Confinement in a Health and Social Services Institution or Treatment Order: Understanding What It Means for You or a Loved One

These two measures both touch on fundamental rights: a person's liberty and integrity. Despite this similarity, they do not carry the same meaning or the same consequences. Understanding what they mean not only helps clarify the rights of the person involved, but above all, helps everyone be better prepared to face the situation.

Confinement in a Health and Social Services Institution

An application for confinement in a health and social services institution allows a judge of the Court of Québec, Civil Division, to authorize that a person be confined to a hospital against their will. Such confinement is most often preceded by a preventive confinement, commonly known as a P-38, and a provisional confinement requested by the hospital or the family (see also the article When a Loved One Refuses Help: What to Do When You're Worried About Someone's Mental Health).

For a judge to order confinement against a person's will, there must be serious grounds to believe that the person poses a danger to themselves or to others. To reach that conclusion, the judge will consider the evidence submitted by the hospital, namely two psychiatric examination reports concluding that confinement is necessary, as well as the testimony of the person involved, and sometimes of those close to them. Once ordered, the person will be confined for a period generally ranging from 7 to 30 days. The confinement order may be renewed at the end of that period.

Important to know: during this period, no member of the treating team may force the person to take medication, except in the case of a serious behavioral crisis requiring emergency administration of medication.

In short, a confinement order represents a pause for the person involved in order to assess and manage any risk of danger, with no obligation to undergo any treatment. It is worth noting that a confinement order may be lifted at any time by the treating team, without the need to return before the court.

Treatment Order

An application for authorization of treatment and/or placement allows a judge of the Superior Court, Civil Division, to authorize that a person receive treatment and/or be placed in a specific facility, against their will.

To reach such a conclusion, the judge must find that the person is, on the one hand, incapable of consenting to care, and on the other hand, that they categorically refuse the proposed treatment. To do so, the judge must review all evidence presented by the hospital, including the treating psychiatrist's medical evaluation report and testimony, as well as the evidence presented in defence, namely the testimony of the person involved.

A treatment and/or placement order most often covers a period of one to three years. It may also include additional orders authorizing, among other things, blood draws, ongoing follow-up appointments, or a period of hospitalization in the event of a behavioral crisis.

In short, a treatment order allows the hospital to administer medication to a person and to place them in a facility, against their will.

Ultimately, please bear in mind that if you, or one of your relatives, is targeted by either of these requests, you have the right to be accompanied by a lawyer.

After reading this article, if you have any questions or would like to be assisted by our services, please contact us at 438-838-6638 extension 2.