Quebec mandates experts to "review" Bill P-38
Faced with the multiplication of incidents, Quebec intends to review the Act respecting the protection of persons whose mental state presents a danger to themselves or to others, adopted more than 25 years ago. The government mandated the Institut québécois de réforme du droit et de la justice to submit a new version.
"If we want to understand the application on the ground, we have to go to those who live it on the ground. We believe that a reflection is needed on our tools to better protect people with mental health problems and the population, "said Wednesday the minister responsible for social services, Lionel Carmant.
Since 1997, Bill P-38 has allowed physicians to ask a judge to order the hospitalization of a patient who does not want to be treated if he or she presents an imminent danger to himself or others.
Lionel Carmant
However, the redesign process will not affect the Commission d'examen des troubles mentaux du Québec (CETM). It was this organization that had dealt with the case of the man suspected of killing police officer Maureen Breau during a routine operation in Louiseville. He had a criminal and mental health history, and posed "a significant risk" to public safety, which did not prevent
him from being released under severe conditions.
According to Mr. Carmant, these events were not "triggers" in the government's decision to initiate an overhaul of Bill P-38. "Already, at the end of the Mental Health Forum that we had done in 2019, we wanted to work on the application of P-38. We have always heard the same complaints," he said, saying that "Quebec society is now ready" for change.
At least 18 monthsPierre Noreau, President of the Institut québécois de réforme du droit et de la justice and professor at the Université de Montréal's Faculty of Law, will lead the consultation work. "We do not assume that the P-38 is necessarily bad, the question is its implementation," he said.
However, he refuses to give a clear deadline for coming up with conclusions, saying first that he wants to "go around" the situation with all stakeholders. At a minimum, says Mr. Noreau, it will be necessary to consider a delay of 18 months. "You can't improvise law amendments on the corner of a table. There's nothing worse than that," he insists.
As early as 2012, the Québec Ombudsman noted "significant disparities in the application" of Bill P-38 "according to institutions, regions and stakeholders from different backgrounds." He recommended a "periodic review" of the law to the government.
Also on site Wednesday, Dr. Pierre Bleau, national director of mental health and forensic psychiatric services at the Ministry of Health and Social Services (MSSS), called on the population to "be careful before conflating." "Mental health disorders do not necessarily lead to such tragedies. Most of the time, people are more dangerous to themselves than to others, which is a challenge for families, especially," he said.
The director of the Réseau Avant de Craquer, René Cloutier, said Wednesday he was "encouraged" by the fact that the approach is "global". "We have to see how we can look at everything that revolves around the law so that it is more satisfactory for everyone, because currently, all the actors are dissatisfied, whether lawyers, judges, families, psychiatrists who have to take steps," he said.
Dr. Claire Gamache, President of the Association des médecins psychiatres du Québec, argued that "the updating of Bill P-38 must be based on both solid legal foundations and the latest medical knowledge." "We hope that this work will also serve to combat the conflation of violence and mental health," she noted.
Measures in sightOn Saturday, in the wake of a La Presse dossier on "the gradation of sanctions" pushing offenders directly to imprisonment, Minister Carmant had cited three measures to improve access to mental health care: hospitalization at home for people with psychotic and mood disorders, specialized rapid intervention teams and community relays, and brief intervention units in psychiatry.
In an interview, Mr. Carmant explained that the objective of these measures, which target "all mental health clienteles", is among other things to reduce the famous phenomenon of "revolving doors" in psychiatry, which leads some patients to repeatedly visit hospitals.
The various mental health programs in the health network followed 250,000 patients this year. In the emergency department, however, there were more than 3 million mental health consultations. For Mr. Carmant, these data show that patients
"need follow-up after their visit" in the emergency room.
"If we want to understand the application on the ground, we have to go to those who live it on the ground. We believe that a reflection is needed on our tools to better protect people with mental health problems and the population, "said Wednesday the minister responsible for social services, Lionel Carmant.
Since 1997, Bill P-38 has allowed physicians to ask a judge to order the hospitalization of a patient who does not want to be treated if he or she presents an imminent danger to himself or others.
Lionel Carmant
However, the redesign process will not affect the Commission d'examen des troubles mentaux du Québec (CETM). It was this organization that had dealt with the case of the man suspected of killing police officer Maureen Breau during a routine operation in Louiseville. He had a criminal and mental health history, and posed "a significant risk" to public safety, which did not prevent
him from being released under severe conditions.
According to Mr. Carmant, these events were not "triggers" in the government's decision to initiate an overhaul of Bill P-38. "Already, at the end of the Mental Health Forum that we had done in 2019, we wanted to work on the application of P-38. We have always heard the same complaints," he said, saying that "Quebec society is now ready" for change.
At least 18 monthsPierre Noreau, President of the Institut québécois de réforme du droit et de la justice and professor at the Université de Montréal's Faculty of Law, will lead the consultation work. "We do not assume that the P-38 is necessarily bad, the question is its implementation," he said.
However, he refuses to give a clear deadline for coming up with conclusions, saying first that he wants to "go around" the situation with all stakeholders. At a minimum, says Mr. Noreau, it will be necessary to consider a delay of 18 months. "You can't improvise law amendments on the corner of a table. There's nothing worse than that," he insists.
As early as 2012, the Québec Ombudsman noted "significant disparities in the application" of Bill P-38 "according to institutions, regions and stakeholders from different backgrounds." He recommended a "periodic review" of the law to the government.
Also on site Wednesday, Dr. Pierre Bleau, national director of mental health and forensic psychiatric services at the Ministry of Health and Social Services (MSSS), called on the population to "be careful before conflating." "Mental health disorders do not necessarily lead to such tragedies. Most of the time, people are more dangerous to themselves than to others, which is a challenge for families, especially," he said.
The director of the Réseau Avant de Craquer, René Cloutier, said Wednesday he was "encouraged" by the fact that the approach is "global". "We have to see how we can look at everything that revolves around the law so that it is more satisfactory for everyone, because currently, all the actors are dissatisfied, whether lawyers, judges, families, psychiatrists who have to take steps," he said.
Dr. Claire Gamache, President of the Association des médecins psychiatres du Québec, argued that "the updating of Bill P-38 must be based on both solid legal foundations and the latest medical knowledge." "We hope that this work will also serve to combat the conflation of violence and mental health," she noted.
Measures in sightOn Saturday, in the wake of a La Presse dossier on "the gradation of sanctions" pushing offenders directly to imprisonment, Minister Carmant had cited three measures to improve access to mental health care: hospitalization at home for people with psychotic and mood disorders, specialized rapid intervention teams and community relays, and brief intervention units in psychiatry.
In an interview, Mr. Carmant explained that the objective of these measures, which target "all mental health clienteles", is among other things to reduce the famous phenomenon of "revolving doors" in psychiatry, which leads some patients to repeatedly visit hospitals.
The various mental health programs in the health network followed 250,000 patients this year. In the emergency department, however, there were more than 3 million mental health consultations. For Mr. Carmant, these data show that patients
"need follow-up after their visit" in the emergency room.
