- Last edited on January 3, 2023
Emergency Capacity Assessments (ON)
Primer
Sometimes, you may be paged about an urgent capacity issue while on call, and a patient wants to leave. The following 2×2 table can help guide your decisions on whether a patient should leave. When in doubt, always use a Form 1! It is called an Application for Psychiatric Assessment for a reason!
Approach
2x2 Capacity Decision Table
| Capable | Incapable | |
|---|---|---|
| Wants to stay | - | • There is no requirement for for Mental Health Act Detention. Patient is neither voluntary nor involuntary. • SDM consulted for treatment decisions • INFORMALLY admitted to hospital per HCCA |
| Wants to leave | • Consider Mental Health Act Detention (Form 1/Form 3) if mental health disorder contributing to safety risk requiring psychiatric admission for safety • Remember you cannot treat medical issues against a patient's will if capably refusing | • SDM consulted for medical treatment decisions/plan of care that includes hospitalization if needed to enable required treatment • If the physical risks of patient leaving AMA without treatment meet a serious risk, then consider if patient is suitable for informal status via HCCA, and/or • If admission is a concurrent medical and psychiatric admission, and the Form 3 criteria are met, issue a Form 3 |
Resources
Detailed Approach