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Welcome to the PPAO

The Psychiatric Patient Advocate Office protects and promotes the rights and entitlements of Ontarians with mental illness through advocacy, rights advice and education.

We envision a society where the rights of all individuals, regardless of mental illness or disability, are respected, protected and realized. Read more about us and our mandate here.


This May 2013 marks the 30th anniversary of the Psychiatric Patient Advocate Office (PPAO). Since its inception, the PPAO has worked tenaciously to uphold the civiland human rights of people with mental illness throughout Ontario.

The PPAO continues to fulfill its mandate as a rights protection program by providing individual and systemic advocacy in nine of the ten tertiary care psychiatric facilities and rights advice in the vast majority of Schedule 1 mental health hospitals across the province. In 2012, the PPAO addressed nearly 3,000 individual advocacy issues and provided rights advice on more than 34,000 mental health forms.

The PPAO is also an essential and expert educator within the mental health system and to the public at large. Through education, the PPAO actively disseminates information that empowers consumers of mental health services to take a more active role in their own care and treatment, recovery and individual life choices. Moreover, the PPAO promotes the realization and protection of mental health consumers’ rights by raising professional and public awareness about existing safeguards in mental health and allied legislation.

Over the past three decades, the PPAO has demonstrated its importance as an integral component of Ontario’s mental health system by supporting a balance between individual autonomy and professional obligation and authority. In its delivery of rights protection and mental health advocacy services, the PPAO helps to mitigate the stigma and discrimination experienced by mental health consumers and, in so doing, supports their full social inclusion.

Please join me in celebrating the PPAO’s 30 years of accomplishment and the positive contribution the office has made to the lives of the vulnerable Ontarians that it serves and to the mental health system.



Susan Picarello

Director (A)



En mai 2013, le Bureau de l’intervention en faveur des patients des établissements psychiatriques (BIPEP) célèbre son 30e anniversaire. Depuis sa création, le BIPEP a travaillé sans relâche pour faire respecter les droits civils et humains des personnes atteintes de maladie mentale en Ontario.

Le BIPEP continue de réaliser son mandat de programme de protection des droits en fournissant une défense individuelle et systémique dans neuf des dix établissements de soins psychiatriques tertiaires ainsi que des conseils en matière de droits dans la grande majorité des hôpitaux de santé mentale de l’annexe 1 dans la province. En 2012, le BIPEP a abordé près de 3 000 questions individuelles relatives à la défense et a fourni des conseils en matière de droits sur plus de 34 000 formulaires relatifs à la santé mentale.

Le BIPEP est également un éducateur essentiel et expert au sein du système de santé mentale et auprès du grand public. Grâce à l’éducation, le BIPEP diffuse activement de l’information qui permet aux bénéficiaires des services de santé mentale de jouer un rôle plus actif dans leurs soins, leur traitement, leur rétablissement et les choix qu’ils font dans leur vie. En outre, le BIPEP favorise la réalisation et la protection des droits des bénéficiaires de services de santé mentale en sensibilisant les professionnels et le public aux mesures de protection qui existent dans les dispositions législatives sur la santé mentale et des secteurs associés.

Au cours des trois dernières décennies, le BIPEP a démontré l’importance de son intégration au système de santé mentale de l’Ontario en appuyant l’établissement d’un équilibre entre l’autonomie des individus et les obligations et l’autorité des professionnels. Dans le cadre de sa prestation de services de protection des droits et de défense de la santé mentale, le BIPEP aide à réduire la stigmatisation et la discrimination dont font l’objet les bénéficiaires des soins de santé mentale; ce faisant, il appuie leur pleine inclusion dans la société.

Veuillez vous joindre à moi pour célébrer les réalisations des 30 dernières années du BIPEP et l’apport positif du bureau sur la vie des Ontariens et des Ontariennes vulnérables qu’il sert, ainsi que sur le système de santé mentale.

Veuillez agréer l’expression de mes sentiments les plus distingués.


Susan Picarello

Directrice (A)

PPAO Commends Ontario Association of Chiefs of Police for Sealing Mental Health Records

The Psychiatric Patient Advocate Office (PPAO) today commended the Ontario Association of Chiefs of Police (OACP) for its new guideline protecting the privacy of persons with mental illness who encounter police as front-line emergency health care responders.

Until now, police forces across Ontario have been individually responsible for deciding whether to publicly disclose mental health information about someone who has been subjected even to a routine background check.

An inconsistent patchwork of procedures often led to unfair disclosure of non-criminal information on routine background checks and vulnerable-sector screenings, leading to discriminatory hiring practices by employers and volunteer organizations.

"By prohibiting the release of non-criminal mental health information collected by police, the new guideline is a meaningful step forward that will protect tens of thousands of Ontarians from stigma and discrimination" says Ryan Fritsch, the PPAO's legal counsel.

Vahe Kehyayan, Director of the PPAO says "We commend the OACP for developing the guideline in consultation with the Police Record Check Coalition and our office to better protect Ontarians with disabilities from criminalization and marginalization.”

For 28 years, the Psychiatric Patient Advocate Office has provided rights advice and advocacy services to patients with mental illness in Ontario. In 2010, the PPAO provided rights advice 25,000 times and advocacy services to more than 3,500 clients.

Since 2006, the PPAO has lobbied government and police forces as Co-Chair to the Police Record Check Coalition. The Coalition has dozens of institutional and individual members including the Ontario Association of Patient Councils and the Canadian Mental Health Association, Ontario Division.

Fritsch said the PPAO is urging all police forces across the province to adopt and implement the new guideline. "Persons with disabilities deserve every equal opportunity to work and volunteer in their communities without barriers or fear of discrimination," he said.

The new Guideline will be made available to the public on the OACP website. The PPAO has also prepared a self-advocacy InfoGuide.

PPAO Launches Monthly Lecture Series, "Living your Rights"

Living Your Rights is a FREE monthly education series to introduce & inform those involved in the mental health system about their rights, gain a clear understanding of the core principles of mental health law & allied legislation, learn strategies for handling mental health law issues and network with leaders in the field & peers who share your challenges.

This first lecture, "A Guide to the Mental Health Act", takes place July 7, 2011 at 2:00PM at the North York General Hospital and features Stanley Stylianos, Program Manager, and Ryan Fritsch, Legal Counsel, Psychiatric Patient Advocate Office.

For further information and to register, email Theresa at Central LHIN C/S Network: or telephone 647-203-3726.

Presented by the Central LHIN Consumer/Survivor Network & the Psychiatric Patient Advocate Office.

PPAO concerned with Retirement Home Act draft regulations

On April 8, 2011, the PPAO filed submissions to the Ontario Senior's Secretariat regarding the recently drafted Regulations under the Retirement Homes Act (S.O. 2010, Ch. 11). Certain sections of the Act remain inoperative until the Regulations come into force, including important protections on background checks and vulnerable sector screenings, the use of restraints in retirement homes, assessment and care planning with the participation of the resident, and the availability of rights advice to particularly vulnerable residents.

The PPAO raised additional concerns related to the potential use of covert medication and recommended that the prescribed use of restraints will inevitably lead to abuses without significantly enhanced protections.

11.04.08 - RHA Regs 2011 - PPAO.pdf    
PPAO takes stand against cross-border mental health disclosures
A recent article in the Toronto Star highlights how personal health information is finding it's way across the border -- and being used to discriminate against basic civil liberties.
"Canadian woman denied entry to U.S. because of suicide attempt" describes how Lois Kamenitz arrived at Pearson International Airport in November, hoping to board a flight to California. But she was stunned to learn that U.S. border officials were barring her entry. The reason: Years ago, she attempted suicide.
As the article notes, it is an issue the PPAO is hearing about with increasing frequency:

It’s not an isolated incident, says Ryan Fritsch, legal counsel for the Psychiatric Patient Advocate Office. He has heard of about eight similar cases in the past year, all involving non-criminal contact between police and people with mental health issues — records of contact that end up at the Department of Homeland Security.

"These kinds of disclosures and the retention of this kind of information has a chilling effect on persons with mental illness," said Fritsch, who fears people will think twice before calling 911. "A mental crisis should not be a lifelong sentence for stigma and discrimination."

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