Mental Health Review Board (British Columbia)

• If patients do not agree with a physician's decision to certify them under the BC Mental Health Act, they have the right to a review panel hearing.
• A patient is entitled to one Review Panel Hearing for every certification period.
• The patient, or someone acting on their behalf, can apply for a review panel hearing using Form 7 (Application for Review Panel).
• There is no cost for a hearing and the patient has the right to an advocate or lawyer to represent them and help prepare for and present the case.
  • Alternatively, the patient may represent themselves or have a family member or friend represent them.
  • The patient does not have to attend the hearing, and an advocate or a lawyer can present the case on the patient's behalf.
  • Patients may also call witnesses to testify on their behalf.

• If a patient asks for a review panel hearing within their first 2 months of an involuntary admission (i.e. - are on their second Form 4, or first Form 6), the hearing must be held within 14 days of the patient making the application.
• After these first 2 months (i.e. - are on their second Form 6), the hearing must be held within 28 days of the patient making the application.
• Thereafter (i.e. - are on their 6-month renewals), a hearing must be held within 28 days of the patient making the application, but a hearing cannot be asked for until at least 90 days have passed since the results of the last hearing.

• When a patient applies for a review board hearing, a Form 18 must also be issued to a Near Relative to notify them of the application.

• A patient can withdraw their request/cancel their hearing at any time before the hearing begins without penalty.
• Upon withdrawal, a patient or their representative may bring a new application during the same certification period by submitting the request through a communication to the Review Board.

A review panel is independent of the hospital and consists of:

1. A lawyer
2. A doctor who is not on the patient's treatment team
3. A member of the community

• It is important to note that a patient cannot change their treatment plan or diagnosis through the review panel process. Rather, the patient should complete Form 11 (Request for Second Medical Opinion) for such changes to be made.

• When a patient or near relative applies for and is scheduled a review panel, the hospital or community mental health team will assign a case presenter to attend the hearing.
• The case presenter is not the patient's advocate, but is someone who will provide evidence and should be knowledgeable of the patient's history and condition.
  • It is thus often presented by a patient's treating physician
  • However, the facility can assign another individual to be the case presenter, such as a case manager, nurse, mental health clinician or social worker.
• The case presenter’s job is to provide information about the patient's detention and explain why the health care team believes the patient continues to meet the involuntarily certification criteria and requires continued treatment in or through a designated facility.
• The case presenter will answer questions about the case from the patient or representative and the review panel.

The chair of a Review Panel may:

• Exclude the patient from attendance at the hearing or any part of it, but only if the chair of the Review Panel is satisfied that the exclusion is in the best interests of the patient, or
• Make orders respecting the taking, hearing or reproduction of evidence as the chair of the Review Panel considers necessary to protect the interests of the patient or any witness.

• After holding a hearing and considering the evidence, the panel determines whether the patient should continue to be detained because they still meet the criteria for involuntary admission.
  • Following a hearing, the decision is usually immediate. However, the Review Panel may take up to 48 hours to reach a decision
  • If they decide that the patient does meet the criteria, the patient remains certified and must stay in hospital/on Extended Leave.
  • If the panel decides the patient does not meet the criteria, the patient will be decertified.
• The Review Board must submit their determination no later than 48 hours after the hearing and must issue their reasons within 14 days of the determination.

• A Form 8 details the decision of the panel and is distributed by the Review Panel chair to the hospital director, the patient, and their lawyer/advocate once the decision is made.
  • A copy of the determination must be provided, without delay, to the patient (or the person acting on the patient's behalf) and to the director.
  • The panel may not consider the issues related to compliance with the Mental Health Act’s admission and detention process in making its decision.

• If the determination is that the patient should remain certified, a patient must wait until the next certification period to apply for another Review Panel (and given it has been at least 90 days since the last ruling).

• Mental Health Review Board website
• Resources for Mental Health Professionals