Mental Health Act

BC Mental Health Act: Medical Certificates for Involuntary Admissions: Forms 4.1 & 4.2 - Video (15 minutes)

RECOMMENDED: Any physician and nurse practitioner who provides involuntary psychiatric treatment of care.

Links to forms 4.1 and 4.2

• FORM 4.1 FIRST MEDICAL CERTIFICATE (INVOLUNTARY ADMISSION)
• FORM 4.2 SECOND MEDICAL CERTIFICATE (INVOLUNTARY ADMISSION)
   

The Mental Health Act, along with the BC Ministry of Health's MHA provincial standards and Guide to the Mental Health Act, outlines the authority, criteria and procedures for involuntary admission and psychiatric treatment. These guiding documents ensure that these provisions are applied in an appropriate, consistent and lawful manner that is respectful of the person's dignity and individual needs.

All physicians, nurse practitioners and staff who are regularly and actively involved in the admission and treatment of patients under the Mental Health Act are required to complete provincially approved education regarding admissions under the Mental Health Act.

• Mental Health Act
• MHA provincial standards 
• Guide to the Mental Health Act
   

​​For more information about the Mental Health Act and resources including: discharge and transfer documents. MHA infobits newsletter, practice support tools and more, please visit the Island Health Intranet at: Mental Health Act (islandhealth.ca).

Questions & Support: MHASupport@islandhealth.ca

Memos:

January 31 Deadline - Adoption of New Mental Health Act (MHA) Forms 4.1 & 4.2

The following has been sent to all Island Health staff and medical staff on behalf of Dr. Ben Williams, VP, Medicine, Quality & Chief Medical Officer; Marko Peljhan, VP Clinical Svs Acute Care CI/SI & Provincial Programs; and James Hanson, VP Clinical Svs, Acute Care NI & Community Svs

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January 16, 2024

**January 31 Deadline: Adoption of New Mental Health Act (MHA) Forms 4.1 & 4.2

WHAT IS HAPPENING

Protecting and upholding the rights of our patients, especially those who are most vulnerable, is vital. In order to do this, we need to adhere to the criteria and procedures for involuntary admission and psychiatric treatment outlined by the Mental Health Act, the BC Ministry of Health's MHA provincial standards, and Guide to the Mental Health Act.

These guiding documents ensure these provisions are applied in an appropriate, consistent, and lawful manner that is respectful of patients’ dignity and individual needs. Proper Mental Health Act Form completion is a crucial part of protecting the rights of patients certified under the Mental Health Act and is required by law.

All B.C. health authorities are required to implement the new Mental Health Act (MHA) medical certificates (Form 4.1 and Form 4.2) by January 31, 2024. The old medical certificate (Form 4) will no longer be legally recognized effective February 1, 2024.

The new medical certificates require significant practice changes for physicians, leaders, nurse practitioners and nursing staff that you need to be aware of. These include:

• Nurse Practitioners are now authorized to complete
• Form 4.1 as the examining professional. Form 4.1 and Form 4.2 require a person other than the examining professional. This is known as an MHA Director Delegate and can be any nursing role or other physician to review and co-sign Section 2 to validate it.
• The MHA Director Delegate’s date and timed signature on Form 4.1 marks the start of the involuntary admission under the MHA.

Full practice change expectations can be found on the What’s New page of Island Health’s Mental Health Act intranet site, and on the Medical Affairs’ Mental Health Act web page.

WHAT DO DESIGNATED MHA FACILITIES NEED TO KNOW?

Physicians and/or Nurse Practitioners:

• After completing Section 1 of the form, request that the MHA Director Delegate (any nursing role or physician) review and complete Section 2 of the form
• The MHA Director Delegate may not be the same individual who examined the patient and signed Section 1 of the form
• The form is only valid if completed and signed by the examining physician in Section 1 and by the MHA Director Delegate in Section 2

Any nursing role / physician may act as the Director Delegate:

• Use Form 4.1 or 4.2 Checklist to review Section 1 for accuracy
• If the form does not meet required standards, return the form to the examining professional for amendment (the physician who signed 4.1)

WHAT IF MY FACILITY IS NOT MHA DESIGNATED?

Physicians and/or Nurse Practitioners:

• After completing Form 4.1 Section 1, arrange for transport of patient to a MHA designated facility using the usual patient transport processes

Thank you for your support in helping to facilitate this important change and for continuing to uphold the rights and quality of care for our patients.

If you have any questions about this provincially-mandated change please contact MHASupport@islandhealth.ca.