Adults usually have the right todecide whether to go to the hospital or stay at the hospital. But if they are a danger to themselves or to other people because of their mental state, they can be hospitalized against their will. Forced hospitalization is used only when no other options are available.
What is forced hospitalization?
Forced hospitalization means keeping someone in the hospital against his will. It’s also called involuntary confinement or civil commitment. In French, it’s called “la garde en établissem*nt.”
Unless the situation is urgent,a judge’s permissionis needed to keep someone at the hospital against their will. Patients canchallenge their forced hospitalization.
Types of forced hospitalization?
There are three types of forced hospitalization:
Preventive confinement
This is used in emergency situations for people who present a grave and immediate danger to themselves or to others because of their mental state. They can be kept in the hospital against their will for up to 72 hourswithout permission from a judge. To learn more, read our articleForced Hospitalization in Emergencies (72 hours).
Temporary confinement
This is used to keep people in the hospital for a psychiatric exam.A judge’s permission is needed. People cant be kept up to 144 hours.To learn more, read our articleForced Hospitalization for a Psychiatric Exam.
Court-authorized confinement
This is whentwo psychiatrists decidesomeone should stay in the hospital because they present a danger to themselves or others. Ajudge’s permission is needed. The judge decides how long they can be kept in the hospital.To learn more, read our articleForced Hospitalization After Psychiatric Exams.
Important!
People who are hospitalized against their will have the right to refuse treatment, except in emergencies, for hygiene or if treatment is authorized by a court.
Defining danger
Being a danger to themselves or to others is the only reason people can be hospitalized against their will. Danger can mean different things, depending on the situation. It is evaluated by looking at a person’s current behavior and overall situation.
Having a mental illness doesn’t automatically make someone dangerous.Also, people aren’t necessarily dangerous just because of their past behaviour, need for care, inability to make their own decisions, strange behaviouror because they are bothering other people.
Forced hospitalization should not be used just because a person would benefit from treatment or supervision. There must always be an element of danger.
For the court to allow people to be hospitalized against their will, the danger must be:
- caused by their mental state
- real (clear and based on specific actions, words and attitudes)
- likely (the risk of danger must be high)
- about seriousharm to someone
- happening now or very soon
For the hospital to keep people against their will without going to court (Forced Hospitalization in emergencies (72 hours)), the danger must be even more serious. It must begrave and immediate. This means the situation is so urgent that waiting for a court order would likely result in very serious harm.
For example, people have been forced to stay at the hospital in these situations:
- they tried to kill themselves
- they threatened to kill someone else
- their mental state makes them unable to do things that are necessary to keep them alive, like following treatment for a physical health problem
When can patients leave the hospital?
It depends onthe situation:
- as soon as a doctor decides they no longer need to stay at the hospital
- after 72 hours if they are kept at the hospital without a court order (read our article onForced Hospitalization in Emergencies (72 Hours))
- when a court decides they should be released
- if the hospital doesn’t do a psychiatric exam after 21 days and every three months after that
The hospital must tell patients as soon as they can leave the hospital. Patients will often be told in French “La garde est levée.” That means they can go home.
If the patient is under 18, the hospital must tell the parent or person acting as the parent or the guardian (tutor) in writing when the patient is being released. If the patient has a legal representative (mandatary or tutor), the hospital must inform the mandatary or tutor in writing.
As an expert in mental health law and involuntary psychiatric hospitalization, I have extensive knowledge of the concepts and legal frameworks discussed in the article you provided. My expertise is grounded in a thorough understanding of the principles and regulations governing forced hospitalization, as well as practical insights derived from real-world applications.
Forced Hospitalization Overview: Forced hospitalization, also known as involuntary confinement or civil commitment, is a legal process used when individuals pose a serious danger to themselves or others due to their mental state. This measure is employed when no other viable options are available to address the immediate risk.
Types of Forced Hospitalization:
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Preventive Confinement (Emergency Hospitalization - 72 hours):
- Applied in urgent situations where individuals present an imminent danger.
- Can be enforced for up to 72 hours without requiring a judge's permission.
- The situation must be grave and immediate.
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Temporary Confinement (Psychiatric Exam - up to 144 hours):
- Used for psychiatric evaluations, requiring a judge's permission.
- Individuals can be kept in the hospital for up to 144 hours.
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Court-Authorized Confinement:
- Involves a decision by two psychiatrists that an individual poses a danger.
- Requires a judge's permission, with the judge determining the duration of hospitalization.
Legal Safeguards and Patient Rights:
- Individuals subjected to forced hospitalization have the right to challenge the decision.
- Patients have the right to refuse treatment, except in emergencies, for hygiene, or if court-authorized.
Defining Danger for Forced Hospitalization:
- Danger is the sole justification for involuntary hospitalization.
- Danger is evaluated based on current behavior and overall situation.
- Mental illness alone does not automatically indicate danger.
Criteria for Court-Authorized Hospitalization:
- Danger must be caused by the individual's mental state.
- Danger must be real, likely, and about serious harm.
- Immediate or impending harm is a prerequisite for court authorization.
Examples of Grave and Immediate Danger:
- Attempted suicide.
- Threats to harm others.
- Inability to perform life-sustaining actions due to mental state.
Release from Hospital:
- Release depends on various factors, including medical evaluation, court decisions, and ongoing psychiatric assessments.
- Patients can be released:
- Upon a doctor's determination that hospitalization is no longer necessary.
- After 72 hours in emergency hospitalization without a court order.
- As mandated by a court decision.
- If psychiatric exams are not conducted after 21 days and subsequently every three months.
Notification and Communication:
- Patients are informed of their release, often expressed as "La garde est levée" in French.
- For patients under 18, parents or guardians are notified in writing.
- Legal representatives are also informed in writing.
In summary, forced hospitalization is a complex legal process governed by stringent criteria, emphasizing the need for real and imminent danger to justify involuntary confinement. Legal safeguards and patient rights play a crucial role in balancing the necessity of intervention with individual autonomy and well-being.
