Understand your rights under the Mental Health Services Act 

In Canada, you have many protections from discrimination because of mental disability.

Section 15 of the Canadian Charter of Rights and Freedoms says people must be treated as equal. Each person can expect to be treated fairly even though there may be differences of nationality, race, colour, religion, sex, age, mental or physical disability. 

No one is allowed to discriminate against you for any reason including a mental disability. 

General rights

The law says people must take your ability into account. They must treat you fairly and equally. Mental health services must be provided with the same consideration for all people.

Agreeing to receive mental health services

Any person may ask for and receive mental health services. If you ask for services, you have the right to accept or refuse them. When you ask for services, you must give consent before you can be examined or treated. If you cannot understand what this means, your nearest relative may explain this for you OR someone else may give permission if you have applied to a judge to name someone else.

Perhaps you need care and treatment for your mental health, but you are unable or unwilling to ask for help.

Under exceptional circumstances, The Mental Health Services Act allows for you to receive care and treatment without your consent. The Act also protects your rights when this happens.

Examination against your will

A person may be ordered to be examined by a psychiatrist. This can happen in the following ways:

1. A doctor examines you. The doctor believes you have a mental disorder and need treatment. The doctor writes a certificate saying you must be examined by a psychiatrist.
2. Another person believes you have a mental disorder. That person tells a judge. The judge writes an order saying you must be examined by a psychiatrist.
3. A police officer sees you acting in a disorderly way in a public place. The officer believes you have a mental disorder and takes you to a doctor to be examined.
4. You are in another province and are admitted against your will. Then you may be moved back to Saskatchewan to be examined.
5. You are charged with an offence. A judge orders that you be examined by a psychiatrist.
6. You have been held under the Criminal Code and you have to be examined.
7. You are under a Community Treatment Order and have not lived up to its terms. Your doctor says you must be examined.

The examination must be done promptly. You have the right to:

• be told the reasons for the examination;
• contact a lawyer;
• receive a copy of any certificate, warrant or order that says you must be examined.

Admission against your will

You may be admitted to a mental health unit in a hospital and held there against your will. This can happen in three ways:

• under medical certificates;
• under orders where you have been charged or convicted of a criminal offence; or
• under a court order for long-term detention.

To be held under medical certificates, two different certificates are signed by two different doctors. At least one doctor must be a psychiatrist. Both doctors must certify the following:

• you have a mental disorder and need treatment and supervision which can only be provided in a hospital;
• your mental disorder keeps you from understanding that you need treatment and supervision, so you cannot make an informed decision; and
• your mental disorder will probably make you harm yourself or others, or make your illness get worse if you are not treated.

In an emergency you may be held under medical certificates for up to three days. Where two doctors have written medical certificates, you may be held for up to 21 days. If your doctor believes you need to stay longer, two more medical certificates may be written to make you stay up to another 21 days.

If you are asking for treatment and care, you cannot be treated without permission.

If your mental illness keeps you from understanding and you won't give permission, you may be treated without your permission in the following situations:

• you are being held under medical certificates in a special mental health unit in a hospital;
• you are being held under a court order for long-term detention; or
• you are placed under a Community Treatment Order.

There are rules that must be followed when you are treated without your permission:

• your doctor must explain the treatment to you and consider your views;
• before electronconvulsive therapy (ECT) is given, two psychiatrists must examine you and write special certificates;
• psychosurgery and experimental treatment are not allowed.

Community Treatment Order (CTO)

Your psychiatrist may place you under a CTO.  This can only happen if:

• you have a mental disorder and need treatment and supervision in the community and you do not need to be in hospital;
• in the last two years you have been hospitalized for psychiatric treatment against your will for 60 or more days OR you have had three or more separate admissions;
• your mental disorder will probably make you harm yourself or others, or make your illness get worse if you are not treated;
• the services which you need are available in the community;
• your mental disorder keeps you from understanding that you need treatment and supervision, so that you cannot make an informed decision;
• you are able to co-operate with the CTO. If a second doctor examines you and supports a CTO written by your psychiatrist, you must comply with the order. You must then follow prescribed medical treatment and attend appointments with your psychiatrist or case manager.

When a certificate is issued on you and you are treated against your will, you have the right to special protection under the Act.

Official representatives

Official representatives are lawyers with expertise in the menatl health field.  They have been appointed to help people who have been detained under The Mental Health Services Act understand their rights.

• An official representative will visit you if you are being treated, transferred or ordered to receive ECT against your will. He or she will visit you within 24 hours if you are being held under a certificate.
• An official representative is notified if you are examined against your will. He or she may contact you.
• An official representative is notified if you are placed under a CTO. He or she may contact you.
• You may ask to speak with an official representative at any time.

Review panel

A review panel has been set up in your health region to investigate appeals. There are three people on the panel. The chairperson is a lawyer. The vice chairperson is a doctor and the third person is a citizen.

• You may appeal to the review panel if you disagree with being held, transferred or treated against your will.
• If you appeal, the review panel will hold a hearing. This will happen within three business days of your application.
• An appeal will be sent to the review panel for you automatically if you are held for longer than 21 days and you did not appeal the first set of certificates. If you are under a CTO for longer than six months, an appeal will be sent to the review panel automatically.
• You may also appeal to the review panel if the doctor has ordered ECT. ECT is not allowed while the review panel is looking at your appeal.

Your rights at a hearing

You have the right to:

• be present at an appeal hearing;
• give evidence;
• see and hear all evidence given by others; and
• be represented by any other person.  You can cross-examine people. You may ask an official representative to accompany you and provide help.

There is no charge for official representative or review panel services.

The authority of the review panel

The review panel can over-rule decisions which have been made. This includes decisions to keep and treat you in hospital, transfer you, give you ECT or give you treatment in the community against your will. The review panel has three business days to give you its decision.

If you do not like a decision made by the review panel on any matter except ECT, you have the right to appeal to the Court of Queen's Bench.

All information about your diagnosis and treatment is confidential. Information will only be released:

• to persons who need it to give you treatment;
• to other persons with your written consent; and
• otherwise as required by law.

You have a right to information about yourself. It may be kept from you only if it will hurt you or another person. In case of dispute, you may appeal to a judge for an order to release the information.

If you would like more information about your rights under The Mental Health Services Act:

• ask a psychiatrist or other mental health professional;
• ask an official representative in your health region;
• contact the mental health service of your local health region.