What you can do if you're certified as an involuntary patient
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What does it mean to be certified under BC's Mental Health Act?
The Mental Health Act is the law that sets out the rules for when a person can be kept in the hospital against their will.
That law says that you can be certified as an involuntary patient only if a doctor or nurse practitioner has examined you and believes you meet all four of these criteria:
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your ability to react to your environment and associate with others is seriously impaired because of a mental disorder,
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you need psychiatric treatment in or through a facility,
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you need care, supervision, and control:
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to protect you or others, or
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to prevent you from deteriorating substantially, either mentally or physically, and
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you can't be admitted as a voluntary patient.
If you've been certified, you may feel scared, confused, or angry, especially if you aren't sure what your rights are.
When you're certified:
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you can't leave the hospital without your doctor's permission, and
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you can't refuse psychiatric treatment, including medication.
But you can still talk to your doctor about your treatment, and you don't lose all your rights.
How long do I have to stay in the hospital?
That depends on how many certificates have been completed. One certificate (Form 4.1) lets your doctor or nurse practitioner keep you in hospital for up to 48 hours. If a second certificate (Form 4.2) is completed, you may have to stay for up to 1 month.
If, at any point, the doctor believes you no longer meet the criteria, you will be decertified.
If the doctor believes you still meet the criteria after a month, they can renew your certification, first for 1 month, then for 3 months, then for periods of 6 months.
During each of these certification periods, you have the right to:
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be told what your rights are,
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be examined by a doctor to see if you still meet the criteria for certification,
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ask for a review panel hearing, and
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ask for a second medical opinion.
What rights do I have if I'm certified?
You have the right to know where you are
Ask a nurse if you need to know the name and address of the hospital.
You have the right to know why you've been certified
The doctor or nurse practitioner must write the reasons for your hospitalization on your medical certificate (Form 4.1). If your certification has been renewed, on your renewal certificates (will explain how you continue to meet the four criteria (Forms 4.2, 6). You have the right to know what is on your certificates.
You have the right to be examined by a doctor
A doctor must examine you before deciding to renew you as an involuntary patient (Forms 4.2, 6).
You have the right to ask for a review panel hearing
If you don't agree with the doctor's decision to certify you, you can challenge your hospitalization. One way is to ask for a hearing with a review panel. There is no cost for a hearing.
A review panel is independent of the hospital and includes:
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a lawyer,
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a doctor who isn’t on your treatment team, and
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a member of the community.
They will hear your case and decide if you meet the criteria for hospitalization. If they decide that you don't, you'll be decertified. If they decide that you do, you'll have to stay in the hospital.
To apply for a review panel hearing, ask a nurse to help you fill out Form 7. Another person, such as a family member or supporter, can also fill out and submit Form 7 on your behalf. If you are in a 1-month certification period, your hearing will be scheduled within 14 days from when you apply. If you are in your 3-month or 6-month certification period, it may take up to 28 days after the submission.
You have the right to have an advocate or lawyer represent you and help you prepare and present your case to the review panel. For example, you can ask for free legal help from the Mental Health Law Program:
604-685-3425 in the Lower Mainland
1-888-685-6222 elsewhere in BC
E-mail: [email protected]
You can also call witnesses to testify on your behalf.
You can ask the review panel if you can bring someone to support you, but it's up to the chair of the panel to decide if this will be allowed.
If you have any other questions about hearings, you can contact the Mental Health Review Board for more information:
Website: bcmhrb.ca
E-mail: [email protected]
Phone (toll free): 1-833-660-2325
You have the right to ask for a second medical opinion
If you don't agree with your psychiatric treatment, you can ask for a second opinion from another doctor. To do this, ask a nurse to help you fill out Form 11.
You can choose any doctor licensed to practice in BC to examine you, but you may have to pay for their travel costs.
Be aware that the second opinion is just an opinion, and your treatment team doesn't have to follow the other doctor's recommendations.
You have the right to speak with a lawyer and apply to court
The facility must provide access to a phone and a private room to contact a lawyer, if this is something you are interested in. A lawyer can help you challenge your certification by asking a judge to review your case. They can also give you legal advice about your rights as a certified patient. You may have to pay the lawyer's fee and court costs.
If you can't afford a lawyer, Access Pro Bono offers 30 minutes of free legal advice over the phone. Call to make an appointment:
604-878-7400
9:30 am – 12:30 pm or 1:30 pm – 4:30 pm, Monday to Friday (excluding holidays)
Website: www.accessprobono.ca/our-programs/summary-advice-program
Another free option is Legal Aid BC. They will start by asking you some questions and checking what legal supports you qualify for:
604-235-1338 in Greater Vancouver
1-844-235-1338 elsewhere in BC
9 am – 3:30 pm (call times may be longer between 12 – 2 pm)
Website: legalaid.bc.ca/contact-us
If you have questions about any of these rights, you can request to meet with a rights advisor.
Rights Advisors have specialized training on the Mental Health Act. They can meet you in private to explain your legal rights, and let you know how to exercise those rights. They will not share any information with your treatment team or support network without your consent. They help without judgement.
To request an appointment, speak to a member of your treatment team and ask for an appointment with the Independent Rights Advice Service. If they do not submit an appointment request for you, you can contact the Independent Rights Advice Service Intake Coordinator at 604-681-4070 for help.
Website for more information: irasbc.ca/.
What happens when I leave the hospital?
You may either:
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be discharged and be free to go, or
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be placed on extended leave.
Being on extended leave means you can live out in the community, but you will still be certified and will have to follow conditions, like visiting a mental health team and taking psychiatric medications.
You have the right to know if you're being discharged or placed on extended leave. You have all of the same rights on extended leave as you do in the hospital, including the right to ask for a review panel hearing.
What if I'm unhappy about my care?
Patient Care Quality Offices
If you want to make a formal complaint regarding the quality of care that you or a loved one has received, or you would like more information about making a complaint, you can contact the Patient Care Quality Office in your health authority.
For the contact information for the Patient Care Quality Office in your health authority, including phone numbers and e-mail address, see www.patientcarequalityreviewboard.ca/makecomplaint.html
Patient Care Quality Review Board
If you have submitted your concerns to the health authority's Patient Care Quality Office and are not satisfied with how they were handled or the response you received, you can request that the Patient Care Quality Review Board look into the matter.
Website: www.patientcarequalityreviewboard.ca
E-mail: [email protected]
Phone (toll free): 1-866-952-2448
BC Ombudsperson
The office of the Ombudsperson is an independent body and can help with complaints about public institutions, like the hospital.
Website: bcombudsperson.ca
E-mail: [email protected]
Phone (toll free): 1-800-567-3247
Representative of Children and Youth
If you or someone you are supporting is under the age of 19 and has had a negative experience while detained and experiencing involuntary treatment under the Mental Health Act, the Representative for Children and Youth may be able to support.
You can find more information on the Representative for Children and Youth below:
Website: rcybc.ca
Email: [email protected]
Phone: 1-800-476-3933
Where can I get more information about my rights?
Read a summary of your rights on Form 13. A nurse will ask you to sign that form to show that someone has told you about your rights.
If you'd like a family member or friend to help you with your rights, you can ask a nurse to give them rights information.
If you have questions about your rights, talk to a nurse or a mental health team member to learn more. You can also ask them for an appointment with the Independent Rights Advice Service. The service operates separately from the health care system, and rights advisors will not share any information with your treatment team or support network without your consent.
Website for more information and resources: irasbc.ca.
About the author
The Mental Health Act Rights Advice (MHARA) research team's aims were to create patient-centred materials to help patients better understand their rights and to encourage clinicians to foster a culture where patients feel safe to talk about their rights. The team was coordinated by Iva Cheung. The Independent Rights Advice Service provides information to people who are detained and experiencing involuntary treatment under the Mental Health Act in BC. This information helps people understand what their legal rights are and how they can act on those rights. For more information: irasbc.ca
