Page 14 - Guide to PICU
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Mental Health Act (MHA) – Health Care Consent Act
Form 1 (HCCA)
Used in the context of the patient who refuses When a patient has been deemed as
a psychiatric assessment but a physician requiring an emergency medical assessment
deems it necessary and/or treatment of a non-psychiatric
condition, the HCCA can be utilized to
Under the MHA, the physician has up to 7 days prevent departure and to initiate medical
to complete a FORM 1 if their personal investigation and treatment
assessment deemed the patient a risk
Unless the condition is an imminent danger to
Restraints life or limb, consent must be obtained from a
- Can be restrained for detainment under SDM, as quickly as reasonable possible
the MHA without compromising the patient’s care
Discontinuing a FORM 1 Restraints
- Requires a complete psychiatric - Can be ordered under the HCCA If
assessment including the assessment of patient is a harm to self which may
the presence or absence of a mental lead to imminent self-harm
disorder and a risk assessment - Can be ordered under Common Law
- Does not require a specialist in if a patient is harm to others
psychiatry but does require a physician - It is a myth that restraining a patient
licensed in Ontario to conduct the under the health care consent act or
assessment under common law requires that the
- The assessment must be done face-to- patient then be placed on a FORM 1.
face, and can use corroborating
sources from community contacts and Examples of patients appropriate for HCCA
allied health workers - Patient presenting with delirium due to
- This assessment cannot be delegated intoxication
- Acute illness, dementia or medical
Criminal Code trumps a FORM 1 concerning behaviour
- There is no need for a FORM 1 if the - Life threatening OD going to the ICU
patient is in police custody - Chronic stable psychosis with
- The patient is only needing medical behaviour consistent with past visits
clearance with follow-up arranged
Examples of Patients appropriate for FORM 1 REMEMBER
- If a voluntary patients tries to leave the - Remember a FORM 1 is simply an
ED before the completion of the application for an involuntary
psychiatric assessment and the initial psychiatric assessment, allows an
assessment by the physician was individual to be detained in hospital for
concerned with risk the purpose of a psychiatric
- A patient refusing a psychiatric assessment
assessment when deemed necessary - A FORM 1 DOES NOT allow and is NOT
applicable to the detention of
individuals in hospital for any other
reason
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