Strengthening mental health care

Overview

In 2019, a ruling by the Alberta Court of King’s Bench found some sections of the Mental Health Act to be unconstitutional or incomplete.

The Mental Health Amendment Act addresses the concerns of the court and further modernizes the Mental Health Act, while reducing red tape to improve efficiency in the mental health care system.

Key changes

Updating admission criteria

The Mental Health Act allows individuals with serious mental disorder to be involuntarily detained in a designated facility for treatment or to receive mandatory treatment in the community.

The amendment act revised admission criteria so only people whose disorder could be improved by treatment can be detained.

As of March 31, 2021, patients with a permanent brain injury, such as people with Fetal Alcohol Syndrome Disorder or stroke, are no longer detained unless they also have a mental disorder such as schizophrenia or bipolar disorder.

Improving access to care

To provide better access to care, the amendment act:

• allows nurse practitioners to assess, examine and supervise patients receiving community treatment, while maintaining physician oversight where necessary
• allows people who are held under the act to be assessed and examined by videoconferencing, where appropriate
• will allow initial assessments and examinations to be conducted at more locations to reduce travel and wait time
• allows care providers to provide information to a patient’s close family member, if appropriate

Reducing red tape

To improve efficiency in the mental health care system, the amendment act cuts red tape by:

• giving physicians and patients more time to coordinate examinations for the required 6-month renewal of community treatment orders
• no longer requiring a form to move patients between two Alberta Health Services facilities
• authorizing the minister to designate and classify facilities so the health system can be more responsive to emerging needs

Strengthening patient rights

The amendment act requires hospitals and health care facilities to:

• provide patients with free, timely access to:
  • medical records
  • information about legal counsel (including access to free legal counsel, if applicable)
  • information about the Mental Health Patient Advocate
• review forms in a timely way so patients know why they are detained
• annually report to the minister on the completion and accuracy of documentation used to justify why a patient is detained
• provide a treatment plan to patients staying in hospital for 30 days or more, including criteria for release

The amendment act also expands the Mental Health Patient Advocate’s role to include an expanded legal responsibility to help people who have been detained in hospital or who are receiving mandatory treatment in the community. The advocate will:

• connect with patients who ask for help to review key documents and ensure they receive complete information
• work with Alberta Health Services to ensure all patients and their families are provided with necessary information about their detention and legal rights

Changes to Mental Health Review Panels

Mental Health Review Panels hear applications from patients on issues such as admission and renewal certificate cancellations, and the cancellation of Community Treatment Orders. They also hear applications related to treatment decisions.

The amendment act:

• gives patients 30 days, instead of 14, to appeal a review panel’s decision
• allows review panels to:
  • order a facility to issue a Community Treatment Order instead of detaining a patient, when doing so is more appropriate
  • order additional, independent psychiatric opinions, if needed

Next Steps

While some amendments came into effect upon receiving royal assent on June 26, 2020, the majority of changes came into effect upon proclamation on September 30, 2020. The narrowed definition of “mental disorder” came into effect on March 31, 2021.

News

• Proposed amendments strengthen patient rights (June 4, 2020)