Thursday, January 16, 2014

Involuntary admission for psychiatric assessment

There are three ways that a person may be involuntarily admitted to a psychiatric facility in Ontario for a maximum 72 hour observation period.  Note that during the period treatment may not be given except with consent and the purpose of the admission is for assessment only.  Admission for treatment after assessment is not assured and the person may be discharged without treatment:

Police

When a person is acting in a disorderly manner, the Mental Health Act (Ontario) allows the police to take someone already in custody to a designated psychiatric facility for examination by a physician if they believe that the person is an immediate danger to himself or herself, an immediate danger to others, or not able to care for himself or herself to an extent that physical impairment will result. The officer must also believe there is an immediate threat of danger or physical impairment and other options for assessment or treatment are not viable.

Justice of Peace

In situations where there is no immediate danger, anyone can bring evidence to a justice of the peace that the person is a danger to himself or herself, a danger to others, or is not able to care for himself or herself. The judge can then order a person to be examined by a physician and authorize the police to take the person to a physician for examination.  Such order to the police is effective for seven days – if the police cannot locate the person within that time another order is required.

Physician

Where a physician (note, any physician – not necessarily a psychiatrist) examines a person and has reasonable cause to believe that the person,
 
  (a) has threatened or attempted or is threatening or attempting to cause bodily harm to himself or herself;
    (b) has behaved or is behaving violently towards another person or has caused or is causing another person to fear bodily harm from him or her; or
    (c) has shown or is showing a lack of competence to care for himself or herself,
and if in addition the physician is of the opinion that the person is apparently suffering from mental disorder of a nature or quality that likely will result in,
    (d) serious bodily harm to the person;
    (e) serious bodily harm to another person; or
    (f) serious physical impairment of the person,

the physician may make application for a psychiatric assessment of the person.

Alternatively, where a physician examines a person and has reasonable cause to believe that the person,
    (a) has previously received treatment for mental disorder of an ongoing or recurring nature that, when not treated, is of a nature or quality that likely will result in serious bodily harm to the person or to another person or substantial mental or physical deterioration of the person or serious physical impairment of the person; and
    (b) has shown clinical improvement as a result of the treatment,
and if in addition the physician is of the opinion that the person,
    (c) is apparently suffering from the same mental disorder as the one for which he or she previously received treatment or from a mental disorder that is similar to the previous one;
    (d) given the person’s history of mental disorder and current mental or physical condition, is likely to cause serious bodily harm to himself or herself or to another person or is likely to suffer substantial mental or physical deterioration or serious physical impairment; and
    (e) is incapable, within the meaning of the Health Care Consent Act, 1996, of consenting to his or her treatment in a psychiatric facility and the consent of his or her substitute decision-maker has been obtained,
the physician may make application in the prescribed form for a psychiatric assessment of the person.


In both cases the physician fills out a form authorizing the police to bring the person in for a psychiatric assessment.  The form has an effective similar to an order from a Justice of the Peace.

2 comments:

Clair Culliford said...

James:

Thank you very much for this.

I live in Parkdale and have seen over the years two persons who would definitely have benefited from a 72 hour observation period.

On both I occasions, I asked people who were concerned about the persons if they knew, legally, what could be done for them. No one did.

The next time I see such a person, I will give a description of their continuing behaviour to the local bicycle police and hope for the best.

Thanks for the bears, as always.

Clair Culliford

James C Morton said...

Thanks for this.