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on-call [on November 6, 2019]
psychdb
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psychdb
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-~~Title: On-Call Resources ~~ +~~META: 
-<​HTML><​style>#​lastedit {display:​none} body {background:​ #f2f2f2} </​style><​span style="​height:​0.75em;​ display: block;"></​span></​HTML>​ +title = On-Call Resources 
-<​grid>​ +~~ 
-<col sm="​3">​ + 
-{{page>​side-menu}} +====== On-Call Resources ======
-</​col>​ +
-<col sm="​9">​+
 <​HTML>​ <​HTML>​
-<div class="​card"​>+<style> 
 +.list-inline {display: none} 
 +</style>
 </​HTML>​ </​HTML>​
-~~NOTOC~~+ 
 +===== On-Call ===== 
 +== Patient Care ==
 <WRAP group> <WRAP group>
 <WRAP half column> <WRAP half column>
-===== Ontario Mental Health Act ===== 
-<alert icon="​fa fa-arrow-circle-right fa-lg fa-fw" type="​success">​See section: **[[teaching:​on-mha:​home|Introduction to Ontario'​s Mental Health Laws ]]**</​alert>​ 
- 
-==== Common Forms ==== 
 <​accordion collapsed="​true">​ <​accordion collapsed="​true">​
-<panel icon="​fa fa-file-text-o ​fa-fw" title="​Form 1 (Psychiatric Assessment) + Form 42 (Notice to Patient)"> +<panel icon="​fa fa-life-bouy fa-fw" title="​Patient ​is Suicidal!">​ 
- +<button ​type="danger" size="sm" block="​true" icon="​fa fa-arrow-circle-right">​[[teaching:suicide-risk-assessment-sra]]</button>
-<btn type="success" size="xs" icon="​fa fa-question-circle">​[[http://​www.psychdb.com/​_media/​form_1_and_42_-_explained.pdf|How to Fill a Form 1/42 in 5 mins]]</btn>+
 ---- ----
- +<WRAP group> 
-**[[teaching:​on-mha:​form-1-42|Form 1]]** (//​Application by Physician for Psychiatric Assessment//​) +<WRAP half column> 
-  * Detains patient for //​assessment//​ only +**Always document "​CAIPS"​** 
-  * Valid for 72 hours +  * **C**hronic Factors 
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download"​>[[http://www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetAttachDocs/​014-6427-41~1/​$File/​6427-41_.pdf|Download Form 1]]</btn>+  * **A**cute Factors 
 +  * **I**mminent Warning Signs 
 +  * **P**rotective Factors 
 +  * **S**ummary Statement 
 +</WRAP> 
 +<WRAP half column>​ 
 +**Safety Planning**  
 +  * {{ :teaching:​coping_with_suicidal_thoughts.pdf |Coping with Suicidal Thoughts}} 
 +  * {{ ::​safety-comfort-plan.pdf |Safety and Comfort Plan}} 
 +  * {{ ::coping-card-170308-acc.pdf |Coping Card}} 
 +  * {{ ::​camh_safety_plan_template.pdf |Safety Planning Template (CAMH)}} 
 +  * {{ :​psychotherapy:​dbt_approaches_in_er.pdf |Using DBT Skills in the ER}} 
 +</​WRAP>​ 
 +</WRAP>
 ---- ----
-**[[teaching:on-mha:form-1-42|Form 42]]** (//Notice to Patient//+**PDFs** 
-  * Give original Form 42 to patient +  * {{ ::how_to_write_a_suicide_risk_assessment_that-s_clinically_sound_and_legally_defensible.pdf ​|How to Write a SRA}} 
-  * Keep a copy in chart +  ​{{ :​apa_suicide_risk_assessment.pdf | Suicide Risk Assessment ​(APA}} 
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-1787-41~1/​$File/​1787-41_.pdf|Download Form 42]]</​btn>​ +  * {{ :​suicide_risk_assessment_template.pdf | Suicide Risk Assessment Template (CAMH)}} 
 +  * {{ ::​child_and_adolescent_suicide_assessment.pdf |Child and Adolescent Suicide Assessment Template (SickKids)}}
 </​panel>​ </​panel>​
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 3 (Involuntary Admission) + Form 30 (Notice to Patient)">​ 
  
-**[[teaching:on-mha:form-3|Form 3]]** (//​Certificate of Involuntary Admission//​) +<panel icon="​fa fa-stethoscope fa-fw" title="​Patient Looks Unwell!">​ 
-  * Involuntary admission for 14 days (REMEMBER: It is 14 days //​including//​ the day you sign the form, therefore, you add only 13 days, NOT 14 days) +<button type="​danger"​ size="​sm"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[on-call:basic-life-support|]]</button> 
-  * Same criteria as Form 1 both Box A and B are available + 
-  * A Form 30 must be given to patient immediately to notify them +<button type="​danger"​ size="​sm"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[neurology:​1-approach-neuro-emergencies|Neurological Emergencies]]</​button>​ 
-  * Rights Advice must be notified + 
-  * If you signed the Form 1, you **cannot** sign a Form 3 it must be a different MD! +<button ​type="danger" size="sm" block="​true" icon="​fa fa-arrow-circle-right">​[[on-call:approach-to-im-on-call-emergencies-issues|Internal Medicine Emergencies and Issues]]</​button>​ 
-<btn type="primary" size="xs" icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetAttachDocs/​014-6429-41~1/​$File/​6429-41_.pdf|Download Form 3]]</btn>+ 
 +<button type="​danger"​ size="​sm"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[teaching:​3-medical-clearance-screening|]]</button> 
 ---- ----
-**[[teaching:on-mha:form-30|Form 30]]** (//Notice to Patient//) + 
-  * Give the original Form 30 to patient after Form 3 or Form 4 is signed +**Consider**:​ 
-  * Keep a copy in chart +  * **Withdrawal**: ​[[addictions:alcohol:home|Alcohol]], GHB, [[meds:​opioids:​home|opioids]],​ other drugs 
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-1076-41~1/​$File/​014-1076-41.pdf|Download Form 30]]</​btn>​+  * **Bloodwork**:​ consider CBC, [[cl:​hyponatremia|electrolytes]],​ BUN, creatinine, glucose, blood [[addictions:​alcohol:​home|alcohol]],​ [[meds:​urine-drug-screen|urine drug screen]]. Always consider doing beta hCG in females of reproductive age. 
 +  * **Investigations**:​ 
 +    * CBC, electrolytes,​ BUN, Creatinine, Glucose 
 +    * Urine or serum toxicology (including alcohol levels) 
 +    * Consider ​[[neurology:ct-scan|CT head]], ECG, or CXR 
 +    * For females between ages 12 to 55, bHCG should be ordered
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 33 (Finding of Incapacity)"> +<panel icon="​fa fa-frown-o fa-fw" title="​Patient is Agitated!">​ 
-**[[teaching:​on-mha:​form-33|Form 33]]** (//Notice to Patient - Incapacity//​) +<button ​type="danger" size="sm" block="​true" icon="​fa fa-arrow-circle-right">​[[meds:agitation]]</button>
-  * Patient is not capable to (one or more of the following):​ +
-    - Consent to treatment (unable to understand AND/OR appreciate a proposed treatment) +
-      * Do a [[teaching:​on-mha:​consent-capacity|capacity assessment]] for your proposed treatment +
-      * You must immediately find a [[teaching:​on-mha:​consent-capacity#​substitute-decision-maker|substitute decision maker (SDM)]] or if unable to locate, contact [[https://​www.attorneygeneral.jus.gov.on.ca/​english/​family/​pgt/​index.php|The Office of the Public Guardian and Trustee (OPGT)]] +
-    - To manage property (AKA finances) +
-      * Do a [[teaching:​on-mha:​financial-capacity|financial capacity assessment]] and fill out a Form 21 +
-      * Contact [[https://​www.attorneygeneral.jus.gov.on.ca/​english/​family/​pgt/​index.php|The Office of the Public Guardian and Trustee (OPGT)]] +
-      * {{ ::​guardian_finances_patient_handout.pdf |Handout for Patients Deemed Financially Incapable}} +
-    - To consent to release of their health information +
-<btn type="primary" size="xs" icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-1088-41~3/​$File/​1088-41_.pdf|Download Form 33]]</btn>+
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-file-text-o ​fa-fw" size="xs" ​title="Request for Rights Advice (PPAO)">​ +<panel icon="​fa fa-sign-out fa-fw" title="​Patient Wants to Leave!">​ 
-**Rights Advice ​Form** (//Request for Rights Advice Mental Health Inpatient//+<button type="​danger" size="sm" ​block="true" icon="​fa fa-arrow-circle-right">​ 
-  * You must notify the Psychiatric Patient Advocate Office (PPAO) each time a patient is placed on a Form 3, Form 4, Form 21, or given a Form 33 +[[teaching:​bc:​mha:​form-4|Form (BC)]] 
-  * A rights advisor will arrive to see patient and inform them of their legal rights to challenge the admission +</​button>​ 
-<btn type="primary" size="xs" icon="​fa fa-download">​[[https://​www.sse.gov.on.ca/​mohltc/​ppao/​en/​Documents/​4918-57E_re_%20Inpatient.pdf|Download PPAO Form]]</btn>+ 
 +<button ​type="danger" size="sm" block="​true" icon="​fa fa-arrow-circle-right"> 
 +[[teaching:on:emergency-assessment|Emergency Capacity Assessment (Ontario)]] 
 +</button>
 </​panel>​ </​panel>​
 +
  
 </​accordion>​ </​accordion>​
-==== All Forms ====+</​WRAP>​ 
 +<WRAP half column>
 <​accordion collapsed="​true">​ <​accordion collapsed="​true">​
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 2 (Order For Examination)">​ +<panel icon="​fa fa-file-text fa-fw" title="​Handouts and Information for Patients">​ 
-**[[teaching:​on-mha:​form-2|Form 2]]** (//Order For Examination//​) +**Medications** 
-  * Is a form that any member of the public (or family member) can fill out and ask a Justice of the Peace to sign +  * **[[https://psychiatryonline.org/doi/book/10.1176/appi.books.9781615371280|Understanding Psychiatric Medications,​ 3rd Edition Handouts]]** 
-  ​Gives police 7 days to bring someone to hospital +  {{ ::camh_antidepressants_patients.pdf ​Understanding Antidepressants}} 
-  ​Police will bring patient to a hospital for assessment +  * {{ :camh_antipsychotics_patients.pdf | Understanding Antipsychotics}} 
-  * Does not authorize patient to be detained at the hospital; still must complete a Form 1 to keep them in hospital! +  * {{ :​camh_benzodiazepines_patients.pdf | Understanding Benzodiazepines}} 
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/​ssbforms.nsf/GetAttachDocs/​014-6428-41~1/​$File/​6428-41_.pdf|Download Form 2]]</​btn>​ +  * {{ :camh_mood_stabilizers_patients.pdf | Understanding Mood Stablizers}} 
-</​panel>​ +  * {{ ::​ect_education.pdf |ECT Education Booklet}}
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 4 (Certificate of Renewal)">​ +
-**[[teaching:on-mha:form-4|Form 4]]** (//​Certificate of Renewal//) +
-  * The first Form 4 lasts one month (add 1 month, minus 1 day) +
-    * Second Form 4 lasts two months (add 2 months, minus 1 day) +
-    * Third Form 4 lasts three months (add 3 months, minus 1 day) +
-  * Rights advice must be notified +
-  * Give Form 30 each time, plus patient can appeal each time +
-  * There is also a Form 4A ("​Fourth Form 4") (also 3 months, minus 1 day) +
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetAttachDocs/​014-6430-41~1/​$File/​6430-41_.pdf|Download Form 4]]</​btn>​ +
-</​panel>​ +
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 5 (Change to Voluntary Status)">​ +
-**Form 5** (//Change to Informal or Voluntary Status//) +
-  * Fill out this form to end a Form 3 or Form 4 (i.e. - make a patient voluntary again) +
-  * You do not need to fill this out to cancel a Form 1, simply either document are cancelling the Form 1, or cross out the Form 1 +
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-1972-41~1/​$File/​014-1972-41E.pdf|Download Form 5]]</​btn>​ +
-</​panel>​ +
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 9 (Order for Return)">​ +
-**Form 9** (//Order for Return//) +
-  * Used find patients who go AWOL while involuntarily admitted (Form 1, Form 3, Form 4) +
-  * Police will look for patient and take them back to hospital +
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-6431-41~1/​$File/​6431-41E_.pdf|Download Form 9]]</​btn>​+
  
-<btn type="​success"​ size="​xs"​ icon="​fa fa-question-circle">​[[http://psychdb.com/_media/form_9_-_uloa_flowchart_final.pdf|FAQ on Filling a Form 1 after a Form 9]]</​btn>​+---- 
 +**Handouts, Worksheets and Workbooks for Various Mental Disorders** 
 +  * [[https://www.cci.health.wa.gov.au/Resources/For-Clinicians|Centre for Clinical Interventions]] (Great Resource!)
  
 +----
 +**Therapy Handouts**
 +  * {{ ::​grounding-techniques-provider-patient-handout.pdf |Grounding for Emotional Pain (Provider + Patient)}}
 +  * {{ :​list_of_pleasurable_activities.pdf |Pleasurable Activities}}
 +  * {{ ::​assertiveness_handout.pdf |Assertiveness}}
 +  * {{ :​emotions_handout.pdf |Emotions}}
 +  * {{ :​list_of_feelings.pdf |Feelings}}
 +  * {{ :​psychotherapy:​trauma_therapy_toolkit.pdf |Trauma Therapy Toolkit}}
 +  * [[http://​www.cqaimh.org/​pdf/​tool_edu_moodchart.pdf|Mood Charting - Depression Log (PDF)]]
 </​panel>​ </​panel>​
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 10 (Transfer of Patient)"> +<panel icon="​fa fa-lightbulb-o fa-fw" title="​Choosing Wisely Canada">​ 
-**Form 10** (//Transfer of Patient//) +  * [[https://choosingwiselycanada.org/psychiatry/|Choosing Wisely Canada: Psychiatry]]
-  * Transfers patient on a Form 1 or Form 3 to another facility (e.g. - for surgery or medical clearance) +
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://www.forms.ssb.gov.on.ca/mbs/ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-6432-41~1/​$File/​6432-41E_.pdf|Download Form 10]]</​btn>​+
 </​panel>​ </​panel>​
-<panel icon="​fa fa-file-text-o ​fa-fw" title="​Form 21 (Certificate ​of Financial Incapacity)">​ +<panel icon="​fa fa-legal fa-fw" title="​Should I Talk to Police About a Patient?">​ 
-**Form 21** (//​Certificate of Incapacity to Manage One's Property//) +Health care providers have an ethical, professional,​ and legal responsibility to safeguard the personal health information of their patients. Absent a patient’s consent, such information should only be shared with others in exceptional circumstances ​(e.g., imminent risk of harm to others, danger to a child).  
-  * MD fills out this Form to explain why the finding ​of financial incapacity was made +</​panel>​ 
-  * Form 33 must be given to patient to notify them of this finding +<panel icon="​fa fa-phone fa-fw" title="​It'​s Time to Review Case With Staff!">​ 
-<btn type="​primary"​ size="xs" icon="​fa fa-download">​[[http://www.forms.ssb.gov.on.ca/mbs/ssb/​forms/​ssbforms.nsf/​GetFileAttach/014-6440-41~1/​$File/​6440-41E.pdf|Download Form 21]]</btn>+**Checklist** 
 +  * **Diagnosis and Comorbidities** 
 +    * Is this diagnosis based on historical diagnosis or presentation today? 
 +    * Is the patient currently intoxicated?​ 
 +    * How much is substance abuse contributing ​to this picture? 
 +    * What medical comorbidities may be contributing>?​ 
 +  * **Collateral** 
 +    * Have you reviewed past medical records? 
 +    * Spoke with the emergency room physician or referring physician?​ 
 +    * Have you spoken to any community supports, family, or other collateral 
 +  * **Safety** 
 +    * Does this patient have a past history ​of violence/​aggressive behavior/​agitation?​ 
 +    * Is the patient currently agitated? 
 +    * Have you put any de-escalation or preventative procedures in place? 
 +    * What are the [[teaching:​suicide-risk-assessment-sra|risk factors for suicide]] in this patient 
 +    * Does this patient require "​[[teaching:​3-medical-clearance-screening|medical clearance]]"?​ 
 +  * **Reporting Issues** 
 +    * Are there children at risk? 
 +    * Is there a driving risk? 
 +    * Do you have a duty to warn? 
 +  * **Legal Status** 
 +    * Is the patient ​voluntary or involuntary?​ 
 +    * Is there legal or forensic involvement?​ 
 +    * Depending on the jurisdiction,​ have all applicable mental health forms been completed?​ 
 +    * Does the patient consent ​to us speaking or relaying information to family or friends? 
 +  * **Disposition** 
 +    * //If admitting//:​ 
 +      * What is the rationale for admission?​ 
 +      * What are the specific goals of admission?​ 
 +    * //If discharging//:​ 
 +      * Have you done a [[teaching:​suicide-risk-assessment-sra|suicide risk assessment]]?​ 
 +      * What are the protective factors that allow us to discharge the patient? 
 +      * Is there a safety plan for the patient? 
 +      * What supports or referrals are in place for the patient? 
 +</​panel>​ 
 +</​accordion>​ 
 +</​WRAP>​ 
 +</​WRAP>​ 
 +===== British Columbia ===== 
 +==== Legal and Reporting ==== 
 +<​accordion collapsed="true"
 +<​panel ​icon="​fa fa-bullhorn fa-fw" title="​What Needs To Be Reported?"> 
 +  * **[[https://www.cpsbc.ca/files/pdf/PSG-Duty-to-Report.pdf|CPSBC Duty to Report]]** 
 +    * Registrants (Physicians) 
 +      * Duty to report registrants'​s whose practice may constitute a danger to the public 
 +      * Duty to report respecting hospitalized registrant (mental health or addictions) 
 +      * Duty to report sexual misconduct 
 +    * Deaths that require reporting in the province 
 +    * Child welfare/safety concerns 
 +    * Driving safety concerns
 </​panel>​ </​panel>​
-<panel icon="​fa fa-file-text-o fa-fw" title="​Form 45, 47, and 49 (Community Treatment Order)">​ 
  
 +<panel icon="​fa fa-car fa-fw" title="​Should I Report My Patient'​s Driving?">​
 +The Motor Vehicles Act (Section 230) of British Columbia states that registered psychologists,​ optometrists and medical practitioners must report patients to the Office of the Superintendent of Motor Vehicles (OSMV) if:
 +  - A patient has a medical condition that makes it dangerous to the patient, or to the public, for the patient to drive a motor vehicle, **AND**
 +  - Continues to drive after the psychologist,​ optometrist or medical practitioner warns the patient of the danger.
  
-<callout type="​success">​{{fa>​arrow-circle-right?​color=green}} See main article: **[[teaching:​on-mha:​form-45-47-49-cto]]**<​/callout>​ +//"No action for damages lies or may be brought against ​psychologist,​ an optometrist or medical practitioner for making a report under this section, unless ​the psychologistoptometrist ​or medical practitioner made the report falsely and maliciously."//​
-**[[teaching:​on-mha:​form-45-47-49-cto|Form 45]]** (//Community Treatment Order//) +
-  * Allows ​physician to mandate supervised treatment on patient when they are discharged from hospital +
-  * Can be voluntary (i.e. - patient requests ​the CTO), or more commonly involuntary (MD initiates ​the CTO)+
  
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-3760-41~1/​$File/​3760-41_.pdf|Download Form 45]]</​btn>​+**Fitness to Drive**
  
-----+Individuals may drive if:  
 +  ​Their condition is stable  
 +  ​They have been assessed as having sufficient insight to stop driving if their condition becomes acute  
 +  ​They are compliant with any prescribed psychotropic medication regime or other recommended treatment, including regular follow-up where required  
 +  - For commercial drivers who have had a psychotic episode, a specialist is supportive of their return to driving, and 
 +  - Their functional abilities necessary for driving are not impaired ​
  
-**[[teaching:on-mha:​form-45-47-49-cto#​form-47|Form 47]]** (//Order for Examination/​/) +**Resources** 
-  * Issued when patient violates their CTO conditions (i.e. - does not show up for appointments/medication) +  ​* [[https://www.drivinganddementia.ca/|Driving and Dementia Roadmap (DDR)]] 
-  * Allows police to recall patient to hospital ​for assessment +  * [[https://​www.icbc.com/driver-licensing/re-exam/​Pages/​Enhanced-Road-Assessment.aspx|Driver Medical Fitness Information ​for Medical Professionals]] 
-  * Once at a hospital, the patient must be issued a Form 1 - a Form 47 by itself does not allow for involuntary detention +  * [[https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/transportation/driving-your-own-vehicle/driver-fitness-and-assessment|BC Driver Fitness Assessment]] 
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-3761-41~1/$File/3761-41_.pdf|Download Form 47]]</btn>+  * [[https://​bcmj.org/​cohp/​medical-conditions-and-driving-changes-roadsafetybc|BCMJ:​ RoadSafetyBC Guidelines]]
  
 ---- ----
  
-**Form 49** (Notice/​Intention to Start CTO) +  ​{{ :cma-drivers-guide-8th-edition-e.pdf |CMA Driver'​s Guide 8th Edition}} 
-  * This is issued to the patient to notify them of your intention to start or renew a CTO +  * {{ ::​dementia_and_driving_toolkit_for_resident_handout_part_ii.pdf |Dementia and Driving Toolkit}}
- +
-<btn type="​primary"​ size="​xs"​ icon="​fa fa-download">​[[http://​www.forms.ssb.gov.on.ca/​mbs/​ssb/​forms/​ssbforms.nsf/​GetFileAttach/​014-3764-41~1/​$File/​3764-41_.pdf|Download Form 49]]</​btn>​ +
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-file-text-o ​fa-fw" title="​Form 49 (Warrant ​of Committal)">​ +<panel icon="​fa fa-child fa-fw" title="​Should I Report to the Ministry ​of Child and Family Development?​">​ 
-<callout type="danger"​ icon="​true">​Confusion Alert! There are 2 VERY different Form 49s! The other Form 49 is for CTOs (Notice/​Intention to Start CTO).</​callout>​ +"All registrants ​are required by law to report a child in need of protection. In the Child, Family and Community Service Act (CFCSA), a child is defined as someone under the age of 19." -- [[https://www.cpsbc.ca/files/pdf/​PSG-Reporting-Child-in-Need.pdf|College of Physicians ​and Surgeons of British Columbia]]
-**[[teaching:on-mha:​form-49|Form 49]]** (//Warrant of Committal//+
-  * Issued through the Ontario Review Board (ORB), ​ which is essentially a detention orderThe patient does not need any additional Forms signed once brought to the hospital ​and can be involuntarily detained by default.+
  
 +All circumstances of suspected child risk, abuse and neglect must be reported to appropriate child protection agencies at the time of assessment. If you are not sure whether reporting is necessary, you can call and discuss the situation without using the patient’s name. If child protective services advises that you must report, then identifying information must be given to them. There is someone available to receive your call 24 hours a day, 365 days a year.
 </​panel>​ </​panel>​
 </​accordion>​ </​accordion>​
 +==== BC Mental Health Act ====
 +<alert icon="​fa fa-arrow-circle-right fa-lg fa-fw" type="​success">​
 +See section: **[[teaching:​bc:​mha:​home|Introduction to British Columbia'​s Mental Health Laws]]**
 +</​alert>​
  
-===== British Columbia Mental Health Act =====+<WRAP group> 
 +<WRAP half column>
 <​accordion collapsed="​true">​ <​accordion collapsed="​true">​
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 4 (Medical Certificate for Involuntary Admission)">​
 +  * [[teaching:​bc:​mha:​form-4]]
 +</​panel>​
  
-<panel icon="​fa fa-question-circle ​fa-fw" title="​Mental Health Act Documents">​ +<panel icon="​fa fa-file-text-o ​fa-fw" title="​Form 5 (Consent for Treatment [Involuntary Patient])">​ 
-  * [[http://www2.gov.bc.ca/​assets/​gov/​health/​about-bc-s-health-care-system/​heath-care-partners/​colleges-board-and-commissions/​mental-health-review-board/​mha_plain.pdf|Mental Health Act in Plain Language (Government of BC)]]+  * [[teaching:bc:mha:form-5]]
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-file-text-o fa-fw" title="​Forms">​ +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 6 (Renewal Certificate for Involuntary Admission)">​ 
-  * [[http://​www.bclaws.ca/​civix/​document/​id/​complete/​statreg/​96288_01|BC Mental Health Act]] +  * [[teaching:bc:mha:form-6]]
-  * [[http://​www2.gov.bc.ca/​gov/​content/​health/​health-forms/​mental-health-forms|Mental Health Act Forms]]+
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-hospital-o fa-fw" title="​Drug Coverage">​ +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 13 (Notification to Involuntary Patient of Rights)">​ 
-  * {{ ::fmpr_-_pharmacare_bc.pdf |BC Pharmacare Program}}+  * [[teaching:​bc:mha:form-13]]
 </​panel>​ </​panel>​
  
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 15 (Nomination of Near Relative)">​
 +  * [[teaching:​bc:​mha:​form-15]]
 +</​panel>​
 +
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 16 (Notification to Near Relative)">​
 +  * [[teaching:​bc:​mha:​form-16]]
 +</​panel>​
 +</​accordion>​
 +</​WRAP>​
 +<WRAP half column>
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Other Forms">​
 +  * **[[teaching:​bc:​mha:​form-1|Form 1 (Request for Admission [Voluntary Patients])]]**
 +  * **[[teaching:​bc:​mha:​form-2|Form 2 (Consent for Treatment [Voluntary Patient])]]**
 +  * **[[teaching:​bc:​mha:​form-3|Form 3 (Medical Report [Under 16 Years of Age])]]**
 +  * **[[teaching:​bc:​mha:​form-7|Form 7 (Application for Review Panel Hearing)]]**
 +  * **[[teaching:​bc:​mha:​form-9|Form 9 and Form 10 (Application for Warrant and Warrant)]]**
 +  * **[[teaching:​bc:​mha:​form-17|Form 17 (Notification to Near Relative [Discharge of Involuntary Patient])]]**
 +  * **[[teaching:​bc:​mha:​form-20|Form 20 (Leave Authorization)]]**
 +  * **[[teaching:​bc:​mha:​form-21|Form 21 (Director'​s Warrant)]]**
 +</​panel>​
 +<​accordion collapsed="​true">​
 <panel icon="​fa fa-bank fa-fw" title="​Consent and Capacity">​ <panel icon="​fa fa-bank fa-fw" title="​Consent and Capacity">​
   * {{::​consent_capacity_bc_edition.pdf | Capability and Consent Tool - B.C. Edition}}   * {{::​consent_capacity_bc_edition.pdf | Capability and Consent Tool - B.C. Edition}}
Line 173: Line 250:
   * [[https://​www.straight.com/​life/​780486/​bc-patients-challenge-forced-psychiatric-treatment-bid-greater-say-mental-health-care|Georgia Straight: B.C. patients challenge forced psychiatric treatment in bid for greater say in mental-health care]]   * [[https://​www.straight.com/​life/​780486/​bc-patients-challenge-forced-psychiatric-treatment-bid-greater-say-mental-health-care|Georgia Straight: B.C. patients challenge forced psychiatric treatment in bid for greater say in mental-health care]]
 </​panel>​ </​panel>​
- 
 </​accordion>​ </​accordion>​
 +</​WRAP>​
 </​WRAP>​ </​WRAP>​
  
  
 +==== BC Resources ====
 +<WRAP group>
 <WRAP half column> <WRAP half column>
-===== On-Call ===== 
-==== Patient Care ==== 
 <​accordion collapsed="​true">​ <​accordion collapsed="​true">​
-<panel icon="​fa fa-life-bouy ​fa-fw" title="​Patient is Suicidal!">​ +<panel icon="​fa fa-user fa-fw" title="​Adults/​General">​ 
-<button type="​danger"​ size="​xs"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[teaching:psych-interview:suicide-risk-assessment]]</button> +  ​* ​[[http://​www.bc211.ca|BC 211]] 
-----+  * [[http://​www.mdabc.net|Mood Disorders Association of BC]] 
 +  * [[https://​www.anxietycanada.com/​|Anxiety Canada]] 
 +</panel>
  
-<WRAP group> +<panel icon="fa fa-glass fa-fw" ​title="​Addictions">​ 
-<WRAP half column>​ +  * **[[https://www.vch.ca/en/service/​detox-referral-line-access-central#​wysiwyg--31421|Access Central]]**  
-**Always document ​"CAIPS"** +    ​Phone line for adults seeking withdrawal and detox management services who live in the Vancouver Coastal Health region. ​ 
-  * **C**hronic Factors +    Individuals receive a clinical assessment and same-day substance-use virtual care provided by addiction specialists,​ providers, and nurses, with support from Access referral workers
-  * **A**cute Factors +    Access Central phone lines are open 7 days a week from 9 a.m. to 7:45 p.mat **1-866-658-1221** 
-  * **I**mminent Warning Signs +  * [[http://www.bcmhsus.ca/|BC Mental Health & Substance Use Services]]
-  * **P**rotective Factors +
-  * **S**ummary Statement +
-</WRAP> +
-<WRAP half column>​ +
-**Safety Planning**  +
-  * {{ ::​safety-comfort-plan.pdf |Safety and Comfort Plan}} +
-  * {{ ::​coping-card-170308-acc.pdf |Coping Card}} +
-  * {{ ::​camh_safety_plan_template.pdf |Safety Planning Template (CAMH)}} +
-</WRAP> +
-</WRAP> +
----- +
-**PDFs*+
-  {{ ::​how_to_write_a_suicide_risk_assessment_that-s_clinically_sound_and_legally_defensible.pdf |How to Write a SRA}} +
-  {{ :apa_suicide_risk_assessment.pdf | Suicide Risk Assessment (APA) }} +
-  ​{{ :on-call:​camh:​camh_suicide_risk_assessment_template.pdf | Suicide Risk Assessment Template (CAMH)}} +
-  * {{ ::​child_and_adolescent_suicide_assessment.pdf |Child and Adolescent Suicide Assessment Template (SickKids)}}+
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-stethoscope ​fa-fw" title="​Patient Looks Unwell!">​ +<panel icon="​fa fa-user fa-fw" title="​Borderline Personality Disorder">​ 
-<button type="​danger"​ size="​xs"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[neurology:approaches:​1-neuro-emergencies|Neurological Emergencies]]</button>+  ​* ​[[https://​sashbear.org/​en/​family-connections/​family-connections-2|SashBear Family Connections Program]] 
 +</panel>
  
-<button type="​danger"​ size="​xs"​ block="​true" ​icon="​fa fa-arrow-circle-right">​[[on-call:approach-to-im-on-call-emergencies-issues|Internal Medicine Emergencies ​and Issues]]</button>+<panel icon="​fa fa-child fa-fw" title="​Child,​ Youth, and Adolescent"> 
 +  * [[https://​www2.gov.bc.ca/​gov/​content/​health/​managing-your-health/​mental-health-substance-use/child-teen-mental-health|Ministry of Children ​and Family Development'​s Child and Youth Mental Health (CYMH) Teams]] 
 +  * [[http://​keltymentalhealth.ca|Kelty Mental Health]] 
 +  * [[http://​mindcheck.ca|Mind Check]] 
 +  * [[http://​youthinbc.com|Youth In BC Crisis Line and Chat]] 
 +  * [[https://​kidshelpphone.ca/​|Kid’s Help Phone]] 
 +    * [[https://​kidshelpphone.ca/​live-chat-counselling/​|Kid'​s Help Phone Online Chat]] 
 +  * [[https://​www.youthspace.ca/​|YouthSpace.ca Online Chat]] 
 +</panel>
  
-----+<panel icon="​fa fa-phone fa-fw" title="​Crisis and Support Lines">​ 
 +  * [[http://​www.crisislines.bc.ca|Crisis Line Association of BC]] 
 +    * 1-800-SUICIDE (1-800-784-2433) 
 +  * [[https://​crisiscentrechat.ca/​|Crisis Centre BC Chat]] 
 +  * [[https://​www.kuu-uscrisisline.com/​|KUU-US Crisis Line Society (First Nations)]] 
 +</​panel>​
  
-Consider: +<panel icon="​fa fa-commenting fa-fw" title="​Counselling + Psychotherapy">​ 
-  * **Withdrawal**: ​[[addictions:alcohol|Alcohol]], GHB, [[meds:opioids:​home|opioids]], other drugs +  * [[https://​bouncebackbc.ca/​|Bounce Back BC (referral only)]] 
-  * **Bloodwork**consider CBC, [[cl:hyponatremia|electrolytes]], BUN, creatinine, glucose, blood [[addictions:alcohol|alcohol]][[addictions:urine-drug-screen|urine drug screen]]. Always consider doing a beta hCG in females of reproductive age+  * [[https://​mdabc.net/​resources/​mdabc-support-groups/​|Mood Disorders Association of BC (Peer Support Groups)]] 
-  * **Investigations**: consider CT head, ECG, or CXR+  * [[http://​www.sfu.ca/​cpc|Clinical Psychology Centre (Simon Fraser UniversityBurnaby)]] 
 +  * [[http://​clinic.psych.ubc.ca|UBC Psychology Clinic]] 
 +  * [[http://​ecps.educ.ubc.ca/​clinical-instructional-resources/​new-westminster-UBC-counselling- centre/|UBC Counselling Centre - New Westminster]] 
 +  * [[http://​www.fsgv.ca|Family Services of Greater Vancouver]] 
 +  * [[https://​www.newwestcity.ca/​parks-and-recreation/​facilities/​century-house|Century House (for adults 50+)]] 
 +  * [[http://​www.burnabyfamilylife.org|Burnaby Family Life]] 
 +  * [[http://​fraserside.bc.ca|Fraserside Community Services]] 
 +  ​[[http://​sharesociety.ca|Share Counselling]] 
 +  ​[[http://​www.vancouvercbt.ca/​|Vancouver CBT]] 
 +  ​[[http://​purposesociety.org/​Home.html|The Lower Mainland Purpose Society for Youth and Families]] 
 +  ​[[http://​livingsystems.ca/​contact-us|Living Systems Counselling]] 
 +</​panel>​
  
-----+<panel icon="​fa fa-child fa-fw" title="​Developmental Disorders">​ 
 +  * [[https://​www.autismbc.ca/​|Autism BC]] 
 +  * [[https://​pacificautismfamily.com/​overview/​|Pacific Autism Family Network]] 
 +  * [[http://​www.communitylivingbc.ca/​what-support-is-available/​provincial-assessment-centre/​|Provincial Assessment Centre (PAC)]] 
 +  * [[https://​www.communitylivingbc.ca/​|Community Living British Columbia]] 
 +  * [[http://​www.disabilityalliancebc.org|Disability Alliance BC]] 
 +  * [[https://​www2.gov.bc.ca/​gov/​content/​family-social-supports/​services-for-people-with-disabilities/​transition-planning-for-youth-young-adults|Services to Adults with Developmental Disabilities (STADD)]] 
 +    * Transitional planning with a navigator for youth. 
 +  * [[http://​sswr.fetchbc.ca/​service.html?​i=502|Child and Youth Neuropsychiatry Clinic]] 
 +</​panel>​
  
-  * {{ ::​ed_medical_screen.pdf | Medical Screening Suggestions}} +<panel icon="​fa fa-hospital-o fa-fw" title="​Drug Coverage">​ 
-  * {{ :on-call_stat_notes.pdf | Toronto Notes On-Call STAT Notes}} +  * [[https://www2.gov.bc.ca/​gov/​content/​health/​health-drug-coverage/​pharmacare-for-bc-residents| PharmaCare]] 
-  * {{:er_medical_screening_of_patients_with_psychiatric_complaints.pdf|ER Medical Screening of Psychiatric Patients}}+  * {{ ::​fmpr_-_pharmacare_bc.pdf |BC Pharmacare Program}}
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-frown-o ​fa-fw" title="​Patient is Agitated!">​ +<panel icon="​fa fa-user fa-fw" title="​Grief and Bereavement">​ 
-<button type="​danger"​ size="​xs"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[meds:agitation]]</button>+  ​* ​[[http://​www.bcbereavementhelpline.com|BC Bereavement Helpline]] 
 +  * [[http://​www.crossroadshospice.bc.ca|Crossroads Hospice Society]] 
 +  * [[http://​lmgr.ca|Lower Mainland Grief Recovery Society]]
 </​panel>​ </​panel>​
 +</​accordion>​
  
-<panel icon="​fa fa-sign-out ​fa-fw" title="​Patient Wants to Leave!">​ +</​WRAP>​ 
-<button type="​danger"​ size="​xs"​ block="​true"​ icon="​fa fa-arrow-circle-right">​[[teaching:on-mha:emergency-assessment|Emergency Capacity Assessment]]</button>+<WRAP half column>​ 
 +<​accordion collapsed="​true">​ 
 +<panel icon="​fa fa-blind fa-fw" title="​Geriatric">​ 
 +  *  [[https://​www.jfsvancouver.ca/​services/​counselling/​|Jewish Seniors Alliance Peer Counselling for Seniors]] 
 +    * Do not need to be from Jewish community to be eligible ​-- open to all seniors 
 +    * Jewish Family Services also provides Older Adult Mental Health Outreach 
 +  * [[https://​www.bcbrainwellness.ca/​|BC Brain Wellness Program]] 
 +  * [[http://​seniorsfirstbc.ca/​|Seniors First BC (formerly BC Centre for Elder Advocacy and Support)]] 
 +  * [[https://​www.trustee.bc.ca|Public Guardian and Trustee of British Columbia (PGT)]] 
 +  * [[http://​www.vch.ca/​locations-services/​result?​res_id=1238|ReAct Adult Protection Program]] 
 +  * [[http://​www.vch.ca/​locations-services/​directory-sub-pages/​report-adult-abuse-neglect|VCH: BC Reporting Elder Abuse and Neglect]] 
 +  * [[http://​seniorsfirstbc.ca/​|Seniors First BC (formerly BC Centre for Elder Advocacy and Support)]]
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-file-text fa-fw" title="​Handouts and Information for Patients"> +<panel icon="​fa fa-balance-scale fa-fw" title="​Eating Disorders">​ 
-**Medications** +  * [[http://www.bcchildrens.ca/our-services/mental-health-services/assessment-treatment/eating-disorders|BC Children'​s Hospital: Eating Disorders]] 
-  ​* **[[https://psychiatryonline.org/doi/book/10.1176/appi.books.9781615371280|Understanding Psychiatric Medications,​ 3rd Edition Handouts]]** +</​panel>​
-  * {{ ::​camh_antidepressants_patients.pdf | Understanding Antidepressants}} +
-  * {{ :​camh_antipsychotics_patients.pdf | Understanding Antipsychotics}} +
-  * {{ :​camh_benzodiazepines_patients.pdf | Understanding Benzodiazepines}} +
-  * {{ :​camh_mood_stabilizers_patients.pdf | Understanding Mood Stablizers}}+
  
----- +<panel icon="​fa fa-hospital-o fa-fw" title="​Emergency + Urgent Care">​ 
-**Handouts, Worksheets ​and Workbooks for Various ​Mental ​Disorders** +  * [[https://​www.islandhealth.ca/​our-services/​mental-health-substance-use-services/​outpatient-treatment-mental-health|Victoria:​ Urgent Short Term Assessment and Treatment (USTAT)]] 
-  * [[https://​www.cci.health.wa.gov.au/Resources/For-Clinicians|Centre ​for Clinical Interventions]] (Great Resource!)+  [[http://​www.vch.ca/​locations-services/​result?​res_id=1186|Vancouver:​ Access and Assessment Centre (AAC)]] 
 +  ​[[http://​www.vch.ca/​your-care/​mental-health-substance-use/​richmond-mental-health-and-substance-use|Richmond: ​Mental ​Health and Substance Use]] 
 +  * **Fraser Health** 
 +    * [[https://​www.fraserhealth.ca/​Service-Directory/​Services/​mental-health-and-substance-use/​mental-health---community-services/​adult-short-term-assessment-and-treatment-program|Adult Short-Term Assessment and Treatment Program (ASTAT)]] 
 +    * [[https://​www.fraserhealth.ca/​Service-Directory/​Locations/​Burnaby/​burnaby-mental-health-centre|Burnaby:​ Community Mental Health and Substance Use Centre]] 
 +    * [[https://​www.fraserhealth.ca/Service-Directory/Locations/​New-Westminster/​new-westminster-mental-health-centre|New Westminster:​ Mental Health and Substance Use Centre]] 
 +    * [[https://​www.fraserhealth.ca/​Service-Directory/​Service-At-Location/​9/​5/​surrey-mental-health-and-substance-use-urgent-care-response-centre|Surrey:​ Mental Health and Substance Use Urgent Care Response Centre]] 
 +</​panel>​
  
----- +<panel icon="​fa fa-transgender fa-fw" title="​LGBT+"> 
-**Therapy Handouts** +  * [[http://www.phsa.ca/​transcarebc/​|TransCare BC]] 
-  * {{ ::​grounding-techniques-provider-patient-handout.pdf |Grounding for Emotional Pain (Provider ​Patient)}} +  * [[http://​www.qmunity.ca|Qmunity]]
-  * {{ :list_of_pleasurable_activities.pdf |Pleasurable Activities}} +
-  * {{ ::​assertiveness_handout.pdf |Assertiveness}} +
-  * {{ :​emotions_handout.pdf |Emotions}} +
-  * {{ :​list_of_feelings.pdf |Feelings}} +
-  * {{ :​psychotherapy:​trauma_therapy_toolkit.pdf |Trauma Therapy Toolkit}} +
-  * [[http://​www.cqaimh.org/​pdf/​tool_edu_moodchart.pdf|Mood Charting - Depression Log (PDF)]]+
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-lightbulb-o ​fa-fw" title="​Choosing Wisely Canada">​ +<panel icon="​fa fa-stethoscope ​fa-fw" title="​Primary Care">​ 
-  * [[https://choosingwiselycanada.org/psychiatry/|Choosing Wisely Canada: Psychiatry]]+  * [[https://bccfp.bc.ca/for-the-public/​find-a-family-doctor/|BC College of Family Physicians]]
 </​panel>​ </​panel>​
  
-==== Legal and Reporting ==== +<panel icon="​fa fa-dollar ​fa-fw" title="​PWD and Disability"
-<panel icon="​fa fa-bullhorn ​fa-fw" title="​What Needs To Be Reported?">+  * [[https://​www2.gov.bc.ca/​gov/​content/​family-social-supports/​services-for-people-with-disabilities/​disability-assistance|Government of BC: Disability Assistance]] 
 +  * [[https://​disabilityalliancebc.org/​category/​publications/​help-sheets/​|Disability Alliance BC (Benefits Help Sheets)]] 
 +</panel>
  
-<callout type="success">​{{fa>arrow-circle-right?color=green}} See main article: **[[http://​www.cpso.on.ca/policies-publications/​policy/mandatory-and-permissive-reporting|CPSO Guidelines on Reporting]]**</callout>+<panel icon="​fa ​fa-flash fa-fw" title="​Psychological Trauma">​ 
 +  ​* [[http://​www.victimlinkbc.ca|Victim Link BC]] 
 +  * [[http://vast-vancouver.ca|Vancouver Association for the Survivors of Torture (VAST)]] 
 +</panel>
  
-Reporting to an agency or organization can either be mandatory or permissiveRefer to the CPSO guidelines for full details.+<panel icon="​fa fa-flash fa-fw" title="​Traumatic Brain Injury">​ 
 +  * [[https://​www.brainstreams.ca/|BC Brain Injury Association]] 
 +</​panel>​
  
 +<panel icon="​fa fa-female fa-fw" title="​Women">​
 +  * [[http://​elizabethfry.com|Elizabeth Fry Society of Greater Vancouver]]
 +  * [[https://​www.wavaw.ca/​|Rape Crisis Centre (Women Against Violence Against Women)]]
 +  * [[http://​www.bcwomens.ca/​our-services/​specialized-services/​sexual-assault-service|BC Women'​s Sexual Assault Service]]
 +</​panel>​
 +</​accordion>​
 +</​WRAP>​
 +</​WRAP>​
 +
 +
 +
 +===== Ontario =====
 +
 +==== Legal and Reporting ====
 +<​accordion collapsed="​true">​
 +<panel icon="​fa fa-bullhorn fa-fw" title="​What Needs To Be Reported?">​
 +Reporting to an agency or organization can either be mandatory or permissive. Refer to the [[http://​www.cpso.on.ca/​policies-publications/​policy/​mandatory-and-permissive-reporting|CPSO guidelines]] for full details.
 **Mandatory reporting situations:​** **Mandatory reporting situations:​**
   - Child Abuse or Neglect   - Child Abuse or Neglect
Line 292: Line 424:
  
 <panel icon="​fa fa-car fa-fw" title="​Should I Report My Patient'​s Driving?">​ <panel icon="​fa fa-car fa-fw" title="​Should I Report My Patient'​s Driving?">​
-<callout type="​danger">​ +The //Highway Traffic Act// requires physicians report ​a patient ​when they are of opinion that the individual has a medical condition or functional impairment that may make it dangerous for them to operate a motor vehicle. This act was most recently updated in 2018, and has new mandatory reporting situations.
-Please refer to the **[[https://www.oma.org/sections/managing-your-practice/​running-your-practice/​fitness-to-drive/​|OMA Recommendations]]** on whether or not a patient ​needs to be reported. +
-</​callout>​+
  
-In Ontario, the Highway Traffic Act requires that physicians report a patient, when they are of opinion that the individual has a medical condition or functional impairment that may make it dangerous for him or her to operate a motor vehicle. This act was most recently updated in 2018, and has new mandatory reporting situations.  +  ​* [[https://www.ontario.ca/page/reporting-driver-medical-review|Government of Ontario: Reporting a driver for medical review]] 
- +  * [[https://content.oma.org//wp-content/uploads/MayJune2018OMR-FitnesstoDrive.pdf|OMA Recommendations]] 
-**Forms** +  * [[https://www.porticonetwork.ca/learn/videos/quick-takes-2-ontario-ministry-of-transportation-reporting-requirements-december-2018|New Reporting Rules Quick Takes and FAQs]]
-    ​* [[http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/023-5108E~1/$File/5108E.pdf|Medical Condition Report Form]] +
-    * [[http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/​ssbforms.nsf/​GetFileAttach/​023-5108E~2/​$File/​5108E_Guide.pdf|How to Complete the Medical Condition Report Form]]+
  
 ---- ----
Line 308: Line 436:
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-child fa-fw" title="​Should I Report to a Children'​s Aid Society?">​+<panel icon="​fa fa-child fa-fw" title="​Should I Report to a Children'​s Aid Society ​or the Ministry?"> 
 +  * //"​Physicians who have reasonable grounds to suspect a child is in need of protection must report directly to a CAS, and not rely on any other person to report on their behalf."//​ -- [[https://​www.cpso.on.ca/​Physicians/​Policies-Guidance/​Policies/​Mandatory-and-Permissive-Reporting|The College of Physicians and Surgeons of Ontario: Mandatory and Permissive Reporting]] 
 +  * All circumstances of suspected child risk, abuse and neglect must be reported to appropriate child protection agencies at the time of assessment. If you are not sure whether reporting is necessary, you can call and discuss the situation without using the patient’s name. If child protective services advises that you must report, then identifying information must be given to them. There is someone available to receive your call 24 hours a day, 365 days a year.
  
-<​callout>​ +**Key Terms**: 
-"​Physicians who have reasonable grounds ​to suspect ​a child is in need of protection must report directly ​to a CAS, and not rely on any other person to report on their behalf."​ -- [[https://​www.cpso.on.ca/​Physicians/​Policies-Guidance/​Policies/​Mandatory-and-Permissive-Reporting|The College ​of Physicians and Surgeons of Ontario: Mandatory and Permissive Reporting]] +  * **Crown ward** = the local children'​s aid has extended care of the child 
-</​callout>​ +  * **Society ward** = the local children'​s aid has custody of the child but if the parents are proven fit, the child will be returned 
- +  * **Apprehension** = to bring a child to a place of safety 
-All circumstances ​of suspected child risk, abuse and neglect must be reported ​to appropriate child protection agencies at the time of assessment. If you are not sure whether reporting is necessary, you can call and discuss the situation without using the patient’s nameIf child protective services advises that you must report, then identifying information must be given to +  * **Age of Protection** = A 16-17 year old can be brought ​to care of Children’s Aid Society under a Voluntary Youth Services Agreement (VYSA)Parental consent ​is not required.
-them. There is someone available to receive your call 24 hours a day, 365 days a year.+
  
 **Developmental Milestones** **Developmental Milestones**
   * {{ ::​ontario-age-based-milestones.pdf |Ontario Age-Based Milestones}}   * {{ ::​ontario-age-based-milestones.pdf |Ontario Age-Based Milestones}}
 +</​panel>​
 +</​accordion>​
  
 +
 +==== Ontario Mental Health Act ====
 +<alert icon="​fa fa-arrow-circle-right fa-lg fa-fw" type="​success">​
 +See section: **[[teaching:​on:​mha:​home|Introduction to Ontario'​s Mental Health Laws]]**
 +</​alert>​
 +
 +<WRAP group>
 +<WRAP half column>
 +== Common Forms ==
 +<​accordion collapsed="​true">​
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 1 (Psychiatric Assessment) + Form 42 (Notice to Patient)">​
 +
 +<btn type="​success"​ size="​sm"​ icon="​fa fa-question-circle">​
 +[[http://​www.psychdb.com/​_media/​form_1_and_42_-_explained.pdf|How to Fill a Form 1/42 in 5 mins]]
 +</​btn>​
 +----
 +
 +**[[teaching:​on:​mha:​form-1-42|Form 1]]** (//​Application by Physician for Psychiatric Assessment//​)
 +  * Detains patient for //​assessment//​ only
 +  * Valid for 72 hours
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​
 +{{ teaching:​on:​mha:​form_1_ontario_mha.pdf |Download Form 1}}
 +</​btn>​
 +----
 +**[[teaching:​on:​mha:​form-1-42|Form 42]]** (//Notice to Patient//)
 +  * Give original Form 42 to patient
 +  * Keep a copy in chart
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​
 +{{ teaching:​on:​mha:​form_42_ontario_mha.pdf |Download Form 42}}
 +</​btn>​
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-legal fa-fw" title="​Should I Talk to Police About a Patient?">+<panel icon="​fa fa-file-text-o ​fa-fw" title="​Form 3 (Involuntary Admission) + Form 30 (Notice ​to Patient)">
  
-  ​* {{ ::police_handover_flow_sheet.pdf | Police Handover Flowsheet}} +**[[teaching:​on:​mha:​form-3|Form 3]]** (//​Certificate of Involuntary Admission//​) 
-  {{ :disclosing_patient_information_to_police.pdf ​Disclosing ​Patient ​Information ​to Police}} +  * Involuntary admission for 14 days (REMEMBER: It is 14 days //​including//​ the day you sign the form, therefore, you add only 13 days, NOT 14 days) 
-  * {{ :police_handover_protocol.pdf |Police Handover Protocol}}+  * Same criteria as Form 1 - both Box A and B are available 
 +  * A Form 30 must be given to patient immediately to notify them 
 +  * Rights Advice must be notified 
 +  * If you signed the Form 1, you **cannot** sign a Form 3 - it must be a different MD! 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:on:mha:form_3_ontario_mha.pdf |Download Form 3}} 
 +</​btn>​ 
 +---- 
 +**[[teaching:on:​mha:​form-30|Form 30]]** (//Notice to Patient//) 
 +  * Give the original Form 30 to patient after a Form 3 or Form 4 is signed 
 +  * Keep a copy in chart 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:form_30_ontario_mha.pdf |Download Form 30}} 
 +</​btn>​ 
 +</​panel>​
  
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 33 (Finding of Incapacity)">​
 +**[[teaching:​on:​mha:​form-33|Form 33]]** (//Notice to Patient - Incapacity//​)
 +  * Patient is not capable to (one or more of the following):
 +    - Consent to treatment (unable to understand AND/OR appreciate a proposed treatment)
 +      * Do a [[teaching:​on:​consent-capacity|capacity assessment]] for your proposed treatment
 +      * You must immediately find a [[teaching:​on:​consent-capacity#​substitute-decision-maker|substitute decision maker (SDM)]] or if unable to locate, contact [[https://​www.attorneygeneral.jus.gov.on.ca/​english/​family/​pgt/​index.php|The Office of the Public Guardian and Trustee (OPGT)]]
 +    - To manage property (AKA finances)
 +      * Do a [[teaching:​on:​financial-capacity|financial capacity assessment]] and fill out a Form 21
 +      * Contact [[https://​www.attorneygeneral.jus.gov.on.ca/​english/​family/​pgt/​index.php|The Office of the Public Guardian and Trustee (OPGT)]]
 +      * {{ ::​guardian_finances_patient_handout.pdf |Handout for Patients Deemed Financially Incapable}}
 +    - To consent to release of their health information
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​
 +{{ teaching:​on:​mha:​form_33_ontario_mha.pdf |Download Form 33}}
 +</​btn>​
 </​panel>​ </​panel>​
  
-==== Medical Education ​====+<panel icon="fa fa-file-text-o fa-fw" size="​sm"​ title="​Request for Rights Advice (PPAO)">​ 
 +**Rights Advice Form** (//Request for Rights Advice Mental Health Inpatient//​) 
 +  * You must notify the Psychiatric Patient Advocate Office (PPAO) each time a patient is placed on a Form 3, Form 4, Form 21, or given a Form 33 
 +  * A rights advisor will arrive to see patient and inform them of their legal rights to challenge the admission 
 +<btn type="​primary"​ size="​sm"​ icon="fa fa-download">​ 
 +{{ ::​ppao_request.pdf |PPAO Request}} 
 +</​btn>​ 
 +</​panel>​ 
 +</​accordion>​ 
 +</​WRAP>​ 
 +<WRAP half column>​ 
 +== All Forms == 
 +<​accordion collapsed="​true">​ 
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 2 (Order For Examination)">​ 
 +**[[teaching:​on:​mha:​form-2|Form 2]]** (//Order For Examination//​) 
 +  * Is a form that any member of the public (or family member) can fill out and ask a Justice of the Peace to sign 
 +  * Gives police 7 days to bring someone to hospital 
 +  * Police will bring patient to a hospital for assessment 
 +  * Does not authorize patient to be detained at the hospital; still must complete a Form 1 to keep them in hospital! 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_2_ontario_mha.pdf |Download Form 2}} 
 +</​btn>​ 
 +</​panel>​ 
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 4 (Certificate of Renewal)">​ 
 +**[[teaching:​on:​mha:​form-4|Form 4]]** (//​Certificate of Renewal//​) 
 +  * The first Form 4 lasts one month (add 1 month, minus 1 day) 
 +    * Second Form 4 lasts two months (add 2 months, minus 1 day) 
 +    * Third Form 4 lasts three months (add 3 months, minus 1 day) 
 +  * Rights advice must be notified 
 +  * Give Form 30 each time, plus patient can appeal each time 
 +  * There is also a Form 4A ("​Fourth Form 4") (also 3 months, minus 1 day) 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_4_ontario_mha.pdf |Download Form 4}} 
 +</​btn>​ 
 +</​panel>​ 
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 5 (Change to Voluntary Status)">​ 
 +**Form 5** (//Change to Informal or Voluntary Status//) 
 +  * Fill out this form to end a Form 3 or Form 4 (i.e. - make a patient voluntary again) 
 +  * You do not need to fill this out to cancel a Form 1, simply either document are cancelling the Form 1, or cross out the Form 1 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_5_ontario_mha.pdf |Download Form 5}} 
 +</​btn>​ 
 +</​panel>​ 
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 9 (Order for Return)">​ 
 +**Form 9** (//Order for Return//) 
 +  * Used find patients who go AWOL while involuntarily admitted (Form 1, Form 3, Form 4) 
 +  * Police will look for patient and take them back to hospital 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_9_ontario_mha.pdf |Download Form 9}} 
 +</​btn>​ 
 + 
 +<btn type="​success"​ size="​sm"​ icon="​fa fa-question-circle">​[[http://​psychdb.com/​_media/​form_9_-_uloa_flowchart_final.pdf|FAQ on Filling a Form 1 after a Form 9]]</​btn>​
  
-<panel icon="​fa fa-phone fa-fw" title="​It'​s Time to Review Case With Staff!">​ 
-  * {{ ::​review_with_staff_checklist.pdf |Resident Checklist Before Reviewing}} 
-  * {{ :​on-call-supervision-record.pdf |On-Call Supervision Record}} 
 </​panel>​ </​panel>​
  
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 10 (Transfer of Patient) and Form 11 (Transfer of Patient for Medical Treatment)">​
 +A Form 10 or Form 11 needs to be completed if a patient is being transferred from one facility to another.
  
-==== Hospital-specific ==== +**Form 10** (//Transfer of Patient//​) 
-<panel icon="​fa fa-hospital-o fa-fw" ​title="​Centre ​for Addiction and Mental Health ​(CAMH)"> +  * Transfers patient on a Form (e.g. 3, 4 or 4A) from one facility to another 
-<button icon="fa fa-lock" size="xs" ​type="success">[[on-call:camh:home|CAMH On-Call (password-protected)]]</button>+  * This is usually a permanent transfer and the patient can be discharged 
 + 
 +<btn type="​primary"​ size="​sm" ​icon="​fa fa-download"
 +{{ teaching:​on:​mha:​form_10_ontario_mha.pdf |Download Form 10}} 
 +</​btn>​ 
 + 
 +**Form 11** (//Transfer of Patient ​for Medical Treatment//​) 
 +  * Transfers patient on a Form (e.g. - 3, 4 or 4Ato another facility for //medical treatment or medical clearance// that cannot be provided at the current facility 
 +  * If the patient is to return back to the original facility, do not discharge the patient from the original facility yet, as this will invalidate the current MHA Form! Only discharge the patient if you are certain they are not returning 
 +  * A copy of the current MHA Form (e.g. - 3, 4 or 4A) must be provided to the hospital treating the patient 
 +<btn type="primary" size="sm" ​icon="fa fa-download"> 
 +{{ teaching:on:mha:form_11_ontario_mha.pdf ​|Download Form 11}} 
 +</​btn>​ 
 + 
 +The Form 10 and Form 11 requires the signature of an Officer-in-Charge, and this can be any one of: 
 +  * Physician-in-Chief 
 +  * Chief of Nursing 
 +  * Medical Directors 
 +  * Medical Heads 
 +  * Hospitalists 
 +  * Unit Manager 
 +  * After hours: duty physician, on-call resident, or after-hours manager 
 + 
 +<​callout>​ 
 +**NOTE**: The patient'​s attending physician **cannot** sign as the officer-in-charge,​ even if they happen to be acting in one of the above roles. 
 +</callout>
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-hospital-o fa-fw" title="​St. Michael'​s Hospital ​(SMH)">​ +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 21 (Certificate of Financial Incapacity)"> 
-<button icon="fa fa-lock" size="xs" ​type="success">[[on-call:smh|StMichael'​s On-Call (password-protected)]]</button>+**Form 21** (//​Certificate of Incapacity to Manage One's Property//​) 
 +  * MD fills out this Form to explain why the finding of financial incapacity was made 
 +  * Form 33 must be given to patient to notify them of this finding 
 +<btn type="primary" size="sm" ​icon="fa fa-download"> 
 +{{ teaching:on:mha:​form_21_ontario_mha.pdf |Download Form 21}} 
 +</btn>
 </​panel>​ </​panel>​
  
-<panel icon="​fa fa-hospital-o fa-fw" title="​Sunnybrook Hospital ​(SHSC)">​ +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 45, 47, and 49 (Community Treatment Order)">​ 
-<button ​icon="​fa fa-lock" size="​xs" type="​success">​[[on-call:sunnybrook|Sunnybrook On-Call (password-protected)]]</button>+<alert icon="​fa fa-arrow-circle-right fa-lg fa-fw" type="​success">​ 
 +**See main article: ​[[teaching:on:mha:form-45-47-49-cto]]** 
 +</​alert>​ 
 +**[[teaching:on:mha:form-45-47-49-cto|Form 45]]** (//​Community Treatment Order//) 
 +  * Allows a physician to mandate supervised treatment on a patient when they are discharged from hospital 
 +  * Can be voluntary ​(i.e. patient requests the CTO), or more commonly involuntary (MD initiates the CTO) 
 + 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_45_ontario_mha.pdf |Download Form 45}} 
 +</​btn>​ 
 + 
 +---- 
 + 
 +**[[teaching:​on:​mha:​form-45-47-49-cto#​form-47|Form 47]]** (//Order for Examination//​) 
 +  * Issued when patient violates their CTO conditions (i.e. - does not show up for appointments/​medication) 
 +  * Allows police to recall patient to hospital for assessment 
 +  * Once at a hospital, the patient must be issued a Form 1 - a Form 47 by itself does not allow for involuntary detention 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_47_ontario_mha.pdf |Download Form 47}} 
 +</btn> 
 + 
 +---- 
 + 
 +**Form 49** (Notice/​Intention to Start CTO) 
 +  * This is issued to the patient to notify them of your intention to start or renew a CTO 
 + 
 +<btn type="​primary"​ size="​sm"​ icon="​fa fa-download">​ 
 +{{ teaching:​on:​mha:​form_49_ontario_mha.pdf |Download Form 49}} 
 +</​btn>​ 
 </​panel>​ </​panel>​
  
 +<panel icon="​fa fa-file-text-o fa-fw" title="​Form 49 (Warrant of Committal)">​
 +<callout type="​danger"​ icon="​true">​Confusion Alert! There are 2 VERY different Form 49s! The other Form 49 is for CTOs (Notice/​Intention to Start CTO).</​callout>​
 +**[[teaching:​on:​mha:​form-49|Form 49]]** (//Warrant of Committal//​)
 +  * Issued through the Ontario Review Board (ORB), ​ which is essentially a detention order. The patient does not need any additional Forms signed once brought to the hospital and can be involuntarily detained by default.
 +
 +</​panel>​
 </​accordion>​ </​accordion>​
 </​WRAP>​ </​WRAP>​
 </​WRAP>​ </​WRAP>​
  
-===== Greater Toronto Area Resources ====+ 
-<​accordion collapsed="​true">​+==== Ontario ​Resources ====
 <WRAP group> <WRAP group>
 <WRAP half column> <WRAP half column>
 +<​accordion collapsed="​true">​
 <panel icon="​fa fa-child fa-fw" title="​Child,​ Youth, and Adolescent">​ <panel icon="​fa fa-child fa-fw" title="​Child,​ Youth, and Adolescent">​
 **Organizations** **Organizations**
Line 373: Line 678:
  
 <panel icon="​fa fa-child fa-fw" title="​Developmental Disorders">​ <panel icon="​fa fa-child fa-fw" title="​Developmental Disorders">​
-  * **Under 18:** [[http://​http://​csptoronto.surreyplace.ca/​|Coordinated Service Planning - Toronto Region]] +**Under 18:*
-    * {{ ::​family-guide-to-csp-detailed.pdf |CSP Guide for Families}} +  ​* [[http://​http://​csptoronto.surreyplace.ca/​|Coordinated Service Planning - Toronto Region]] 
-  ​* ​**Over 18:** [[http://​www.dsontario.ca/​agencies/​dso-toronto|Developmental Services Ontario]]+  * {{ ::​family-guide-to-csp-detailed.pdf |CSP Guide for Families}} 
 + 
 +---- 
 +**Over 18:*
 +  ​* [[http://​www.dsontario.ca/​agencies/​dso-toronto|Developmental Services Ontario]]
   * [[http://​www.readycanada.org/​|READY Canada (Resources for Disruptive Behaviour in Youth)]]   * [[http://​www.readycanada.org/​|READY Canada (Resources for Disruptive Behaviour in Youth)]]
   * [[https://​www.porticonetwork.ca/​treatments/​disorders-qr/​dual-diagnosis/​dual-diagnosis-resources|Portico:​ Dual Diagnosis Resources]]   * [[https://​www.porticonetwork.ca/​treatments/​disorders-qr/​dual-diagnosis/​dual-diagnosis-resources|Portico:​ Dual Diagnosis Resources]]
  
 +----
 **PDFs:** **PDFs:**
   * {{ ::​developmental_services_ontario.pdf |ER Resources for Developmental/​Intellectual Disability Patients}}   * {{ ::​developmental_services_ontario.pdf |ER Resources for Developmental/​Intellectual Disability Patients}}
Line 392: Line 702:
 **General** **General**
   * [[https://​www.211toronto.ca/​detail/​en/​163654|Toronto Seniors Helpline]] (416-217-2077)   * [[https://​www.211toronto.ca/​detail/​en/​163654|Toronto Seniors Helpline]] (416-217-2077)
-    ​{{ ::​toronto_seniors_helpline.pdf |Handout (PDF)}} +  ​[[https://​sinaigeriatrics.ca/|Mount Sinai Geriatics]]
-  * {{ ::​geriatric_resources.pdf |Toronto Geriatric Resources}}+
   * [[https://​igericare.healthhq.ca/​|iGeriCare]]   * [[https://​igericare.healthhq.ca/​|iGeriCare]]
-  * {{ ::​sf7-toolkit-v1-2018.pdf |Senior Friendly 7 Toolkit ​(PDF)}}+  * [[https://​www.rgptoronto.ca/​services/​|Regional Geriatric Program ​(RGPToronto]]
   * [[https://​www.baycrest.org/​Baycrest/​Healthcare-Programs-Services/​Clinical-Services/​Neuropsychology-Cognitive-Health/​Neuropsychology-Treatment-Programs/​Learning-the-Ropes-for-MCI|Baycrest:​ Mild Cognitive Impairment - Learning the Ropes]]   * [[https://​www.baycrest.org/​Baycrest/​Healthcare-Programs-Services/​Clinical-Services/​Neuropsychology-Cognitive-Health/​Neuropsychology-Treatment-Programs/​Learning-the-Ropes-for-MCI|Baycrest:​ Mild Cognitive Impairment - Learning the Ropes]]
   * [[https://​fountainofhealth.ca/​|Fountain of Health]]   * [[https://​fountainofhealth.ca/​|Fountain of Health]]
 +
 +----
 +**PDFs**
 +  * {{ ::​sf7-toolkit-v1-2018.pdf |Senior Friendly 7 Toolkit (PDF)}}
 +  * {{ ::​toronto_seniors_helpline.pdf |Handout (PDF)}}
 +  * {{ ::​geriatric_resources.pdf |Toronto Geriatric Resources}}
 +
 +----
  
 **BPSD** **BPSD**
   * [[http://​www.bcbpsd.ca|BC BPSD Algorithm App]]   * [[http://​www.bcbpsd.ca|BC BPSD Algorithm App]]
   * {{ ::​mas_20questionsthathelpexplainwhypeoplewithdementiagetagitated.pdf |20 Questions that Help Explain Dementia Aggression (PDF)}}   * {{ ::​mas_20questionsthathelpexplainwhypeoplewithdementiagetagitated.pdf |20 Questions that Help Explain Dementia Aggression (PDF)}}
 +  * {{ :​do_you_remember_-_dementia.pdf |Things Not To Say To People With Dementia (PDF)}}
 </​panel>​ </​panel>​
  
 <panel icon="​fa fa-flash fa-fw" title="​Traumatic Brain Injury">​ <panel icon="​fa fa-flash fa-fw" title="​Traumatic Brain Injury">​
   * [[http://​abinetwork.ca/​|Acquired Brain Injury Network]]   * [[http://​abinetwork.ca/​|Acquired Brain Injury Network]]
 +  * [[https://​obia.ca/​|Ontario Brain Injury Association]]
 </​panel>​ </​panel>​
  
Line 417: Line 736:
 **Drug and Alcohol Helpline** **Drug and Alcohol Helpline**
   * 1-800-565-8603   * 1-800-565-8603
- 
----- 
- 
-**Referrals** 
-  * [[http://​www.stmichaelshospital.com/​programs/​mentalhealth/​rapid-access-clinic.php|St. Michael'​s Hospital - Addictions Rapid Access Clinic Referral]] 
-  * [[https://​www.camh.ca/​en/​your-care/​programs-and-services/​addiction-medicine|CAMH - Addiction Medicine Service]] 
-    * {{ ::​addiction_medicine_service_info.pdf |Addiction Medicine Service Drop-in Handout}} 
-  * [[http://​www.smhemerg.com/​uploads/​1/​5/​4/​5/​15458024/​true_north_pads_v6.pdf|True North Medical (Opioid) Referral]] 
- 
----- 
- 
-**Detox Beds** 
-  * {{ ::​toronto_central_detox.pdf |Toronto Central Detox Handout}} 
-  * Patients need to call Central Access at 1-866-366-9513 and complete a phone assessment to access a detox bed. If there are no detox beds available, the patient must continue to call Central Access every hour. There is no wait list for beds. 
- 
  
 ---- ----
Line 448: Line 752:
   * [[http://​johnhoward.on.ca/​durham/​community-justice-services/​anger-management/​|John Howard Society]]   * [[http://​johnhoward.on.ca/​durham/​community-justice-services/​anger-management/​|John Howard Society]]
 </​panel>​ </​panel>​
 +
 +</​accordion>​
  
 </​WRAP>​ </​WRAP>​
 <WRAP half column> <WRAP half column>
-<panel icon="​fa fa-transgender fa-fw" title="​Transgender">+<​accordion collapsed="​true">​ 
 +<panel icon="​fa fa-transgender fa-fw" title="​LGBTQT+">
   * [[https://​ctys.org/​|Transceptance - Central Toronto Youth Services]]   * [[https://​ctys.org/​|Transceptance - Central Toronto Youth Services]]
   * [[https://​pflagcanada.ca/​|Pflag Canada]]   * [[https://​pflagcanada.ca/​|Pflag Canada]]
Line 457: Line 764:
 </​panel>​ </​panel>​
 <panel icon="​fa fa-user fa-fw" title="​Borderline Personality Disorder">​ <panel icon="​fa fa-user fa-fw" title="​Borderline Personality Disorder">​
-<callout type="success">​{{fa>arrow-circle-right?color=green}} ​See main article: **[[personality:​borderline|]]**</​callout>+<alert icon="​fa ​fa-arrow-circle-right ​fa-lg fa-fw" type="​success">​See main article: **[[personality:​borderline|]]**</​alert>
   * {{ ::​borderline_personality_disorder_resources_pdf.pdf |Borderline Personality Disorder Resources (CAMH)}}   * {{ ::​borderline_personality_disorder_resources_pdf.pdf |Borderline Personality Disorder Resources (CAMH)}}
   * {{ :​psychotherapy:​dbt_approaches_in_er.pdf |DBT Approaches in the ER}}   * {{ :​psychotherapy:​dbt_approaches_in_er.pdf |DBT Approaches in the ER}}
 +  * {{ ::​dbt_online_resource_list.pdf |DBT Online Resource List}}
 </​panel>​ </​panel>​
  
Line 471: Line 779:
  
 <panel icon="​fa fa-commenting fa-fw" title="​Counselling + Psychotherapy">​ <panel icon="​fa fa-commenting fa-fw" title="​Counselling + Psychotherapy">​
 +**Organizations**
 +  * [[http://​www.gppaonline.ca/​|GP Psychotherapy Association]]
 +  * [[http://​www.mooddisorderscanada.ca/​|Mood Disorders Canada]]
 +  * [[http://​www.psychotherapyontario.com/​|Ontario Society of Psychotherapists]]
 +  * [[http://​www.psychotherapyontario.org/​|Psychotherapy Ontario]]
 +  * [[http://​www.oaccpp.ca|Ontario Association of Consultants,​ Counsellors,​ Psychometrics and Psychotherapists]]
 +  * [[http://​therapytoronto.ca|Toronto Therapy Network for Psychotherapy Self-Referral]]
 +
 +----
 +
 +**Online**
 +  * [[https://​www.mindbeacon.com/​pricing/​|MindBeacon]]
 +  * [[https://​ontario.abiliticbt.com/​home|AbilitiCBT.com]]
 +
 +----
 +
 +**Lists**
   * {{ ::​toronto_cbt_and_psychotherapy_list.pdf |Toronto CBT and Psychotherapy List}}   * {{ ::​toronto_cbt_and_psychotherapy_list.pdf |Toronto CBT and Psychotherapy List}}
 +  * {{ ::​psychotherapy_resources_camh_pdf.pdf |List of Psychotherapy Resources (CAMH)}}
   * {{ ::​walk-in_counselling_for_adults.pdf |Walk-in Counselling For Adults}}   * {{ ::​walk-in_counselling_for_adults.pdf |Walk-in Counselling For Adults}}
-  * {{ ::​psychotherapy_resources_toronto.pdf |Psychotherapy Resources Toronto}} 
 </​panel>​ </​panel>​
 <panel icon="​fa fa-home fa-fw" title="​Shelters and Housing">​ <panel icon="​fa fa-home fa-fw" title="​Shelters and Housing">​
Line 523: Line 848:
   * Eligible for OHIP+ patients age 24 or younger, or age 65 or older   * Eligible for OHIP+ patients age 24 or younger, or age 65 or older
     * {{ ::​odb_primer_-_final_version.pdf |ODB Primer and Introduction (PDF)}}     * {{ ::​odb_primer_-_final_version.pdf |ODB Primer and Introduction (PDF)}}
 +
 +----
 +
 **Ontario Disability Support Program (ODSP)** **Ontario Disability Support Program (ODSP)**
   * [[http://​www.mcss.gov.on.ca/​documents/​en/​mcss/​social/​publications/​HCP_Guide.pdf|Health Care Provider'​s Guide]]   * [[http://​www.mcss.gov.on.ca/​documents/​en/​mcss/​social/​publications/​HCP_Guide.pdf|Health Care Provider'​s Guide]]
   * [[http://​www.mcss.gov.on.ca/​documents/​en/​mcss/​social/​info_sheets/​ODSP_what.pdf|What is ODSP?]]   * [[http://​www.mcss.gov.on.ca/​documents/​en/​mcss/​social/​info_sheets/​ODSP_what.pdf|What is ODSP?]]
   * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​odsp/​income_support/​IS_Application.aspx|Applying for ODSP]]   * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​odsp/​income_support/​IS_Application.aspx|Applying for ODSP]]
-    * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​odsp/​income_support/​odsp_medical_transport.aspx|Mandatory Special Necessities Benefit Request]] ​({{ :​mandatory_special_necessities_benefit_request.pdf |PDF Form}})+    * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​odsp/​income_support/​odsp_medical_transport.aspx|Mandatory Special Necessities Benefit Request]]
     * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​special_diet_apply.aspx|Special Diet Allowance]] ({{ :​special_diet_allowance.pdf |PDF Form}})     * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​special_diet_apply.aspx|Special Diet Allowance]] ({{ :​special_diet_allowance.pdf |PDF Form}})
 +
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 **Ontario Works (OW) ** **Ontario Works (OW) **
   * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​ow/​apply.aspx|OntarioWorks]]   * [[http://​www.mcss.gov.on.ca/​en/​mcss/​programs/​social/​ow/​apply.aspx|OntarioWorks]]
 +
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 **CPP Disability Benefits** **CPP Disability Benefits**
   * [[http://​www.servicecanada.gc.ca/​eforms/​forms/​sc-isp-2519(2014-05-09)e.pdf|Medical Report]]   * [[http://​www.servicecanada.gc.ca/​eforms/​forms/​sc-isp-2519(2014-05-09)e.pdf|Medical Report]]
   * [[http://​www.servicecanada.gc.ca/​eforms/​forms/​sc-isp-1151(2016-06-22)e.pdf|Application for Disability Benefits]]   * [[http://​www.servicecanada.gc.ca/​eforms/​forms/​sc-isp-1151(2016-06-22)e.pdf|Application for Disability Benefits]]
 +
 +----
  
 **Employment Insurance (EI)** **Employment Insurance (EI)**
Line 551: Line 885:
   * [[https://​mindtools.io|MindTools.io (Mental Health Apps Guide)]]   * [[https://​mindtools.io|MindTools.io (Mental Health Apps Guide)]]
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