What Form 6 is for
An involuntary admission lasts one month. Under section 24 of BC’s Mental Health Act, the director or an authorized physician must examine the patient during each period and either discharge them or record a written report giving reasons the criteria still apply. Form 6 is that written report, and it is itself the renewal of the authority to detain.
It is often confused with Form 4.2, the second admission certificate. Form 4.2 continues the first admission past 48 hours. Form 6 is used at each renewal after that.
Who completes it
The director of the designated facility, or a physician the director authorizes, completes and signs the whole form. For a patient on leave, that can be a community physician named on the patient’s Form 20.
How to fill in the renewal certificate
Patient, facility and dates
Enter your name, the facility, the date you examined the patient, their name, the date they were admitted as an involuntary patient, and the facility they were admitted to. Then enter the renewal period in months and the date the renewal expires, which is the date by which they must be examined again.
The examination the Act requires
The form prints section 24(2.1). Your examination must consider all reasonably available evidence of the patient’s history of mental disorder, including hospitalizations and adherence to treatment plans after discharge. It must also assess whether there is a significant risk that, if discharged, the patient would fail to follow the treatment plan needed to prevent another detention.
Your reasons
The reasons box should show why sections 22(3)(a)(ii) and (c) still describe the patient: that they need care, supervision and control in or through a designated facility to prevent substantial deterioration or protect themselves or others, and that they can’t suitably be a voluntary patient. Speak to the history and the risk on discharge, since those are what the examination must cover. Continue on the back if you run out of space, then sign and date.
Common reasons it’s questioned
- The examination falls outside the period the Act allows, so the renewal lapses.
- A renewal period that doesn’t follow the one, three, then six-month sequence.
- Reasons that describe the illness but not the history and risk on discharge.
- A physician who hasn’t been authorized by the director.
- The expiry date left blank.
Submitting and who pays
The renewal stays on the patient’s record at the designated facility. At each renewal, the patient’s rights must be explained again and documented on Form 13. Physicians bill MSP under the Mental Health Act fee items in the MSC Payment Schedule.