Form 6 (British Columbia - Renewal Certificate for Involuntary Admission)

A Form 6 (Medical Report on Examination of Involuntary Patient Renewal Certificate) also known as a Renewal Certificate, is a form under the British Columbia Mental Health Act that allows a person's involuntary hospitalization to be extended beyond the first month (i.e. - after two Form 4s have been issued).

Download Form 6

The criteria for involuntary admission renewal are the same as those for original certification. When considering renewal of an involuntary status for a patient, the physician must directly examine the patient and all available information regarding:

  1. The patient's mental disorder
  2. The patient’s hospitalizations for psychiatric treatment
  3. Whether they have followed treatment plans after leaving hospital, and
  4. Be of the opinion that if discharged, due to their mental disorder, the patient is likely to experience significant risk as a result of not following treatment plans and will be involuntarily admitted again.
  • Section 24(1) of the MHA states the patient must be examined by a physician to determine eligibility for renewal of the involuntary admission:
    • (1) Toward the end of the 1st and 2nd months of involuntary hospitalization (i.e., the Form 4s and initial Form 6), and
    • (2) During the last month of the 3rd month and 6th month periods (i.e., subsequent Form 6s).[1]
    • In other words, within 1 month of the end of each period of hospitalization, the patient must be examined by a physician on whether or not they meet the involuntary admission criteria.
  • The MHA itself offers no guidance regarding how many days prior to the end of the last month of a period the examination must be completed, however, it is recommended this be done reasonably close to the end of the period.
    • Different practitioners may interpret this “reasonably close” definition as between 2 weeks to 1 month.
  • A new Form 13 must be issued to the patient for each Form 6 that is issued.

If an involuntary patient requires continued hospitalization beyond the first 1-month period authorized by the two medical certificates (i.e. - two Form 4s), a Form 6 is completed, which adds an additional 1-month of involuntary admission. If hospitalization is required beyond this second 1-month period, the length of the next Form 6 is 3 months. Beyond this 3 month period, all successive periods of involuntary hospitalization are 6 months in length.

What's a Month in BC?

It is important not to interpret a ‘month’ as being 30 days or 31 days. This is because the provincial Interpretation Act provides direction on how to calculate periods in terms of months. The basic rule is that a “month” means the corresponding day of the next month less a day.[2]
  • If there has been an oversight and the Form 6 is not completed in time before the expiry date, but the patient continues to require involuntary hospitalization, the patient must be re-admitted under a Form 4 again.[3]

Example

Action Form to Fill Length of Involuntary Admission Form to Give to Patient Begins Expires
Involuntary Hospitalization Date - - - March 15, 2020 (AKA - involuntary hospitalization date) -
1st Medical Certificate Form 4 48 hours Form 13 March 15, 2020 48 hours after March 15, 2020
2nd Medical Certificate Form 4 1 month from involuntary hospitalization date (minus 1 day) Form 13 March 15, 2020 April 14, 2020 @11:59pm
1st Renewal Form 6 1 month (minus 1 day) Form 13 April 15, 2020 May 14, 2020 @11:59pm
2nd Renewal Form 6 3 months (minus 1 day) Form 13 May 15, 2020 August 14, 2020 @11:59pm
3rd Renewal and Additional Renewals Form 6 6 months (minus 1 day) Form 13 August 15, 2020 Feb 14, 2021 @11:59pm

When There Is No Corresponding Renewal Date

  • When there is no corresponding date in the month the certificate/renewal ends, the Interpretation Act in BC directs that the last day of that month be used.
  • For example, if two Form 4s are completed for an involuntary admission beginning on January 31, 2021, there is no February 31st, 2021!
    • In these cases, the last day of the following month will be used
    • Thus, the 1 month period of hospitalization will end at midnight on February 28, 2021 (or 29 in a leap year), following the “last day of the month” rule.
  • If the patient continues to require involuntary hospitalization, the subsequent first renewal (Form 6) will begin on March 1, 2021, and will end on on March 31, 2021 (i.e. - one month less a day)
  • From that point on, all future renewals take effect from the 1st of the month in perpetuity (e.g. - second renewal (Form 6), will start April 1, 2021, and ends June 30, 2021).
  • For further clarity and a detailed table of dates, refer to Table 1: Renewing Involuntary Status, Guide to the Mental Health Act (pg. 83)