These community organizations unanimously denounce the rushed adoption of Bill 23, which had nonetheless been the subject of over 60 briefs submitted during the consultation phase, the majority of which expressed significant reservations. Let us also recall that key groups were not heard during the consultations despite their desire to be, including the Barreau du Québec, the Association des juristes progressistes, the Ligue des droits et libertés, and the Réseau d’aide aux personnes seules et itinérantes de Montréal (RAPSIM), whose members are concerned about this legislative change that will directly impact them. It is noteworthy that over 165 organizations (including the authors of this press release) and 1,360 individuals signed, during the year, the Declaration When Madness Has Broad Shoulders, calling for the possibility of coercion not to be expanded.
It is also observed that, despite around fifty amendments debated, several fundamental issues raised in the bill were not addressed at all, while the reform constitutes a major setback for fundamental rights in contexts of vulnerability. Moreover, several provisions of Bill 23 ignore the key recommendations and the spirit of the IQRDJ report submitted in 2025; the Institute had nonetheless been mandated by the government itself to conduct extensive consultations and research to guide the reform.
The IQRDJ report had also clearly highlighted the only current consensus: the lack of resources in mental health to respond to voluntary requests for care leads to hospitalizations that could have been avoided. Despite this finding and in a context of budgetary restrictions, the government is choosing to invest over $100 million in a legislative reform that only changes structures and does not add any care on the ground, while further rolling back fundamental rights. We are alarmed that such a decision is being made when no study has been conducted to demonstrate the effectiveness of coercive measures and forced treatments in mental health.
WHAT IMPACT FOR MARGINALIZED PERSONS?
As is often the case with coercive measures, the consequences of this reform will be felt disproportionately by marginalized persons. Already with the P-38, persons experiencing homelessness are nearly 65 times more likely to be subjected to institutional custody than the general Montreal population, and persons in situations of poverty are overrepresented in statistics on forced hospitalizations. The experience of frontline organizations shows that interventions under constraint are experienced as traumatizing and undermine trust in institutions. Furthermore, the consequences of forced hospitalization sometimes amplify the initial crisis situations: “We come out of there more traumatized than before,” say persons who have experienced institutional custody. By broadening the criteria, Bill 23 exacerbates exclusion dynamics rather than addressing the causes and risks increasing the distress and crises it claims to address.
“Beyond the trauma, for many persons experiencing homelessness, whose trajectories are already marked by multiple institutional violences, the use of coercion reinforces a loss of trust already deeply rooted in the health system and public services, increases mistrust, and kills any desire to seek services.” notes Tsanta Sen Chen, community organizer at RAPSIM.
IT IS POSSIBLE TO DO THINGS DIFFERENTLY
Yet, according to a broad consultation, 8 out of 10 people who underwent a P-38 had previously voluntarily sought help, and they could have benefited from it if primary care, dramatically underfunded, had been more accessible. This observation aligns with field experience: as soon as alternatives are deployed, the rate of P-38 use drops significantly (by about 80% in the cases of the 24-7 Squad in Bas-Saint-Laurent and the Carrefour en santé mentale des familles et de l’entourage initiative in Longueuil, for example). These initiatives also enable coordination among the network, police forces, and community organizations within the current legal framework, while including and supporting loved ones. “Rather than relying on coercion, we must collectively focus on existing community alternatives, whether crisis centers, community-based outreach, transitional housing, or mutual aid groups.” notes Anne-Marie Boucher of the RRASMQ.
“Approaches based on consent and fostering the development of a therapeutic relationship have proven effective and yield better clinical outcomes while avoiding increased reliance on coercion. Without structural investments in prevention and access to care, expanding coercion risks merely shifting the problem rather than solving it.” says Mylène Demarbre, Clinical Director of Mental Health at Doctors of the World Canada.
Let us recall that Canada is the Western country with the highest rate of forced hospitalization: Bill 23 is a missed opportunity to change this sad record by drawing inspiration from best practices and protecting people’s rights. In light of this reform, we expect the government to rigorously monitor the evolution and impacts of the use of forced hospitalizations and involuntary treatments and to ensure the rapid deployment of the necessary resources so that forced hospitalizations become a truly exceptional measure.
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For AGIDD-SMQ: Nancy Melanson, Sociopolitical Officer and Coordinator sociopolitique@agidd.org (450) 204-8000
For LDL: Claude Rioux, Communications Officer (514) 715-7727
For Doctors of the World: Guillaume Bambina, Communications and Mobilization Advisor – guillaume.bambina@medecinsdumonde.ca – (438) 404-6997
For the Association of Progressive Lawyers: Colin Renaud, Administrator, info@ajpquebec.org
For RAPSIM: Tsanta Sen Chen, Community Organizer, 514-879-1949 ext. 106
For RRASMQ, Anne-Marie Boucher, Co-Coordinator, anne-marie@rrasmq.com
For ReprésentACTION smQ and the Collective of Survivors of P-38, Claudia Barabé, claudia.barabe@agidd.org, 450-559-1686