Psychiatrists are welcoming a reform of Quebec\u2019s mental health law that would lower the threshold for involuntary hospitalization, while lawyers and advocates for patients warn the changes could infringe on rights without addressing a lack of mental health resources across the province.<\/p>\n
Health Minister Sonia B\u00e9langer tabled Bill 23 \u2014 the overhaul of Quebec\u2019s mental health law, known as P-38 \u2014 on Tuesday. Premier Fran\u00e7ois Legault had promised to make the changes following the death of Quebec police officer Maureen Breau, who was killed by a man experiencing a mental health crisis in 2023. The man had been allowed to live outside of an institution despite being considered \u201ca significant risk to public safety.\u201d<\/a>\u00a0The bill also comes two weeks after Plateau-Mont-Royal d\u00e9panneur owner Chong Woo Kim was stabbed to death<\/a> by a man who had a violent criminal past<\/a>, and who police had attempted and failed to preventatively detain in hospital in August.<\/p>\n In addition to lowering the threshold for involuntary hospitalization from a \u201cserious and immediate\u201d danger to situations where there is a risk of danger \u2014 allowing earlier interventions \u2014 the overhaul would also allow some procedures, like psychiatric evaluations, to happen without consent. Some decisions related to involuntary hospitalization would also be handled by an administrative tribunal instead of the courts.<\/p>\n B\u00e9langer said the change is aimed \u201cprimarily at better supporting individuals whose mental state could pose a risk to their own safety or that of others.\u201d<\/p>\n \u201cAfter more than 25 years, it was time to modernize our tools to intervene more humanely and earlier,\u201d she wrote in a statement.<\/p>\n J\u2019ai d\u00e9pos\u00e9 le Projet de loi visant principalement \u00e0 mieux accompagner les personnes dont l’\u00e9tat mental pourrait repr\u00e9senter un risque pour leur propre s\u00e9curit\u00e9 ou celle d’autrui. Apr\u00e8s plus de 25 ans, il \u00e9tait temps de moderniser nos outils pour intervenir plus t\u00f4t humainement. pic.twitter.com\/n99Qk0GW1Q<\/a><\/p>\n \u2014 Sonia B\u00e9langer (@SBelangerCAQ) March 24, 2026<\/a><\/p>\n The overhaul is welcomed by forensic psychologist Marie-Mich\u00e8le Boulanger of the Institut national de psychiatrie l\u00e9gale Philippe-Pinel. She said under the current criteria, \u201cyou almost have to wait until the person actually does something dangerous\u201d to keep them in hospital.<\/p>\n \u201cI\u2019ve never spoken to a psychiatrist who didn\u2019t think those criteria were too restrictive,\u201d she said. \u201cSo often in the emergency room, we have to let people go even though they seem dangerous to us because they don\u2019t meet the criteria, they\u2019re not yet \u2018dangerous.\u2019 But we know that, given the course of their illness, they likely will be soon, either to themselves or to others, and there\u2019s nothing we can do.<\/p>\n \u201cThat\u2019s why you keep seeing it in the news: Someone commits a violent act, and it turns out they had been in the ER a week earlier and were released. People wonder: \u2018Why were they let go? They were clearly unwell.\u2019 But that\u2019s exactly why: They didn\u2019t meet the legal criteria to be held in hospital.\u201d<\/p>\n But Patrick Martin-M\u00e9nard, a health law lawyer who represents patients in proceedings for involuntary confinement and court-authorized treatment, said the current version of P-38 is already used \u201cvery broadly.\u201d<\/p>\n \u201cCoercion is already widely used in the current system, and it primarily affects the most vulnerable: People experiencing homelessness, people with intellectual disabilities, people who are generally not in a position to defend themselves,\u201d he said.<\/p>\n When it comes to the killings that led to the proposed changes, Martin-M\u00e9nard said \u201cthe best way to prevent these kinds of situations is to have a system with sufficient resources to ensure proper follow-up and provide appropriate services.\u201d<\/p>\n The man who killed Breau, Isaac Brouillard Lessard, who was shot dead by police, had schizoaffective disorder and was still considered dangerous when a Quebec mental health tribunal allowed him to live outside of an institution. He had been required to follow treatment recommended by professionals.<\/p>\n A coroner\u2019s inquest heard of numerous failings in the assessment and supervision of Brouillard Lessard, who had been found not criminally responsible for offences five times between 2014 and 2018 because of mental illness. Witnesses testified he was resistant to treatment and wasn\u2019t following court orders regarding medication.<\/p>\n The coroner said the deaths of Breau and Brouillard Lessard highlighted the need for the province\u2019s mental health board to revise its approach to surveilling people who are resistant to treatment.<\/p>\n \u201cIf the system is well funded and functioning properly, then the professionals within it can use the tools that already exist to prevent these situations,\u201d Martin-M\u00e9nard said Thursday. \u201cYou can make the criteria as strict or as coercive as you want, but if the underlying system doesn\u2019t have the resources to provide the care these individuals need, and the follow-up required, tragedies \u2026 will continue to happen.\u201d<\/p>\n Speaking more generally, Fran\u00e7ois Winter, spokesperson for the Association des groupes d\u2019intervention en d\u00e9fense des droits en sant\u00e9 mentale du Qu\u00e9bec (AGIDD-SMQ), said being exposed to excessive coercion can create resentment toward the system among patients.<\/p>\n \u201cFor many, being locked somewhere you can\u2019t leave is traumatic,\u201d Winter said. \u201cThis isn\u2019t an escape room. This is serious. It\u2019s a loss of liberty without having been accused of a crime. That\u2019s extremely serious in a society governed by the rule of law.\u201d<\/p>\n Martin-M\u00e9nard had similar concerns, highlighting the repercussions of that trauma.<\/p>\n \u201cWhen they actually need help, they no longer turn to it,\u201d he said. \u201cThey become more marginalized, and at that point are at greater risk of deterioration. It becomes a vicious cycle.\u201d<\/p>\n Martin-M\u00e9nard also said the shift to an administrative tribunal instead of the courts when it comes to decisions regarding involuntary hospitalizations and treatment removes the only procedural safeguards that exist for patients to defend themselves.<\/p>\n Winter said the AGIDD-SMQ is \u201cvery concerned\u201d about the proposed changes to the law, in part because they\u2019re inconsistent with some of the recommendations made following consultations by the Institut qu\u00e9b\u00e9cois de r\u00e9forme du droit et de la justice (IQRDJ) \u2014 notably when it comes to access to mental health services.<\/p>\n \u201cThe IQRDJ didn\u2019t propose changing the hierarchy of the courts in the process, and it didn\u2019t propose redefining the concept of dangerousness,\u201d he said. \u201cThis bill does both.\u201d<\/p>\n Winter said he\u2019s already heard from people who are worried about the proposed changes.<\/p>\n \u201cThis bill is creating anxiety and even panic,\u201d he said.<\/p>\n Asked about the reaction from patients\u2019 rights advocates, Boulanger called their role important.<\/p>\n \u201cThey want involuntary hospitalization to remain a measure of last resort and to prevent abuse, because being hospitalized against your will is extremely traumatic,\u201d she said. \u201cWe don\u2019t do it lightly. It\u2019s only when it\u2019s necessary. It\u2019s normal and important that there are groups making sure the law doesn\u2019t become too permissive. \u2026 But among psychiatrists, there\u2019s pretty broad agreement that the criteria needed to be revised. Police and families also tend to agree.\u201d<\/p>\n Speaking of patients with schizophrenia who experience recurring psychotic episodes, she said psychiatrists want to intervene when they see an episode beginning, \u201cbefore it\u2019s too late.\u201d<\/p>\n \u201cWhen patients are ill, they don\u2019t want to be kept \u2026 otherwise, there wouldn\u2019t be a problem. We wouldn\u2019t need a law. But when they get better, they often ask us: \u2018Why didn\u2019t you keep me when I was in hospital?’\u201d she said.<\/p>\n Some have been brought in multiple times by police or family while unwell, she explained, but didn\u2019t meet the criteria to stay.<\/p>\n \u201cMeanwhile, their condition worsens, and because they\u2019re ill, they do things they would never do otherwise,\u201d Boulanger said. \u201cThey put themselves in danger, drive recklessly, spend all their money. By the time they finally reach the threshold for involuntary hospitalization, the illness is much more advanced and much harder to treat. And when they recover, they ask why we waited until everything fell apart.\u201d<\/p>\n Like Martin-M\u00e9nard, Winter said there needs to be better funding for mental health services in Quebec.<\/p>\n \u201cIn the end, we\u2019re still facing a situation where we\u2019re in a social crisis, a public services crisis,\u201d he said. \u201cThere\u2019s a wall in front of us, and instead of turning and going in another direction, we\u2019re pressing the gas pedal and turning up the radio so we don\u2019t hear anything.\u201d<\/p>\n kthomas@postmedia.com<\/a><\/p>\n \t\tEditor\u2019s Picks\t<\/p>\n \t\t