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Presenting a request for a prescription for a psychiatric evaluation.

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Have you noticed significant changes in your loved one’s behaviour and habits? Do you have many concerns about your loved one’s health and safety or those of others? Despite your best efforts, your loved one refuses to consult you?
This article contains two parts. In the first part, the information related to “The law of protection of the person whose mental state presents a danger to himself or to others”.   And in the second part, the steps of the accompaniment that we can offer you if your loved one presents a danger to himself or to others are described.  

It should be noted that the content of this brochure is for information purposes only and has no legal value.

   
Information on the protection law “The law for the protection of a person whose mental state presents a danger to himself or to others is the application of article 27 of the Civil Code of Quebec, which states:
“If there are serious grounds for believing that a person presents a danger to himself or to others by reason of his mental state, the court may, on the application of a physician or of an interested person, order that he be temporarily detained in a health or social services institution, notwithstanding the absence of consent, to undergo a psychiatric examination.”
To better understand the application of this law:   First of all, you should know that this is an exception law and can only be used if the following conditions are present:
  • your loved one refuses to consult
AND
  • his or her mental state presents elements of danger to him or herself or to others.
Institutional Custodies When your loved one is taken to the hospital with or without their consent, they may be placed in custody for a period of time to ensure their safety or the safety of others. This is called institutional care. There are actually three types of institutional custody, the use of which will be determined by the situation. 1- Preventive custody When there is an emergency and the situation requires a rapid intervention, you must call directly on the police. To have recourse to this intervention, your loved one must demonstrate, by his words or actions, an immediate and serious danger to his health, his safety or that of others. Here are some examples: Your loved one has hallucinations that cause him/her to be violent towards him/herself (self-mutilation), physically violent (breaking objects). He or she is threatening to you, pushing you around, making verbal threats, etc. [1]    
Information about accompanying a request for a prescription for a psychiatric examination Foreword   Necessary information to consider before the application process:   Two people are required to sign the documents. One will act as the applicant and the other will act as the respondent. According to the law, any MAJOR person who shows a particular interest in a person who manifests a dangerous mental state for him/herself or for others: family, doctor friend, intervener, social worker, etc. and who is able to demonstrate the behaviours and facts related to the dangerousness can constitute the plaintiff or the respondent. The plaintiff is the person who undertakes the application process because he (she) believes that his (her) loved one, through his (her) words and/or actions, demonstrates a serious danger to his (her) health, safety or that of others. The respondent is the person who also knows about the person’s current mental state (the defendant) and supports the application process undertaken by the applicant. The respondent is the person who presents a serious danger to his or her health or safety or to the health or safety of others. It is preferable that at least one family member be present during the application process. If, for some reason, no family member can be present, it is important to be able to explain to the judge the reason(s) for your absence by attaching a letter. The application process with accompaniment First contact   Generally, the first contact with us is made by telephone. You will be asked to briefly describe the situation and the reasons why you have reason to believe that your loved one presents a serious and immediate danger to his or her health, safety or that of others. If the necessary conditions are present to have recourse to the Act for the protection of persons whose mental state presents a danger to themselves or to others, the intervener will suggest that, before the meeting, you briefly write down the facts and recent behaviours that you have observed and that summarize the situation that concerns you. These writings will be a valuable tool for the rest of your process. The counsellor may also ask you to contact the attending physician and/or the professionals involved with your loved one in order to obtain a letter from them expressing their support. In addition, any other elements (photos, writings) relevant to the situation may be useful. Meeting at your association Support for the drafting process (request) After gathering information that demonstrates that your loved one is in serious and immediate danger to himself or others, the intervener will accompany you in the drafting process. These writings must be based on measurable and observable facts and demonstrate to the court that your loved one’s recent behaviours present a danger to himself or to others. It is through these writings that the judge will assess whether your loved one’s mental state requires a psychiatric evaluation. Accompanying your loved one to the courthouse If you represent the plaintiff, you must go to the courthouse in the municipality where your loved one resides, at the date and time indicated by the intervener. It is strongly recommended that you be accompanied by the person who represents the respondent. In addition to benefiting from his or her support, his or her presence will add credibility to the presentation of your claim. Arrival at the courthouse Upon your arrival at the courthouse, you will be directed to the Civil Registry to be sworn in. You will then be invited to go to the room designated to meet the judge.   How your presentation to the judge will proceed The meeting with the judge always takes place in camera, meaning that no one not involved in the application can attend the presentation. However, at your request, it is possible that the intervener from your association may be present. The judge will review your application. He or she may ask you to explain the situation in more detail. You must then describe in what way the current situation leads you to believe that your loved one is in a dangerous mental state for him or herself or for others. It is best to give concrete examples. The judge will then make a decision concerning your request. If the judge finds that your loved one is dangerous, he or she will sign a temporary custody order for a psychiatric evaluation. Accompanying you to the police station Once the judge has signed the order, you must go to the police station serving your loved one’s place of residence or location. Accompaniment to the police station may be possible, ask your association. When you arrive, you must present the order to the police and hand over the documents for the hospital. A police officer may ask to meet with you in order to better prepare for his intervention. They will ask you a few questions about your loved one: is he or she aggressive, does he or she have weapons, where is he or she? You can also ask questions about your concerns about the process or anything else. *** Translated with www.DeepL.com/Translator (free version) ***    
Some police officers can provide transportation to the hospital in their vehicle. But most of the time, your loved one is transported by ambulance.
If you decide not to be present, the police may ask you to make certain arrangements. For example: have a copy of the keys, notify the superintendent to ensure access to your loved one’s premises in case he or she refuses to open the door. [1] Note that there may be a charge for ambulance service. (For more information see “Frequently asked questions # 2”)
That is, you must present the order to the police immediately after you get it from the court. If for some reason you delay, there is a risk that the police will refuse to enforce it. However, if your loved one cannot be found on the day of the order, the order becomes enforceable as soon as you see or know where he or she is, even if there is a delay of a few days since the order was obtained.
Upon arrival at the hospital, the police or paramedics will give the documents (application, order and, if applicable, other attached documents) to the psychiatrist for psychiatric assessment.

Frequently asked questions

No. There is no fee charged for accompanying the application.

However, a bailiff's fee may be charged if the judge requests that the application be served on your loved one and/or the responding party.

The costs are usually covered by the HHSC. 

Yes. If the judge feels that the level of dangerousness is not sufficient, has not been sufficiently demonstrated or lacks information the judge may not issue an order.  Hence the importance of being well prepared and gathering as many facts related to the situation as possible.

Yes, as soon as you again observe evidence that your loved one's mental condition presents a danger to him or herself or others.

In recent years, Msss has discontinued the sectorization of mental health services. However, it is preferable to choose the Hospital Center closest to your home that has a psychiatric unit or the Hospital Center where your loved one is already being followed.

NO!  The request is only for a psychiatric evaluation. Only when the evaluations by two psychiatrists conclude that he or she is dangerous to himself or herself or others and your loved one refuses to be hospitalized will the hospital center forward a request for institutional care to the court.

This order does not require your loved one to accept care. This means that your loved one can refuse any treatment. A treatment order can only be requested by a psychiatrist.

Be available to give more information to the psychiatrist so that he or she can better conduct the assessment. It is important to ensure that the psychiatrist has contact information for you.

No, it is even suggested that you ask the nurse to find out if it is a good time for a visit.

As long as the level of dangerousness is present to themselves or others your loved one will be required to remain hospitalized.

Non, à cause de la loi sur la confidentialité et surtout si votre proche refuse de donner son autorisation. En revanche, il vous est possible de communiquer verbalement ou par écrit avec le psychiatre pour lui transmettre de l’information que vous détenez. 

Une demande d'évaluation n'aboutira pas nécessairement à un diagnostic mais l'évaljuation de la dangerosité sera faite.

Yes, be aware that you are never obligated to take your loved one back into your home unless you live in their home.

On the other hand, it is important to let the care team know of your intention as soon as possible so that the psychiatry department worker can be notified and begin the appropriate steps with your loved one.

Probably not. Although it may happen, it's more likely that your loved one will notify you of their leave.

No. This entire process is done in civil court and has no criminal consequences.
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