What Form 4.2 is for
Under section 22 of BC’s Mental Health Act, a person admitted on one medical certificate can be held for 48 hours. A second certificate, Form 4.2, lets detention and treatment continue past that point, for up to one month from admission. The certificate and the examination it describes must both be completed within the 48 hours after the time of admission.
Form 4.2 is also used under section 29 for a person in a correctional centre or youth custody centre, which is why the form has two versions of Section 2.
Who completes it
A physician who has examined the patient completes Section 1. If a physician completed the Form 4.1, a different physician must complete this one. The facility’s Mental Health Act director or delegate completes Section 2.
How to fill in Section 1
Patient and facility
Print the patient’s name, Personal Health Number if available, the examination date, and the name and address of the designated facility. For a section 29 certificate, give the correctional centre or youth custody centre instead.
The four opinions
Give reasons for each of the four statements: a disorder of the mind that requires treatment and seriously impairs the ability to react to the environment or associate with others; a need for treatment in or through a designated facility; a need for care, supervision and control to prevent substantial deterioration or protect the patient or others; and that the patient can’t suitably be admitted voluntarily. Base them on your own examination. Copying the first certificate’s reasons weakens the second opinion the Act asks for.
Signature block
Print your name and add your signature, phone number, College ID number, the date and the time signed. Tick whether the summary continues on the back and whether the patient was given a copy.
Common reasons it’s questioned
- Completed after the 48 hours following admission.
- Signed by the physician who signed the Form 4.1.
- A blank or one-line reason under any of the four opinions.
- Missing time signed, which is what shows the 48-hour limit was met.
- The wrong part of Section 2 used for a section 29 admission.
Submitting and who pays
The certificate stays with the patient’s record at the designated facility. The director or delegate completes Section 2 Part A for ordinary admissions, or Part B for admissions under section 29(5). To go beyond one month, a Form 6 renewal is needed, and the patient’s rights must be explained again at each renewal and recorded on Form 13. Physicians bill MSP under fee item 00065, or 00066 for a previously assessed case.