What Form 5 is for
Form 5 ends a patient’s involuntary status under subsection 20(7) of the Mental Health Act and continues them in the same psychiatric facility as an informal or voluntary patient. You use it when, on examination, the patient no longer meets the criteria for involuntary admission but will stay in hospital.
It is the counterpart to Forms 3 and 4, which admit and renew an involuntary patient. Those certificates carry criteria and expiry dates. Form 5 records only who ended the status, when, and why.
Who completes it
The attending physician completes and signs the whole form. The patient doesn’t complete any part of it.
How to fill in the form
Physician, patient and facility
Print your name as attending physician, the patient’s full name and the psychiatric facility. Use the patient’s name exactly as it appears on the Form 3 or Form 4 so the two records match.
Dates
Enter the date you last examined the patient and the date the most recent Certificate of Involuntary Admission, Certificate of Renewal or Certificate of Continuation was signed. Take the certificate date from the chart rather than memory, since a renewal may have been signed since the original Form 3.
The factors behind the decision
Describe what changed: improvement in mental state, resolution of the risk that supported the certificate, the patient’s engagement with treatment, and their willingness or their substitute decision-maker’s consent to remain. Short, specific findings from your examination are enough.
Common reasons it causes problems
- The date of the wrong certificate, usually the Form 3 when a Form 4 was signed later.
- No examination date, or one that predates the decision by days.
- A blank factors box.
- Signed by a physician who isn’t the attending physician.
Submitting and who pays
Form 5 isn’t sent to a payer. File it in the patient’s record at the facility and follow the facility’s process for notifying staff of the change in status.