You think that the mental state of someone you are caring for poses a danger to them or to you. Something must be done.
How do you assess this danger? Do you feel that you are mistaken? How do you deal with your feeling of helplessness? How can you get support in this difficult and delicate situation? Here are some tips and advice.
Are you afraid of making a mistake when you think that the person you are caring for is a danger to themselves, to others, to you? Do you feel troubled by the idea of going against their wishes?
Jean-Pierre, whose son suffers from schizophrenia, gives a poignant testimony in this regard.
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How do you gauge the level of danger at the heart of the situation while providing the best possible support for the person you are caring for? L’Appui pour les proches aidants would like to give you concrete examples, rooted in the experience of the Caregiver Support counselors. The goal is to help you find your way in your own situation and with regard to a difficult and delicate situation.
Case studies
Examples
Serious and immediate danger
The brother of a caregiver is depressed. He confides in her that he has suicidal thoughts but will not act on them because he does not want to hurt his family.
The caregiver prepares for the eventuality that the situation changes, for example, if the brother says that he has a concrete plan to commit suicide with a firearm and expresses the desire to carry it out within the next 24 hours. If this situation arises, the caregiver plans to contact 911, as there is a serious and immediate danger to themselves.
Serious and imminent danger
The daughter of the caregiver is 20 years old and experiences her first psychotic episode. She is plagued by paranoid ideas. She feels that the government is watching her through the monitors. She prepares to defend herself against government agents with knives. She thinks she is invincible.
The caregiver consults their caregiver association to help them file a petition for interim custody, as her daughter is a serious and imminent danger to others.
No serious or imminent danger
The caregiver’s mother has bipolar disorder. She has recently stopped her medication and is in a manic phase. She hardly sleeps at all and is constantly working on a new business venture, a venture that is the result of a delusion. The mother is spending huge amounts of money on this project, which is not going to work.
The caregiver tries to convince her mother to undergo treatment, but the mother refuses. Since her mother is not in immediate/imminent danger, the caregiver cannot force her mother to receive treatment or to undergo an assessment. In this case, the right to autonomy of the cared-for person is protected by law. The caregiver contacts the Caregiver Support Helpline or her caregiver association for support in feeling powerless and for strategies to encourage the person being cared for to consent to an assessment or treatment.
Stéfanie Brideau
Caregiver counselor
If in doubt, do not take any risks and contact emergency services. Caregivers are not trained to recognize these situations. There is therefore no harm in contacting the emergency services, who can make this assessment and act accordingly.
Stéfanie Brideau
Caregiver counselor
Situations where there is no serious and immediate/imminent danger are heartbreaking; they go against the caring values of caregivers. It can be difficult to accept that the system does not intervene. Let’s remember that these laws are designed to protect the right to autonomy of citizens and that it is a serious matter to contravene this fundamental right.
Why use an agency in the process of applying for a psychiatric assessment?
The agency can help you write the application, accompany you to the police station, or assist you in preparing the application.
My father is a senior citizen with a substance abuse disorder. His home is unsanitary and he falls frequently. His last fall resulted in a broken hip. The medical team suggests a move to a CHSLD but he categorically refuses…
In this case, the healthcare institution may decide to go to court and apply for a court care order.
I have heard of the P-38 law. What is it?
This is the Act respecting the protection of persons whose mental state presents a danger to themselves or others. In certain cases and contexts, the mental state of the person being cared for represents a danger to themselves, to others, and to you as the caregiver. In these exceptional cases, Quebec civil law allows the person to be placed in temporary custody in a healthcare institution. This procedure is governed by Act P-38. Here are some details (in French only).
The person I am caring for is in temporary custody. What is the next step from here?
Twenty-four hours after the person you are caring for has been taken into care, a psychiatrist will carry out a psychiatric assessment. A diagram shows the process (p. 14, in French only).
I have a thousand questions running through my mind…
Here are some frequently asked questions (in French only) developed by CAP santé mentale: psychiatric assessment orders, interim custody, hospitalizations, levels of dangerousness, etc.
Chaîne Youtube de CAP santé mentale. Témoignage de Jean-Pierre dont le fils est atteint de schizophrénie.
Educaloi. Les soins forcés.
LégisQuébec. p-38.001 - Loi sur la protection des personnes dont l’état mental présente un danger pour elles-mêmes ou pour autrui.
Need to talk?
Contact our Caregiver Support Helpline for counselling, information and referrals.
Every day from 8 a.m. to 8 p.m.
Free of charge.
