Forced Hospitalization: Three Types

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Adults usually have the right to decide whether to go to the hospital or stay at the hospital. But if they are a danger to themselves or to other people because of their mental state, they can be hospitalized against their will.  Forced hospitalization is used only when no other options are available.

 

What is forced hospitalization?

Forced hospitalization means keeping someone in the hospital against his will. It’s also called involuntary confinement or civil commitment. In French, it’s called “la garde en établissement.” 

Unless the situation is urgent, a judge’s permission is needed to keep someone at the hospital against their will. Patients can challenge their forced hospitalization.

 

Types of forced hospitalization?

There are three types of forced hospitalization: 

 

Preventive confinement 

This is used in emergency situations for people who present a grave and immediate danger to themselves or to others because of their mental state. They can be kept in the hospital against their will for up to 72 hours without permission from a judge.  To learn more, read our article Forced Hospitalization in Emergencies(72 hours).

 

Temporary confinement 

This is used to keep people in the hospital for a psychiatric exam. A judge’s permission is needed. People cant be kept up to 144 hours. To learn more, read our article Forced Hospitalization for a Psychiatric Exam.

 

Court-authorized confinement 

This is when two psychiatrists decide someone should stay in the hospital because they present a danger to themselves or others. A judge’s permission is needed. The judge decides how long they can be kept in the hospital. To learn more, read our article Forced Hospitalization After Psychiatric Exams

IMPORTANT: People who are hospitalized against their will have the right to refuse treatment, except in emergencies, for hygiene or if treatment is authorized by a court.  

 

Defining danger

Being a danger to themselves or to others is the only reason people can be hospitalized against their will. Danger can mean different things, depending on the situation. It is evaluated by looking at a person’s current behavior and overall situation.

Having a mental illness doesn’t automatically make someone dangerous. Also, people aren’t necessarily dangerous just because of their past behaviour, need for care, inability to make their own decisions, strange behaviour or because they are bothering other people. 

Forced hospitalization should not be used just because a person would benefit from treatment or supervision. There must always be an element of danger. 

For the court to allow people to be hospitalized against their will, the danger must be: 

  • caused by their mental state
  • real (clear and based on specific actions, words and attitudes)
  • likely (the risk of danger must be high)
  • about serious harm to someone
  • happening now or very soon

For the hospital to keep people against their will without going to court (Forced Hospitalization in emergencies (72 hours)), the danger must be even more serious. It must be grave and immediate. This means the situation is so urgent that waiting for a court order would likely result in very serious harm. 

For example, people have been forced to stay at the hospital in these situations: 

  • they tried to kill themselves
  • they threatened to kill someone else
  • their mental state makes them unable to do things that are necessary to keep them alive, like following treatment for a physical health problem

 

When can patients leave the hospital?

It depends on the situation: 

  • as soon as a doctor decides they no longer need to stay at the hospital 
  • after 72 hours if they are kept at the hospital without a court order (read our article on Forced Hospitalization in Emergencies (72 Hours))
  • when a court decides they should be released
  • if the hospital doesn’t do a psychiatric exam after 21 days and every three months after that 

The hospital must tell patients as soon as they can leave the hospital. Patients will often be told in French “La garde est levée.”  That means they can go home.  

If the patient is under 18, the hospital must tell the parent the person acting as the parent or the guardian (tutor) in writing when the patient is being released. If the patient has a legal representative (mandatary, tutor or curator), the hospital must tell the legal representative in writing.

Important !
This article explains in a general way the law that applies in Quebec. This article is not a legal opinion or legal advice. To find out the specific rules for your situation, consult a lawyer or notary.