Clinically significant differences among Canadian mental health acts.
OBJECTIVE
First, to highlight the major differences among mental health acts in different Canadian jurisdictions as they relate to involuntary admission criteria, treatment authorization, review and appeal procedures, and conditional leave and community treatment orders. Second, to analyze the impact of these differences on the care that individuals with mental illness receive.


METHODS
We examined the mental health act provisions of all Canadian jurisdictions to determine how the clinical management of a typical case would differ among jurisdictions. We used a statement of principles for mental health legislation endorsed by the Canadian Psychiatric Association to guide the analysis. We confirmed interpretation of each act and its implementation through key informant contact in each province and territory.


RESULTS
We found clinically significant differences among the provinces and territories on all major components of their mental health acts.


CONCLUSIONS
Provisions that prevent patients receiving appropriate clinical care can be found in some Canadian mental health acts. Alternate provisions that support appropriate clinical care, that respect the human rights and personal dignity of patients, and that are consistent with the Canadian Charter of Rights and Freedoms can be found in the legislation of other jurisdictions.
Gray
J E
JE
Policy and Systems Development, Adult Mental Health Division, Ministry of Health, British Columbia. john.gray@moh.hnet.bc.ca
O'Reilly
R L
RL
D002170:Canada; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010344:Patient Advocacy / Q000331:legislation & jurisprudence*