Centre intégré universitaire de santé et de services sociaux de l’Ouest-de-l’Île-de-Montréal
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Ask the expert
Justice and Mental Health

What should I do if I'm worried about the mental state of a family member and fear the person might harm him or herself?

If the life of your family member is at risk, contact the crisis intervention unit in your region. However, if a unit member is not available and the situation is urgent, you can call the police, as set out in the Act respecting the protection of persons whose mental state presents a danger to themselves or others. For more details, consult the Practical Guide to Mental Health Rights published by the MSSS.

Can anybody claim to have a mental health disorder to try to escape justice?

In theory, yes, a person can try to do this. However, the person must undergo in-depth psychiatric examinations performed by experts in the field. These experts are well versed in the signs of manipulation and faked symptoms. Also, even if someone is declared not criminally responsible on account of mental disorder, this person will probably not be released. He or she risks being detained in a hospital. The Commission d'examen des troubles mentaux (CETM) will determine if the defendant poses a danger to the public and, depending on the case, will authorize either continued confinement in a psychiatric institution or conditional or full release depending on the circumstances.
- Anne Crocker, PhD, 2010

Do alcohol and drugs increase the risk of violence?

Alcohol and drugs increase the risk of violence in both people with mental disorders and the general population. That being said, people with mental disorders are more likely to have problems with alcohol or drugs, which they use either to self-medicate or maintain social ties or because they are more sensitive to the effects of these substances.
- Anne Crocker, PhD, 2010

Does the police have other options besides detention when they intervene in the case of a person with a mental health problem?

The police may work with someone from a crisis intervention unit, such as the UPS-J in Montreal. If the person seems to pose a danger to him or herself or other people, the police may accompany the person to a psychiatric emergency department.
- Anne Crocker, PhD, 2010

What are the rights of people placed under protective confinement?

They have the right to information, the right to communication, and the right to be transferred to another institution under certain conditions. In the case of preventive confinement, the person has the right to consent to or refuse care. For more details, consult the Practical Guide to Mental Health Rights published by the MSSS.

What happens once the person has been taken to an institution by the police?

The institution has the obligation to admit the person as soon as possible and to have the person examined by a doctor. If the doctor who examines the person believes that his or her mental state poses a grave and immediate danger, the doctor must place the individual under preventive confinement for a maximum of 72 hours. The doctor may also release the person if he or she deems that the person does not pose a grave or immediate danger to him or herself or other people. For more details, consult the Practical Guide to Mental Health Rights published by the MSSS.

Is the PAJ-SM a way to escape justice?

No. The goal of the Programme d'accompagnement justice - santé mentale (PAJ-SM) is not to relieve a person of responsibility for his or her actions but rather to better meet the needs and problems of the defendant, for example, by providing referrals to mental health resources that correspond to the person's situation.
- Anne Crocker, PhD, 2010

How can you say people with mental illness are as likely to commit crimes as the general public when it 's obvious that someone who commits a crime is mentally ill?

You can make anything into a mental illness. Criminal behaviour for the moment is not considered a mental illness. In psychiatry we use DSM (the diagnostic and statistical manual for diagnosis); and we talk about Axes 1 and Axes 2. Axes 2 refers to the personality dimension. Sometimes personality characteristics become disorders but that don't necessarily fall into the category of treatable mental illnesses. They're more like “character traits”, or a way of being, and some people with certain of those traits can turn to criminality. We do not put them into the same category as the rest of the people we treat. That doesn't mean that somebody who is a criminal cannot suffer from a mental illness, just like anybody else. But criminal behaviour is part of a different category—a different way of looking at things.
-Mimi Israël, MD, Mini-Psych School 2006

Studies show that 90% of people with a mental health problem do not exhibit violent behaviour. In fact, these people are 15 times more likely to be the victim of violence instead of the perpetrator.
- Anne Crocker, PhD, 2010

What should I do if a family member with a mental disorder is arrested by the police?

First, you must reassure and support the person. You must also remind the person that he or she has the right to be represented by a lawyer, even during questioning. You can also help the person find and contact a lawyer. For more details, consult the Practical Guide to Mental Health Rights published by the MSSS.

Are people with a mental health problem violent?

Studies show that 90% of people with a mental health problem do not exhibit violent behaviour. In fact, these people are 15 times more likely to be the victim of violence instead of the perpetrator.
- Anne Crocker, PhD, 2010

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