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 email@example.com. And there will probably be other opportunities to offer your input as this research progresses, so watch this space!