Bill 22, British Columbia

Thank you to Irit Shimrat for providing this summary

Here is a summary of Bill 22, a bill to amend British Columbia's mental
health act in order to more easily incarcerate, detain and forcibly treat
people whose behaviour disturbs others. The summary is followed by some
gory details from the actual bill.

1. One doctor can certify an individual, who can then be detained for 48
hours on the basis of that certification. A second certification must be
obtained during that time. (Previously, the initial incarceration required
two doctor's signatures to do this to someone.)

Criteria for certification include "prevention of mental or physical
deterioration." (The criteria used to be limited to "danger to self or

Patients on extended leave ("extended leave" is a euphemism for outpatient,
or community, committal) can be rehospitalized for going off medications.

If a patient has a history of going off medication and has been recently
hospitalized, criteria for extended leave can include forced treatment (in
other words, the person can be forcibly treated in the community)

A history of going off medication can be used to keep a person in hospital

Patients who are on extended leave for more than a year will have their
cases reviewed by review panels. A person on extended leave has a right to
a review panel after one month.


Please note that patient advocate Roderick Louis received a letter from the
director of Adult Mental Health, Ministry of Health, dated May 8, 1998,
stating: "In response to your telephone call of May 7, 1998, requesting
information on a draft proposal for outpatient committal, I can advise that
the Ministry has not developed such a proposal; furthermore, it is not a
legislative consideration that is currently being pursued."

[The bill was passed July 26]


Details from the bill

Section 1 of the Mental Health Act, RSBC 1996, c. 288, is amended
(a) by adding the following definition:
"designated facility" means a Provincial mental health facility,
psychiatric unit or observation unit;
(b) by repealing the definitions of "director" and "mentally disordered
person" and substituting the following:
"director" means a person appointed under the regulations to be in charge
of a designated facility and includes a person authorized by a director to
exercise a power to carry out a duty conferred or imposed on the director
under this [the Mental Health] Act or the Patients Property Act;
"mentally disordered person" means a person who has a disorder of the mind
that requires treatment and seriously impairs the person's ability
(a) to react appropriately to the person's environment, or
(b) to associate with others

Involuntary admissions
22(1) The director of a designated facility may admit a person to the
designated facility and detain the person for up to 48 hours for
examination and treatment on receiving one medical certificate respecting
the person completed by a physician in accordance with subsections (3) and

(2) On receipt by the director of a second medical certificate completed by
another physician ... the detention and treatment of that patient may be
continued beyond [the initial period]

(3) Each medical certificate under this section must be completed by a
physician who has examined the person to be admitted, or the patient
admitted, under subsection (1) and must set out
(a) a statement by the physician that the physician
(i) has examined the person or patient on the date or dates set out, and
(ii) is of the opinion that the person or patient is a mentally disordered

10(b)(2.1) An examination under subsection (2) must include
(a) consideration of all reasonably available evidence concerning the
patient's history of mental disorder including
(i) hospitalization for treatment, and
(ii) compliance with treatment plans following hospitalization, and
(b) an assessment of whether there is a significant risk that the patient,
if discharged, will as a result of mental disorder fail to follow the
treatment plan the director or physician considers necessary to minimize
the possibility that the patient will again be detained under section 22.

[(a) and (b) above are also the criteria which must be used in review panel
hearings and court hearings regarding the patient's fate]

Emergency procedures
28(1) A police officer or constable may apprehend and immediately take a
person to a physician for examination if satisfied from personal
observations, or information received, that the person
(a) is acting in a manner likely to endanger that person's own safety or
the safety of others, and
(b) is apparently a mentally disordered person

Direction and discipline of patients
32 Every patient detained under this Act is, during detention, subject to
the direction and discipline of the director and the members of the staff
of the designated facility authorized for that purpose by the director.

Application to court for discharge
33(1)In this section:
"patient" means
(a) a person whose admission is requested, or a patient who is admitted,
under section 20(1)(a)(ii)

Advice to near relative
34(2) The director must give notice in the prescribed manner to a near
relative of a patient immediately after
(a) discharging a patient from the designated facility
(b) receipt of a request under section 25(1) from someone who is not a near
relative of the patient.

(4) If the director or chair has no information about the identity of the
patient's near relatives, the section is sufficiently complied with if the
notice is sent to the Public Trustee.

Authority to detain continues despite leave or transfer
39(1) The release of a patient on leave or the patient's transfer to an
approved home under section 37 or 38 does not, of itself, impair the
authority for the patient's detention under this Act and that authority may
be continued, according to the same procedures and to the same extent, as
if the patient were detained in a designated facility.

(6) A patient detained in a designated facility who leaves the designated
facility under the circumstances set out in subsection (1) may be
apprehended for the purpose of returning the patient to the facility,
within 48 hours from the time the patient leaves, even though no warrant
has been issued under this section.