Lecture notes
Mental Health Nursing lecture notes
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- Institution
Emma Lin and Anne Pottinger Lecture notes for mental health nursing at York University - Fall 22/23
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WEEK 2*If highlighted like this, know this for the test*
Mental Health Act Forms
- Form 1: F42
- Assessment form (good for 72 hours since the time [not date] the form was
issued)
- Always accompanied by form 42 (notifying the patient that they are being put on
a form 1)
- Can be discontinued anytime and put on another form (such as form 3)
- If the patient did not receive a form 42, they cannot be put on form 1
- If the patient just leaves when they are still under the 72 hours, the police will be
involved
- Form 2
- Justice of peace form
- Relatives can get this form from justice of peace to be able to bring the patient to
the hospital so the doctor can make assessments (form 1) and decide what to do
- Brought in by justice of peace
- Form 3: F30
- After form 1, the patient can be put on form 3
- Form is good for 14 days (from the DATE, not time)
- A patient who is under form 1, cannot be given a form 3
- Form 30 notifies the patient that they are being put on form 3
- Can be put on this form if they fall under any of the 3 criteria for certification (see
below)
- Form 4: F30
- Before form 3 expires, the doctor can issue a form 4
- This form is good for 1 month
- Form 30 notifies the patient that they are being put on form 4
- The right advisor is assigned (automatically)
- When the patient is getting a form 30, they can disagree and they can
advocate/appeal for themself
- Form 4 can have a second renewal (for 2 months) – goes by MONTHS not days
- Form 4 can then have a third renewal (for 3 months) – goes by MONTHS not
days
- Example: if the patient is put on the form on January 30, then the form
would expire February 27 (not February 28, always one day before)
- Form 4 can have a fourth renewal (for 3 months) – from here it’s always three
months
- After the third renewal of the form, they have to undergo the review board since
they will be hospitalized for a long time and they need an unbiased decision
- Form 5: F30
- Within 2 weeks, the patient is getting better, taking their medication and do not
meet the form 3 criteria
- This means that the form 3 or 4 is getting discontinued
, WEEK 2
- Form 10: psych to psych
- Transferring a patient from one psychiatric hospital to another
- Some hospitals cannot handle the patient so they need to be transferred
- The form will go with them (this ensures that the form continues in the other
hospital)
- Form 11: psych to medical
- Transferring from a psychiatric hospital to a medical hospital
- Form 9
- Notifying the police that the patient needs to return to the hospital
- The police will look for the patient for a month and if they do not find them, then
the patient is free
- Form 33
- Patient has been declared to be mentally incompetent to consent for treatment
- There will be a substitute decision maker
- Form 50
- Form 50 notifies the nurse that the right advisor is assigned and gave advice to
the patient
Form 3 – Criteria for Certification (be able to apply the knowledge)
1. Danger to self
a. Suicide
2. Danger to others
3. Inability to take care of self
a. Failure to thrive
Legal aspects of caring for the mental health population:
- Most clients with mental health issues are treated in the community
- Admission into hospital occurs at a time when there is a crisis or danger to the client
Need for hospitalization
- Reasons why a person would be required to be admitted into hospital for mental health
issues?
- Client feeling unsafe
- Having lost control of self to stay safe
- Lost any will to live
- Increased self harm behaviour or made a suicidal attempt
- Has failed many trials of medication
- Experiencing symptoms of psychosis
- Client expresses suicidal/homicidal thoughts
- Symptoms creating inability to care for self, poor judgement, dangerous behaviours
- Crisis situation
Types of hospital admissions
, WEEK 2
- how does one get admitted into the mental health/psychiatric ward/hospital
- By two ways:
- Civil committal:
- Voluntary (admit self) : physician admits, come through ER, GP, Psych physician exam;
JP order; police action. ALL by mental health act
- Informal-substitute decision-maker admits
- Criminal committal
- Court order under criminal code
- Patient will be assessed at court
- Not criminally Responsible
- Because when they committed the crime, they were mentally ill
Voluntary admission status
- Many people come to the hospital voluntarily
- may agree to be admitted into hospital to appease family/friends
- May agree to admission, but may be reluctant to take medication or treatment
Involuntary admission status:
- Clients who are admitted into hospital are done under the Mental Health Act
- Form 1:
- Completed by a physician who has assessed the client in the last 7 days
- Valid only for 72 hours, and is used to assess the client further under a
psychiatrists care
- Form 2:
- Completed by the justice of the peace
- Brought to the attention by family or friend
- Stating the individual is displaying dangerous activity to self or others
- Only for an ER evaluation
Assessment & Admission Criteria
- One or more three criteria that warrant an inpatient admission for a psychiatric
assessment:
- Danger to self or others
- Risk of serious physical impairment of the person
- Context of mental illness (note: addiction included)
- For form 1 or 2, a fourth criterion:
- previous treatment has been helpful &
- likely to cause harm or substantial physical or mental deterioration if not treated
&
- person is incapable & SDM consents
Psychiatric Assessment at the hospital:
● •Psychiatrist must assess person within 72 hours
● •Person can be a) discharged if does not meet admission criteria, b) admitted voluntarily
c) admitted involuntarily
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