a) the representation of individuals before the Ontario Board of Review and the Ontario Consent and Capacity Review Board; and

A Board of Review makes and reviews dispositions (orders) concerning any person facing criminal charges in respect of whom a criminal court has made a finding of unfit to stand trial or a verdict or not criminally responsible by reason of mental disorder.

A finding of unfit to stand trial occurs when it is demonstrated to a court that an accused person does not understand the nature or object of the proceedings or their consequences or is unable to communicate with counsel.

A verdict of not criminally responsible results from a finding that at the time of an alleged offence the accused person was suffering from a mental disorder that made him/her unable to appreciate the nature and quality of the act or to know that it was wrong.

In the case of a finding of unfit to stand trial or a verdict of not criminally responsible the accused person will be ordered to be detained in a mental institution to await further disposition by the Review Board for that province.

In all such cases the accused person must be given at least one Review Board Hearing each year.

The Review Board usually convenes at the mental institution where the accused person is being detained. The Review Board panel includes a chairperson (usually a former judge or lawyer), two psychiatrists, a lawyer and a lay person.

The hospital treatment team prepares a report relating to the patient's history and progress and includes a recommendation for the terms which should be part of the continuing order for the following year (or, if appropriate, for the order to be terminated).

The hospital's case is normally presented by the patient's treating physician.

A representative of the Crown Attorney's Office is present to advocate on behalf of the public. The patient is expected to be present and may be represented by counsel.

The hospital presents its case first by way of evidence from the doctor and any other witnesses the hospital chooses to call. The Crown may then call witnesses followed by the patient, who may give evidence and call witnesses. In each case the other parties are entitled to cross examine. Often there are questions from the various members of the panel.

All parties are then given the opportunity to make submissions to the panel.

In the case of a person who has been found to be unfit to stand trial the Board makes a finding as to whether or not the person is fit to stand trial. If so, then that finding will be recorded and the person will be referred back to the Criminal Court for his or her trial. If not, the Board then decides what restrictions should be placed upon the person's liberty during the ensuing year to protect the interests of the public.

In the case of a verdict of not criminally responsible, the Board concerns itself with whether or not the person has recovered from his or her mental illness and if not, the degree of risk which the person continues to present to the public and what restrictions need to be placed upon the person's liberty during the ensuing year.

Under the Health Care Consent Act, a patient may be found to be incapable of giving consent to psychiatric treatment, thereby losing control over decisions relating to his/her psychiatric treatment. When this occurs the patient has the right to apply to the Board for a review of the decision relating to his or her incapacity. The test which the Board applies is whether or not the patient is able to understand the information relating to the making of a decision about treatment and is able to appreciate the reasonably foreseeable consequences of a decision relating to treatment. Where the Board determines that the patient lacks the necessary capacity, members of the patient's family can be substituted as decision makers or in the absence of such persons, the authority can be given entirely to the treating physician.

Under the Mental Health Act, a person can be detained in a psychiatric institution if the conditions for involuntary admission to a hospital are met. A patient so detained is entitled to a review of his/her involuntary status by the Consent and Capacity Review Board.

The essence of the test for involuntary admission is whether or not the patient, because of mental disorder, if not detained and treated, is likely to do serious bodily harm to him or herself or another person, or is likely to suffer substantial mental or physical deterioration (and would leave the hospital if not detained).

Under the Mental Health Act, a person can be found to lack capacity to manage his/her financial affairs. The person is entitled to have this finding reviewed by the Ontario Consent and Capacity Review Board. If the board decides that the person lacks the necessary capacity to manage his or her financial affairs, the authority is given to the Public Guardian and Trustee for the province of Ontario. Such procedures will be unnecessary in cases where the person, while still capable, has signed a Continuing Power of Attorney for Property in favor of another individual.

The Ontario Consent and Capacity Review Board convenes in the Psychiatric Institution where the patient is residing. Normally the panel consists of a chairperson, who is a lawyer, a psychiatrist and a layperson, all of whom are provincial appointees.

Normally the hospital treatment team will have prepared a report, setting out the patient's history and progress, and the hospital's reasons for the continuation of the certificate of incapacity or involuntary admission, as the case may be.

The hospital's case is presented by the treating physician with assistance from other witnesses, where appropriate. The patient will normally be present and is entitled to be represented by counsel, who may cross-examine the doctor and hospital witnesses. The patient can give evidence or not as he or she sees fit and can refuse to answer questions by the doctor or panel.

Capacity problems arising from accident or illness can be largely avoided in advance by the subject person giving the authority to make decisions to another person.

Personal care decisions can be given by a Power of Attorney for Personal Care.