Mental health law and legislation are very challenging to read and understand, especially for those who immigrated or are used to a different standard of health and treatment. Today, I will break down the Ontario Mental Health Act to allow an easier understanding of how mental health is governed across Canada, including healthcare, the justice system, health professionals, and more. 

The Canada Health Act or CHA governs Canada’s publicly funded health care system. The primary objective of the CHA is “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.” The CHA attempts to ensure equal healthcare access to everyone without having to pay [1]. 

In Canada, health is governed by each province and territory, meaning Ontario, Quebec, Alberta, The Yukon Territories, etc., all have their own Mental Health Act [2]. Although they share vital similarities in having to abide by the same Charter of Rights and Freedoms [3], there are still some essential differences that I will highlight throughout this breakdown. 

 Understanding the Mental Health Act Canada’s Scope and Purpose

The Ontario Mental Health Act aims to provide standards and regulate the facilitation of mental health facilities and hospitals in Ontario. It oversees the admission process for mental health patients and assessments and provides guidelines for treatment [4]. 

The Mental Health Act aims to protect the rights of those living with mental health conditions by regulating the admission processes, involuntary admissions into hospitalization, and assessment and care. It ensures that the autonomy and wishes of the patients are put first if found capable while consistently monitoring the needs of citizens in Ontario [6]. 

Navigating Legal Dimensions: Key Provisions and Framework

         [5] The Ontario Mental Health Act is broken down into five parts: Standards, Hospitalization, Estates, Veterans, etc., and Miscellaneous. As with every act, there is a definitions section to explain key terms for those reading through the document and to clear any confusion and whether it infringes on any rights and privileges of Ontario citizens (spoiler alert, it does not). 

Part 1: Standards

         Part 1: Standards, discusses where and how the act is used and by whom. The Mental Health Act applies to every psychiatric association and hospital throughout all Ontario. It also maintains that mental health professionals are to be assigned by the Ministry [of Health], who can, along with the Ministry, visit any psychiatric facility and ensure that it is operating under appropriate standards. 

The key aspects that stay the same throughout all of Canada include that a physician has to complete the initial civil commitment certificate. This also allows the physician to hospitalize for assessment, and if the patient is to be detained longer, a second physician must also agree to the committal criteria. Some provinces, such as New Brunswick and Quebec, give special permissions regarding admission and commitment to police officers and justices of the peace. [7]. 

Part 2: Hospitalization

           Part II: Hospitalization is essential in assessing the rights of individuals. If the patient’s needs do not need immediate hospitalization, the patient always has the right to refuse hospitalization (clause 11). Informal or voluntary patients can be admitted to a psychiatric facility with a physician’s recommendation (clause 13), and these patients are never allowed to be detained in a psychiatric facility (clause 14). Saskatchewan, Nova Scotia, Newfoundland, and Labrador have laws that indicate that if an individual can make treatment or admission decisions, they can only be admitted as a voluntary patient [7]. 

         When a person is to be assessed for detainment in a psychiatric facility, it must be approved by two physicians who believe that the person is a danger to themselves or others, cannot take care of themselves, or suffers from a mental disorder that will result in harm to themselves or others. Furthermore, suppose the patient has previously received treatment in a facility for a mental illness and has improved or is incapable of consenting to their treatment. In that case, the physician can apply for an assessment of that individual. The physician must inquire into all the details regarding the individual’s mental disorder, including the testimony of others, and must apply within seven days of assessment (clause 15). Another physician can change the status of a voluntary patient to involuntary by filing a change for the certificate of involuntary admission. (clause 19). 

         Justices of the peace, along with police officers, may prescribe an examination and have the individual taken into custody for examination, respectively, if they are considered a threat to themselves or others or suffer from a mental condition that will result in harm to themselves or others (clause 16, 17). Furthermore, if practical, this examination should be held at a psychiatric or hospital facility (clause 18). 

         Under the Criminal Code of Canada, an individual in a psychiatric facility is detained under the Mental Health Act while provided care under the Health Care Consent Act (clause 25). With the exceptions listed in the Mental Health Act of Ontario, communication should never be delayed or withheld by an individual who has been admitted (clause 26).  

Part 3: Estates

         Part III: Estates are used to ensure capability with managing property. Suppose the physician, at any time, determines that the individual cannot care for the property. In that case, they must file a certificate of incapacity which will then transfer over the estate to their public guardian and trustee (clauses 54-76). 

Part 4: Veterans, Etc.

         Part IV: Veterans, etc., regards the treatment of veterans who suffer from mental health conditions and maintains that veterans can be treated in Ontario facilities (clause 77). 

Empowering Individuals: Rights and Protections Under the Act

         Individuals committed to a psychiatric hospital or facility remain residents of Canada with the same rights as those outside, including the right to vote. Patients must always be informed of their rights when involuntarily detained. [7]. Individuals are also entitled to communicate without delay or interruption when in a psychiatric facility, as in clause 26. 

Voluntary patients are always entitled to withdraw consent and can never be detained in a program, including community treatment plans (clause 33.4). Regarding consent, they are permissive to many of the Health Care Consent Act laws, except in the various cases of involuntary patients who cannot consent to care. Repeating clause 11, If the patient’s needs do not need immediate hospitalization, the patient always has the right to refuse hospitalization. 

Individuals are also entitled to privacy under clause nine, which indicates except with the person’s consent, any information obtained during the assessment or treatment of the patient shall not be disclosed in court. 

Avenues for Seeking Support: Treatment and Intervention Options

Patients detained under the criminal code or those under involuntary commitment who cannot consent to their treatment shall never receive psychosurgery (clause 49). Under clause 20, an individual can only be detained in a psychiatric facility for 72 hours unless admitted as a voluntary or involuntary patient with a maximum of 3 months. After this period, they must be admitted as a voluntary or informal patient. 

You can get a recommendation from your physician to gain admittance into a treatment hospital. Our complimentary health care covers mental health care, so you can seek information about treatment or counselling through your family doctor, who can provide you with the resources to seek the help you need. 

Promoting Mental Wellness: Collaborative Approach and Advocacy

           A Community Treatment Plan (CTO) provides people with community-based treatment outside a psychiatric facility. It is more confining than psychiatric care in a facility. It allows them to be surrounded by friends and family and gain community support to help with a severe mental condition. This is one way that legislation promotes family care and inclusivity. 

           With overall well-being, it is so uplifting to have family and community support. They are the people that will pick you up when you fall, whom you can rely on to help or get you help that you may need, and who motivate you with their presence and goals to promote your overall well-being. Mental health professionals are also crucial for general well-being, as they can assess you for any concerns, provide medical support on improving your overall well-being, and tell you where to find further resources. When incorporating family support, they must know where to find help and get resources to ensure their rights are met. The Canadian Mental Health Association has a long list of resources for support for caregivers and families and services available with places to find help and guidance.