Upstream action must be the priority
Between 2014 and 2022, the use of institutional custody increased by 56%. In 2022, 12,605 requests were filed in Montreal, or one every 41 minutes. Designed as an exceptional measure, involuntary custody is now tending to become a common practice, revealing above all the difficulties in accessing mental health services.
The report by the Quebec Institute for Legal Reform, commissioned by the government in 2023, also recommended preserving the exceptional nature of the current law and prioritizing preventive interventions focused on screening and rapid access to care. It is in this spirit that MdM Canada offers community-based mental health services directly in the environments frequented by disenfranchised populations.
Concerning effects for the most vulnerable individuals
Our teams, who work with persons experiencing homelessness facing mental health issues, attest to this: police interventions and experiences of forced hospitalization are often traumatizing, and they contribute to worsening crises by creating a climate of mistrust toward the system. Coercion undermines therapeutic alliances and discourages the individuals concerned from seeking the services they need.
This dynamic disproportionately affects persons experiencing homelessness, who are nearly 65 times more likely to be subjected to institutional custody than the general Montreal population.
Effective alternatives exist
Approaches that promote consent, such as those implemented by MdM Canada, have proven effective and yield better clinical outcomes while avoiding the judicialization of situations. Outreach services that are multidisciplinary, adapted, and continuous over time—before, during, and after a crisis—demonstrate that it is possible to defuse many situations without resorting to involuntary hospitalization and to guide individuals toward services voluntarily.
Without structural investments in prevention and access to care, expanding coercion risks merely shifting the problem rather than solving it.
Finally, Médecins du Monde will thoroughly analyze the provisions of the bill to fully understand its consequences and impacts on the rights, safety, and mental health of the individuals we support. We intend to participate in the specific consultations on Bill 23.
About Médecins du Monde Canada
Médecins du Monde (MdM) Canada is an independent medical NGO that has been working in Montreal for 30 years to defend the right to health of persons in situations of vulnerability. Through its human rights-based approach and its focus on reducing health inequalities, MdM works in Canada and internationally to make care accessible, inclusive, and equitable.
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Guillaume Bambina – Communications and Mobilization Advisor
438-404-6997
guillaume.bambina@medecinsdumonde.ca