When does the Act come into force?

The new Act came into force September 1, 2018.

The new Act is a complete re-write of the 1988 Act. The legislature approved the new Act in October 2015.

Why do we need a new Mental Health Act?

Mental health philosophies of care and best practices have changed a lot since the 1988 Act. The new Act modernizes care and support for people experiencing a mental health emergency.

The purpose of the new Mental Health Act is to:

• Provide short-term assessment, care, and treatment.
• Uphold patient rights.
• Balance patient rights with the need for care and treatment.

The new Act is based on these principles:

• No unreasonable delays in making or carrying out decisions affecting the treatment of the individual.
• Treatment decisions should respect the individual’s cultural, linguistic and spiritual or religious ties.
• The least restrictive measures should be used to ensure the safety of the individual and other people.
• Family and community are involved in supporting the individual.
• Individuals are supported in making their own decisions about treatment.
• The individual’s mental health information will be handled with the utmost respect for privacy.

How many Regulations were developed for the new Mental Health Act?

Six different sets of regulations that are required to guide the administration of the new Mental Health Act were completed. These are:

• Mental Health Forms Regulations
• Mental Health General Regulations
• Assisted Community Treatment Regulations
• Apprehension, Conveyance and Transfer Regulations
• Mental Health Act Review Board Regulations
• Designation of Facilities Regulations

Without these regulations, we would not be able to enforce the new Act.

Why did it take time to implement the new Mental Health Act?

While the bill for the new Mental Health Act was passed in 2015, this is a complex piece of legislation concerned with providing services to some of our most vulnerable residents. As such, it has been extremely important to take the time to get it right. Since 2015 the Department have been working with the Department of Justice and other stakeholders to draft the six Mental Health Act regulations, develop communications for the public and staff (including website content, pamphlets), recruit and appoint Review Board members, develop training materials and provide training sessions to front line health professionals, Review Board members and other relevant stakeholders.

What is a designated facility?

Under the new Mental Health Act, a designated facility is a facility with the resources to properly examine, care for, and treat people with a mental health disorder.

The Regulations have granted these facilities to be listed as designated facilities:

• Stanton Territorial Hospital
• Inuvik Regional Hospital
• Hay River Health Centre
• Fort Smith Health and Social Services Centre

Stanton Territorial Hospital is the only facility with an inpatient psychiatric unit and full time psychiatrists on staff.

What rights will patients have?

Patients will have the right to:

• Know why they are in hospital as an involuntary patient.
• Apply to the Mental Health Act Review Board if they feel they should not be held under the Mental Health Act, or disagree with decisions about their care.
• Identify a person to be notified when admitted to hospital.*
• Contact a lawyer and talk to them in private.*
• Be informed and ask questions about their care and treatment.
• Consent to or refuse treatment.**
• Talk to their Substitute Decision Maker, if they have one.*
• Have visitors during visiting hours.*
• Make or receive phone calls.*
• Write, send, and receive mail.*
• Not be deprived of any right or privilege enjoyed by others*

*These rights may be limited if there is a risk of harm to you or another person.

**Unless you have been appointed a substitute decision maker.

What rights will a patient’s family have?

A patient’s health information is private. Generally, family members can be involved in a patient’s care and treatment with the patient’s permission. 

Who is an involuntary patient?

Involuntary means the person does not control the fact that they are held in a facility for assessment, care, and treatment. The facility may hold the person against their will.

An involuntary patient is not allowed to leave the hospital until the doctor says they can. The doctor examines the patient regularly to make sure both they and others will be safe when released.

Who is a voluntary patient?

A voluntary patient is a person who asks for care and treatment at a designated facility. A doctor assesses the person and decides if care and treatment may help them.

A voluntary patient may leave the facility when and if they want.

If a voluntary patient wants to leave and a doctor believes the person is at risk of harm to self or others, the doctor may hold the patient for 24 hours to determine if the patient should be admitted as an involuntary patient. The doctor must examine the patient during that time.

What is a substitute decision maker?

Under the new Act, the substitute decision maker will be someone who makes treatment decisions for a patient who cannot make their own medical decisions.

The Substitute Decision Maker:

• Is usually a family member or someone else that knows the patient well.
• Has had personal contact with the patient in the last 12 months.
• Is mentally competent.
• Is available and willing to make decisions on the patient’s behalf.
• Signs the certificate to confirm the relationship with the person.

A doctor assesses the patient to see if they can make decisions, such as deciding to take a specific treatment. When needed, the doctor appoints a substitute decision maker. The doctor considers the patient’s wishes when deciding who to appoint. 

What will the substitute decision maker be able to do?

The substitute decision maker:

• Supports and advocates for the patient;
• Makes treatment decisions on the patient’s behalf based on the patient’s best interests; and
• Can apply to the Review Board on the patient’s behalf.

With each decision, the substitute decision maker considers these factors:

• What is in the patient’s best interests?
• Will the patient’s condition improve or get worse?
• Do the expected benefits outweigh the risks?
• Is the treatment the least intrusive to meet the patient’s treatment needs?
• What wishes did the patient express when they were mentally competent?

What is the Mental Health Act Review Board?

The Mental Health Act Review Board (MHARB) is established under the new Mental Health Act to provide better protection of individual rights. Any person being held under the Mental Health Act who wishes to appeal a decision made by their health professional will be able to apply to the MHARB for a hearing. Others will also be able to apply to the MHARB on a person’s behalf.

The MHARB will be independent of government and hospitals. Members will include lawyers, doctors, and members of the public.

What is Assisted Community Treatment (ACT)?

Assisted Community Treatment is a new model of care for the Northwest Territories intended to help ease the integration back to communities with support from family, professionals, and community. It allows involuntary patients to live outside of a designated facility while receiving supervision and treatment or care in the community. It will be an option for involuntary patients where it is safe and the necessary supports are available. A comprehensive Community Treatment Plan would be collaboratively developed between the patient, their doctor, and community supports.

What is a Community Treatment Plan?

This is a signed agreement between the patient, doctor, treatment team, and community supports.

It outlines everyone’s responsibilities and commitments to help.

Each community and person is different. Each plan has a list of agreements tailored to the community and patient.

Examples:

• Check in with the nurse for medication three times a week.
• Have coffee with the social worker two afternoons a week.
• Volunteer or help an elder once a week.
• Go to the gym three times a week or go for a 30-minute walk with a friend four times a week.
• Have supper with a family member once a week.
• Attend counselling once a week.