Area of Law: Health Law
Answer # 708
Voluntary patients in a psychiatric hospitalRegion: Ontario Answer # 708
While “voluntary patient” is not defined in the Mental Health Act, it is generally agreed that voluntary patients are capable of making a decision about staying or leaving the psychiatric or mental health unit of a hospital. In addition, the Act does state that a psychiatric facility is not allowed to detain a voluntary patient. Also, voluntary patients are presumed to have the capacity to make decisions about their treatment options and personal health information on the basis of informed consent.
They are allowed to leave the hospital at any time and the hospital cannot restrain them or stop them from leaving.
How to become a voluntary patient in a psychiatric facility
Voluntary patients agree to be in the hospital for the purposes of observation, care and treatment. In most cases, a voluntary patient must be referred to the facility by a physician for assessment. The four ways to become a voluntary patient are:
- If a doctor thinks a person is in need of observation, care and treatment that can be provided by a hospital;
- If a person is detained in the hospital on either an Application by Physician for Psychiatric Assessment or is an involuntary patient with a Certificate of Involuntary Admission, but the doctor does not renew these certificates once they expire;
- A doctor changes the patient’s status as a patient from involuntary to voluntary before the Certificate of Involuntary Admission expires; and
- If a person is admitted to the hospital as a medical patient but the doctor feels that they should also be a psychiatric patient.
Admission to a mental health care facility can be refused if its management or doctors believe hospitalization is not urgent or necessary. The facility must give the applicant reasons for the refusal and the person may be able to request that the decision be reconsidered by a provincial review body or even the courts.
Rights of a voluntary patient
Once a person has been admitted as a voluntary patient in a psychiatric hospital, he or she has certain rights.
- have the right to be informed that they are being made a voluntary patient, and given the opportunity to agree to stay in the hospital. The agreement should be recorded in the person’s personal health information;
- should be allowed to leave the hospital whenever they choose;
- cannot be restrained, unless the doctor feels that such immediate action is necessary to prevent serious bodily harm to themselves or others. Once restrained, they must immediately be assessed to see if they meet the criteria for being involuntary patients, and if not, then the restraints should be immediately discontinued.
For more information about voluntary patients in a psychiatric hospital, contact the Psychiatric Patient Advocate Office.
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