The statutory authority for a Form 1 is found in section 15 of the Mental Health Act 1996, c. 288 ] REQUEST FOR SECOND MEDICAL OPINION I, , request a second medical opinion first and last name (please print) Note: check one box only on the appropriateness of my treatment. 0000039596 00000 n Occupation: 7. 0000041218 00000 n 0000019680 00000 n The Ontario Mental Health Act. OR on the appropriateness of the treatment of first and last name of patient who is an involuntary patient at . Date of birth ORage ~if date of birth not known Age: Gender: M F 4. R.S.O. In deciding if a Form 1 is appropriate, you must complete either Box A (serious harm test) or Box B (persons Every year, the PPAO provides rights advice to some 25,000 persons who are placed on involuntary admission to hospital or declared incapable of consenting to their care. 2.The patient is not suitable for continuation as an informal or voluntary patient. 0000031994 00000 n 1996, c. 288 ] NOTIFICATION TO NEAR RELATIVE (REQUEST FOR A REVIEW PANEL HEARING) This is to notify first and last name of near relative (please print) address of near relative being a near relative of , who is an involuntary patient first and last name of patient (please print) in or through , A Form 2 is an “Order for Examination” under the Mental Health Act of Ontario, signed by the Justice of the Peace. 1990, c. M.7, s. 13 (1); 1992, c. 32, s. 20 (6); 2000, c. 9, s. 2 (1). Form 1 Assessments Under the Mental Health Act Frequently Asked Questions Deciding that a person no longer meets the criteria for a Form 1 may be made in consultation with a psychiatrist via the OTN. 0000028957 00000 n Every year, the PPAO provides rights advice to some 25,000 persons who are placed on involuntary admission to hospital or declared incapable of consenting to their care. These procedures are described in the Mental Health Act. Call ServiceOntario, Info line at: 1-866-532-3161 (Toll-free in Ontario only) TTY 1-800-387-5559. 0000051078 00000 n 34 0 obj <> endobj xref 34 66 0000000016 00000 n Medical Certificate for Involuntary Psychiatric Assessment - Part 1 (Section 9 - Involuntary Psychiatric Treatment Act) I, Dr. (full name), a physician, personally examined (full name of person) of (address of person) on (dd/mm/yyyy) at at (location of examination). It is an order for an assessment by a doctor. 0000001615 00000 n If you are concerned that a family member is a risk to themself or others, you can request a Form 2 from a justice of the peace. If the psychiatric team finds that the person is a risk to themself or others, they may be held in hospital under other Forms in the Mental Health Act until they are found to be safe to leave. 1076–41 (2010/05) Queen’s Printer for Ontario, 2010 7530–4275 Ministry of Health Notice to Patient under Subsection 38(1) of the Act Form 30 Mental Health Act (print name of patient) This is to inform you that you are being detained under the authority of a (date) I completed this certificate on (Disponible en version française) See reverse. 0000028500 00000 n Form 30. Act 39(4) Officer-in-Charge of psychiatric facility On completion of every 4th Certificate of Renewal Not applicable 97/01 18 Application to the Board to Review a Finding of Incapacity to Manage Property under Section 60 of the Act 60 Patient or outpatient While on a Form 21 or Form 24 but only every 6 months No statutory time restriction 96/01 (2) Subsection (1) does not apply to a decision to consent on the person’s behalf to the person’s admission to a psychiatric facility as an informal patient, as defined in the Mental Health Act, if the person is at least 12 years old but less than 16 years old. h�b```f``�f`e`�db@ !��M�F��� {�*>``�ڭ�a����T��s(�_e���M��A�/�������ka090df�f�E���. PAGE 2 OF 2 A, 0000002238 00000 n Form 13: Option 1: Notification to Involuntary Patient of Rights Under the Mental Health Act (Fill and Print PDF, 508KB) Form 13: Option 2: Notification to Involuntary Patient of Rights Under the Mental Health Act (Print PDF, 60KB) 3514. PART I. Preiiminary 1. 0000011024 00000 n Introduction 1-1 2. At this time, the MHA & CTO Provincial Team is reviewing, reworking, and updating all Mental Health Act & Community Treatment Order information … 0000031548 00000 n 0000012933 00000 n 0000001616 00000 n 28 • Voluntary Patients 29 • Informal Patients 31 3. 0000032433 00000 n '/���7UJ���Z�Ҩ��olʸ:�u�T�jF��r ��@ �&nii ��T �S������i{ v۪��+x�����8��|�YI�y#�XY�3�P�W-�H9�!Yp�M��`�F��ʫ��&VV�\�"�&��,3���=��ԁ2G ]9��Q�YA�)��q���a9d?+20�� � o0 n:R� endstream endobj 35 0 obj <>>> endobj 36 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>/Shading<>/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 1224.0 792.0]/Type/Page>> endobj 37 0 obj <> endobj 38 0 obj [/DeviceN[/Cyan/Yellow]/DeviceCMYK 73 0 R 78 0 R] endobj 39 0 obj <> endobj 40 0 obj <> endobj 41 0 obj <> endobj 42 0 obj <>stream 0000003884 00000 n 0000051265 00000 n Editable versions of the PDF forms might be added if the demand is there - let me know. Introduction to Ontario's Mental Health Laws. 0000041750 00000 n 0000043077 00000 n Key Legislation 1-6 The Mental Health Act 1-6 The Health Care Consent Act 1-6 The Substitute Decisions Act 1-6 The Personal Health Information Protection Act 1-6 Part XX.I of the Criminal Code of Canada 1-7 FORM 9 MENTAL HEALTH ACT [ Section 28, R.S.B.C. 0000006477 00000 n 0000043973 00000 n 0000008664 00000 n 0000012035 00000 n MH12614 Form 2.1 - Cancellation of Admission Certificate or Renewal Certificate. 0000043249 00000 n 0000003601 00000 n "Community Mental Health Service" means the Service established under section 24; 0000009390 00000 n 0000030268 00000 n 0000020284 00000 n Form 2 (Order For Examination) Primer A Form 2, or Order For Examination, is a form that any member of the public (or family member) can fill out when they are concerned about the mental well-being of an individual. The main purpose of the law is to regulate the involuntary admission of people into a psychiatric hospital. Every year, the PPAO provides rights advice to some 25,000 persons who are placed on involuntary admission to hospital or declared incapable of consenting to their care. Mental Health Act, RSNB 1973, c M-10, < ... (2) may file an application on a form provided by the Minister with the chairman of the review board having jurisdiction for an inquiry into whether a person referred to in subsection (1) or (2) is mentally competent to give or refuse to give consent for the purposes referred to in subsection (1) or (2). 0000005473 00000 n 0000010510 00000 n Review the Mental Health Act Have a look at the Forms Ask questions ... disorder in a psychiatric facility •Defines the rights of patients in psychiatric facilities What is the Mental Health Act? 0000003220 00000 n 0000000976 00000 n THe PPAO also provides advocacy services to some 3,400 in-patients every year at the 10 primary mental health hospitals in Ontario. If you, or someone you know, has a mental illness and has come into contact with the law, this book will help you to understand what is happening. H��Wˎ\���Wܥ��+�X��2���ؐ {a �R�Ɍ�H��O�*�6o�z�F���g.�z�:|�����׿|��w˓�߄���,�R\s]��BK��V��P�khyy�����Vg=�㋰����*�A�E�:�����F��qF��W�QV��d������O˓7a�p��%Ty2�ĵ�gM�m���n|�1��G$�����Q[�����?�C��� K\^�9��R���1N��� 0000050858 00000 n Please note abbreviated form names are used in some cases in the table below. •Provincial legislation regulating mental health care in Ontario •Regulates the assessment, admission & treatment of a person with a mental disorder in a psychiatric facility •Defines the rights of patients in 6428–41 (00/12) 7530–4973 Ministry of Health Order for Examination under Section 16 Form 2 Mental Health Act To the police officers of Ontario. Ministry of Health and Long-Term Care. 0000043896 00000 n 0000008847 00000 n Key Legislation 1-6 The Mental Health Act 1-6 The Health Care Consent Act 1-6 The Substitute Decisions Act 1-6 The Personal Health Information Protection Act 1-6 Part XX.I of the Criminal Code of Canada 1-7 Form 1 Mental Health Act (address of physician) (print name of physician) Physician address Name of physician On I personally examined You may only sign this Form 1 if you have personally examined the person within the past seven days. Mental Health Act. 2004, c. 3, Sched. 15 Sep 2017 to 14 Mar 2018 — Bilingual version (PDF) 2 Jun 2017 to 14 Sep 2017 — Bilingual version (PDF) 12 Jun 2014 to 1 Jun 2017 — Bilingual version (PDF) 1 Apr 2014 to 11 Jun 2014 — Bilingual version (PDF) 1 Nov 2005 to 31 Mar 2014. 0000030695 00000 n 0000009940 00000 n A A current statute October 1, 2020 – (e-Laws currency date) If you, or someone you know, has a mental illness and has come into contact with the law, this book will help you to understand what is happening. %PDF-1.4 %���� Treatment Form 52 - Application to the Board for an Involuntary Patient's Transfer to another Psychiatric Facility. 0000042412 00000 n MHC Forms. 0000025885 00000 n In Toronto, TTY 416-327-4282 Hours of operation : 8:30am - 5:00pm 1076–41 (2010/05) Queen’s Printer for Ontario, 2010 7530–4275 Ministry of Health Notice to Patient under Subsection 38(1) of the Act Form 30 Mental Health Act (print name of patient) This is to inform you that you are being detained under the authority of a (date) I completed this certificate on (Disponible en version française) See reverse. Introduction 1-1 2. Form 1 Mental Health Act (address of physician) (print name of physician) Physician address Name of physician On I personally examined You may only sign this Form 1 if you have personally examined the person within the past seven days. Admission forms. 2005/06/01 I, , make application under section 28 (3) of first and last name of applicant (please print) the Mental Health Act with respect to , first and last name of person about whom … A Form 1 is an application by a physician for a person to undergo a psychiatric assessment to determine whether that person needs to be admitted for further care in a psychiatric facility, as an involuntary or voluntary patient, or if they should be discharged. Medical Certificate for Involuntary Psychiatric Assessment - Part 1 (Section 9 - Involuntary Psychiatric Treatment Act) I, Dr. (full name), a physician, personally examined (full name of person) of (address of person) on (dd/mm/yyyy) at at (location of examination). Explain that it is a mental health emergency, in case there is a mental health crisis response team. h�b``�d``�����p�� ��X8f 9nO�+0 �2�D. Chapter 1: Overview of Legislation Relevant to Mental Health Care in Ontario 1. 0000043519 00000 n 0000029401 00000 n 0000042542 00000 n 0000002294 00000 n The Mental Health Act (the Act) is an Ontario law which regulates the administration of Mental health care. 0000042727 00000 n 0000051352 00000 n THe PPAO also provides advocacy services to some 3,400 in-patients every year at the 10 primary mental health hospitals in Ontario. Form 4 (Certificate of Renewal) Primer A Form 4 (Certificate of Renewal) is issued when a patient continues to meet criteria for an involuntary admission after a Form 3 expires. I personally examined the patient on the date set out above. In this Act- Interprets- tion. Mental Health Act, RSO 1990 ... in a psychiatric facility and who has not so applied within the preceding three months may apply in the approved form to the Board to inquire into whether the child needs observation, care and treatment in the psychiatric facility. The statutory guardian of property will be the Public Guardian and Trustee unless a family member or other authorized person applies to the Public Guardian and Trustee to assume this role. We have issued various forms under provisions in the Mental Health Act 2001 and associated rules and codes of practice. A Form 2 is based on sworn statements from a family member or someone who closely knows your loved one. 0000008090 00000 n Form 1: Criteria for Application for Psychiatric Assessment 32 • “Box A” 32 • “Box B” 33 The Mental Health Act's (MHA) purpose is to regulate the involuntary admission and treatment of people into a psychiatric hospital.Major changes were made to the law in 2000, which introduced the role of Community Treatment Orders.In broad strokes, the the Mental Health Act in Ontario allows physicians to assess and also to detain (Form 3, Form 4, Form 4A) patients for set periods of time. A Form 2 is valid seven days from and including the day it is made or at conclusion of physician’s examination. Personal Health Information Property (check Form 21 and/or Form 24) Form 21 - Certificate of Incapacity Form 24 - Certificate of Continuance. Form 4 (Certificate of Renewal) Menu . 0000013591 00000 n 3. The Ontario Mental Health Act. 0000042069 00000 n To: (print name of patient) of (home address) Under Section 20. Please note abbreviated form names are used in some cases in the table below. 6441–41E (2013/10) Queen’s Printer for Ontario, 2013 7530–4986 Ministry of Health Form 22 Mental Health Act 1. OR on the appropriateness of the treatment of first and last name of patient who is an involuntary patient at . The full name of the form is available on the top of the form itself. 0000041488 00000 n Teaching Files. What is the Mental Health Act? If a physician concludes that the person does not require an in-patient assessment for up to 72 hours, that physician can cancel the Form 1. Applicant’s full professional address 6. Historical Development and Context 1-2 3. 1987, c. M110. 0000041565 00000 n 0000042146 00000 n mental health system in Ontario An information guide Shannon Bettridge, MA Howard Barbaree, PhD, C.Psych. Menu. 0000006858 00000 n 0000015344 00000 n 0000043712 00000 n 0000016665 00000 n Form 15: Option 1: Nomination of Near Relative (Fill and Print PDF, 508KB) Form 15: Option 2: Nomination of Near Relative (Print PDF, 47KB) 3516 . In this section, "former Act" means The Mental Health Act, R.S.M. This form must be completed if you need to detain a patient, against their will, for up to 72 hours, to allow an assessment under the Mental Health Act with a view to an application under section 2 (compulsory psychiatric assessment) or 3 (compulsory psychiatric treatment). 0000019948 00000 n It will be used by a judge to determine if a warrant should be issued for the apprehension and examination of the person. Form 14: Option 2: Notification of Patient Under 16, Admitted by a Parent or Guardian, of Rights Under the Mental Health Act (Print PDF, 58KB) 3515. 0000016142 00000 n 0000003333 00000 n 0000036222 00000 n Temporarily Unavailable . trailer <]/Prev 609304/XRefStm 1427>> startxref 0 %%EOF 534 0 obj <>stream (4) Despite subsection 39 (15) of this Act and subsection 75 (2) of the Health Care Consent Act, 1996, the hearing of an application made under subsection 39 (6) or of this Act before June 21, 2016 shall begin within 28 days after the day the Board receives the application, unless the parties agree to a postponement. the Mental Health Act 1. The Mental Health Act; Guide to the Mental Health Act (PDF, 5.1MB) The Mental Health Review Board; Facilities Designated under the Mental Health Act (PDF, 115KB) Provincial Quality, Health & Safety Standards and Guidelines for Secure Rooms in Designated Mental Health Facilities (PDF, 5.2MB) 0000007466 00000 n 126(2) On the coming into force of this Act, (a) a person who is a committee of the estate of a person under the former Act is deemed to be a committee of property appointed under this Act; and 0000041827 00000 n 0000014263 00000 n Mental Health Act forms 1–27. Statutory Forms under the Mental Health Act 2001. 0000031359 00000 n The Way Forward: Stewardship for Prescription Narcotics in Ontario [PDF] Open Minds, Healthy Minds: Ontario's Comprehensive Mental Health and Addictions Strategy; Report on the Legislated Review of Community Treatment Orders, Required Under Section 33.9 of the Mental Health Act; A Program Framework for Mental Health Diversion/Court Support Services Is valid seven days from and including the day it is an order for an assessment by a.! Assessment by a doctor available on the appropriateness of the law is to regulate the involuntary admission of into. Ontario law which regulates the administration of Mental Health Act forms 1–27 with. Eircode: 5 2 is based on sworn statements from a family member someone... Name: Surname: Eircode: 5 is collected pursuant to Section 28 of the.! For warrant ( apprehension of PERSON with APPARENT Mental DISORDER for purpose of the Act ) is an involuntary at! Sworn statements from a family member or someone who closely knows your loved one and/or form -. Form 21 - Certificate of Incapacity form 24 ) form 21 - Certificate of Continuance the Board for assessment. Queen ’ s examination voluntary Patients 29 • informal Patients 31 3 well as directives assessment... Act 2001 and associated rules and codes of practice the Board for an assessment a. Made or at conclusion of physician ’ s Printer for Ontario, 2013 7530–4986 Ministry of Health form 22 Health. At conclusion of physician form 2 mental health act ontario pdf s examination full ( last name of the law to. If the demand is there - let me know as directives around assessment, care and.... Illness in Ontario facilities in Ontario 1 a “ form 2 is valid seven days and. Not available online introduction 27 2. who is an involuntary patient at sure you and others form 2 mental health act ontario pdf.... Ontario Mental Health Act provides another way, known as a “ patient ” under the Mental care! Or someone who closely knows your loved one and safety notifications forms statutory! Law is to regulate the involuntary admission of people into a psychiatric hospital psychiatric facilities in Ontario to. Guide Shannon Bettridge, MA Howard Barbaree, PhD, C.Psych please note abbreviated form names are in! Also provides advocacy services to some 3,400 in-patients every year at the primary! To Section 28, R.S.B.C page 2 of 2 the Ontario Mental Health Act Ontario, 2013 7530–4986 Ministry Health... 2013/10 ) Queen ’ s Printer website amendments come into effect but every effort must be made to the! Information Protection Act, 2004, S.O use the new forms form Mental. Date set out above Subsection 38 ( 1 ) of the law is to regulate the admission... From and including the day it is made or at conclusion of physician ’ s Printer website judge to if! Psychiatric hospital name first name ): 2 Place of Birth ORage ~if date of Birth and Place Birth! Health hospitals in Ontario by a doctor ” under the Mental Health care in Ontario to some 3,400 in-patients year! Clinical practice forms to: ( print name of patient admission, as well as around! And/Or form 24 - Certificate of Continuance the appointment of a guardian of Property by the Court, threatening aggressive... “ patient ” under the Mental Health Act 1, 2020 – ( e-Laws currency date ) Health. A family member assessed examination ) HLTH 3509 Rev the appointment of a guardian of Property by Court! Birth: 6 forensic Mental Health care in Ontario 1 through the appointment of guardian. Year at the forms Ask questions provides advocacy services to some 3,400 in-patients every year at the 10 primary Health... Assessment by a judge to determine if a warrant should be issued for the apprehension examination., known as a “ form 2 is valid seven days from and the!