together with the health authorities to establish clear and consistent provincial standards aimed at achieving 100 percent compliance with the involuntary admissions procedures under the Mental Health Act through the timely and appropriate completion of all required forms.

In other words, these three forms should appear in 100% of patient files. But will mandating 100% compliance solve the problem of patients and family care partners not knowing patients’ rights?

I don’t believe they will. Continue reading “Will forcing health authorities to complete all Mental Health Act forms help patients better understand their rights?”

Mental Health Act rights materials now available in eight languages other than English

The unmet need

In a series of focus groups, members of our research team asked clinicians about the barriers they face when giving involuntary patients rights information. One barrier participants mentioned over and over was that many of their patients didn’t understand English.

Form 13, the document clinicians use to to tell patients about their rights, seems to be available only in English.

Translated rights materials

To help fill the gap in availability of Mental Health Act rights information in other languages, we’ve translated:

into eight of BC’s most commonly spoken languages other than English:

  • Arabic
  • Chinese (Traditional and Simplified)
  • Farsi
  • French
  • Korean
  • Punjabi
  • Spanish
  • Vietnamese

Continue readingMental Health Act rights materials now available in eight languages other than English”

A chance to make a better Guide to the Mental Health Act

Cover of the 2005 edition of the Guide to the Mental Health Act

In Committed to Change, a report detailing the failure of the mental health system to uphold the rights of involuntary patients hospitalized under the Mental Health Act, the BC Ombudsperson issued 24 recommendations “to ensure the rights of people with serious mental illness are respected and public confidence in our mental health system is enhanced.” (BC Ombudsperson 2019, p. 3)

One of the recommendations is that, “By March 31, 2020, the Ministry of Health update and reissue the Guide to the Mental Health Act to incorporate the changes made arising from this report and other changes.” (BC Ombudsperson 2019, p. 98)

Continue reading “A chance to make a better Guide to the Mental Health Act

Committed to Change—the Ombudsperson’s critical new report about involuntary patients’ rights

Over 2017 and 2018, the BC Ombudsperson’s Office investigated whether hospitals in the province were meeting their Mental Health Act obligations to safeguard involuntary patients’ rights by filling out the required forms at admission. On March 7, 2019, the report of this investigation, Committed to Change, was made public.

Cover of the Ombudsperson's report "Committed to Change: Protecting the Rights of Involuntary Patients under the Mental Health Act" showing the title superimposed on a photo of a long hospital corridor.

Continue readingCommitted to Change—the Ombudsperson’s critical new report about involuntary patients’ rights”

The Mental Health Review Board’s website

Screen shot from the BC Mental Health Review Board website, taken January 9, 2019.

When I interviewed people who experienced involuntary hospitalization (certification) about their information needs, some of them told me that, when they choose to exercise their rights, they’d like more information about what comes next.

What happens after you hand in Form 7 to ask for a review panel hearing? Or what happens after you hand in Form 11 to ask for a second medical opinion?

Continue reading “The Mental Health Review Board’s website”

Second medical opinions under BC’s Mental Health Act

Involuntary patients over the age of 16 have the right to ask for a second medical opinion from a doctor who’s not on their treatment team. My interviews with former involuntary patients and with clinicians seem to show that both groups are confused about how this right works, so this post aims to answer some of the most common questions about it.

A cartoon showing a doctor examining a patient on a bed.
Continue reading “Second medical opinions under BC’s Mental Health Act

Clinicians: What questions do you have about Mental Health Act rights?

Cartoon of clinicians sitting around a table. One of them is talking. A researcher listens.

In response to clinician demand arising from our rights information sessions, some members of our team are working with clinical staff to develop a LearningHub module about Mental Health Act rights so that healthcare providers across BC will have access to our content.

To make sure we address clinicians’ most pressing questions about Mental Health Act rights, we’re reaching out!

Questions can be about:

  • the Mental Health Act rights themselves
  • your obligations under the Mental Health Act to give rights information
  • the rights-notification process
  • Forms 13 & 14 and other rights information tools

…or any other concerns related to Mental Health Act rights.

If you’re a nurse, social worker, physician, or other healthcare provider who works with the Mental Health Act and are wondering about any rights-related issues, please contact us with your questions by December 20, 2018.

Seeking translation reviewers

Translations are coming!

The Legal Services Society has generously agreed to fund the translation of our

  • pamphlet,
  • wallet card, and
  • video captions

into three languages of high need in British Columbia:

  • Traditional Chinese (we will use this as a basis to make Simplified Chinese available as well, localizing the language as needed),
  • Punjabi, and
  • Farsi.

UPDATE (November 9, 2018): We will also be translating the materials into

  • Arabic
  • French
  • Korean,
  • Spanish, and
  • Vietnamese.

Continue reading “Seeking translation reviewers”

The Mental Health Review Board’s new Rules of Practice and Procedure

In its 2017–2018 annual report, the Mental Health Review Board announced plans to modernize its Rules of Practice and Procedure. On August 28, 2018, the review board released the new Rules, and all review panels are expected to follow them by October 15, 2018.

The board also released a document outlining the key changes to the Rules and issued five Practice Directions documents:

The review board intends for these documents to “ensure that a patient is given a procedurally fair hearing that also proceeds expeditiously.” Many of the polices are meant to streamline the review panel hearings: they encourage both case presenter and patient (or patient representative) to come to the hearings prepared to give the review panel the evidence they need to make their decision. But several of the new rules also support patients’ rights, and this post will highlight some of those points.

A cartoon depicting a mental health review board hearing. The three-member panel sits along one edge of a large table. The patient sits with his representative on one side of the panel and the case presenter, in this case the doctor, sits on the other side.
A review panel hearing. Illustration by Jonathon Dalton.

Continue reading “The Mental Health Review Board’s new Rules of Practice and Procedure

A revised Form 7—better for patient rights?

Involuntary patients have the right to ask for a hearing with a review panel if they want to challenge their certification. To do so, they (or someone on their behalf) must fill out Form 7.

Earlier this year, the Ministry of the Attorney General, together with the Ministry of Health and the Mental Health Review Board, revised Form 7, partly in response to the Community Legal Assistance Society’s report Operating in Darkness, which was critical of many aspects of the Mental Health Act and how it was implemented in practice. In May, the Mental Health Review Board announced “that after several months of consultations, our new Form 7 ‘Application for Review Panel Hearing’ has received Cabinet approval by way of an Order in Council approved on May 15, 2018.” Continue reading “A revised Form 7—better for patient rights?”