The Mental Health Review Board
The Mental Health Review Board ("Board") is an independent tribunal established in April 2005 to conduct review panel hearings under the Mental Health Act ("Act"). The Board's mandate is based on involuntary psychiatric patients' periodic rights to fair and timely reviews of their loss of liberty.
The Board has jurisdiction to conduct hearings to review and decide whether persons committed/detained at any mental health facility in British Columbia should continue to be committed/detained based on criteria in the Act. The Board's function is to ensure that patients admitted by physicians and detained involuntarily in provincial mental health facilities have access to an objective review process.
The system is subject to the constitutional rights of section 7 of the Canadian Charter of Rights and Freedoms, which states that "[e]veryone has a right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice". The patient may be an involuntary patient, an involuntary patient on extended leave, or a voluntary patient under 16 years of age. The Board's legal mandate requires that it operate at arm's length from government.
Before April 4, 2005, the Act provided for a party-appointed review panel model whereby several of the review panel members were nominated by the hospital and patients. Each hearing was conducted by a chair appointed by the Minister, a physician appointed by the detaining facility, and another person appointed by the detained patient. After a core services review in the fall of 2001, Cabinet decided in February 2002 to abolish the party-appointed review panel model because it undermined the panel's impartiality and contributed to an adversarial environment. In its place Cabinet created the current structure to strengthen the independence of review panels.
The Mental Health Review Board is comprised of a chair and members who are appointed by the Minister of Health. All members are authorized to sit as review panel members and conduct hearings. Currently, the Board has 77 legal, medical and community members living in various locations throughout the province. A review panel is comprised of three or more members of the Board. After a hearing, the review panel decides whether a patient should be discharged from involuntary status.
A review panel must consist of a medical practitioner, a member in good standing of the Law Society of British Columbia or a person with equivalent training, and a third member who is neither a medical practitioner nor a lawyer. Board members must conduct hearings within statutory time limits of either 14 or 28 days from the day an application is received unless the patient waives this right.
When a patient, or someone acting on a patient's behalf, submits a request for review of a physician's decision (an initial certification requires a decision from two physicians) to detain a patient involuntarily, the board's chair must designate a review panel if a hearing has not been held since his/her last certificate or renewal certificate (during a six month renewal period, a hearing can only be requested 90 days after the conclusion of a previous hearing). After a hearing, the review panel then decides whether a patient should be discharged from involuntary status based on criteria specified in the Mental Health Act. These decisions usually involve balancing serious and competing issues such as freedom of the individual and protection of the public. Review panel hearings normally take place in private at the hospital or community facility where the patient is detained.