The prospect of being certified—hospitalized and treated against your will—can be one of the scariest aspects of living with a severe mental illness. For many people, involuntary hospitalization brings with it not just a loss of freedom but also stigma, helplessness, and a sense of lost control.
Criteria for Certification
Ideally, certification should happen as a last resort. Each province has a different Mental Health Act, but in BC, someone can be certified only if a doctor has examined them and has determined that they meet all four of these criteria:
- they have a mental disorder that seriously impairs their ability to react appropriately to their environment or to other people,
- that mental disorder needs to be treated,
- the person must be hospitalized to prevent them from deteriorating mentally or physically or to protect them or those around them, and
- they cannot or will not accept treatment voluntarily.
Mental Health Act Rights
People who are certified don’t lose all of their rights. In fact, under the Mental Health Act, involuntary patients have specific rights—like the right to a review panel hearing or the right to a second medical opinion—that must be explained to them when they are admitted, if they are transferred to another facility, or if their certification is renewed.
Advising patients of their rights and supporting them as they exercise those rights may have an important therapeutic effect: Patients given the chance to argue their case are more likely to feel empowered and to be engaged in their own treatment and recovery.
Unfortunately, a 2011 survey of short-stay mental health patients in BC suggests that effective rights advice doesn’t always happen. Among the involuntary patients surveyed, 43% of them said they were not explained their Mental Health Act rights in a way they could understand.
Rights Advice Research
In my work with the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University, I am looking for ways to improve the rights advice process and, ultimately, to improve patient experience with involuntary hospitalization.
Right now, the task of giving patients rights advice usually falls to nurses and sometimes to social workers, who are supposed to read the rights from a government form, Form 13, and ask the patient to sign it.
There are many possible reasons the current process isn’t working as well as we’d like. One of them may be that Form 13 isn’t the best way to communicate rights information. We don’t know because it’s never been tested with people with lived experience. But that’s what I’m trying to do now.
Want to get involved?
If you’ve been involuntarily hospitalized in BC in the past five years and are 19 years of age or older, I invite you participate in a study to see how well Form 13 works as a rights advice document. I also invite you to give your opinions on the documents and tools other provinces and organizations are using to advise involuntary patients of their rights. Each study session, usually run at SFU Harbour Centre in downtown Vancouver, takes about an hour. I will thank participants with a $10 gift card. You can find more details on the study consent form.
If you are interested in participating, or if you have questions about this study, please get in touch with me at ivac@sfu.ca. And there will probably be other opportunities to offer your input as this research progresses, so watch this space!
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I was certified 3 times in the past 3 weeks, the first time unnecessarily, and ‘rights’ were never mentioned to me, let alone a form to sign. It certainly wasn’t approached as a ‘last resort’. If you need info, contact me – I have a lot to say.
Hi joan. I desperately need info and help. I was misdiagnosed and there was misinformation put in my file. I have been harrassed by my psych who refuses to let me switch doctors. My team keeps renewing my extended leave and they are slowly killing me. I have no choice but to put up with their phone calls and its gotten to the point where after the phone call i feel literally ill. Can a regular doctor uncertify a patient? Ive read somewhere they can. Im going through hell with these people please help.
Going thru the same as you there all liars, just trying to make money
I would love to talk with you ASAP re: a young women who voluntarily admitted herself and was told by her doc she was uncertified and then left for a week holiday and they are telling her she is certified and injecting her with high doses of Adavan and other drugs at UBC hospital I am going to see her today Aug 23/2018 I am a aboriginal traditional healer!
Candace Hill
candacebrownbearhill@gmail.com
I am interested in the study. I am certified under the mental health act and I am not happy with the treatment I am receiving. Jacqueline 7787070155 Thank you
Treating people nicely though firmly is possible, “I am here to help YOU do the hard things.” Don’t take irritability and words personally! A persuasive patient that talks a carer out of life-preserving treatment is a patient TRAPPED in their mental fog. A patient with anorexia nervosa, a mental illness, appears to fight for “right to refuse treatment,” but confusingly wants to be treated–conscious of need for control to be wrested, taken, from them, so that THEY don’t have to fight for control (voice of anorexia takes over from them–apparently fighting against treatment). The sufferer finds it a relief to surrender control (nature of the illness is aversion to treatment). Puzzling is that, taking AWAY a-given is a motivator, where offering something for cooperation is not effective, e.g. Your pass is cancelled because disorder has you hiding food from your tray (effective against ED); You can have a pass if you cooperate (an offer, is not effective against the ED), response is “Who cares; you can’t fool me.” Short-term solutions, e.g. one goes home and resumes lifestyle! LONG-TERM treatment is necessary to undo the compulsive restricting behaviour, months to years. The process of committing a patient, “sectioning,” is necessary to begin the turn-around (life-threatening low physical data AND mental distress that feels like ‘mastery of restricting’ to a sufferer, seems a familiar comfort, a friend in sad mental state). After the arguing is over, the sufferer is a changed person, hopeful–as opposed to a persuasive individual talking their way out of long-term treatment, and the sufferer is released to the voices and impulses of the eating disorder! Words get in the way. The Form 13 looks sensible–the attitude of staff is crucial, “I am here to help YOU do the right thing,” not accepting refusal from the patient, but using compassion to cajole behaviour. Avoid “I don’t know you, but I know your kind,” threatening with treatment (otherwise welcome treatment, except for attitudes!)–skilled people are the total opposite. Angry or threatening treatment providers are taking “irritability,” a symptom of the disorder, personally! Those should be dismissed. There are plenty of other jobs that need doing that don’t require flexibility and insight that is required from a truly skilled health services provider.
I am currently in the mental health ward in Kamloops bc… I never saw the form 13.. I have been certified and have been here for 14 Days.. I have totally participated in the meds protocol and feel stable… my anxiety and fears are gone… no more bad dreams and excited to get on with my life… the problem is the Doctor won’t let me go… the nutrition is horrid and I’m starting to feel sick physically from just sitting around… I asked to leave and continue the meds at home where I can eat healthy, excercise and work.. they don’t pay well in here…I have no more negative thoughts and I’m not a harm to me nor anyone else.. I don’t believe they have the right to keep me
I am being held against my will at [personal information removed]. A young pushy doctor named DR. [personal information removed] at [personal information removed] certified me because I went to the clinic for help because I suspect that my partner is trying to poison me. But instead of helping me and listening, she wanted to push drugs on me and when I refused, she said she was transferring me to [personal information removed]. When I arrived here, the nurses took away all my personal possessions and I was put in a room under observation with just a glass wall between me and the hallway with people walking by constantly. Anyone recommend a good human rights lawyer in the Vancouver area, please? [personal information removed]