Formal Patients Under The Mental Health Act

The Mental Health Act recognizes three criteria for the issuance of admission or renewal certificates. All three of the following criteria must be present in the opinion of a physician in order for the physician to sign the certificate.

1. The person is suffering from mental disorder;
2. The person is likely to cause harm to self or others or to suffer substantial mental or physical deterioration or serious physical impairment; and
3. The person is unsuitable for admission to a facility other than as a formal patient (in the case of an admission certificate); or the formal patient is unsuitable to continue at a facility other than as a formal patient (in the case of a renewal certificate).

The following words are often used:

• Facility – a place or part of a place (usually a hospital) designated in the regulations as a facility.
• Formal Patient – a patient detained in a facility on the authority of two admission certificates or two renewal certificates.
• Mental Disorder – a substantial disorder of thought, mood, perception, orientation or memory that grossly impairs:
  1. Judgement,
  2. Behaviour,
  3. Capacity to recognize reality, or
  4. Ability to meet the ordinary demands of life.

Common questions

Am I a formal patient or an informal patient?

If you decide to seek treatment and have admitted yourself to hospital, you are a voluntary or “informal” patient. If two physicians examine you and find that you are:

1. Suffering from a mental disorder,
2. Likely to cause harm to self or others or to suffer substantial mental or physical deterioration or serious physical impairment, and
3. Unsuitable for admission to a facility other than as a formal patient,

you will have been hospitalized as a formal patient on the authority of two “admission certificates.”

The hospital will:

• Provide you with the reasons, in simple language, why these admission certificates were issued;
• Give you copies of the certificates and tell you how to apply to the review panel if you want to have the certificates cancelled;
• Give you a brochure about how the review panels work; and
• Provide you with the name and address of the Chair of the review panel for the facility where you are a patient.

Can my status as a formal or informal (voluntary) patient change from time to time?

Yes. Your status as a formal patient will end when:

• The certificates expire, unless a physician and a psychiatrist each issue a renewal certificate;
• A physician cancels the certificates;
• The review panel cancels the certificates; or
• Court of Queen’s Bench cancels the certificates.

What procedures may lead to formal admission?

The Mental Health Act allows a person to be brought to a facility in order to be examined by a physician at the facility. There are three ways in which this can happen:

1. By Physician – A physician may examine a person and find that the person meets each of three criteria that are specified in the Mental Health Act. If this is the case, the physician may issue an “admission certificate” within 24 hours of the examination. A signed admission certificate must be taken to a facility within 72 hours where another physician conducts a second examination and may issue a second admission certificate.
2. By Judge’s Warrant – Anyone who has grounds to believe that a person is suffering from a mental disorder and is likely to cause harm to self or others or to suffer substantial mental or physical deterioration or serious physical impairment may bring information before a provincial judge. If the provincial judge is satisfied that the person is likely to cause harm to self or others or to suffer substantial mental or physical deterioration or serious physical impairment, and an examination can be arranged in no other way, the provincial judge may issue a warrant. The warrant enables any peace officer to bring the person to a facility where a physician will examine the person. A warrant is valid for seven days and it may be extended for another seven days.
3. By Peace Officer’s Powers – When a peace officer believes that:
   1. A person is suffering from mental disorder,
   2. The person is likely to cause harm to self or others or to suffer substantial mental or physical deterioration or serious physical impairment,
   3. It would be dangerous to try to get a judge’s warrant, the peace officer may, apprehend the person and take the person to a facility to be examined by a physician.

Once I am brought to a facility, how long can I be detained?

The Act says that you can be detained at the facility for 24 hours unless two admission certificates are issued in your name before the 24 hour period expires.

How long do admission or renewal certificates last?

Admission certificates are effective for one month from the date that the second admission certificate is issued. Renewal certificates have the following duration:

• The first set of two renewal certificates are effective for a period of not more than one additional month;
• The second set of two renewal certificates are effective for a period of not more than one additional month;
• The third and subsequent sets of two renewal certificates are effective for a period of not more than six additional months.

Renewal certificates must be signed by two separate physicians. One of these physicians must be on the facility’s medical staff, and one must be a psychiatrist.

What can I do if I want my admission or renewal certificates to be cancelled?

You may obtain an application form from hospital staff and send this application form to the Review Panel Chair, who has been appointed for the facility where you are.

What happens after I send my application to the Review Panel Chair?

The Chair will set a hearing date and will give you at least seven days notice of the date, time, place and purpose of the hearing.

The hearing will be held within 21 days of the date the Chair receives your application. Further details are available in a brochure on the review panels under the Mental Health Act.

Do I need a lawyer?

It is your right to have unrestricted access to legal counsel. Legal Aid Alberta provides legal services under certain circumstances. A lawyer acting on your behalf is permitted to visit you at any time.

Can I get assistance?

If you wish, a social worker or nursing staff may help you complete the application form and will answer your questions.

The Mental Health Patient Advocate office can also provide information and assistance to formal patients (one or two admission certificates) upon request.

Review Panel hearings

Applications for a Review Panel hearing can be sent to the appropriate Chair for your zone at the address below –

Edmonton and North Mental Health Review Panel
R. Allan Harris, Chair
Suite 302, Energy Square, 10109 – 106 Street N.W.
Edmonton, Alberta  T5J 3L7

Calgary and South Mental Health Review Panel 
Marilyn Smith, Chair
323 – 11 Avenue N.E.
Calgary, Alberta  T2E 0Z2

Central Alberta Mental Health Review Panel
Alan Fielding, Chair
4708 – 49 Street
Camrose, Alberta  T4V 1M7

If you are not sure which health zone you live in to determine which Chair to contact, check the Alberta Health Services Zone map.