Form 13 (British Columbia - Notification to Involuntary Patient of Rights)

Form 13 (British Columbia - Notification to Involuntary Patient of Rights)

Form 13 (British Columbia - Notification to Involuntary Patient of Rights)

Primer

A Form 13 (Notification to Involuntary Patient of Rights Under the Mental Health Act), is a form under the British Columbia Mental Health Act that is given to a patient to explain to their rights under the Act. This Form notifies the patient that they are being involuntarily detained/treated, and advises the patient of their rights under British Columbia's Mental Health Act and their rights under section 10 of the Canadian Charter of Rights and Freedoms.

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Procedure

People admitted involuntarily must be given information about their rights under the Mental Health Act.
A patient's rights, as described in Form 13 must be communicated to the patient upon all involuntary admissions and upon all renewals of involuntary status.
Thus, a Form 13 must be given to a patient any time a Form 4 or Form 6 is completed.
- A copy of Form 13 is given to the patient and the original is placed in the patient's chart.
The patient should also sign a Form 13 themselves.
- In some instances, a patient may be unable or unwilling to sign a Form 13. One must still provide the notice to the patient, document the patient’s refusal or inability to complete the form and maintain a copy on file to demonstrate that the notification was provided in a timely way.
In cases where a patient an involuntary patient is transferred to another facility, they must be given the rights information by the new facility to which they are transferred.
- This applies even though the person was given the rights information when admitted to the initial facility. The information must be provided “on admission” to the new facility.

Understanding of Rights

A designated healthcare professional or staff (e.g., nurse or social worker) is responsible for assessing whether a patient understands their rights and provide chances for the patient to ask questions.
If the patient does not appear to understand their rights, this must be documented in their chart.
The designated staff must also re-inform the patient of their rights within a reasonable amount of time and once again document if the patient does not appear to understand.
- The staff must attempt to complete the Form 13 (i.e. - notify the patient of their rights) at least once per 12-hour shift.
- There should be documentation if the attempt has failed or the patient was inaccessible (e.g. - decreased level of consciousness, delirium, or significant agitation)
This process must continue to be repeated at reasonable intervals until it is clear that the patient is capable of understanding their rights.

Capable

If the patient is capable, ask patient to sign the form when/if they understand their rights. Place original form in the patient's chart.

Not Capable

If patient is not capable of understanding rights information:
- Document on the form why the patient was not capable of comprehending rights and place in chart
- Reassess and document on form every 12 hours for change in capability to comprehend rights up to 72 hours
- Once patient regains capability, provide rights advice on new form.
After 72 hours, if there is no expectation that patient will regain capability, document assessment and pause attempts at form completion.

Declines

If patient understands information, but declines to sign, further attempts are not required.
Document that the patient reviewed and declined to sign, and place in chart.

Example: Agitated Psychotic Patient

If a patient is admitted to the unit in a psychotic or agitated state, it is not appropriate to delay completing the Form 13 until the patient is in a position to understand their rights.
Whether staff believe that the patient can understand the rights information or not, the Mental Health Act clearly outlines the constitutional and legislative requirements for patients to be provided their rights at the time the patient is detained, regardless of their mental state at t he time.
Failure to provide rights information to involuntary patients increases the risk that the facilities and staff are violating patient's Charter rights (i.e. - an illegal detention).

When to Notify

When Must Staff Notify Patients of Their Rights?

Staff must verbally inform and provide written notification (Form 13) to patients of their rights as soon as possible:

When admitted to the designated facility on the first certificate (Form 4); no longer than 24 hours post-admission
Following a transfer to another designated facility
Whenever a Renewal Certificate is completed (Form 6)
When the patient's status changes (i.e. - from voluntary to involuntary)
Whenever the patient requests their rights to be read
When a patient is transferred to the facility from a hospital or mental health facility in another province (section 42(1) of the Mental Health Act)
When a patient is transferred to the facility from a prison or correctional centre (section 29 of the Mental Health Act)

Patient Rights

The patient is notified of the 8 following rights:

To know the name and location of the facility that are being admitted to
To know the reason why they are being admitted under the Mental Health Act
To contact a lawyer
To be examined regularly by a medical doctor to see if they still need to be an involuntary patient
To apply to the review panel to decide if they should be discharged
To apply to the court to ask a judge if your medical certificates are in order (normally a lawyer is required)
To appeal to the court your medical doctor's decision to keep you in the facility (normally a lawyer is required)
To request a second medical opinion on the appropriateness of their medical treatment (note that the second opinion is not about whether the patient should continue as an involuntary patient, but rather, is on the appropriateness of the medical treatment). To request a second opinion, a Form 11 is filled out.

Form 14 (Under Age 16)

For patients under the age of 16 who have been admitted by their parent or guardian, a Form 14 (Notification to Patient Under Age 16, Admitted by Parent or Guardian, or Rights under the Mental Health Act) is given instead of a Form 13

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