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​Sta​​ndards for Mental Health and Capacity Assessments

​​1.​

​​When completing a medical certificate for involuntary admission under the Mental Health Act or a capacity assessment1nurse practitioners act in compliance with the nurse practitioner standards of practice, relevant le​gislation, employer policies, and their individual competence​.

​2.​

​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​.​​

Mental Health Act – Involuntary Admis​​sions

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

  • An initial medical certificate to support a person's involuntary admission under section 22(1) (Involuntary Admission), or
  • A medical certificate requested by a police officer or constable under section 28 of t​​he Act (Emergency Procedures).

Nurse practitioners complete medical certificates in Form 4 - 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:

  • To complete a second medical certificate under section 22(2) to support a person's continued detention and treatment;
  • To complete a Form 6 (Medical Report on Examination of Involuntary Patient [Renewal Certificate]),
  • To provide a second medical opinion, or
  • To authorize or take respo​nsibility for an Extended Leave (Form 20).

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 Condition​s​

​​1.

Nurse practitioners successfully complete ​​one of the following courses before completing a Form 4 (Medical Certificate [Involuntary Admission]) under the Mental Health Act:

​a.

​BC Mental Health Act​​ – Education for Nurses, Allied Health & Medical Staff2


​b.

​BC Mental Health Act Edu​​cation - Pediatric Focus2​

​2.

​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.​

​3.

​Nu​rse practitioners act in accordance with the B.C. Ministry of Health document, “Guide to the Mental Health Act”.​

A​​​dult Guardianship Act – Financial Incapability Assess​ments

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 

1.

Nurse practitioners may act as qualified health care providers under Part 2.1 of the Adult Guardianship Act for the purpose of conducting the functional component of a financial incapability assessment in accordance with Part 3 of the Statutory Property Guardianship Regulation under that Act, if they successfully complete the Ministry of Health course "A Guide to the Certificate of Incapability Process under the Adult Guardianship Act."

2.

Nurse practitioners acting as qualified health care providers under Part 2.1 of the Adult Guardianship Act must also follow the Ministry of Health and Public Guardian and Trustee's procedural guide, "A Guide to the Certificate of Incapability Process under the Adult Guardianship Act."

Health Care (Consent) and Care Facility (Admission) Act – Incapabi​lity 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: ​

1.

Have successfully completed the Ministry of Health course, "Consent to Care Facility Admission in British Columbia: A Course for Managers and Assessors"; and

2.

Follow the Ministry of Health guidelines, "Practice Guidelines for Seeking Consent to Care Facility Admission".​

More In​​formation

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

​1.
​​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.
​2.
​Available through the PHSA Learning Hub.

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Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
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With great respect, we acknowledge that BCCNM’s office is located on the unceded territories of the hən̓q̓əmin̓əm̓ speaking peoples – xʷməθkʷəy̓əm (Musqueam), and sel̓íl̓witulh (Tsleil-Waututh) Nations, and the Sḵwx̱wú7mesh-ulh Sníchim speaking peoples - Sḵwx̱wú7mesh Úxwumixw (Squamish Nation) whose historical relationships with the land continue to this day.​