Hospital admission
This topic covers the types of hospital admission, the processes preceding and following admission, and the oversight and protection role of the Mental Health Review Boards as laid down in the Mental Health Care Act 2002 (MHCA). It also contains a downloadable version of the MHCA 04 form.
Please visit our Mental Health Care Act topic to view and download a copy of the Act and of the latest regulations, which contain the current versions of all the MHCA forms. Chapter I of the Act contains definitions of the terminology used in the Act.
Types of hospital admission
There are three main types of admission in terms of the Mental Health Care Act:
- Voluntary care, treatment and rehabilitation – when the person is in need of psychiatric treatment and willingly agrees to be admitted to a mental health facility for in-patient treatment.
- Assisted care, treatment and rehabilitation – when the person is in need of psychiatric treatment but is incapable of making an informed decision due to their mental health status but does not refuse the health intervention.
- Involuntary care, treatment and rehabilitation – when the person is in need of psychiatric treatment but is incapable of making an informed decision due to their mental health status and refuses health intervention
The Act also provides for temporary immediate admission and treatment for a maximum of 24 hours:
- Emergency admission or Treatment without Consent – when there are exceptional circumstances where there is high risk, and it is not possible to delay treatment until examination is completed
Role of the Mental Health Review Boards
The primary purpose of the provincial Mental Health Review Boards established in terms of the Mental Health Care Act is to protect the mental health care user. Any admission under the Act implies some kind of restriction of the user’s freedom. This can only be justified after a careful risk assessment which is performed by the Board. The Board continues to monitor the situation of the user throughout their stay at the facility.
FSS talks on hospital admission and MHCA process
These two talks, both by Chairpersons of the Western Cape Mental Health Review Board, cover the application and admission process for assisted, involuntary and emergency admissions, the use of various MHCA forms, and the role of the Mental Health Review Board. Both are worth viewing as they contain somewhat different material and emphases.
Hospital admissions under the Mental Health Care Act
A talk given by Michelle de Goede, Western Cape Mental Health Review Board Chairperson and Director of Comcare Trust, at the July 2024 online support group meeting of Family Support for Schizophrenia.
Equips family members with the knowledge and tools to facilitate an admission for their relative under the MHCA. Emphasises the balance between the process and logistics on the one hand, and the emotions of the family member on the other. Comprehensive and detailed information including admission statistics.
Understanding the Mental Health Care Act and the functions of the Mental Health Review Board
A talk given by Elsa van der Watt, Mental Health Review Board Chairperson, at the August 2022 online support group meeting of Family Support for Schizophrenia.
Explains admission and review processes using MHCA forms. Emphasises the role of the Mental Health Review Board. Includes detailed discussion of the MHCA04 form, and the processes for Involuntary Outpatient care, appealing decisions, and reporting exploitation and abuse.
MHCA forms
Every admission under the Mental Health Care Act is documented using a series of MHCA forms which are submitted to the Mental Health Review Board for review and decision at key points.
The two Mental Health Care Act (MHCA) forms you are most likely to encounter in the process of applying for assisted or involuntary admission of your loved one to a public health establishment are:
- Form MHCA 04: Application for assisted or involuntary care, treatment and rehabilitation
- Form MHCA 22: Handing over custody by the South African police services of a person suspected of being mentally ill or severely or profoundly intellectually disabled and likely to inflict serious harm
Form MHCA 04, also known as the Founding affidavit, is the most important MHCA form, as it lays down the basis for all the ensuing processes. It is critical that it is completed properly. If you need assistance, contact your nearest provincial mental health society or Review Board, or take the form with you to the health establishment you are applying to.
Here are some pointers regarding Form MHCA 04:
- Form MHCA 04 is the only MHCA form completed by members of the public.
- The same form is used for assisted care or involuntary care. The relevant box at the top of Section A must be marked accordingly.
- The “user” is the patient who is being admitted into the mental health care system. In terms of the Act, a “mental health care user” is a person receiving care, treatment and rehabilitation services aimed at enhancing their mental health status.
- The “applicant” is the person who completes the application form. The applicant should preferably be a family member or someone who knows the user well.
- The completed form must be signed under oath in the presence of a Commissioner of Oaths, otherwise it will not be valid.
- Each designated health establishment will have an official who is an authorised Commissioner of Oaths.
Note that in the case of an application for voluntary admission no MHCA forms are needed. The standard admission forms of the facility are used.
Where to get MHCA forms
Form MHCA 04: Application form
Other sources
- From your nearest provincial mental health society
- From all emergency centres, all state hospitals and some police stations
Form MHCA 22: SAPS custody form
Other sources
- Every police station should have copies of Form MHCA 22 at hand. If you call on the police for help in taking your loved one to the hospital and they do not have a copy, you can download and print one for them.
Contact details
Western Cape Mental Health Review Board
Contact the Western Cape Mental Health Review Board with any queries about MHCA processes and forms for health establishments in the Western Cape.