Committing Patients Who are a Danger to Themselves or Others


Tracey Tremayne-Lloyd and Lonny J. Rosen
Tremayne-Lloyd Partners,
Toronto, Ontario

Of all the symptoms associated with illnesses that commonly affect geriatric patients, the most difficult to manage--for the patient and his or her physician--are those that affect the patient's mental faculties. Physicians attempting to treat geriatric patients who suffer the onset of mental illness, must deal with such issues as the patients' capacity to consent to treatment and their ability to participate in the management of their symptoms, including the regular taking of prescribed medication. While physicians always had tools embedded in provincial mental health legislation to assist them in the care of their mentally ill patients, these tools offered practically no alternative to committing patients to a psychiatric facility, something physicians have been loath to do.

After years of confusion within the mental health system, provincial governments in Mani-toba, Saskatchewan, British Columbia and now Ontario, have passed amendments to their mental health legislation which could lead to better care for people with serious mental disorders, including the elderly.

One of the main purposes of mental health legislation is to allow a medical practitioner to admit, or recommend for admission, to a psychiatric hospital for the purpose of an assessment, persons viewed by the practitioner as constituting a danger to themselves or others.