Renewal & Recertification

Gagan Kullar| Jasprit Sandhu| Mandeep Pannu| Monika Phunal

Important Information about

What is Extended Renewal of Mental Health Act Extended Leave
Leave? for an Involuntary Admission Nursing Roles
• Client-centered therapeutic intervention
• Notification of review panel • Earliest possible opportunity for release from hospital.
• Form 4 allows person to involuntary pt. for
• A leave for an involuntary patient from a • Community living through the provision of support for
up to 48 hours • Authorizing treatment
designated facility that is authorized under • After completion of form 4 (second) within treatment compliance once out of hospital
• Requests for second opinion
Section 37 of the Mental Health Act 48 hours, pt. may be kept for up to 1 month • Does not reduce an involuntary patient’s length of stay in
• An additional month is permitted on a first • Inform rights
• Must be implemented consistent with hospital when the patient is still in need of inpatient care.
renewal certificate (form 6), additional 3 • Notify near relative
Section 9 of the regulation months on a second a renewal certificate • Suitable for an involuntary patient who meet the criteria
• Form signed by patient
• Always requires the approval of the (form 6), and an additional 6 months on a for involuntary hospitalization
third of any further renewal certificate • Ensure patient has access to
director of the designated facility or a • PREREQUISITES:
• Physician must examine the person and designated facility in case of recall
physician complete a renewal certificate (form 6) • Can be actively monitored for compliance with treatment
(British Columbia Ministry of Health, 2005; Guide to the Mental Health Act, 2005)
before each certificate period expires in the community;
(British Columbia Ministry of Health, 2005; Guide to the Mental Health Act, 2005) (British Columbia Ministry of Health, 2005; Guide to the Mental Health Act, 2005) • Will be provided appropriate services in the community;
Planning • Will be permitted reasonable choice as to geographic
Initiating Extended location of residence;
Extended Leave Leave • Is capable of being informed of the meaning of extended
leave and the conditions of leave.
• Review and provide clinical • Hospital physician should
write an order in the patients
Case Study (British Columbia Ministry of Health, 2005; Guide to the Mental Health Act, 2005)

documentation on the decision abut

health record- Ex. "Release
accepting the patient on extended leave. on Extended Leave"
• Ensure direct communication between • A copy of form 20 should be With Mr. Smith, he has been involuntarily submitted into the
the attending (hospital) physician and provided to the patient hospital with form 4 on July 1. With this form he is assigned to stay
community physician. • Inform patient of: Name and in the hospital for the maximum of 48 hours July 3. If the
• Develop condition of leave and a location of the community psychiatrist feels that Mr. Smith should stay longer for treatment
comprehensive plan . physician, name of the one more form 4 can be signed off. This will allow one month of
community mental health treatment for Mr. Smith as the doctors can carefully assess him for
• Complete form 20 (leave authorization).
case worker, location of the
• Ask patient to sign the form to confirm suicide risk and come up with a care plan for a treatment plan.
mental health center and
that the leave conditions have been appointments, and location of August 3 would be the last day of his form 4 and the certification is
explained to them. the facility or residence finished. During this period, the psychiatrist can fill out a form 6
• Provide the (draft) form 20 to the where patient will be placed. which recertify Mr. Smith for 3 months resulting in Mr. smith stay at
community physician and health authority (British Columbia Ministry of Health, 2005; Guide to the Mental Health Act, the hospital till November 3. However, after this 3 month period
2005)
director of mental heal and addictions or another renewal can occur which an additional form 6 is filled out
designate. and Mr. Smith will be getting treatment for an additional 6 months
• Community physician signs the form which would be May 3. After every 6 months, Mr. Smith will be
recertified as an involuntary admission until the psychiatrist sees
(British Columbia Ministry of Health, 2005; Guide to the Mental Health Act, 2005)
that treatment is working for him.
(British Columbia Ministry of Health, 2005; Guide to the Mental Health
Act, 2005)
Form 6:
• Medical Report on examination of Form 20:
involuntary patient • Leave authorization- the leave is longer than 14 days
• Under section 24 • Under section 37
• Signed by the physician • Signed by the physician, director, and patient
(Province of British Columbia, 2018)
(Province of British Columbia, 2018)