61

 

Third Session, 45th General Assembly

55 Elizabeth II, 2006

BILL 61

AN ACT RESPECTING MENTAL HEALTH CARE AND TREATMENT

Received and Read the First Time................................... December 5, 2006 

Second Reading.............................................................. December 7, 2006  

Committee................................................... Amendment December 11, 2006

Third Reading.................................................................................................

Royal Assent...................................................................................................

HONOURABLE TOM OSBORNE

Minister of Health and Community Services

Ordered to be printed by the Honourable House of Assembly

 

EXPLANATORY NOTES

This Bill would repeal the Mental Health Act and establish a new regime for the involuntary certification of persons with a mental disorder who, as a result of the mental disorder, are likely to cause harm to self or others or to suffer substantial mental or physical deterioration without treatment and supervision.  The Bill would provide a process for the apprehension, custody, assessment, committal, treatment and care and supervision of these individuals which would be the least intrusive and restrictive means of achieving treatment and protection.  This which would be consistent with guaranteed rights.

Part I of the Bill would describe the powers of the minister with respect to the designation of psychiatric units, the making of agreements in relation to the provision of mental health services and the conduct of a mandatory review of the Act and regulations every 5 years.  Part I of the Bill would also establish regulation-making authority, provide for protection from liability of peace officers and health care professionals acting under the authority of the Bill and create an offence and penalty respecting the giving of false information.

Part II of the Bill would set out the procedural rights of persons apprehended and taken into custody for the purpose of a psychiatric assessment and of persons committed to psychiatric units as involuntary patients.  This Part would impose duties upon peace officers and administrators to inform these persons of the legal basis for apprehension and of their right to retain and instruct counsel.  The Bill would also require administrators to provide patients with a copy of the order or certificate authorizing detention and with information respecting review of detention by the Mental Health Care and Treatment Review Board.  This Part would also set out the rights of involuntary patients to access to counsel, to receive visitors, to make phone calls and to send and receive correspondence.

Part II of the Bill would provide for the appointment of rights advisors by the minister.  The rights advisor would be responsible for meeting with persons detained under the authority of the Bill and the representatives of these persons in order to provide information and advice with respect to a person's status as an involuntary patient, the exercise of rights, the retention of counsel and applications to and hearings by the review board.

Part III of the Bill would establish a new process for certification of involuntary patients.  This Part would provide for clear admission criteria, shortened timelines for assessment and detention, ongoing assessment of the person and automatic review of extended periods of detention.  The new process would ensure that a person would only be detained as an involuntary patient on the strength of 2 certificates, one of which would be issued by a psychiatrist.  The maximum period of detention on initial certification would be 30 days with the possibility of successive renewals following a psychiatric assessment.

With respect to treatment, while the Bill would permit treatment to be administered without the consent of the involuntary patient, the Bill would require the attending physician to take the best interests of the person into account in the making of treatment decisions and to consult with both the person and his or her representative before administering treatment.  The Bill would prohibit the administration of psychosurgery.  The Bill would also permit the granting of authorized leaves as a method of facilitating the reintegration of involuntary patients into the community.

Part IV of the Bill would establish a new community treatment order which is designed to allow a person with a mental disorder requiring treatment and care and supervision to reside in the community rather than in a psychiatric unit under terms and conditions prescribed in a comprehensive community treatment plan.  The order would be issued by a psychiatrist, taking into account the statutory criteria, and would remain in effect for 6 months with the possibility of further renewals.  This Part would also establish processes respecting the renewal, variation, termination and revocation of the order.

Part V of the Bill would establish a new 13 member Mental Health Care and Treatment Review Board to replace the existing Mental Health Review Board.  The board would be headed by a chairperson who is a lawyer and consist of 4 lawyers, 4 physicians and 4 other persons.  The board would sit in panels of 3 members to hear and determine applications related to a person's status as an involuntary patient, the issuance or renewal of a community treatment order and an allegation of a denial of a patient's rights.  The board would have the authority to confirm or rescind a person's status as an involuntary patient, to confirm or rescind a community treatment order and to make a non-binding recommendation to an administrator where a violation of rights has been determined.  The decisions of the board would be appealable on a question of law to the Supreme Court, Trial Division.

Part VI of the Bill would provide mechanisms for the transfers of involuntary patients from one psychiatric facility to another, from a psychiatric unit to a hospital and from one province to another.  This Part would also address the transfer of mentally disordered adult and young offenders from a custodial facility to a psychiatric facility for treatment.  This Part would also provide for mandatory assessment of individuals detained under a disposition under the Criminal Code to determine if these individuals meet the criteria for certification as an involuntary patient.  Certification would permit these individuals to be treated during the period of detention under the Criminal Code.

Part VII of the Bill would effect a number of transitional amendments to address the status of individuals certified under the current Mental Health Act, the renewal of certifications issued under the Mental Health Act and the disposition of outstanding applications before the review board established under the Mental Health Act.  The Part would also make consequential amendments and repeal the Mental Health Act.

Part VII would also provide that the Act, with the exception of Part IV, would come into effect on October 1, 2007.  The commencement of Part IV would be deferred until January 1, 2008.

A BILL

AN ACT RESPECTING MENTAL HEALTH CARE AND TREATMENT

Analysis


        1.   Short title

        2.   Interpretation

        3.   Purpose

              PART I
GENERAL

        4.   Powers of minister

        5.   Agreements

        6.   Review of Act

        7.   Protection from liability

        8.   Regulations

        9.   Offence

              PART II
RIGHTS
AND RIGHTS ADVISORS

      10.   Duties of peace officer on apprehension or detention

      11.   Duties of facility on apprehension or detention

      12.   Procedural rights of involuntary patient

      13.   Rights advisor

      14.   Functions of rights advisor

      15.   Notice to rights advisor

              PART III
ASSESSMENT, ADMISSION, TREATMENT
AND DISCHARGE

      16.   Admission only on certificates

      17.   Certificate of involuntary admission

      18.   Effect of one certificate of admission

      19.   Judge's order for involuntary psychiatric assessment

      20.   Apprehension by a peace officer

      21.   Powers and duties of person apprehending and conveying

      22.   Assessment of detained person

      23.   No assessment or no admission

      24.   Admission on 2 certificates

      25.   Detention pending conveyance

      26.   Admission to a treatment facility

      27.   Certificates of involuntary admission to be filed

      28.   Length of detention

      29.   Ongoing assessment

      30.   Renewal or discharge

      31.   Detention under certificate of renewal

      32.   Discharge

      33.   Automatic review of detention

      34.   Change in status of a voluntary patient

      35.   Treatment

      36.   Prohibition on treatment

      37.   Authorized leave

      38.   Unauthorized leave

      39.   Part does not apply

              PART IV
COMMUNITY TREATMENT ORDERS

      40.   Community treatment order

      41.   Form and contents of community treatment order

      42.   Community treatment plan

      43.   Notice of issue or renewal

      44.   Responsibility of attending psychiatrist

      45.   Responsibilities of persons named in the order

      46.   Treatment

      47.   Duration of order

      48.   Renewal of community treatment order

      49.   Variation

      50.   Termination

      51.   Revocation of order

      52.   Protection from liability

      53.   Board review of order

      54.   No limitation

              PART V
MENTAL HEALTH
CARE AND TREATMENT REVIEW BOARD

      55.   Parties defined

      56.   Mental Health Care and Treatment Review Board

      57.   Appointment

      58.   Term of appointment

      59.   Remuneration

      60.   Chairperson of board

      61.   Panels

      62.   Decision making procedure of panel

      63.   Ineligibility to participate on panel

      64.   Jurisdiction of board

      65.   Power to dismiss an application

      66.   Application

      67.   Referral of application

      68.   Powers of panel

      69.   Conduct of proceedings

      70.   Rights of parties

      71.   Decision of the board

      72.   Order of the panel

      73.   Appeal

              PART VI
CRIMINAL CODE
AND TRANSFERS

      74.   Detention under Criminal Code

      75.   Transfer to another psychiatric unit

      76.   Temporary removal or transfer

      77.   Notice of transfer

      78.   Adult offenders

      79.   Young offenders

      80.   No appeal or review

      81.   Transfer of patients to and from the province

              PART VII
TRANSITIONAL PROVISIONS, CONSEQUENTIAL AMENDMENTS
AND REPEAL

      82.   Transitional

      83.   Consequential amendments

      84.   RSNL1990 cM-9 Rep.

      85.   Commencement


Be it enacted by the Lieutenant-Governor and House of Assembly in Legislative Session convened, as follows:

Short title

        1. This Act may be cited as the Mental Health Care and Treatment Act.

Interpretation

        2. (1) In this Act

             (a)  "administrator" means the person in charge of administrative functions within a psychiatric unit and includes his or her designate;

             (b)  "attending physician" means the physician who is given responsibility for the observation, care and treatment of a person during the period that a certificate or order in respect of the person is in effect and includes an attending psychiatrist;

             (c)  "board" means the Mental Health Care and Treatment Review Board established under section 56;

             (d)  "certificate" means a certificate issued under this Act and includes a certificate of involuntary admission and a certificate of renewal;

             (e)  "community treatment order" means an order issued under subsection 40(2);

              (f)  "community treatment plan" means the plan referred to in paragraph 40(2)(c) that is a required part of a community treatment order;

             (g)  "court" means, unless the context indicates otherwise, the Provincial Court of Newfoundland and Labrador and includes a judge of the Provincial Court whether sitting in court or in chambers;

             (h)  "facility" means a place where a psychiatric assessment may be conducted and includes a physician's office;

              (i)  "involuntary patient" means a person who is the subject of 2 certificates of involuntary admission issued in accordance with section 17 or a certificate of renewal issued in accordance with paragraph 30(2)(a);

              (j)  "judge" means, unless the context indicates otherwise, a Provincial Court judge appointed under the Provincial Court Act, 1991 and includes the chief judge;

             (k)  "mental disorder" means a disorder of thought, mood, perception, orientation or memory that impairs

                      (i)  judgment or behaviour,

                     (ii)  the capacity to recognize reality, or

                    (iii)  the ability to meet the ordinary demands of life,

and in respect of which psychiatric treatment is advisable;

              (l)  "minister" means the minister appointed under the Executive Council Act to administer this Act;

            (m)  "next of kin" means the first named person or a member of the category of person on the following list who has reached the age of 19 years and is mentally competent and available:

                      (i)  a spouse or cohabiting partner,

                     (ii)  son or daughter,

                    (iii)  father or mother,

                    (iv)  brother or sister,

                     (v)  grandson or granddaughter,

                    (vi)  grandfather or grandmother,

                   (vii)  uncle or aunt, and

                  (viii)  nephew or niece;

             (n)  "nurse practitioner" means a nurse practitioner as defined in the Registered Nurses Act;

             (o)  "peace officer" means

                      (i)  a member of the Royal Canadian Mounted Police,

                     (ii)  a member of the Royal Newfoundland Constabulary, and

                    (iii)  a sheriff, sub-sheriff, bailiff and deputy sheriff appointed under the Sheriff's Act, 1991;

             (p)  "physician" means a person who is licensed to engage in the practice of medicine in the province or is otherwise lawfully engaged in the practice of medicine in the province;

             (q)  "psychiatric unit" means a facility which is a hospital or part of a hospital and that has been designated by the minister for the observation, assessment, detention, custody, restraint, treatment, care and supervision of a person with a mental disorder;

              (r)  "psychiatrist" means a physician who holds a specialist's certificate in psychiatry issued by The Royal College of Physicians and Surgeons of Canada or equivalent qualification acceptable to the minister;

             (s)  "psychosurgery" means a procedure that by direct access to the brain removes, destroys or interrupts the normal connections of the brain for the primary purpose of treating a mental disorder but does not include neurosurgical procedures designed to treat reliably diagnosed organic brain conditions or epilepsy;

              (t)  "representative" means a person, other than a rights advisor, who has reached the age of 19 years and who is mentally competent and available who has been designated by, and who has agreed to act on behalf of, a person with a mental disorder and where no person has been designated, the representative shall be considered to be the next of kin, unless the person with the mental disorder objects;

             (u)  "rights advisor" means a person appointed under section 13; and

             (v)  "voluntary patient" means a person who remains in a psychiatric unit with his or her consent or with the consent of a substitute decision-maker.

             (2)  A person who has a duty to inform or to advise under this Act satisfies that duty by informing or advising another to the best of his or her ability and in a manner that addresses the special needs of the person receiving the information or advice, whether or not that person understands the information or advice.

             (3)  For the purpose of this Act, except where otherwise indicated, a reference to "approved form" means a form approved by the minister.

Purpose

        3. (1) The purpose of the Act is as follows:

             (a)  to provide for the treatment, care and supervision of a person with a mental disorder that is likely to result in dangerous behaviour or in substantial mental or physical deterioration or serious physical impairment;

             (b)  to protect a person with a mental disorder from causing harm to himself or herself or another and to prevent a person with a mental disorder from suffering substantial mental or physical deterioration or serious physical impairment;

             (c)  to provide for the apprehension, detention, custody, restraint, observation, assessment, treatment and care and supervision of a person with a mental disorder by means that are the least restrictive and intrusive for the achievement of the purpose set out in paragraphs (a) and (b); and

             (d)  to provide for the rights of persons apprehended, detained, restrained, admitted, assessed, treated and cared for and supervised under this Act.

             (2)  Nothing in this Act shall be considered to affect the rights or privileges of a person except as specifically set out in this Act.

PART I
GENERAL

Powers of minister

        4. (1) The minister may, by order published in Part I of the Gazette, designate a facility or a part of a facility, a class or classes of facilities, a hospital or part of a hospital, or other place as a psychiatric unit for the assessment, treatment, care, supervision, custody or other purpose relating to persons having a mental disorder and upon publication of the order the facility, part of the facility, class or classes of facility, hospital or part of a hospital or other place described in the order shall operate and be used for the purpose specified in that order.

             (2)  The minister may approve forms for the purpose of this Act.

Agreements

        5. (1) The minister may enter into agreements with the Government of Canada or another province or territory of Canada or with a person, entity or organization with respect to

             (a)  the provision and funding of mental health services;

             (b)  the transfer, reception, observation, assessment, detention, custody, restraint, treatment, care and supervision of persons with a mental disorder in a psychiatric unit;

             (c)  the assumption of all or part of the charges incurred by a resident of the province detained in or admitted to a hospital, mental health facility, psychiatric unit or treatment facility in another province or territory of Canada; and

             (d)  the sharing of costs, the provision of services, and treatment, care and supervision of persons with a mental disorder.

Review of Act

        6. The minister shall, every 5 years, conduct a review of this Act and the regulations and the principles upon which this Act is based and consider the areas in which improvements may be made and report his or her findings to the Lieutenant-Governor in Council.

Protection from liability

        7. (1) An action shall not be brought against, and an administrator, a physician, a psychiatrist, a rights advisor, a nurse practitioner, a health care professional, the board, a panel appointed by the chairperson of the board, a member of the board, or another person or organization shall not be liable for an act or failure to act, or for a proceeding initiated or carried out or purportedly initiated or carried out in good faith under this Act, or for carrying out duties or obligations under this Act or for an application, decision, order, certificate, notice or other authorization made or enforced or purported to be made or enforced in good faith under this Act.

             (2)  An action shall not be brought against, and a facility, a psychiatric unit, a hospital authority, a peace officer or the Crown or an officer, employee, servant or agent of a facility, a psychiatric unit, a hospital authority, a peace officer or the Crown shall not be liable for a tort committed by a person who is subject to a certificate or order issued under this Act while that certificate or order is in effect.

Regulations

        8. The Lieutenant-Governor may make regulations

             (a)  prescribing the duties, functions and powers of rights advisors in addition to the duties, functions and powers prescribed by this Act;

             (b)  respecting appeals to the Trial Division from a decision of the board;

             (c)  prescribing the duties of the board and panels appointed under this Act and of the chairperson and members of the board, in addition to the requirements of this Act;

             (d)  respecting the assessment, admission, detention, custody, treatment, authorized leave, transfer, discharge and placement of persons having a mental disorder, including the specification of the contents of a certificate, order or other authorization or documentation in relation to the assessment, admission, detention, custody, treatment, leave, transfer or discharge of a person, in addition to the requirements of this Act;

             (e)  respecting the annual report of the board;

              (f)  respecting the proceedings of the board and of panels of the board, including the form and content of applications to the board, the conduct of hearings, the reception of evidence, the disposition of applications, the internal rules and procedures of the board and panels and the provision of notice and other communications to parties to an application and witnesses;

             (g)  respecting and governing community treatment orders and community treatment plans, including the contents of orders and their administration and enforcement;

             (h)  prescribing persons or classes of persons, in addition to physicians and nurse practitioners, who may complete and sign a certificate of involuntary admission;

              (i)  prescribing a place or classes of place at which a person may be detained pending conveyance to a psychiatric unit as provided for in section 25 and the powers and duties of persons in charge of that place or class of place with respect to the detained person;

              (j)  respecting the exercise of the rights set out in Part II of this Act;

             (k)  defining a word or expression used but not defined in this Act;

              (l)  re-defining or further defining a word or expression defined in this Act; and

            (m)  generally to give effect to the purpose of this Act.

Offence

        9. (1) A person who, for the purpose of obtaining a certificate, a renewal of a certificate, an order or other authorization under this Act, wilfully supplies an administrator, physician, nurse practitioner, psychiatrist or other person authorized by the regulations, a peace officer or another person having the custody, care, control or supervision of a person with a mental disorder, with untrue or incorrect information, is guilty of an offence.

             (2)  A person who commits an offence under subsection (1) is liable, on summary conviction, to a fine of not more than $2,000.

PART II
RIGHTS AND RIGHTS ADVISORS

Duties of peace officer on apprehension or detention

      10. Where a person is apprehended by a peace officer under the authority of subsection 18(2) or 19(4) or section 20, the peace officer shall promptly inform the person

             (a)  of the reasons for his or her apprehension or detention;

             (b)  that he or she is being taken to a facility for an involuntary psychiatric assessment; and

             (c)  that he or she has the right to retain and instruct counsel without delay.

Duties of facility on apprehension or detention

      11. (1) Where a person is conveyed to a facility for the purpose of an involuntary psychiatric assessment under the authority of subsection 18(2) or 19(4) or section 20, or is detained in a psychiatric unit under the authority of section 34 or 74 or subsection 81(4), upon arrival at the facility or at the time of detention, as the case may be, or if the person is apparently not able to understand, as soon as the person appears able to understand the information, the attending physician or his or her designate shall ensure that the person

             (a)  is informed

                      (i)  where he or she is being detained,

                     (ii)  the purpose of the detention, and

                    (iii)  that he or she has the right to retain and instruct counsel without delay; and

             (b)  is provided with a copy of the certificate, order or other authorization under which he or she is apprehended or detained as soon as is reasonably practicable.

             (2)  The person in charge of a facility shall make best efforts to determine whether a person referred to in subsection (1) has a representative and, where a representative has been ascertained,

             (a)  ensure that the representative is informed as soon as is practicable following the person's arrival at or detention in the facility that

                      (i)  the person is being detained in the facility for the purpose of an involuntary psychiatric assessment, and

                     (ii)  the person detained has the right to retain and instruct counsel without delay; and

             (b)  provide the representative with a copy of the certificate, order or other authorization under which the person has been apprehended or detained.

             (3)  A person who is detained in a facility for the purpose of an involuntary psychiatric assessment under section 18, 19, 20, 34, 74 or subsection 81(4) shall not be denied

             (a)  access at any time to the person's legal counsel and the right to consult with legal counsel in private either in person or by other means;

             (b)  access to a telephone to make or receive calls;

             (c)  access to the person's representative and the right to meet in private with the representative either in person or by other means; and

             (d)  where applicable, access to visitors during scheduled visiting hours.

             (4)  The rights referred to in paragraphs (3)(b) to (d) may be subject to the reasonable limits that are prescribed in the regulations.

Procedural rights of involuntary patient

      12. (1) A person who is an involuntary patient shall not be denied

             (a)  the right to consult and instruct his or her legal counsel in private at any time either in person or by other means;

             (b)  access to a telephone to make or receive calls;

             (c)  access to visitors during scheduled visiting hours;

             (d)  access to the rights advisor;

             (e)  access to his or her representative; and

              (f)  access to materials and resources necessary to write and send correspondence, and reasonable access to correspondence that has been sent to the person.

             (2)  The rights referred to in paragraphs (1)(b) to (f) may be subject to the reasonable limits that are prescribed in the regulations.

             (3)  The administrator shall ensure that an involuntary patient is provided, at the time of admission, with an oral explanation of, and a written statement setting out, the rights referred to in subsection (1) and that a notice of those rights is prominently displayed in all wards and in public reception areas of the psychiatric unit.

             (4)  Where a person is admitted as an involuntary patient, or where the person's status as an involuntary patient is renewed, the attending physician shall ensure that he or she is

             (a)  informed of the reasons for the issuance of the certificates of involuntary admission or certificate of renewal;

             (b)  provided with a copy of the certificates of involuntary admission or certificate of renewal;

             (c)  advised of his or her right

                      (i)  to retain and instruct counsel without delay, and

                     (ii)  to meet with the rights advisor as provided for in paragraph 14(2)(a); and

             (d)  provided with a written statement setting out

                      (i)  the functions of the board,

                     (ii)  the address of the board, and

                    (iii)  the right of the person or his or her representative acting on behalf of the person to apply to the board for a review of the certificates of involuntary admission or certificate of renewal.

             (5)  Where the person does not appear able to understand the information provided under subsection (4) at the time it is provided, the attending physician shall ensure that the information is repeated at the request of the person and again as soon as the person appears able to understand it.

             (6)  Where an involuntary patient does not understand or speak the language in which the information referred to in subsection (4) is provided, the attending physician shall advise the administrator and the administrator shall ensure that the involuntary patient is provided with the assistance of an interpreter.

             (7)  As soon as is practicable following the admission of a person as an involuntary patient or the renewal of a person's status as an involuntary patient, the administrator shall ensure that the involuntary patient's representative is informed

             (a)  of the person's status as an involuntary patient and the reasons for the issuance of the certificates of involuntary admission or the certificate of renewal;

             (b)  that the involuntary patient has the right to retain and instruct counsel without delay in private either in person or by other means;

             (c)  that the involuntary patient or his or her representative acting on his or her behalf may apply to the board for a review of the certificates of involuntary admission or the certificate of renewal; and

             (d)  that the representative has the right to meet with the rights advisor.

             (8)  The administrator shall provide a copy of all notices and other information required to be given to the involuntary patient to the representative.

Rights advisor

      13. (1) The minister may appoint one or more rights advisors in accordance with the regulations.

             (2)  A rights advisor shall not be a person who is

             (a)  involved in the direct clinical care of the person to whom the rights advice is to be given; or

             (b)  providing treatment or care and supervision under a community treatment plan.

Functions of rights advisor

      14. (1) The rights advisor may offer advice and assistance in accordance with this Act to

             (a)  a person who is detained in or admitted to a psychiatric unit; or

             (b)  a person who is residing in the community under a community treatment order or its renewal; and

             (c)  the representative of a person referred to in paragraph (a) or (b).

             (2)  The rights advisor shall

             (a)  meet in person or by other means as soon as possible with a person referred to in paragraph (1)(a) or (b) and in any event within 24 hours of the person's detention in or admission to the psychiatric unit or the issuance of a community treatment order and meet after that at the request of the person referred to in paragraph (1)(a) or (b) or as required by this Act or the regulations;

             (b)  explain the significance of a certificate of involuntary admission or a community treatment order or the renewal of a certificate of involuntary admission or a community treatment order to the person who is subject to the certificate or order;

             (c)  communicate information in a neutral, non-judgmental manner;

             (d)  meet as soon as is practicable in person or by other means with the representative of a person referred to in paragraph (1)(a) or (b) and after that at the request of the representative or as required by this Act or the regulations;

             (e)  at the request of the person or his or her representative, assist the person in making application to the board in accordance with this Act and the regulations;

              (f)  at the request of the person or his or her representative, assist the person in obtaining legal counsel;

             (g)  at the request of the person or his or her representative, accompany the person to board hearings;

             (h)  maintain confidentiality; and

              (i)  perform other functions prescribed by the regulations.

Notice to rights advisor

      15. (1) The administrator shall ensure that the rights advisor is given notice of

             (a)  a decision to admit or detain a person in a psychiatric unit;

             (b)  the filing of each certificate in respect of an involuntary patient;

             (c)  the cancellation or expiration of a certificate of involuntary admission and the release of an involuntary patient from a psychiatric unit;

             (d)  the change in status of a voluntary patient to an involuntary patient; and

             (e)  an application to the board under section 33.

             (2)  The administrator or attending psychiatrist, as appropriate, shall ensure that the rights advisor is given notice of

             (a)  the issuance, renewal, expiry, termination or revocation of a community treatment order; and

             (b)  an application to the board under subsection 53(3).

PART III
ASSESSMENT, ADMISSION, TREATMENT AND DISCHARGE

Admission only on certificates

      16. Except as otherwise provided in subsection 82(1), but notwithstanding another provision of this Act, a person may only be admitted to and detained in a psychiatric unit as an involuntary patient under the authority of 2 certificates of involuntary admission or a certificate of renewal completed in accordance with this Part.

Certificate of involuntary admission

      17. (1) A certificate of involuntary admission shall be in the approved form and shall contain the following information:

             (a)  a statement by a person described in subsection 17(2) that he or she has personally conducted a psychiatric assessment of the person who is named or described in the certificate within the immediately preceding 72 hours, making careful inquiry into all of the facts necessary for him or her to form an opinion as to the nature of the person's mental condition;

             (b)  a statement by the person who has conducted the psychiatric assessment referred to in paragraph (a) that, as a result of the psychiatric assessment, he or she is of the opinion that the person who is named or described in the certificate

                      (i)  has a mental disorder, and

                     (ii)  as a result of the mental disorder

                            (A)  is likely to cause harm to himself or herself or to others or to suffer substantial mental or physical deterioration or serious physical impairment if he or she is not admitted to and detained in a psychiatric unit as an involuntary patient,

                            (B)  is unable to fully appreciate the nature and consequences of the mental disorder or to make an informed decision regarding his or her need for treatment or care and supervision, and

                            (C)  is in need of treatment or care and supervision that can be provided only in a psychiatric unit and is not suitable for admission as a voluntary patient;

             (c)  a description of the facts upon which the person who has conducted the psychiatric assessment has formed the opinion described in subparagraphs (b)(i) and (ii), distinguishing between the facts observed by him or her and those that have been communicated by another person;

             (d)  the time and date on which the psychiatric assessment was conducted;

             (e)  the dated signature of the person completing the certificate of involuntary admission; and

              (f)  another matter required by the regulations.

             (2)  A certificate of involuntary admission shall be completed and signed as follows:

             (a)  the first certificate of involuntary admission may be completed and signed by a physician, nurse practitioner or other person authorized by the regulations; and

             (b)  the second certificate of admission shall be completed by a psychiatrist or, where a psychiatrist is not readily available to assess the person and complete and sign a second certificate, by a physician who is a person other than the person who completed and signed the first certificate.

Effect of one certificate of admission

      18. (1) Where a person has been the subject of a psychiatric assessment by a person described in paragraph 17(2)(a) and the person conducting the psychiatric assessment is of the opinion that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) are met, he or she shall complete and sign a first certificate of involuntary admission in accordance with subsection 17(1).

             (2)  The completion and signing of the first certificate of involuntary admission under subsection (1) is sufficient authority

             (a)  for a person acting under the authority of the certificate of involuntary admission

                      (i)  to apprehend the person who is named or described in the certificate and to convey him or her without his or her consent to a facility for an involuntary psychiatric assessment by a person described in paragraph 17(2)(b), and

                     (ii)  to observe, detain and control the person during his or her apprehension and conveyance to a facility;

             (b)  for the person who completed the first certificate of involuntary admission to authorize treatment for the person who is named or described in the certificate during apprehension and conveyance;

             (c)  for the person who is named or described in the certificate of involuntary admission to be detained, restrained, treated and assessed without his or her consent following his or her arrival at the facility for a period not to exceed 72 hours; and

             (d)  for a person described in paragraph 17(2)(b) to conduct an involuntary psychiatric assessment.

             (3)  The authority to apprehend and convey a person to a facility for a psychiatric assessment under subsection (2) shall expire 7 days after the date on which the first certificate of involuntary admission is completed and signed.

Judge's order for involuntary psychiatric assessment

      19. (1) Anyone who has reasonable grounds to believe that a person

             (a)  has a mental disorder;

             (b)  as a result of the mental disorder has caused or is likely to cause harm to himself or herself or others or is likely to suffer substantial physical or mental deterioration or serious physical impairment; and

             (c)  refuses to submit to a psychiatric assessment

may apply to a judge for an order for a psychiatric assessment of the person.

             (2)  An application under subsection (1) shall be in writing and under oath or affirmation and state reasons in support and may be made without notice to another person.

             (3)  A judge, after considering the allegations of the person making the application and the evidence of any witnesses, may issue an order for an involuntary psychiatric assessment of a person where the judge is satisfied that

             (a)  the allegations of the applicant are founded; and

             (b)  the person who is the subject of the application

                      (i)  has a mental disorder,

                     (ii)  requires a psychiatric assessment to determine whether he or she should be admitted to a psychiatric unit as an involuntary patient, and

                    (iii)  has refused or is likely to refuse a psychiatric assessment.

             (4)  An order granted under this section

             (a)  shall direct a peace officer to apprehend and convey the person who is named or described in the order to a facility for an involuntary psychiatric assessment; and

             (b)  is sufficient authority for

                      (i)  the peace officer to observe, detain and control the person named or described in the order during the apprehension and conveyance,

                     (ii)  for a person described in paragraph 17(2)(a) to conduct an involuntary psychiatric assessment.

             (5)  An order under subsection (3) shall expire 7 days after the date on which it is made.

             (6)  The procedures respecting an application for an order, the hearing of the application, the making of an order under this section and any forms shall be in accordance with rules made under the Provincial Court Act, 1991.

Apprehension by a peace officer

      20. Where a peace officer has reasonable grounds to believe that a person

             (a)  has a mental disorder;

             (b)  as a result of the mental disorder has caused or is likely to cause harm to himself or herself or another or is likely to suffer substantial physical or mental deterioration or serious physical impairment; and

             (c)  refuses to submit to a psychiatric assessment

and it is not feasible in the circumstances to make an application for an order under section 19, the peace officer may immediately apprehend that person and convey him or her to a facility for an involuntary psychiatric assessment.

Powers and duties of person apprehending and conveying

      21. (1) Where a person is apprehended and conveyed to a facility for an involuntary psychiatric assessment under section 18, 19 or 20

             (a)  the person effecting the apprehension and detention may take reasonable measures, including the entering of premises and the use of physical restraint, to apprehend the person and to take him or her into custody; and

             (b)  the person who is apprehended and detained shall be conveyed to a facility for a psychiatric assessment as soon as practicable and by the least intrusive means possible without compromising the safety of that person or the public.

             (2)  Where a person is apprehended and conveyed to a facility for an involuntary psychiatric assessment under section 18, 19 or 20, the person conducting the assessment shall be provided with

             (a)  the first certificate of involuntary admission, where the person is apprehended and conveyed under subsection 18(2),

             (b)  the judicial order made under subsection 19(3), where the person is apprehended and conveyed under subsection 19(4); or

             (c)  a written statement from a peace officer, where the person is apprehended and conveyed under section 20, setting out

                      (i)  the name of the person conveyed, if known,

                     (ii)  the date, time and place at which the person was apprehended, and

                    (iii)  the grounds on which the peace officer formed his or her belief and any other information relating to the circumstances which led to the taking of the person into custody.

             (3)  A person who has effected an apprehension under section 18, 19 or 20 shall remain at the facility and retain custody of the person who has been apprehended until the involuntary psychiatric assessment is completed.

             (4)  Subsection (3) does not apply where the person conducting the involuntary psychiatric assessment advises that continuing custody is not required.

Assessment of detained person

      22. (1) Where a person is conveyed to or detained in a facility under section 18, 19 or 20, a psychiatric assessment shall be conducted as soon as possible and in any event within 72 hours of the arrival of the person at the facility.

             (2)  A person who is detained at a facility for a psychiatric assessment under subsection (1) may be treated without his or her consent during the period of detention.

No assessment or no admission

      23. (1) Where a person has been conveyed to a facility under section 18, 19 or 20 and

             (a)  a psychiatric assessment has not been conducted within 72 hours of arrival at the facility; or

             (b)  a psychiatric assessment has been conducted within 72 hours of arrival at the facility and it is the conclusion of the person conducting the assessment that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) are not met,

the person in charge of the facility or other responsible person shall ensure that the person is promptly informed that he or she has the right to leave the facility, subject to a detention that is lawfully authorized otherwise than under this Act.

             (2)  Where a person is released from the facility under subsection (1), the person who brought the person to the facility or another person who has assumed custody shall, unless the detained person otherwise requests, arrange for the return of the person to the place where the person was when taken into custody or to another appropriate place.

Admission on 2 certificates

      24. Where 2 certificates of involuntary admission have been completed in accordance with section 17, the person named in the certificates shall be promptly admitted to a psychiatric unit as an involuntary patient and where the second certificate has been completed at a facility other than a psychiatric unit, the person shall be immediately conveyed to a psychiatric unit for admission as an involuntary patient.

Detention pending conveyance

      25. Notwithstanding section 24, where 2 certificates of involuntary admission have been completed but it is not practicable to immediately convey the person who is the subject of the completed certificates to a psychiatric unit for admission as an involuntary patient, the person may be held at an appropriate place in accordance with the regulations for a period not exceeding 7 days, pending conveyance to the psychiatric unit.

Admission to a treatment facility

      26. (1) Notwithstanding section 24, where 2 certificates of involuntary admission have been completed but the attending physician is of the opinion that the person who is named in the certificates requires medical treatment or other health care services that cannot be supplied in a psychiatric unit, the person may be detained and treated at another place and shall be admitted to the psychiatric unit when the treatment is concluded, provided that the period of detention authorized by the certificates of involuntary admission has not expired.

             (2)  Where a person is detained in another place under subsection (1), the person in charge of the place where the person is detained has, in addition to the powers conferred upon him or her by the Act respecting that place, the powers and duties of an administrator under this Act in respect of the custody and control of the person and the person shall be considered to continue as an involuntary patient of the psychiatric unit in the same manner and to the same extent as if he or she were detained in the psychiatric unit.

Certificates of involuntary admission to be filed

      27. Where 2 certificates of involuntary admission have been completed and signed in accordance with section 17 and the person named in the certificates has been admitted as an involuntary patient, the original of each certificate of involuntary admission shall be placed in the patient's chart and a copy filed with the administrator of the psychiatric unit.

Length of detention

      28. Where a person has been admitted as an involuntary patient under section 24, he or she may be detained in the psychiatric unit for a period not to exceed 30 days from the date of the completion and signing of the first certificate of involuntary admission.

Ongoing assessment

      29. (1) During the period of detention referred to in section 28, the attending physician shall

             (a)  assess an involuntary patient on an ongoing basis; and

             (b)  conduct an assessment of the involuntary patient at the patient's request, except where an assessment has been conducted in the immediately preceding 48 hours,

in order to determine whether the criteria set out in subparagraphs 17(1)(b)(i) and (ii) continue to be met.

             (2)  Where, as a result of an assessment referred to in subsection (1), the attending physician is satisfied that the criteria referred to in subparagraphs 17(1)(b)(i) and (ii) do not continue to be met

             (a)  the certificates of involuntary admission shall be cancelled and the patient's status as an involuntary patient shall be terminated; and

             (b)  the administrator shall advise the person of his or her change in status and of his or her right to leave the psychiatric unit, subject to a detention that is lawfully authorized other than under this Act.

Renewal or discharge

      30. (1) Where a person's status as an involuntary patient has not been terminated under subsection 29(2), within 72 hours immediately preceding the expiration of the 30 day period of detention referred to in section 28 the attending physician shall conduct a psychiatric assessment of the person in order to determine if the criteria set out in subparagraphs 17(1)(b)(i) and (ii) continue to be met.

             (2)  Where a psychiatric assessment of a person has been conducted under subsection (1) and the attending physician is satisfied

             (a)  that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) continue to be met, he or she shall sign and complete a certificate of renewal; or

             (b)  that the criteria referred to in subparagraphs 17(1)(b)(i) and (ii) are not met, the person shall be advised that his or her status as an involuntary patient has been terminated and that he or she has the right to leave the psychiatric unit subject to any detention that is lawfully authorized otherwise than under this Act.

             (3)  The requirements of section 17 respecting a certificate of involuntary admission apply, with the necessary changes, to a certificate of renewal referred to in paragraph (2)(a), and, where a certificate of renewal has been completed and signed in accordance with this section, the original of the certificate of renewal shall be placed in the patient's chart and a copy filed with the administrator of the psychiatric unit.

Detention under certificate of renewal

      31. (1) Where a certificate of renewal has been completed and filed under subsection 30(2), an involuntary patient may be detained in a psychiatric unit according to the following:

             (a)  not more than 30 days under the first certificate of renewal;

             (b)  not more than 60 additional days under a second certificate of renewal; and

             (c)  not more than 90 additional days under a third or subsequent certificate of renewal.

             (2)  There are no limits upon the number of certificates of renewal which may be issued in respect of an involuntary patient.

             (3)  The requirements of sections 29 and 30 apply, with the necessary changes, to the assessment of an involuntary patient detained under a certificate of renewal.

Discharge

      32. Where an authorized period of detention has expired and a certificate of renewal has not been issued in respect of the involuntary patient, the administrator shall ensure that the person is promptly informed that his or her status as an involuntary patient is terminated and that he or she has the right to leave the psychiatric unit, subject to a detention that is lawfully authorized otherwise than under this Act.

Automatic review of detention

      33. (1) On the filing of a second certificate of renewal and on the filing of each second certificate of renewal after that, the administrator shall apply to the board for a review of the person's status as an involuntary patient.

             (2)  An application by an administrator under subsection (1) shall be considered to be an application by the patient and may be determined by the board as if it were an application made under paragraph 64(1)(a).

Change in status of a voluntary patient

      34. (1) A member of the nursing staff of a psychiatric unit may detain and where necessary restrain a voluntary patient requesting to be discharged if the staff person believes on reasonable grounds that the patient

             (a)  has a mental disorder;

             (b)  as a result of the mental disorder is likely to cause harm to himself or herself or another, or to suffer substantial mental or physical deterioration or serious physical impairment if he or she leaves the psychiatric unit; and

             (c)  requires a psychiatric assessment.

             (2)  Where a psychiatric assessment of the voluntary patient has been conducted and the person conducting the assessment is of the opinion that the criteria set out in subparagraphs 17(1)(b) (i) and (ii) are met, that person shall complete and sign a certificate of involuntary admission in accordance with subsection 17(1) and sections 18, 22, 23 and 24 shall apply, with the necessary changes, to the person who is named in the certificate.

             (3)  The psychiatric assessment referred to in subsection (2) shall be completed as soon as practicable and in no case more than 4 hours following the request for discharge by the voluntary patient.

Treatment

      35. (1) Where a person is an involuntary patient, the attending physician or other person may, taking into account the best interests of the involuntary patient, perform or prescribe diagnostic procedures that he or she considers necessary to determine the existence or nature of a mental disorder, and administer or prescribe medication or other treatment relating to the mental disorder without the consent of the involuntary patient during the period of detention.

             (2)  For the purpose of subsection (1), in taking into account the best interests of the involuntary patient, the attending physician or other person shall consider

             (a)  whether the mental condition of the involuntary patient will be or is likely to be improved by the specified treatment;

             (b)  whether the mental condition of the patient will improve or is likely to improve without the specified treatment;

             (c)  whether the anticipated benefit from the specified treatment and other related medical treatment outweighs the risk of harm to the patient;

             (d)  whether the specified treatment is the least restrictive and least intrusive treatment that meets the requirements of paragraphs (a), (b) and (c); and

             (e)  the wishes of the involuntary patient expressed when the involuntary patient was competent.

             (3)  In the course of the application of diagnostic procedures or the administration of treatment, the attending physician and another health care professional involved in the treatment of the involuntary patient shall, where appropriate,

             (a)  consult with the involuntary patient and his or her representative;

             (b)  explain to the involuntary patient and his or her representative the purpose, nature and effect of the diagnostic procedure or treatment; and

             (c)  give consideration to the views of the involuntary patient and his or her representative with respect to the diagnostic procedure or treatment and alternatives and the manner in which diagnostic procedures or treatment may be provided.

Prohibition on treatment

      36. Psychosurgery shall not be performed on or administered to an involuntary patient.

Authorized leave

      37. (1) The attending physician or his or her designate may issue a pass, in the approved form, to an involuntary patient, permitting the patient to be absent from a ward or a psychiatric unit for a specified period of time, subject to the conditions specified in the pass and in the regulations.

             (2)  A copy of a pass issued under subsection (1) shall be in the approved form and filed with the administrator and the original shall be placed on the patient's chart.

             (3)  The provisions of this Act respecting an involuntary patient continue to apply, with the necessary changes, to an involuntary patient who has been issued a pass under subsection (1).

Unauthorized leave

      38. (1) Where an involuntary psychiatric patient is absent from a psychiatric unit and

             (a)  a pass has not been issued under subsection 37(1); or

             (b)  the period of leave authorized by the pass under subsection 37(1) has expired,

the administrator may issue an order, in writing, in the approved form and in accordance with the regulations, to a peace officer or other person designated by the administrator to apprehend the patient and return him or her to the psychiatric unit.

             (2)  An order under subsection (1) is sufficient authority for the peace officer or other person designated by the administrator to

             (a)  apprehend the person who is named or described in the order and to return him or her to the psychiatric unit; and

             (b)  observe, detain and control the person during his or her apprehension and return to a psychiatrist or a psychiatric unit.

             (3)  An order under subsection (1) expires 30 days after the day it is issued and where an involuntary patient has not been returned to the psychiatric unit within that time he or she shall be considered to have been discharged from the psychiatric unit.

             (4)  A person who is returned to a psychiatric unit under this section may

             (a)  be detained for the remainder of the authorized period of detention to which the person was subject when the person's absence was discovered; or

             (b)  where the authorized period of detention has expired during the period the person was absent from the psychiatric unit,

                      (i)  be subject to a psychiatric assessment in order to determine whether a first certificate of involuntary admission should be completed in accordance with subsection 17(1); or

                     (ii)  be discharged from the psychiatric unit, subject to a detention that may be authorized otherwise than under this Act.

             (5)  Where, as a result of a psychiatric assessment referred to in subparagraph (4)(b)(i), a certificate of involuntary admission is completed in accordance with subsection 17(1), sections 18, 22, 23 and 24 shall apply with respect to the admission of the person who is the subject of the certificate as an involuntary patient.

Part does not apply

      39. Nothing in this Part authorizes the granting of a pass under subsection 37(1) to an involuntary patient who is subject to a detention lawfully authorized under this Act.

PART IV
COMMUNITY TREATMENT ORDERS

Community treatment order

      40. (1) For purpose of this Part, "in the community" means outside a psychiatric unit.

             (2)  A psychiatrist may issue or renew a community treatment order with respect to a person where the following criteria are met:

             (a)  he or she has examined the person named in the order within the immediately preceding 72 hours and on the basis of the examination and other pertinent facts respecting the person or the person's condition that are known by or have been communicated to the psychiatrist, he or she is of the opinion that

                      (i)  the person is suffering from a mental disorder for which he or she is in need of continuing treatment or care and supervision in the community,

                     (ii)  if the person does not receive continuing treatment or care and supervision while residing in the community, he or she is likely to cause harm to himself or herself or another, or to suffer substantial mental or physical deterioration or serious physical impairment,

                    (iii)  as a result of the mental disorder, the person is unable to fully appreciate the nature and consequences of the mental disorder and is therefore unlikely to voluntarily participate in a comprehensive community treatment plan,

                    (iv)  the services that the person requires in order to reside in the community so that he or she will not be likely to cause harm to himself or herself or to others, or to suffer substantial mental or physical deterioration or serious physical impairment,

                            (A)  exist in the community,

                            (B)  are available to the person; and

                            (C)  will be provided to the person, and

                     (v)  the person is capable of complying with the requirements for treatment or care and supervision set out in the community treatment order;

             (b)  during the immediately preceding 2 year period the person

                      (i)  has been detained in a psychiatric unit as an involuntary patient on 3 or more separate occasions, or

                     (ii)  has been the subject of a prior community treatment order;

             (c)  the person, the psychiatrist who is considering issuing the community treatment order or his or her designate and another health professional, person or organization involved in the person's treatment or care and supervision have developed a community treatment plan for the person; and

             (d)  the psychiatrist who is considering issuing the community treatment order or his or her designate has consulted with the health professionals, persons and organizations proposed to be named in the community treatment plan and each has agreed in writing to be named in the plan.

Form and contents of community treatment order

      41. (1) A community treatment order shall be in the approved form and shall be signed by the attending psychiatrist who issues the order.

             (2)  A community treatment order shall

             (a)  set out the date on which the examination referred to in paragraph 40(2)(a) took place;

             (b)  set out the facts on which the psychiatrist has formed the opinion referred to in paragraph 40(2)(a);

             (c)  identify the psychiatrist who has issued the order and who is responsible for its general supervision and management;

             (d)  describe the community treatment plan referred to in paragraph 40(2)(c);

             (e)  identify the person who has agreed to accept responsibility for the general supervision and management of the community treatment plan and set out the reporting obligations of that person;

              (f)  identify the health professionals, persons and organizations referred to in paragraph 40(2)(d) who have agreed to provide treatment and support services and set out the reporting obligations of those persons;

             (g)  contain an undertaking by the person who is the subject of the order to

                      (i)  attend appointments with the psychiatrist who issued the community treatment order, or with another health care professional, person or organization referred to in the community treatment plan at the time and places scheduled from time to time, and

                     (ii)  comply with the community treatment plan described in the community treatment order; and

             (h)  satisfy another requirement prescribed by the regulations.

             (2)  In addition to the information required under subsection (1), a community treatment order shall also contain a notice in writing to the person who is the subject of the order advising him or her that

             (a)  he or she has the right to retain and instruct counsel without delay in person or by other means;

             (b)  he or she has the right to meet with a rights advisor as provided for in paragraph 14(2)(a); and

             (c)  he or she or his or her representative has the right to apply to the board for a review of the issuance, renewal or revocation of the community treatment order, including in this notice the functions and address of the board.

Community treatment plan

      42. A community treatment plan referred to in paragraph 40(2)(c) shall contain

             (a)  a plan of treatment for the person subject to the community treatment order that describes the necessary medical and other supports, including income and housing, required for the person to live in the community;

             (b)  conditions relating to the treatment or care and supervision of the person;

             (c)  the obligations of the person who is the subject of the community treatment order;

             (d)  the name of the psychiatrist who has issued the order and who is responsible for its general supervision and management;

             (e)  the name of the person who has agreed to accept responsibility for the general supervision and management of the community treatment plan;

              (f)  the names of the health care professionals, persons and organizations who have agreed to provide treatment or care and supervision under the community treatment plan and their obligations under the plan; and

             (g)  another requirement prescribed by the regulations.

Notice of issue or renewal

      43. Where a community treatment order is issued or renewed, a copy of the issued or renewed order shall be provided to the person who is the subject of the order, the person's representative, the rights advisor and each health care professional, person and organization named in the community treatment plan by

             (a)  the administrator, where the person who is the subject of the community treatment order was an involuntary patient at the time the order was issued; or

             (b)  by the psychiatrist who issued the order, where the person who is the subject of the order was not an involuntary patient at the time the order was issued.

Responsibility of attending psychiatrist

      44. (1) Except as otherwise provided in subsection (2), the psychiatrist who issues a community treatment order is responsible for its general supervision and management.

             (2)  Where the psychiatrist who issues a community treatment order is unable to carry out his or her responsibilities under the order, he or she may designate another psychiatrist to act in his or her place with the consent of that psychiatrist, and the order shall be amended to reflect the transfer of responsibilities.

             (3)  Where, under subsection (2), responsibility for the general supervision and management of a community treatment order is transferred to another psychiatrist and the order is amended, written notice of the transfer of supervision and management responsibilities shall be provided to the person who is the subject of the community treatment order, that person's representative, the rights advisor and each health care professional, person and organization named in the community treatment plan by

             (a)  the administrator, where the person who is the subject of the community treatment order was an involuntary patient at the time the order was issued; or

             (b)  the psychiatrist who issued the order, where the person who is the subject of the order was not an involuntary patient at the time the order was issued.

Responsibilities of persons named in the order

      45. (1) The psychiatrist who is responsible for the general supervision and management of a community treatment order may require reports on the condition of the person who is the subject of the order from the health care professionals, persons and organizations who are responsible for providing treatment or care and supervision under the community treatment plan.

             (2)  A health care professional, person or organization providing treatment or care and supervision to the person who is the subject of the order is responsible for implementing the community treatment plan to the extent described in the order.

Treatment

      46. Sections 35 and 36 apply, with the necessary changes, to the diagnostic procedures and treatment that a person is required to submit to under a community treatment order.

Duration of order

      47. (1) A community treatment order expires 6 months after the day it is made unless

             (a)  it is renewed in accordance with section 48; or

             (b)  before its expiry it is terminated under section 50 or revoked under section 51.

             (2)  Where a community treatment order expires and is not renewed, written notice that the order is no longer in effect shall be provided to the person who is the subject of the order, his or her representative, the rights advisor and each health care professional, person and organization named in the community treatment plan by

             (a)  the administrator, where the person who is the subject of the community treatment order was an involuntary patient at the time the order was issued; or

             (b)  by the psychiatrist responsible for the management and supervision of the community treatment order, where the person was not an involuntary patient at the time the order was issued.

Renewal of community treatment order

      48. (1) A community treatment order may be renewed at any time before its expiry for a period of 6 months.

             (2)  There are no limits on the number of renewals under subsection (1).

             (3)  The requirements of sections 40, 41 and 42, with the necessary changes, apply to the renewal of a community treatment order.

Variation

      49. (1) A community treatment plan may be varied by

             (a)  the psychiatrist who is responsible for the general supervision and management of the community treatment order; or

             (b)  by a health care professional, person or organization named in the community treatment plan, with the approval of the psychiatrist who is responsible for the general supervision and management of the community treatment order.

             (2)  Where a community treatment plan has been varied under subsection (1), the psychiatrist who is responsible for the management and supervision of the community treatment order shall provide written notice of the variation to the person who is the subject of the order, his or her representative, the rights advisor and each health care professional, person and organization named in the community treatment plan who is affected by the variation.

Termination

      50. (1) While a community treatment order is in effect, the psychiatrist who is responsible for the management and supervision of the order may at any time and shall, at the request of the person who is the subject of the order, conduct a psychiatric assessment to determine if the person is able to continue to live in the community without being subject to the order.

             (2)  A psychiatrist may refuse to conduct the psychiatric assessment referred to in subsection (1) upon the request of the patient at any time during the 3 months following the date of the last psychiatric assessment.

             (3)  Where, as a result of the assessment conducted under subsection (1), the psychiatrist determines that the criteria referred to in subparagraphs 40(2)(a)(i), (ii) and (iii) no longer continue to be met, he or she shall

             (a)  terminate the community treatment order;

             (b)  provide written notice to the person who is the subject of the order that the order is no longer in effect and that he or she may live in the community without being subject to the order; and

             (c)  provide a copy of the notice referred to in paragraph (b) to the administrator, where appropriate, and to the person's representative, the rights advisor and each health care professional, person and organization named in the community treatment plan.

             (4)  A notice referred to in paragraph (3)(b) shall be in the approved form.

Revocation of order

      51. (1) Where the psychiatrist who is responsible for the management and supervision of a community treatment order has reasonable gounds to believe that the person who is the subject of the order has failed to comply with a condition of the community treatment order, he or she may issue an order in the approved form to a peace officer.

             (2)  The psychiatrist shall not issue an order under subsection (1) unless

             (a)  he or she has reasonable grounds to believe that the criteria set out in subparagraphs 40(2)(a)(i), (ii) and (iii) continue to be met;

             (b)  the person who is the subject of the community treatment order refuses to submit to a psychiatric assessment; and

             (c)  reasonable efforts have been made to

                      (i)  inform the person of his or her failure to comply with the community treatment order,

                     (ii)  inform the person of the possibility that the psychiatrist may issue an order for an involuntary psychiatric assessment and the possible consequences of that assessment, and

                    (iii)  provide reasonable assistance to the person to comply with the terms of the community treatment order.

             (3)  An order under subsection (1) is sufficient authority for a peace officer to

             (a)  apprehend the person who is named in the order and to convey him or her to a facility named in the order for involuntary psychiatric assessment;

             (b)  observe, detain and control the person during his or her apprehension and conveyance to the facility; and

             (c)  take reasonable measures, including the entering of premises and the use of physical restraint, to apprehend the person who is the subject of the order and to take him or her into custody.

             (4)  The authority to apprehend and convey the person under subsection (3) shall expire 30 days after the date of the issuance of the order.

             (5)  Where a person is conveyed to a facility under the authority of an order under subsection (1), as soon as practicable and in any event within 72 hours after arrival, a psychiatric assessment of the person shall be conducted to determine whether

             (a)  the community treatment order should be terminated and the person should be released without being subject to a community treatment order;

             (b)  the community treatment order should be continued, with any necessary variations;

             (c)  where the person conducting the assessment is of the opinion that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) are met, the community treatment order should be revoked and a first certificate of involuntary admission completed in accordance with subsection 17(1).

             (6)  Sections 10 and 11 apply to a person who has been apprehended by a peace officer and conveyed to a facility for an involuntary psychiatric assessment under the authority of an order issued under subsection (1).

             (7)  Where a first certificate of involuntary admission is completed under paragraph (5)(c), sections 18, 22, 23 and 24 shall apply with respect to the admission of the person who is the subject of the certificate as an involuntary patient.

Protection from liability

      52. (1) Where the psychiatrist who is responsible for the management and supervision of a community treatment order believes on reasonable grounds and in good faith that a health care professional, other person or organization that is responsible for providing treatment or care and supervision under a community treatment plan is doing so in accordance with the plan, an action shall not be brought against the psychiatrist and he or she is not liable for a failure by that health care professional, other person or organization to provide treatment or care and supervision or for a default or neglect by that health care professional, person or organization in providing the treatment or care and supervision.

             (2)  Where a health care professional, other person or organization that is responsible for providing an aspect of treatment or care and supervision under a community treatment plan believes on reasonable grounds and in good faith that the psychiatrist who is responsible for the management and supervision of the community treatment order, or a psychiatrist designated under subsection 44(2) or another health care professional, person or organization named in the community treatment plan, is providing treatment or care and supervision in accordance with the plan, an action shall not be brought against, and the health care professional, person or organization person is not liable for a failure by the psychiatrist or his or her designate or another health care professional, person or organization to provide treatment or care and supervision or for a default or neglect by that psychiatrist, designate, health care professional, person or organization in providing the treatment or care and supervision.

Board review of order

      53. (1) A person who is the subject of a community treatment order or his or her representative may apply to the board to review whether the criteria for issuing or renewing an assisted community treatment order are met.

             (2)  An application under subsection (1) may be made each time a community treatment order is issued or renewed.

             (3)  Where a community treatment order is renewed and on the occasion of each second renewal after that, an application shall be made to the board for a review of the order by

             (a)  the administrator, where the person who is the subject of the community treatment order was an involuntary patient at the time the community treatment order was made; or

             (b)  the psychiatrist responsible for the management and supervision of the order, where the person who is the subject of the order was not an involuntary patient at the time the order was made,

except where application for review has been made by the person who is the subject of the order in the preceding month.         

             (4)  An application under subsection (3) shall be considered to be an application by the patient and may be determined by the board as if it were an application made under paragraph 64(1)(b).

No limitation

      54. Nothing in this Part prevents a physician, nurse practitioner, other person authorized by the regulations, a peace officer or a judge from taking an action that he or she may take under Part III.

PART V
MENTAL HEALTH CARE AND TREATMENT REVIEW BOARD

Parties defined

      55. For the purpose of this Part, the following shall be considered to be parties to an application to the board under section 64:

             (a)  where an application is made to review the issuance of certificates of involuntary admission or a certificate of renewal, the involuntary patient and the administrator;

             (b)  where an application is made to review the issuance or renewal of a community treatment order, the person who is subject to the community treatment order and

                      (i)  the administrator, where the person who is the subject of the community treatment order was an involuntary patient at the time the order was issued, or

                     (ii)  the psychiatrist who is responsible for the management and supervision of the community treatment order, where the person who is the subject of the order was not an involuntary patient at the time the order was issued; and

             (c)  where an application is made alleging a violation of a right provided to a person under section 11 or 12, the person alleging the violation of the right and the person in charge of the facility.

Mental Health Care and Treatment Review Board

      56. (1) There shall be a Mental Health Care and Treatment Review Board to hear and decide applications under this Act.

             (2)  The board shall report annually to the minister on its operations and on another matter as required by the minister and perform the other functions that may be prescribed by the regulations.

Appointment

      57. (1) The board shall comprise 13 members appointed by the Lieutenant-Governor in Council and consists of

             (a)  a chairperson who is a member in good standing of the Law Society of Newfoundland and Labrador;

             (b)  4 persons, each of whom is a member in good standing of the Law Society of Newfoundland and Labrador and who expresses an interest in mental health issues;

             (c)  4 persons, each of whom is a physician; and

             (d)  4 persons, each of whom is neither a member of the Law Society of Newfoundland and Labrador nor a physician and each of whom expresses an interest in mental health issues, with preference being given to a person who is or has been a consumer of mental health services.

             (2)  A person appointed to the board shall have knowledge or experience that will assist the board to achieve its mandate and the composition of the board shall reflect the cultural, ethnic and regional diversity of the province.

Term of appointment

      58. (1) A member of the board shall be appointed for a term of 3 years.

             (2)  Notwithstanding subsection (1), members of the first board appointed under this Act shall be appointed to the following terms:

             (a)  the chairperson and 2 persons referred to in each of paragraphs 57(1)(b), (c) and (d) shall be appointed for a term of 4 years; and

             (b)  2 persons referred to in each of paragraphs 57(1)(b), (c) and (d) shall be appointed for a term of 3 years.

             (3)  A member of the board is eligible for reappointment for an additional single term of 3 years immediately upon the expiry of his or her initial term of office.

             (4)  Where a member has served 2 consecutive terms of office, that member shall not be eligible for reappointment to the board until one calendar year has elapsed from the date of expiry of his or her second term of office.

             (5)  Where a vacancy occurs on the board, the Lieutenant-Governor in Council shall appoint a replacement member from the same group as that of the member whose leaving created the vacancy, to serve out the unexpired portion of the term.

             (6)  The exercise of the powers of the board or of a panel shall not be impaired because of a vacancy in membership.

             (7)  All acts done by the board or by a member of the board shall, notwithstanding that it is afterwards discovered that there was a defect in the appointment or qualification of a person purporting to be a member of the board, be as valid as if that defect had not existed.

Remuneration

      59. The remuneration, benefits and expenses of the members of the board shall be determined by the Lieutenant-Governor in Council.

Chairperson of board

      60. (1) The chairperson of the board shall

             (a)  prepare the annual report of the board referred to in subsection 56(2);

             (b)  manage and plan the conduct of applications to the board and matters referred to it, including the assignment of members of the board to panels and the referral of applications to a panel; and

             (c)  exercise the powers and perform the functions that may be conferred on him or her under this Act or the regulations.

             (2)  The chairperson may delegate, in writing, his or her powers under this Act to a member of the board who is appointed under paragraph 57(1)(b), except the power to make an annual report.

             (3)  A delegation under subsection (2) may be made subject to those conditions and restrictions as the chairperson considers appropriate.

             (4)  Where the chairperson becomes permanently incapable of performing his or her responsibilities under this Act, the Lieutenant-Governor in Council shall appoint a new chairperson to serve out the unexpired portion of the chairperson's term.

Panels

      61. (1) A panel of 3 members of the board shall be appointed by the chairperson to hear and decide an application under section 64 as follows:

             (a)  3 members of the board, one of each of whom shall be a person referred to in paragraphs 57(1)(b), (c) and (d); or

             (b)  the chairperson of the board and 2 other members, one of each of whom shall be a person referred to in paragraph 57(1)(c) and (d).

             (2)  A panel

             (a)  appointed under paragraph (1)(a) shall be chaired by a member of the board who is a person referred to in paragraph 57(1)(b); and

             (b)  appointed under paragraph (1)(b) shall be chaired by the chairperson of the board.

             (3)  Where, as result of absence, incapacity or for another reason, a member of the board appointed to a panel under subsection (1) is unable to continue his or her participation on the panel, the chairperson of the board may appoint as a replacement member of the board a person who is of the same class as that of the member whose leaving created the vacancy on the panel.

Decision making procedure of panel

      62. (1) A quorum for a panel of the board is the 3 members referred to in subsection 61(1).

             (2)  A decision of a panel shall be made by majority vote.

             (3)  Each member of a panel is entitled to one vote.

Ineligibility to participate on panel

      63. A member of the board shall not sit as a member of a panel where

             (a)  his or her participation in the panel would give rise to a reasonable apprehension of bias; or

             (b)  he or she has sat on a Criminal Code review board hearing in respect of a patient who is a party to an application under section 64.

Jurisdiction of board

      64. (1) In addition to the automatic reviews provided for in section 33 and subsection 53(3), the following applications may be made to the board:

             (a)  an application by an involuntary patient to review the issuance of certificates of involuntary admission or a certificate of renewal;

             (b)  an application by a person who is the subject of a community treatment order to review its issuance or renewal; and

             (c)  an application by a person detained in a facility alleging a denial of a right set out in section 11 or 12.

             (2)  An application by a person under subsection (1) may be made by the person's representative.

             (3)  Where an application is made under paragraph (1)(a) or (b) to review the issuance of certificates of involuntary admission or a certificate of renewal or the issuance or renewal of a community treatment order, and the certificate or order expires before a decision is made, the application shall be considered to have been withdrawn whether or not the certificate or order is renewed.

             (4)  An application to the board may be withdrawn at any time before a decision is made by serving a notice of withdrawal in the approved form on the chairperson of the panel and the other party to the application.

Power to dismiss an application

      65. (1) The chairperson of the board may summarily dismiss an application without referring it to a panel where

             (a)  the application, in the opinion of the chairperson, is vexatious, frivolous or is not made in good faith; or

             (b)  a review of the matter has been considered by the board in the preceding 30 days.

             (2)  A decision of the chairperson of the board under subsection (1) is not subject to appeal or review.

Application

      66. (1) An application under section 64 shall be made to the board in accordance with the regulations.

             (2)  Except where an application is dismissed under subsection 65(1), within 2 clear days of receipt of an application the chairperson of the board shall appoint a panel and designate a chairperson of the panel and refer the application to the chairperson of the panel.

Referral of application

      67. (1) A panel shall hear and determine an application as soon as is reasonably possible and in any event no more than 10 clear days after receipt of the referral under subsection 66(2).

             (2)  Within 2 clear days of receipt of the referral of the application under subsection 66(2), the chair of the panel shall give notice of the date, time, place and purpose of the hearing to the parties to the application.

             (3)  The notice of application under subsection (2) shall

             (a)  include a copy of the application; and

             (b)  advise a party that he or she may make representations to the panel either in person or in writing and submit evidence relevant to the application by a date to be set out in the notice.

Powers of panel

      68. (1) A panel shall hear and consider applications in accordance with this Act and the regulations and for that purpose a member of the panel has all the powers, duties and immunities of a commissioner appointed under the Public Inquiries Act, and the panel shall be considered to be an investigating body for the purpose of the Public Investigations Evidence Act.

             (2)  It is the duty of a panel to inform itself fully of the facts by means of the hearing, and for this purpose, a panel may

             (a)  require the attendance of witnesses and the production of documents and records, in addition to the witnesses called and the documents and records produced by a party;

             (b)  arrange for the patient to be examined by a psychiatrist; and

             (c)  engage independent medical, psychiatric or other professional persons to present evidence and make submissions with regard to a matter before the board and invite submissions from any other person who, in the opinion of the panel, has a material interest in or knowledge of matters relevant to the application.

Conduct of proceedings

      69. (1) Every proceeding before a panel shall be conducted in private and in as informal a manner as is appropriate in the circumstances and as is consistent with the regulations.

             (2)  Notwithstanding subsection (1), the panel may permit a person who is not a party to be present during all or part of a hearing where the patient requests or consents to the attendance of that person and where the chairperson of the panel is of the opinion that there is no risk of harm or injustice to a person.

             (3)  In a proceeding before the panel

             (a)  all evidence shall be given under oath or affirmation, and for this purpose, an oath or affirmation may be administered by electronic or other means;

             (b)  a record shall be made of all evidence received or adduced in support of the application, and for this purpose, the record may be created in writing or by electronic recording; and

             (c)  the standard of proof is on the balance of probabilities and the onus of proof shall be on the administrator, the person in charge of the facility or the attending psychiatrist, as the case may be.

Rights of parties

      70. (1) A party to the proceedings has the right to

             (a)  be personally present during the presentation of evidence to the panel;

             (b)  be represented by counsel or another person;

             (c)  examine documentary evidence placed before the panel;

             (d)  present evidence; and

             (e)  cross-examine witnesses.

             (2)  Notwithstanding paragraph (1)(a), the person making an application may not be compelled to attend a hearing of the panel but the panel or a member of the panel may interview that person in private for the purpose of assisting it in reaching a decision.

             (3)  For the purpose of paragraph (1)(b), an involuntary patient or a person who is the subject of a community treatment order is considered to have the capacity to retain and instruct counsel for the purpose of a hearing before a panel and an appeal from the decision of a panel.

             (4)  Notwithstanding paragraphs (1)(a) and (c), where a panel is of the opinion that disclosure of the information to the person making the application would seriously endanger the health or safety of that person or another person, the panel shall disclose the information to the legal counsel or representative of the person making the application but may refuse to disclose the information to the person making the application.

Decision of the board

      71. (1) Except in the case of a replacement member appointed under subsection 61(3), a member of a panel shall not participate in a decision unless he or she was present throughout the period the application was under review and heard the evidence of the parties.

             (2)  Within 3 clear days following the conclusion of its review, the chairperson of the panel shall deliver

             (a)  to each party, its decision, in writing, signed by the members of the panel, together with reasons in support of the decision, and where the decision of the panel is not unanimous, any dissenting opinion; and

             (b)  to the chairperson of the board, a copy of its decision, together with reasons, and any dissenting opinions, and a record of all evidence presented to the panel.

             (3)  The record of evidence referred to in paragraph (2)(b) shall be retained by the board for a period of 7 years and shall be available for examination upon the request of a party.

             (4)  In addition to the information referred to in paragraph (2)(a), the chairperson of the panel shall also advise each party of his or her right to appeal the decision of the panel in accordance with this Act and the regulations.

Order of the panel

      72. (1) In its decision, a panel may

             (a)  with respect to an application under paragraph 64(1)(a), confirm the person's status as an involuntary patient if it determines that the criteria for admission as an involuntary patient set out in subparagraphs 17(2)(b)(i) and (ii) were met at the time of the hearing of the application, notwithstanding a technical defect or error in a certificate of involuntary admission or certificate of renewal, or cancel the certificate, where it determines that the criteria for admission as an involuntary patient were not met at the time of the hearing of the application, and order the person to be released from the psychiatric unit, subject to a detention that is lawfully authorized otherwise than under this Act;

             (b)  with respect to an application under paragraph 64(1)(b), confirm the issuance or renewal of a community treatment order, where the panel determines that the criteria set out in subsection 40(2) were met at the time of the hearing of the application, notwithstanding a technical defect or formal error in the community treatment order, or cancel the order, where it determines that the criteria were not met at the time of the hearing of the application, and allow the person to live in the community without being subject to the community treatment order; and

             (c)  with respect to an application under paragraph 64(1)(c), determine whether the person's rights were violated and recommend appropriate corrective action to the person in charge of the facility.

             (2)  A recommendation under paragraph (1)(c) is not binding on the person in charge of the facility and a failure or refusal by that person to comply with the recommendation may not be appealed or reviewed.

             (3)  A decision of the board confirming or cancelling a certificate or order applies to the certificate or order in force immediately before the making of the order by the board.

             (4)  Nothing in this section shall permit the discharge or release of a person who is subject to detention otherwise than under this Act.

             (5)  A decision of the panel shall be considered to be a decision of the board and may be appealed in accordance with section 73, except that the findings of the panel on questions of fact are final and are not subject to appeal.

Appeal

      73. (1) A party to an application may, within 30 days after receiving notice of a decision of the board, appeal the decision on a question of law to the Trial Division by filing a notice of appeal with the Registrar of the Supreme Court.

             (2)  An appeal under this section shall be conducted in accordance with the regulations.

             (3)  An appeal under this section does not stay the decision being appealed unless the Trial Division orders otherwise.

PART VI
CRIMINAL CODE AND TRANSFERS

Detention under Criminal Code

      74. (1) Where a person

             (a)  is found not criminally responsible on account of mental disorder or unfit to stand trial under Part XX.1 of the Criminal Code; and

             (b)  is detained in a psychiatric unit by a disposition or order under the Criminal Code,

within 72 hours of arrival at the psychiatric unit the person shall be assessed without his or her consent by 2 persons, one of whom shall be a person described in paragraph 17(2)(a) and the other of whom shall be a person described in paragraph 17(2)(b), and where each is of the opinion that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) are met, each shall sign and complete a certificate of involuntary admission and the person shall be admitted to the psychiatric unit as an involuntary patient in accordance with section 24.

             (2)  A person referred to in subsection (1) who is admitted to a psychiatric unit as an involuntary patient under subsection (1) is subject to the provisions of this Act respecting involuntary patients, except as follows:

             (a)  there shall be no review under this Act of the order or disposition under the Criminal Code authorizing the detention;

             (b)  the provisions of this Act respecting the transfer of patients shall not apply where the terms of the committing order or disposition under the Criminal Code conflict with those provisions;

             (c)  the person may not be the subject of a community treatment order, including a renewal, while the detention under the Criminal Code is in effect; and

             (d)  the person may leave or be discharged from the psychiatric unit only in accordance with part XX.1 of the Criminal Code.

             (3)  Where a person has been detained under part XX.1 of the Criminal Code as unfit to stand trial or not criminally responsible on account of mental disorder or has been found not guilty by reason of insanity and the person's detention under the Criminal Code is about to expire, within 72 hours before the expiration of the detention the person shall be assessed without his or her consent by 2 persons, one of whom shall be a person described in paragraph 17(2)(a) and the other of whom shall be a person described in paragraph 17(2)(b), and where each is of the opinion that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) are met, each shall sign and complete a certificate of involuntary admission and the person shall be admitted to the psychiatric unit as an involuntary patient in accordance with section 24 and the provisions of this Act respecting involuntary patients shall apply to that person.

Transfer to another psychiatric unit

      75. (1) Except as otherwise provided by the terms of an order or disposition under the Criminal Code, where an administrator believes that it is in the best interests of an involuntary patient to be treated in a psychiatric unit other than the psychiatric unit the patient is currently in, the administrator may authorize the transfer of the patient upon the agreement of the administrator of the other psychiatric unit.

             (2)  Where a patient is transferred to another psychiatric unit under subsection (1), the psychiatric unit receiving the patient has the same authority to detain or treat the patient as the psychiatric facility from which the patient was transferred had.

             (3)  An authorization to transfer shall be in the approved form.

Temporary removal or transfer

      76. (1) Where an involuntary patient requires hospital treatment or other services that cannot as appropriately be provided in a psychiatric unit, the attending physician, may, if otherwise permitted by law and with the consent of a physician in the other facility, transfer the patient to that treatment facility and return him or her to the psychiatric unit on the conclusion of the treatment, in accordance with the regulations.

             (2)  Where an involuntary patient is transferred under subsection (1),

             (a)  the administrator and the attending physician of the facility to which the patient is transferred have, in addition to the powers and duties conferred by another Act, the powers and duties under this Act in respect of the custody and control of the patient; and

             (b)  the patient shall be considered to continue as an involuntary patient of the psychiatric unit in the same manner and to the same extent and is subject to the same control as if he or she were in the psychiatric unit.

Notice of transfer

      77. Notice of a transfer under subsection 75(1) or 76(1) shall be given to the involuntary patient, his or her representative and the rights advisor.

Adult offenders

      78. (1) Where 2 certificates of involuntary admission have been signed and completed in accordance with section 17 respecting a person imprisoned or detained in a

             (a)  correctional institution as defined in the Adult Corrections Act; or

             (b)  prison, jail or lockup operated by a police force,

the Minister of Justice or his or her deputy may order the removal of the person to a psychiatric unit.

             (2)  Where an order is made under subsection (1), the person in charge of the correctional institution, prison, jail or lockup, shall in accordance with the order, cause the person to be transported to the psychiatric unit named in the order and provide the administrator with the completed certificates of involuntary admission and a copy of the order.

             (3)  A person transported to a psychiatric unit under subsection (2) shall be detained in the psychiatric unit until the attending physician certifies that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) do not continue to be met and the Minister of Justice or his or her deputy may then order the person to be

             (a)  returned to the correctional institution, prison, jail or lockup, as the case may be, where the person continues to be liable to imprisonment or detention; or

             (b)  discharged from custody.

             (4)  An order under subsection (1) or (3) shall be in the form approved by the Minister of Justice.

             (5)  Except for the purpose of returning the patient to his or her place of imprisonment, nothing in this section authorizes the discharge of a person who is imprisoned for an offence and whose sentence has not expired.

             (6)  A person transferred under the authority of subsection (1) shall be considered to be an involuntary patient admitted under section 24 of this Act and all the provisions respecting involuntary patients shall apply to that person except that legal custody over the person shall remain with the Minister of Justice.

Young offenders

      79. (1) Where 2 certificates of involuntary admission have been signed and completed in accordance with section 17 in respect of a young person who is detained in a youth custody facility, the provincial director may authorize the removal of the young person to a psychiatric unit.

             (2)  Upon the issuance of an authorization under subsection (1), the provincial director shall, in accordance with that authorization, cause the young person to be transported to the psychiatric unit named in the order and provide the administrator with the completed certificates of involuntary admission and a copy of the order.

             (3)  A young person transported to a psychiatric unit under subsection (2) shall be detained in the psychiatric unit until the attending physician certifies that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) do not continue to be met and the provincial director may then order the person to be

             (a)  returned to a custody facility in accordance with the provisions of the Youth Criminal Justice Act (Canada), where the person continues to be liable to a period of custody or detention; or

             (b)  discharged from custody.

             (4)  An order under subsection (3) shall be in the approved form and in accordance with the regulations.

             (5)  Except for the purpose of returning the young person to his or her place of custody, nothing in this section authorizes the discharge of a person who is subject to detention or who has been sentenced to custody for an offence and whose custodial portion of the sentence has not expired.

             (6)  A young person transported to a psychiatric unit under the authority of subsection (1) shall be considered to be an involuntary patient admitted under section 24 of this Act and all the provisions respecting involuntary patients shall apply to that person except that legal custody over the person shall remain with the provincial director.

             (7)  For the purpose of this section, the terms "young person", "youth custody facility" and "provincial director" have the meaning ascribed to them in the Youth Criminal Justice Act (Canada).

No appeal or review

      80. Notwithstanding another provision of this Act, a decision to transfer a person under section 75, 76, 78 or 79 is not subject to appeal or to review.

Transfer of patients to and from the province

      81. (1) Where it appears to a physician

             (a)  that an involuntary patient in a psychiatric unit has come or been brought into the province and that the patient's care and treatment is the responsibility of another jurisdiction; and

             (b)  that it would be in the best interests of that patient to be cared for in another jurisdiction,

the attending physician may authorize the transfer of the patient to the other jurisdiction where the physician is satisfied that the patient will be the subject of a psychiatric assessment in the receiving jurisdiction.

             (2)  Notwithstanding another provision of this Act, no review or appeal lies from a decision to transfer a person under subsection (1).

             (3)  Where it appears to a physician

             (a)  that there is in another jurisdiction an involuntary patient in a psychiatric facility and the province is responsible for the patient's care and treatment; and

             (b)  that it would be in the best interests of the involuntary patient in the other jurisdiction to be removed to a psychiatric unit in the province

the physician may, where satisfied that suitable arrangements have been made for the transport, care and custody of the involuntary patient, authorize in writing the transfer of the person into the province.

             (4)  Where a person has been transferred to the province under subsection (2), he or she may be detained and treated without his or her consent in a psychiatric unit for a period not to exceed 72 hours and shall be the subject of 2 psychiatric assessments in order to determine whether he or she should be admitted as an involuntary patient under section 24.

             (5)  An authorization referred to in subsections (1) and (2) shall be in the approved form.

PART VII
TRANSITIONAL PROVISIONS, CONSEQUENTIAL AMENDMENTS AND REPEAL

Transitional

      82. (1) Except as otherwise provided in this section, the repeal of the Mental Health Act and the coming into force of this Act shall not affect or invalidate an application, order, warrant, certificate or decision made under the authority of the Mental Health Act or other predecessor legislation.

             (2)  Where, on the day before the day on which this Act comes into force, a person is detained in a psychiatric unit as an involuntary patient under the Mental Health Act, a certificate of involuntary admission issued under that Act shall continue in force notwithstanding the repeal of that Act, but the provisions of this Act respecting involuntary patients shall apply to the person and, when the period of detention authorized under the Mental Health Act expires, the person shall be discharged unless he or she is admitted to the psychiatric unit as an involuntary patient in accordance with Part III of this Act.

             (3)  Where, immediately before the coming into force of this Act, a person

             (a)  has been found not criminally responsible on account of mental disorder or unfit to stand trial under Part XX.1 of the Criminal Code or not guilty by reason of insanity; and

             (b)  is detained in a psychiatric unit by a disposition or order under the Criminal Code

and, upon the coming into force of this Act, the person continues to be detained in a psychiatric unit by a disposition or order under the Criminal Code, within 30 days of the coming into force of this Act the person shall be assessed without his or her consent by 2 persons, one of whom shall be a person described in paragraph 17(2)(a) and the other of whom shall be a person described in paragraph 17(2)(b) and, where each is of the opinion that the criteria set out in subparagraphs 17(1)(b)(i) and (ii) are met, each shall sign and complete a certificate of involuntary admission in accordance with section 17 and the person shall be admitted to the psychiatric unit as an involuntary patient under section 24.

             (4)  Notwithstanding the repeal of the Mental Health Act and the abolition of the Mental Health Review Board established under that Act, that board is continued for the purpose of hearing and determining an application which was made to it before the coming into force of this Act.

             (5)  An application referred to in subsection (4) shall be determined within 30 days after the day this Act comes into force and a person aggrieved by the decision of that board may, within 30 days of the decision, appeal from or against that decision as if the Mental Health Act had not been repealed.

             (6)  Where a person's status as an involuntary patient under the Mental Health Act continues in force under subsection (1), the person may apply to the board established under this Act for a review of his or her status under paragraph 64(1)(a) except where an application in relation to this matter has been continued under subsection (4).

Consequential amendments

      83. (1) Subparagraph 2(g)(iv) of the Access to Information and Protection of Privacy Act is amended by striking out the words "the Mental Health Review Board" and substituting the words "the Mental Health Care and Treatment Review Board".

             (2)  Paragraph 2(b) of the Advance Health Care Directives Act is repealed and the following substituted:

             (a)  "health care decision" means a consent, refusal to consent, or withdrawal of consent of any care, treatment, service, medication, or procedure to maintain, diagnose, treat, or provide for an individual's physical or mental health or personal care and includes

                      (i)  life-prolonging treatment,

                     (ii)  psychiatric treatment for a person other than a person admitted to a psychiatric unit as an involuntary patient under section 24 or detained in a psychiatric unit under subsection 81(4) or released into the community under a community treatment order under subsection 40(2) of the Mental Health Care and Treatment Act,

                    (iii)  the administration of nutrition and hydration, and

                    (iv)  admission to treatment facilities and removal from those institutions, other than the admission, transfer, removal or discharge of a person admitted as an involuntary patient under section 24 or detained in a psychiatric unit under subsection 81(3) or released into the community under an assisted community treatment order under subsection 40(2) of the Mental Health Care and Treatment Act;

             (3)  The Schedule to the Child and Youth Advocate Act is amended by striking out the words "Mental Health Review Board" and substituting the words "Mental Health Care and Treatment Review Board".

             (4)  The Schedule to the Citizens' Representative Act is amended

             (a)  by adding immediately after the words "Insurance Adjusters, Agents and Brokers Appeal Board" the words "Mental Health Care and Treatment Review Board"; and

             (b)  by striking out the words "Mental Health Review Board".

             (5)  Paragraph 7(b) of the Fatalities Investigations Act is amended by striking out the words "Mental Health Act" and substituting the words "Mental Health Care and Treatment Act".

             (6)  Paragraphs 2(c) and (f) of the Mentally Disabled Persons' Estates Act are amended by striking out the words "Mental Health Act" where they twice occur and substituting the words "Mental Health Care and Treatment Act".

             (7)  Subsection 20(1) of the Mentally Disabled Persons' Estates Act is amended by striking out the words "who has been committed to the hospital under and in accordance with the Mental Health Act" and substituting the words "who has been admitted to the hospital as an involuntary patient under the Mental Health Care and Treatment Act".

             (8)  Subsection 20(6) of the Mentally Disabled Persons' Estates Act is repealed and the following substituted:

             (6)  Where, while a patient of the hospital, a person who is voluntarily a patient of the hospital is admitted as an involuntary patient under the Mental Health Care and Treatment Act, the date of admission for purpose of this section is the date on which the first certificate of involuntary admission was completed and signed.

             (9)  Subparagraph 2(i)(ii) of the Neglected Adults Welfare Act is amended by striking out the words "Mental Health Act" and substituting the words "Mental Health Care and Treatment Act".

RSNL1990 cM-9 Rep.

      84. The Mental Health Act is repealed.

Commencement

      85. This Act shall come into force on October 1, 2007, except for Part IV which shall come into force on January 1, 2008.