Mental Health Act (ON)

The Ontario Mental Health Act (MHA) applies to psychiatric care, and provides rules and a legal process for voluntary, informal, and involuntary admissions. Note that the Health Care Consent Act (HCCA) applies to all aspects of health care (both medical and psychiatric) and provides rules for obtaining informed, voluntary consent for treatment, and involvement from substitute decision makers.

The MHA's purpose is to regulate the involuntary admission and treatment of people into a psychiatric hospital. Major changes were made to the law in 2000, which introduced the role of Community Treatment Orders. In broad strokes, the the Mental Health Act in Ontario allows physicians to assess (Form 1) and also to detain (Form 3, Form 4, Form 4A) patients for set periods of time. The Health Care Consent Act and Mental Health Act also allows for the involuntary treatment of patients if they are incapable (Form 33).

The MHA focuses on detention of patients, and thus the MHA alone does not allow you to force treatment (there must be a finding of incapacity under the Health Care Consent Act as well). Only emergency psychiatric treatment is allowed in the event of significant morbidity or mortality. Therefore, if there is no emergency and a patient refuses treatment, you must respect the wishes of the patient. A patient could theoretically be in a situation where they detained under the MHA, but are capable and NOT treated (e.g. - a patient with schizophrenia can be detained under the MHA due to harm to others, but still be capable to make a decision to refuse an antipsychotic).