The College of Physicians of Quebec (CMQ) has significant reservations regarding Bill 23, which aims to relax the criteria for involuntarily hospitalizing a person in crisis.
This is a revision of Bill P-38, the Act respecting the protection of persons whose mental state poses a danger to themselves or to others, which was passed more than 25 years ago.
Currently, authorities can only involuntarily hospitalize a person if they pose a “serious and immediate” danger. This criterion is among the most restrictive in Canada.
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Bill 23 proposes replacing the “serious and immediate” danger criterion with one of a “situation where there is a danger” to the person or to others.
For example, a man with schizophrenia whose condition is reported to be deteriorating, but who does not necessarily pose an immediate danger, could be transported against his will to a hospital where he would remain for seven days.
In a brief sent to the Health and Social Services Committee, a copy of which was obtained by La Presse Canadienne, the CMQ expresses concern that broadening the danger criterion will lead to an increase in the number of involuntary detentions.
It notes that according to the most recent statistics, during the 2023-2024 fiscal year, 19,106 people were placed in preventive custody, a number it already considers “significant.”
“An increase could overwhelm the system and exacerbate current difficulties in accessing care,” he writes to lawmakers.
The professional association recommends that the implementation of Bill 23 be accompanied by “structured mechanisms” to monitor the number of involuntary hospitalizations.
Another new development: individuals struggling with mental health issues would now have the option to complete an advance psychiatric directive (DPA) specifying their wishes in the event of a major breakdown.
Here too, the CMQ issues a warning. “The CMQ foresees several difficulties regarding their implementation and applicability.”
It recommends that DPAs be subject to “further study before being rolled out so that conditions conducive to their implementation can be established and their impact can be better assessed.”
Quebec promises to allocate additional resources to better support these vulnerable individuals, including upon their discharge from the hospital, and to improve information sharing among healthcare providers.
The CMQ notes that the assessment of mental health status constitutes a reserved activity under the Professional Code and may only be performed by authorized healthcare professionals.
–This report by La Presse Canadienne was translated by CityNews
