Mental Health Act

Question 1

Emergency medical treatment may be given to a patient, without _____, if there is imminent and serious danger to the patient’s life or to a limb or vital organ and the patient,

Answer 1

consent

Question 2

Emergency psychiatric treatment – Given to a patient without ______, if there is imminent and serious danger to self or others

Answer 2

consent

Question 3

Right to equality and non-discrimination
Right to privacy
Right to individual autonomy
Freedom from inhumane and degrading treatment
Care in the least restrictive environment
Right to information and participation

Answer 3

Human Rights

Question 4

Canada is committed to ensuring the promotion and protection of ______ of all persons, including people who experience disabilities and mental illness

Answer 4

human rights

Question 5

Sets out in law admission & treatment requirements for clients in designated psychiatric facilities.

Answer 5

Manitoba Mental Health Act

Question 6

does not apply to admission or residence in other types of facilities such as personal care homes or medical unit within a hospital.

Answer 6

The Manitoba Mental Health Act (MMHA)

Question 7

Substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behaviour, capacity to or ability to meet the ordinary demands of life

Answer 7

Mental Illness/ Mental Disorder

Question 8

Persons experiencing intellectual disability
Persons living in a personal care home or other care faculty

Answer 8

Vulnerable Person’s Act

Question 9

______ to consent to or refuse admission
______ to consent to or refuse treatment
Levels of competence to manage own affairs

Answer 9

Competence; Competence

Question 10

The age of Consent in Manitoba is __

Answer 10

16

Question 11

Application for an order for involuntary medical examination

Answer 11

Form 1

Question 12

Order for involuntary medical examination

Answer 12

Form 2

Question 13

Notice to person in custody

Answer 13

Form 3

Question 14

Application by physician for involuntary psychiatric assessment

Answer 14

Form 4

Question 15

Application by attending physician for change of patients status from voluntary to involuntary

Answer 15

Form 5

Question 16

Involuntary admission certificate

Answer 16

Form 6

Question 17

Renewal certificate

Answer 17

Form 7

Question 18

Certificate of change of status to voluntary patient

Answer 18

Form 8

Question 19

Certificate of incompetence to make treatment decisions

Answer 19

Form 9

Question 20

Notice of Cancelation of Certificate of Incompetence

Answer 20

Form 11

Question 21

Request for discharge by voluntary patient

Answer 21

Form 13

Question 22

Order for return of patient absent without permission

Answer 22

Form 14

Question 23

Leave certificate or extension of leave

Answer 23

Form 15

Question 24

Patient’s application to mental health review board

Answer 24

Form 18

Question 25

There are two types of admission: ______ & ______

Answer 25

Voluntary; Involuntary

Question 26

Directly from a physician's office or community-based program Directly from an emergency department Family and friends can begin the process by completing a Form 1 - Application for an Order of Involuntary Medical Examination

Answer 26

How does a person become admitted to an acute care unit?

Question 27

Under the MMHA a person must be assessed as competent to agree to voluntary admission to hospital. A person must be 16 or older to give consent to admission to hospital and treatment. A legal guardian must give consent to admission to hospital and treatment if 15 and under. Anyone who is considered voluntary and wishes to leave a facility contrary to medical advice must first sign a request for discharge.

Answer 27

Voluntary Admission

Question 28

A person may voluntarily be admitted to a psychiatric faculty and then change their mind and request to leave To leave against medical advice, the person must complete a _____ - Request for Discharge by Voluntary Client Client must be assessed by physician within 24 hours, following assessment several options are possible: Client changes their mind & stays voluntarily Client is discharged Physician applies to change client status to involuntary

Answer 28

Form 13

Question 29

Application by Physician for Involuntary Assessment Max 72 hours

Answer 29

Form 4

Question 30

Involuntary Admission Certificate Max 3 weeks

Answer 30

Form 6

Question 31

Renewal Certificate Max 3 months Can be renewed

Answer 31

Form 7

Question 32

Involuntary Admissions – Acute Psychiatric Facility

Answer 32

Form 4, Form 6, Form 7

Question 33

Came into effect in 1998

Answer 33

Manitoba Mental Health Act

Question 34

Completed by any community member to request person be compelled to have a medical examination. Has a mental disorder Is likely to cause harm to self or others Needs to be examined by a physician Refuses to be medically examined In writing and under oath.

Answer 34

Form 1

Question 35

Justice of the peace (Judge) may complete a ______ The police now take the person involuntarily for medical examination

Answer 35

Form 2

Question 36

Police must inform the person in writing as to where they are being taken That it is for an involuntary medical examination That they have a right to legal counsel

Answer 36

Form 3

Question 37

A physician can complete this form if they have examined the person with the last 2 days. Person can now be admitted involuntarily to a psychiatric facility for assessment. Allows for a 72-hour assessment period.

Answer 37

Form 4

Question 38

Believed or known to have a mental disorder Because of the mental disorder is at risk: For serious harm to self Serious harm to others And/or at risk of substantial deterioration if untreated Would benefit from treatment at a psychiatric facility Refuses voluntary admission or is not competent to consent to a voluntary admission

Answer 38

Criteria for Form 4

Question 39

Involuntary admission Valid for 21 days

Answer 39

Form 6

Question 40

Involuntary admission Valid for 3 months

Answer 40

Form 7

Question 41

At any time during the client’s admission, attending physician can apply to change status from voluntary to involuntary Client must be examined by a psychiatrist within 72 hours of _____ being signed If client has already been in hospital 72 hours when Form 5 signed, client must be examined within 24 hours Psychiatrist can then complete a Form 6 – Involuntary Admission Certificate if they believe the person meets the criteria

Answer 41

Form 5

Question 42

Involuntary clients must have: Form 4 - Application by Physician for Involuntary Assessment OR Form 5 - Change of Status AND Form 6 – Involuntary Admission Certificate Followed by a Form 7 is lengthy admission and client remains unable to consent to stay voluntary An involuntary client (form 4 or 5, 6, 7) retains the right to refuse treatment.

Answer 42

Involuntary Admission

Question 43

A clients status can change from involuntary to voluntary by physician/psychiatrist completing a Form 8 - Certificate of Change of Status to Voluntary client Status is also changed: Automatically when discharged MMHA forms (4 or 5, 6, & 7) are allowed to lapse – not renewed

Answer 43

Form 8

Question 44

Emergency Medical Treatment Emergency Psychiatric Treatment Form 9 – Certificate of Incompetence to Make Treatment Decisions

Answer 44

No treatment without consent unless

Question 45

If assessed as unable to make treatment decisions due to illness: Usually a family member will be asked to act as a legal proxy (substitute decision maker) for client & give their consent for treatment Proxy can be a Public Trustee Clients must be informed of status, right to appeal & right to a lawyer Decision maker must be deemed to be acting in the best interest of the client

Answer 45

Form 9

Question 46

Attending Physicians Statement that a Person in Psychiatric Facility has Regained Competence When a person is well enough to consent for treatment the Form 9 should be cancelled.

Answer 46

Form 12

Question 47

is completed prior to discharge as part of discharge planning Collaborative plan of care made with client Consented to by client or proxy is required at discharge Duration 6 months (can be renewed) Client agrees to follow treatment plan in community If client breaches agreement, they can be return to hospital involuntarily & examined by psychiatrist for possible involuntary admission

Answer 47

Form 15

Question 48

If any client leaves the hospital or does not return after a pass, the psychiatrist can complete a _____ and ask the police to return the client to facility

Answer 48

Form 14

Question 49

The psychiatrist is legally responsible to inform a client in writing about: Status under the MMHA Right to appeal to Mental Health Review Board Right to a lawyer Right to speak with an ombudsman

Answer 49

Duty to Inform

Question 50

Patient’s Application to Mental Health Review Board A person may apply to appeal involuntary status and/or decision of incompetence ( Review board consists of – lawyer, psychiatrist, and a member of the public The person may have legal representation during the Review Board Hearing

Answer 50

Form 18

Question 51

Facilities Application to Mental Health Review Board When a person has been assessed an incompetent to make treatment decisions, and the person authorized to make treatment decisions on their behalf (family member or public trustee) has refused to consent to treatment.

Answer 51

Form 19

Question 52

Treatment or restraint by force must be recorded in detail in client's clinical record: (a) Medication used route, dosage, frequency (b) Force or mechanical means: (i) means of restraint, (ii) period of time during which the client was or is expected to be restrained, and (iii) a description of the behaviour that required the client to be restrained or to continue to be restrained.

Answer 52

Imminent risk

Question 53

Certificate of Incompetence to Manage Property

Answer 53

Form 10

Question 54

Notice of Cancelation of Certificate of Incompetence

Answer 54

Form 11

Question 55

Authorization to Transfer

Answer 55

Form 20

Question 56

Certificate of Incapacity

Answer 56

Form 21

Question 57

Order of Committeeship

Answer 57

Form 22

Question 58

Physicians Statement that the Patient is No Longer Capable of Managing Properties

Answer 58

Form 23

Question 59

Notification of Cancellation of Certificate of Incapacity or Committeeship

Answer 59

Form 24

Question 60

Oversees the MMHA Promoting proper interpretation and application of MMHA Administering the Orders of Committeeship Program, including issuing/canceling Orders of Committeeship Issuing Authorizations of Transfer

Answer 60

Director of Psychiatric Services

Question 61

Clients have limited rights to see and correct their medical record Must apply in writing Medical Director can refuse and ask Mental Health Review Board for permission to withhold

Answer 61

Right to View Medical Record

Question 62

Ensure that client understands their rights under the MMHA. Status under MMHA Right to appeal to review board Right to a lawyer Advocates for client’s rights under the MMHA. Inquires about Health Care Directives. Provides education around importance of Health Care Directives. Documentation

Answer 62

Psych Nursing Roles

Question 63

A person may be transferred from a correctional facility for observation, assessment, diagnosis and/or treatment Assessment of fitness to stand trial Assessment to inform responsibility Transfer from prison for treatment The admission would be deemed involuntary

Answer 63

Criminal Code Admission