The review released Thursday includes 101 recommendations on how to improve the law, including 17 recommendations that focus on the review board's failure to hold hearings on time.
Gerard La Forest, a retired judge with the Supreme Court of Canada, and Dalhousie University law professor Bill Lahey were commissioned last year by the former NDP government to conduct the review.
La Forest said in an interview the board must function well in order to protect the human rights of people living with mental illnesses.
"You're putting someone away, you see. You have to have a review," said La Forest in a telephone interview from his home in Fredericton.
La Forest and Lahey say in their report the review board was the area that presented the gravest concerns in how the law is working.
"It was ... disturbing to hear about the many problems that the review board has encountered in discharging its mandate," says the report, which looked at how the act has worked since 2007.
The report says the board couldn't hold hearings for two months because the appointment of the chairwoman had lapsed and it took a month to get her reappointed.
The reviewers say in the report they heard of a number of instances when the three-member review panels — composed of a psychiatrist, a lawyer and a layperson — didn't hold a hearing within the mandated 21 days after a patient requested a review.
"The data wasn't available to do a thorough study of this, but we were told about this a number of times," said Lahey in a telephone interview.
Under the law, people can be committed to care by a psychiatrist if they are "likely to suffer serious physical impairment or serious mental deterioration," or if they threaten or attempt to cause serious harm to themselves or others.
The act allows the review board to convene a panel within 21 days if a patient objects to their committal.
If a patient isn't granted the review in time, their status shifts from "involuntary" to "voluntary" and they may be allowed to leave the facility, said Lahey.
The report says there were cases when hearings were called at the last minute, legal aid lawyers weren't available and board members who were expected to participate in the hearing didn't appear because they were not told about it.
Ken Scott, the director of mental health in Nova Scotia's Health Department, said steps have been taken to try to recruit more board members, particularly more psychiatrists.
Scott said the board has five psychiatrists willing to serve, but the department would prefer to have 10 available.
He also said it has been "some months" since deadlines have been missed, but he didn't specify when the last hearing was missed.
"If we have a few people come in and say, 'I'm not available,' we are vulnerable," he said. "That's why we continuously work on recruiting."
Stephen Ayer, executive director of the Schizophrenia Society of Nova Scotia, said he was pleased La Forest and Lahey flagged the difficulties with the review board in their report.
"Thank goodness the review happened and identified these problems," he said.
Ayer said the board has been limited by a lack of support staff and needs more funding.