Good question. If you happen to live in TV-land, it’s about as difficult as buying a gun on the street or finding a gorgeous studio apartment on a barista’s income—which is to say, not difficult at all. If Hollywood is to be believed, you can have your relative, child or lover committed for just about anything: for being overly sexual, for being homosexual, for being a neglectful mother, and, oh yeah, for being framed for murder by aliens. (We’re looking at you, American Horror Story: Asylum.)
There’s a whole genre of pulp-style sci-fi and horror that’s based on the fear that this may happen to you at any time. Sucker Punch? Gothica? Twelve Monkeys, anyone?
Sure, it makes for good drama—there’s nothing more frightening than the thought that saying or thinking the wrong thing could land you in a straitjacket. That feeling is made worse by the perception that mental illness is very tricky to diagnose. Even Homeland—which has been praised for its realistic portrayal of mental illness—plays into this fear. At the end of season one, Claire Danes’s character voluntarily submits to shock therapy because she believes her bipolar disorder is affecting her judgment, only to find out—spoiler alert!—she’s been right all along.
Involuntary commitment also overrides a person’s personal liberties, which are the foundation on which our democratic society is built. So it’s not just a sensitive and emotional issue, it’s also a political one. (Both the Centre for Addiction and Mental Health (CAMH) in Ontario and the Canadian Mental Health Association ignored multiple requests for interviews on the topic.) The mental health industry in Canada is very cautious about how they talk about institutionalization, thanks in part to some awkward history (at the turn of the century, you could be committed for epilepsy), and to the way psychiatric hospitals are portrayed on television and in film.
In real life though, it is sometimes necessary to have someone committed against their will. Fox News recently reported that the mother of Adam Lanza, who killed 26 people in the recent Connecticut elementary school shooting, may have begun the process to have him committed. That’s an extreme example, and it’s unlikely that many of us will encounter a case like that in our lives. On the other hand, if someone you know has told you they have a plan to commit suicide, and they intend to act on it, involuntary commitment may be your only option.
The basic rule of thumb is that you can’t have someone committed without their consent unless they are a danger to themselves or to others. (No matter what Hollywood thinks, you can’t have someone committed because they believe they are from the future.)
Details vary by province. In Ontario, if someone you know has told you they are going to act on a plan to hurt themselves or others, you can call 911. Police and an ambulance will be dispatched, and if they determine the threat is serious, the person will be detained for up to 72 hours for psychiatric evaluation. In Quebec, any physician can order someone committed for the same period. (In Quebec, this is called “preventative confinement”.) Alternatively, a judge in a Quebec court can order someone into “temporary confinement”, which means they are committed to a mental institution while they wait for psychiatric evaluation. Once confined, two different psychiatrists will evaluate them. If either psychiatrist determines the person isn’t a danger, he or she is released.
Regardless of what province you live in, if someone you know is a direct danger to themselves or others, your best bet is to call 911. It gets much more difficult if the person hasn’t told you they plan to commit harm. If you suspect it but they haven’t communicated that to you, you’ll need to speak with an expert to find out what your options are, and how to proceed if you decide to pursue involuntary admission. You can call Telehealth, or point your browser to the provincial websites for the Canadian Mental Health Association (alberta.cmha.ca, novascotia.cmha.ca, etc). They don’t all have the same menu system, but look for the “Regional Services” page, where you can find resources for adults and children, or “crisis support”. You can also try mentalhealthhelpline.ca. It’s an Ontario service, but they will help route you to support in your province.
Finally, if you or someone you know is considering taking their own life, you can find a crisis centre here.