Guidance on the Mental Health Care Act (MHCA) 17/2002 and Forms
Mental Health Care Act 17/2002
Admitting a patient under the MHCA means:
Who is treated under the MHCA?
Who does not fall under the MHCA?
MHCA Forms : Completed by Inpatient Teams
Process of Involuntary Admission: Section 33
MHCA FORM 05: Exam and findings of MHCP following an application for A or V CTR
Admitting a patient under the MHCA means:
- Removing a person’s right of freedom and autonomy, in order to protect them or others. One needs to balance the users right to autonomy compared to the risk of harm to themselves or others.
- You are submitting a formal application to a Judge of the Western Cape High Court. The judge will scrutinise the forms for completeness and consistency. If accepted, the judge issues an Order of the High Court, to remove the rights of that person.
- HHEs, Clinicians and the Board are at risk of litigation if documents are non‐compliant as this is viewed as the institution violating a person’s human rights through administrative incompetence.
- We have a duty to submit documents that are: Complete, detailed, accurate, within legislated time frames, neat and legible, and on correct copies of the forms.
Who is treated under the MHCA?
Patient suffering from a mental illness who
- Needs treatment
- Can be treated
- Is incapable of making informed decision
- Is a risk to self (suicide/reputation/financial interests) or others (homicide/property)
- Refuses treatment
Who does not fall under the MHCA?
- Suspected mental illness but current primary focus of care = physical illness
- Primary diagnosis of: Substance intoxication or Substance withdrawal
- Personality disorders but no co‐morbid mental illness or not current focus
MHCA Admission Categories
- Does the patient need help?
- Can the patient be helped?
- Is patient capable of making informed decision?
- Does patient want to be admitted?
- Emergency process precedes involuntary process where no other HCP is available
- Allows admission for 24 hours
- Allows time for other sections of ACT ie assisted, involuntary admission
- Both hospitals and police can hold a user for 24 hours only
- Form MHCA 01 to be filled in
- Voluntary user:
- Patient participates in admission AND is capable of making an informed decision
- No MHCA form needed but must clearly document above
- User can request immediate discharge
- Assisted user:
- Suffering from a mental illness or profound intellectual disability, AND
- Requires treatment for his or her health or safety, or that of others AND
- Is not unwilling to receive treatment (does not object ” passive consent”) BUT
- Is incapable of making informed decisions
- Involuntary user
- Suffering from a mental illness AND
- Likely to inflict serious harm on self or others (suicidal/homicidal) or to harm their financial interests or reputation AND
- User is incapable of consenting AND
- Objects to admission
IF ADMITTED FOR 72 HOUR INVOLUNTARY ADMISSION A MHC USER CAN BE DISCHARGED BEFORE COMPLETION OF TIME BY A PSYCHIATRIST
MHCA Forms: Completed by EM
- 04: Application for Assisted or Involuntary CTR by family/associate or MHCP
- 05: Exam and findings of MHCP following application for Assisted or Involuntary CTR
MHCA Forms: Completed by Inpatient Teams
- 06: 72 hr assessment and finding of MHCP after HHE granted application
- 07: Notice by HHE whether to provide Assisted or Involuntary CTR.
- 08: Notice by HHE to board requesting further Assisted or Involuntary CTR.
- 11: Transfer of MHC user on Inpatient basis to Psychiatric facility.
Process of Involuntary Admission : Section 33
1. APPLICATION (Form 04)
- <18 years ‐ Must be made by parent or guardian
- 18 years ‐ Spouse, next of kin, partner, associate, parent or guardian
- OR health care provider if above not available (reason must be given on form)
- MHCP must have seen patient within 7 days
2. EXAMINATION AND REPORTS (Form 05)
- 2 x Form 5
- By 2 MHCPs (one a medical practitioner)
3. Head of Establishment if concurs sends copy to applicant (Form 07)
4. ADMISSION FOR 72‐HOUR ASSESSMENT (08)
o Assessment every 24 hrs (Form 06) = 3 reports
o By 2 mental HCPs (one a medical practitioner)
5.DECISION TO ADMIT FOR TREATMENT PERIOD
MENTAL HEALTH REVIEW BOARD within 7 days (09)
Reports to Head of Establishment within 30 days
MHCA FORM 04: Application for Assisted or Involuntary Care, Treatment and Rehabilitation by family/associate or Health Care Provider (HCP)
- Complete one
- Must be signed by commissioner of oaths (COA)
- Is there adequate written information?
- Who made application (parent, next of kin, spouse etc); has applicant signed?
- If the user is a minor (<18yrs) has a parent / legal guardian signed?
- If the applicant is the HCP have attempts to contact the family been recorded?
- Has the COA signed and dated on the same date and in same place as applicant?
- Has the COA printed their name, surname and recorded the post description in full?
MHCA FORM 05: Exam and Findings of MHCP following an Application for A or V CTR
- Complete 2 by two different HCPs – one qualified to do a physical examination (Dr)
- Word each form differently to indicate that these are the independent findings of two different HCPs? (Must not be copies)
- One form must have the same date as form 04.
- BOTH must be within 24 hours of each other
- Complete all questions. No abbreviations to be used.
- Is there adequate description of the history and clinical findings for the Review Board and Western Cape High Court to make a decision?
- Have each of the two HCPs signed the 05 and printed names and qualification?
