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Being Hospitalized for Mental Health Treatment
Did you know there are multiple ways to become hospitalized for mental health treatment in Ontario? It’s important to understand the system so you can get help for yourself or someone else.
Before we explore the different roads to hospitalization, it’s good to know what the point of hospitalization is in the first place. The purpose of being hospitalized is to become stabilized, and this can be achieved by getting the right kind of meds, being connected with the right supports, etc. There are a few main ways you can enter the hospital system in order to meet these goals:
This is when you go to the hospital and ask for help. You are allowed to leave the hospital at any time unless the doctors think you are at risk or hurting yourself or others or your mental health is getting worse. While you are there the doctors monitor you and care for you. The length of time you stay in the hospital depends on your situation. You could be in the hospital for a few hours, days or months. Once you’re better you’ll be released.
- Informal Patient
An informal patient is someone who is under sixteen or is deemed to be incapable of making treatment decisions for themselves. A substitute decision maker (usually your parent, family member or CAS) has given the doctors consent for you to be there. It is similar to being a voluntary patient because the doctor hasn’t deemed you a risk to yourself or others but recognizes you need treatment. If your substitute decision maker decides to take you home then you’re able to leave. If the doctor thinks you’re a risk to yourself or others or if your illness is getting worse they will shift your status to involuntary.
- Involuntary Patient
This means that the doctor has assessed you and believes you could be at risk of harming yourself or others or that your health is getting worse. This means that you will stay at the hospital to get treatment, you won’t be allowed to leave until your doctor feels like your health has improved.
- Patient admitted on a court order
To get admitted this way you have to be involved with the criminal courts. The first pathway occurs in the courtroom, if the judge thinks you might be experiencing a mental illness, they will order for you to be assessed by a doctor. This is known as a Form 6.
If you’re in custody or already charged with something but begin to experience symptoms of mental illness you can be sent to a psychiatric facility for no more than two months. (Form 8).
- Police apprehension
If your safety is at risk and you have acted in a “disorderly manner” the police might get involved and bring you to the hospital for a mental health assessment. This doesn’t mean the hospital will admit you.
As you can see there are many ways to enter the hospital system. Interestingly your status can change, for example you might start out as a voluntary patient but become increasingly ill, the psychiatrist would then make you an involuntary patient. On the other hand you might start out as involuntary, improve and leave or become a voluntary patient.
When talking to doctors, nurses, social workers or police officers you might hear terms like form one, form two, form three and form four. Here is what each of these terms mean:
- Form 1:
A form that a doctor uses to determine if you should be admitted for observation, examination and treatment for up to 72 hours. This form assess two key areas. The first is if the patient will be at risk of harming themselves or others. Secondly the form explored whether or not the patient has been treated for these symptoms in the past and if the treatment was successful.
- Form 2:
This is a form that is filled out in court, this form allows the police to bring someone to the hospital in order to be assessed by a doctor. Once there, the person might be put on a form one or be sent home. This is often brought about by concerned family members, friends or community members. They go to court and share their concerns with a justice of the peace. If the justice of the peace is worried by what has been shared, they will fill out a form two.
- Form 3, 4 and 4A:
These forms are signed by the doctor if they believe you need to be an involuntary patient, you are a risk to yourself/others or you are getting worse. A form three is done once your form one has expired (after 72 hours) and the doctor believes that you need longer term care. Form 4 and 4A are extension forms if you need to be an involuntary patient for more than two weeks, which is the period of time you are involuntary under a form three.
Hospitalization can be overwhelming and scary. There are resources and support if you or someone you care about is hospitalized. A good place to start is with the patient advocate or the nursing staff.
- A Practical Guide to Mental Health and the Law in Ontario, Ontario Hospital Association, 2016 (PDF)
- What is a substitute decision-maker?, LHSC
- Part 2: Substitute Decision Makers, SpeakUp Ontario
- The Substitute Decision Maker Hierarchy, SpeakUp Ontario
- Powers of Attorney, Ministry of the Attorney General, Ontario
- When a family member is unwilling to seek help, CAMH
- Admission to a Psychiatric Facility under the Ontario Mental Health Act, Hull and Hull LLP
- Consent And Capacity Board
Kathryn is a recent MSW graduate currently trying to #adult. She is a former mindyourmind staff and continues to work in the youth & community development sectors. In her spare time, she is a proud plant parent, home chef and avid volunteer.
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