Bill 41 - An Act Respecting the Mental Health Act

BILL 41

An Act Respecting the Mental Health Act

Her Majesty, by and with the advice and consent of the Legislative Assembly of New Brunswick, enacts as follows:

Mental Health Act

1( 1) Subsection 1(1) of the Mental Health Act, chapter M-10 of the Revised Statutes, 1973, is amended

(a) by repealing the definition “mental disorder”;

(b) in the French version by repealing the definition « directeur exécutif »;

(c) in the definition “psychiatric facility” by striking out “mental disorder” and substituting “serious mental illness”;

(d) in the definition “routine clinical medical treatment” by striking out “mental disorder” and substituting “serious mental illness”;

(e) in the definition « tribunal » of the French version by striking out the semicolon at the end of the definition and substituting a period;

(f) by adding the following definitions in alphabetical order:

“serious mental illness” means a substantial disorder of thought, mood, perception, orientation or memory that grossly impairs a person’s behaviour, judgment, capacity to recognize reality or ability to meet the ordinary demands of life, but does not include an intellectual disability; (maladie mentale grave)

“supervised community care plan” means an individualized plan of care, treatment and supervision established under section 34.01 to support a person living in the community; (plan de soins communautaires supervisés)

(g) in the French version by adding the following definition in alphabetical order:

« directeur général » désigne la personne ainsi nommée en application de l’article 3.2; (Executive Director)

1( 2) Section 1.1 of the Act is amended

(a) in paragraph (a) by striking out “mental disorder” and substituting “serious mental illness”;

(b) in paragraph (b) by striking out “mental disorder” and substituting “serious mental illness”.

1( 3) Section 3.2 of the French version of the Act is amended

(a) in subsection (1) by striking out “exécutif” and substituting “général”;

(b) in subsection (2) by striking out “exécutif” and substituting “général”.

1( 4) Section 7.1 of the Act is amended

(a) in paragraph (1)(a) by striking out “mental disorder” and substituting “serious mental illness”;

(b) in subsection (2)

( i) in paragraph (a) by striking out “mental disorder” and substituting “serious mental illness”;

( ii) in paragraph (b) by striking out “mental disorder” and substituting “serious mental illness”.

1( 5) Section 8 of the Act is amended

(a) in paragraph (1)(c)

( i) in subparagraph (i) by striking out “mental disorder” and substituting “serious mental illness”;

( ii) by repealing subparagraph (ii) and substituting the following:

( ii) the person’s recent behaviour demonstrates that, because of the serious mental illness, the person is likely to cause serious harm to himself or herself or to another person or to suffer substantial mental or physical deterioration,

(b) in subsection (4)

( i) in paragraph (a)

( A) in subparagraph (i) by striking out “mental disorder” and substituting “serious mental illness”;

( B) by repealing subparagraph (ii) and substituting the following:

( ii) in paragraph (c) by striking out “mental disorder” and substituting “serious mental illness”.

1( 6) Subsection 8.1(1) of the Act is amended

(a) in paragraph (a) by striking out “mental disorder” and substituting “serious mental illness”;

(b) by repealing paragraph (b) and substituting the following:

(b) the person’s recent behaviour demonstrates that, because of the serious mental illness, the person is likely to cause serious harm to himself or herself or to another person or to suffer substantial mental or physical deterioration,

1( 7) Section 8.6 of the Act is amended

(a) by repealing paragraph (1)(h);

(b) by repealing paragraph (2)(h).

1( 8) Subsection 9(1) of the Act is amended by striking out “mental disorder” and substituting “serious mental illness”.

1( 9) Section 10 of the Act is amended in the portion following paragraph (c) by striking out “mental disorder” and substituting “serious mental illness”.

1( 10) Subsection 12(1) of the Act is amended

(a) in paragraph (a) by striking out “mental disorder” and substituting “serious mental illness”;

(b) by repealing paragraph (b) and substituting the following:

(b) the voluntary patient’s recent behaviour demonstrates that, because of the serious mental illness, the patient is likely to cause serious harm to himself or herself or to another person or to suffer substantial mental or physical deterioration,

1( 11) Subsection 13(2) of the Act is amended

(a) in paragraph (a) by striking out “mental disorder” and substituting “serious mental illness”;

(b) by repealing paragraph (b) and substituting the following:

1( 12) Section 27 of the French version of the Act is amended

(a) in subsection (1) by striking out “exécutif” and substituting “général”;

(b) in subsection (3) by striking out “exécutif” and substituting “général”.

1( 13) Subsection 28(1) of the French version of the Act is amended by striking out “exécutif” and substituting “général”.

1( 14) Section 30 of the Act is amended

(a) in subsection (1) by striking out “in Council” and substituting “in Council in accordance with the Regulations”;

(b) by repealing subsection (2);

(d) by repealing subsection (4);

(e) by repealing subsection (5);

(f) by repealing subsection (6).

1( 15) Section 31 of the Act is amended

(a) in subsection (1)

( i) in paragraph (a) by striking out “mental disorder” and substituting “serious mental illness”;

( ii) by repealing paragraph (b) and substituting the following:

(b) the involuntary patient’s recent behaviour demonstrates that, because of the serious mental illness, the patient is likely to cause serious harm to himself or herself or to another person or to suffer substantial mental or physical deterioration,

(b) in subsection (3) of the French version by striking out “exécutif” and substituting “général”.

1( 16) Subsection 33(1) of the French version of the Act is amended by striking out “exécutif” and substituting “général”.

1( 17) The Act is amended by adding after section 34 the following:

PART II.I

SUPERVISED COMMUNITY CARE PLAN

Supervised community care plan

34.01 After evaluating a person who is suffering from a serious mental illness, a psychiatrist may establish a supervised community care plan for the person, if the person meets the following conditions:

(a) the person is suffering from a serious mental illness that

( i) is continuous in nature,

( ii) severely limits the person’s functioning in the community, and

( iii) requires care and treatment; and

(b) the person is a patient or former patient who was admitted to a psychiatric facility or, in the opinion of the psychiatrist, the person has a pattern of behaviour while living in the community that demonstrates that, because of the serious mental illness, the person is likely to cause serious harm to himself or herself or to another person or to suffer substantial mental or physical deterioration.

Consent

34.02( 1) Consent to a supervised community care plan is required from the person who is subject to the plan or, in the case of a person who is not mentally competent, by the substitute decision-maker under section 8.6.

34.02( 2) Despite subsection (1), a psychiatrist may make an application to the review board having jurisdiction to have a person who is not mentally competent be made subject to a supervised community care plan in the absence of consent by the substitute decision-maker, if the psychiatrist is of the opinion that it is in the best interests of the person.

Duration of plan

34.03( 1) A supervised community care plan comes into effect on

(a) the date set out in the plan, in a case referred to in subsection 34.02(1), or

(b) the date indicated by the review board, if the plan is confirmed by the board, in a case referred to in subsection 34.02(2).

34.03( 2) A supervised community care plan remains in effect for one year following the date on which the plan comes into effect.

Content of plan

34.04( 1) A supervised community care plan shall be developed in collaboration with the person who is subject to the plan or the substitute decision-maker and the health professionals who have agreed to provide care, treatment or supervision in accordance with the plan.

34.04( 2) A supervised community care plan shall contain

(a) the person’s individualized plan of care, treatment and supervision,

(b) the conditions relating to the care, treatment and supervision,

(d) the obligations of the substitute decision-maker, if applicable,

(e) the name of the psychiatrist who has agreed to accept responsibility for the general supervision and management of the plan,

(f) the names and obligations of the health professionals who have agreed to provide care, treatment or supervision in accordance with the plan,

(g) the contact information and a description of the role of the psychiatric patient advocate services,

(h) the reason for the issuance, amendment or renewal of the plan and the authority under section 34.02 for the issuance, amendment or renewal, and

(i) a description of the role of the review board.

34.04( 3) A psychiatrist may make amendments to a supervised community care plan with respect to medication dosage and appointment frequency and shall advise

(a) the person who is subject to the plan or the substitute decision-maker, if applicable, and

(b) the health professionals named in the plan.

Copy of plan

34.05 Before a supervised community care plan comes into effect, a copy of the plan shall be provided to

(a) the person who is subject to the plan,

(b) the substitute decision-maker, if applicable,

(d) the psychiatric patient advocate.

Failure to comply with plan

34.06( 1) A psychiatrist who has reasonable grounds to believe that a person who is subject to a supervised community care plan is not meeting his or her obligations under the plan shall

(a) make reasonable efforts to inform the person or the substitute decision-maker, if applicable, and

(b) provide reasonable assistance to the person to enable him or her to meet his or her obligations.

34.06( 2) A psychiatrist may issue a certificate of non-compliance with a supervised community care plan if he or she considers it appropriate.

34.06( 3) A certificate under subsection (2) expires 30 days after its issuance.

34.06( 4) A certificate under subsection (2) is sufficient authority for a peace officer to take into custody the person named in the certificate, without a warrant, and to take that person to a medical facility, psychiatric facility or physician’s office where the person may be detained for medical examination.

34.06( 5) A peace officer who takes a person into custody under subsection (4) shall

(a) retain custody of the person until the person has been examined by a psychiatrist or physician, and

(b) if a psychiatrist or physician advises the peace officer that, in the opinion of the psychiatrist or physician, the person does not require hospitalization for the person’s mental condition, return the person, with the person’s consent, to the person’s residence or, if that is not practicable, to the place where the person was taken into custody.

34.06( 6) Despite subsection (5), a peace officer may release a person detained in the peace officer’s custody under subsection (4) on the expiration of three hours after the person has been taken to a medical facility, psychiatric facility or physician’s office.

34.06( 7) A psychiatrist or a physician shall examine the person who is subject to a certificate of non-compliance as soon as possible to determine whether

(a) the psychiatrist or the physician should issue an examination certificate under section 7.1, or

(b) the current supervised community care plan should be followed.

Withdrawing of consent

34.07( 1) A person’s consent to a supervised community care plan is withdrawn 30 days after the person provides written notice to the psychiatrist of his or her intention to withdraw consent.

34.07( 2) A supervised community care plan is no longer in effect on withdrawal of consent.

Renewal

34.08( 1) The review board may renew the supervised community care plan after a hearing to review the plan under subsection 34.1(3).

34.08( 2) Subject to subsection 34.04(3), a psychiatrist shall not make amendments to a supervised community care plan on renewal unless he or she obtains the approval of

(a) the person who is subject to the plan or the substitute decision-maker, if applicable, and

(b) the health professionals named in the plan.

Cancellation

34.09 A psychiatrist who establishes a supervised community care plan or the review board may cancel the plan at any time.

Review by the Board

34.1( 1) If a supervised community care plan is established with the consent of the person who is subject to the plan or the substitute decision-maker, the review board shall review the plan within six weeks after its commencement.

34.1( 2) If a psychiatrist makes an application to the review board under subsection 34.02(2), the Board shall conduct a hearing within 10 business days after the date the application is filed.

34.1( 3) If the review board confirms the establishment of a supervised community care plan, the Board shall conduct a hearing to review the plan in each year that follows the confirmation.

34.1( 4) Despite subsection (3), the person who is subject to a supervised community care plan or the substitute decision-maker may make a request to the review board to have one additional hearing in each year.

34.1( 5) A psychiatrist who establishes a supervised community care plan shall be present at a review board hearing under this section.

Review of this Part

34.2 The Minister shall initiate a review of this Part, and the review shall be completed no later than November 1, 2022, and every five years after that.

1( 18) Subsection 57(1) of the Act is amended by striking out “mental disorder” and substituting “serious mental illness”.

1( 19) Subsection 68(1) of the Act is amended by adding after paragraph (i.6) the following:

(i.61) respecting the composition and appointment of review boards, including the appointment of alternate members of review boards to act in the place of members who for any reason cannot act;

(i.62) respecting the terms of office of members of review boards and their reappointment;

(i.63) respecting quorums in relation to review boards and making the decisions of a majority of the members the decision of the review board;

Regulation under the Mental Health Act

2( 1) Subsection 15(3) of the French version of New Brunswick Regulation 94-33 under the Mental Health Act is amended by striking out “exécutif” and substituting “général”.

2( 2) The Regulation is amended by adding after section 17 the following:

17.1( 1) A member of a tribunal shall be remunerated as follows:

(a) if the member is the chairman of the tribunal, $250 for each hearing and $125 for each hour of travel time to attend a hearing; and

(b) if the member is not the chairman of the tribunal, $80 for each hearing.

17.1( 2) A member of a tribunal is entitled to be reimbursed for travelling and other expenses incurred by the member in the performance of his or her duties in accordance with the Travel Policy of the Board of Management.

2( 3) The Regulation is amended by adding before section 18 the following:

17.2( 1) A review board shall consist of

(a) one member who is a member of the Law Society of New Brunswick and entitled to practise law in the Province who shall act as chairman of the review board,

(b) one member who is a psychiatrist or, if a psychiatrist is not available, a physician, and

17.2( 2) The Lieutenant-Governor in Council may appoint alternate members for each review board and if for any reason a member of the review board cannot act as a member, an alternate member appropriate to comply with subsection (1) shall act in place of the member.

17.2( 3) A member of staff or an employee of a psychiatric facility shall not act as a member of a review board when an application in relation to a patient of that psychiatric facility is being reviewed.

17.2( 4) A member of a review board holds office for the term, not exceeding five years, specified in the appointment and is eligible for reappointment at the expiration of the term.

17.2( 5) Despite the expiry of his or her term, a member of a review board shall remain in office until the member resigns or is reappointed or replaced.

17.2( 6) The three members of a review board constitute a quorum and the decision of a majority is the decision of the review board.

2( 4) Subsection 18(2) of the French version of the Regulation is amended by striking out “exécutif” and substituting “général”.

2( 5) The Regulation is amended by adding after section 20 the following:

20.1( 1) A member of a review board shall be remunerated as follows:

(a) if the member is the chairman of the review board, $250 for each hearing and $125 for each hour of travel time to attend a hearing;

(b) if the member is a psychiatrist or a physician, $125 for each hearing; and

20.1( 2) A member of a review board is entitled to be reimbursed for travelling and other expenses incurred by the member in the performance of his or her duties in accordance with the Travel Policy of the Board of Management.

2( 6) Form 11 of the Regulation is amended by striking out “mental disorder” and substituting “serious mental illness”.

3 This Act comes into force on November 1, 2017.