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1.
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When completing a medical certificate for involuntary admission under the
Mental Health Act or a capacity assessment1, nurse practitioners act in compliance with the nurse practitioner standards of practice, relevant legislation, employer policies, and their individual competence.
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2.
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Nurse practitioners completing a medical certificate for involuntary admission under the
Mental Health Act or a capacity assessment discuss with the client the reasons for completing the medical certificate or the findings of the capacity assessment.
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Mental Health Act – Involuntary Admissions
The
Mental Health Act sets out the criteria for the involuntary admission of a person to a provincial mental health facility, psychiatric unit or observation unit (a “designated facility") for up to 48 hours for examination and psychiatric treatment.
Under the
Mental Health Act, nurse practitioners are authorized to complete:
- The first medical certificate to support a person's involuntary admission under section 22(1) (Involuntary Admission),
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An examination of a person requested by a police officer or constable under section 28 (Emergency Procedures) and, if required, the first medical certificate to support that person’s involuntary admission under section 22(1) (Involuntary Admission).
Nurse practitioners complete Form 4.1 (First Medical Certificate [Involuntary Admission]) after examining the person in accordance with section 22(3) of the Mental Health Act.
Under the Mental Health Act, nurse practitioners are not permitted:
A person examined by a nurse practitioner under sections 22 or 28 is considered to be their client for the purposes of BCCNM standards, limits and conditions.
Before requesting involuntary admission of a client under the Mental Health Act, nurse practitioners must meet the following limits and conditions.
Limits and Conditions
1.
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Nurse practitioners successfully complete the following course before completing a Form 4.1 (First Medical Certificate [Involuntary Admission]) under the Mental Health Act:
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a.
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Protecting People's Rights: Mandatory Mental Health Act Forms (Physicians and Nurse Practitioners)2
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2.
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Nurse practitioners who complete a medical certificate for involuntary admission of a client under the Mental Health Act do so only after assessing the client in person.
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3.
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Nurse practitioners act in accordance with the B.C. Ministry of Health document, Guide to the Mental Health Act.
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Adult Guardianship Act – Financial Incapability Assessments
Under the
Statutory Property Guardianship Regulation, nurse practitioners are authorized to conduct the functional component of an assessment for financial capability (the adult's ability to manage their own financial affairs – section 32(3) of the
Adult Guardianship Act). A medical component must also be completed and only a medical practitioner may do that assessment.
Limits and Conditions
Health Care (Consent) and Care Facility (Admission) Act – Incapability Assessments for Care Facility Admission
Under section 16 of the
Health Care Consent Regulation, nurse practitioners are prescribed as assessors for the purposes of Part 3 of the
Health Care (Consent) and Care Facility (Admission) Act. This authority allows a nurse practitioner to assess an adult for capability to give consent to admission to, or continuing residence in, a care facility (section 26 of the
Health Care [Consent] and Care Facility [Admission] Act).
Limits and Conditions
Nurse Practitioners acting as prescribed health care providers under Part 3 of the Health Care (Consent) and Care Facility (Admission) Act for the purpose of conducting an assessment to determine whether an adult is incapable of giving or refusing consent to admission to, or continued residence, in a care facility, must:
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1.
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Have successfully completed the Ministry of Health course, "Consent to Care Facility Admission in British Columbia: A Course for Managers and Assessors"; and
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Follow the Ministry of Health guidelines, "Practice Guidelines for Seeking Consent to Care Facility Admission".
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More Information
Nurse practitioners with questions regarding the standards, limits, and conditions for mental health and capacity assessments can contact BCCNM Practice Support at practice@bccnm.ca
For more information on the legislation listed above see the BCCNM document Legislation Relevant to Nurses Practice.
Footnotes
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Capacity assessments include the statutory incapability assessments described in these standards, as well as any other capacity assessments that a nurse practitioner is authorized to provide.
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2.
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Available through the PHSA Learning Hub.
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