Table 2.
Legislation, criteria, and procedures in the Americas.
| Country | Legislation | Diagnosis | Other criteria | Proposal | Validation | Duration | Ability to appeal |
|---|---|---|---|---|---|---|---|
| California, USA | Civil Commitment laws, also known as Court–ordered–treatment | Severe mental disorder | Dangerous to self/others; unable to provide for basic personal needs for food, clothing or shelter | Members of a crisis team; other professional figures | Physicians | 72 h for evaluation; 14 days of detention renewable for a maximum of 90 days | Yes |
| Washington, USA | Involuntary Treatment Act (Revised Code of Washington, Title 71, Chapter 71.05: Mental Illness) | Mental disorder or substance use disorder | Danger to self/others; danger of physical harm from failure to provide for essential human needs; severe deterioration in routine functioning as seen in loss of cognitive or volitional control | Third party | Designated mental health professional or a Court hearing | Initial detention up to 72 h; detention up to 14 days renewable for 90 or 180 days | Yes |
| Alberta, Canada | Mental Health Act: legislation for the province of Alberta 2012 | Mental disorder as a disorder of thought, mood, perception, orientation, or memory that grossly impairs capacity to recognize reality or meet ordinary demands of life | Harm to oneself or others; substantial mental or physical deterioration | Anyone | Physicians; renewals require two physicians (at least one psychiatrist) | Assessment: 24 h; hospitalization: 1 month renewable for a maximum of 6 months | Yes; to the Review Panel |
| British Columbia, Canada | Mental health Act 1996 | Person with a mental disorder | The mental disorder seriously impairs the ability to react appropriately to the environment; requires care in a facility to protect the person or others. Danger not required | Anyone | Physicians; police (in emergency) | First certificate: 48 h; second certificate: 1 month renewable for a maximum of 3 months | Yes; to the Mental Health Review Board. Possibility of conditional leave |
| Manitoba, Canada | The Mental Health Act 1998 | Mental disease as a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment and behavior, ability to recognize reality | Risk to cause serious harm to oneself or others; the patient is unwilling or is not mentally competent to consent to a voluntary psychiatric assessment | Physicians; anyone | Medical Director; Officer of the Peace | Involuntary admission certificate 21 days. First renewal 3 months and all subsequent renewals 3 months | Yes; to the Mental Health Review Board |
| New Brunswick, Canada | Mental Health Act 2010 | Mental disorder as a disorder that grossly impairs behavior and judgment and the ability to recognize reality | The recent behavior presents a substantial risk of imminent physical or psychological harm to oneself or others | Psychiatrist to the chairman of the tribunal for admission order | Assessment: physician. Admission order of the tribunal shall in writing order that the person be admitted to a psychiatric facility as an involuntary patient | Assessment: 72 h. First certificate: detention 1 month; second certificate: detention 2 months renewable for a maximum of 3 months | Yes; to the Chairman of the Review Board |
| Newfoundland and Labrador, Canada | Mental Health Care and Treatment Act, SNL 2006 | Mental disorder as a disorder of thought, mood, perception, orientation, or memory that impairs judgment or behavior, ability to recognize reality | Risk to cause harm to oneself or others; possible deterioration; the patient is unable to make decisions regarding their need for treatment or care and supervision | Anyone | Judge under the authority of two certificates. Renewals made by physicians | Assessment: 72 h; first detention: 30 days, renewable for a maximum of 90 days | Yes; to the Mental Health Care and Treatment Review Board |
| Nova Scotia, Canada | Involuntary Psychiatric Treatment Act 2005, amended in 2008 | Mental disorder as a disorder of thought, mood, perception, orientation, or memory that impairs judgment or behavior, ability to recognize reality | Risk to cause serious harm to oneself or others; possible deterioration; necessity of psychiatric inpatient treatment; no capacity to make admission and treatment decisions | Anyone can make a request to a Judge | Two certificates from any officer of the peace are sufficient for detention; admission by psychiatrist | Assessment: 24 h; admission: 1 month renewable for a maximum of 3 months | Yes; to the Review Board |
| Ontario, Canada | Mental Health Act R.S.O. 1990 (Consolidation Period: 2010) | Mental disorder as any disease or disability of the mind | Threat or attempt to cause bodily harm to oneself or others; lack of competence to care for oneself | Anyone (can bring evidence) to a justice of peace | Physician; Judge of peace, police | Assessment: 72 h; admission 2 weeks; renewable for a maximum of 3 months | Yes; to the Board |
| Prince Edward Island, Canada | Mental Health Act 2010 | Mental disorder as a disorder of thought, mood, perception, orientation, or memory that impairs judgment or behavior, ability to recognize reality | The disorder requires hospitalization for safety of the person or others; the patient is unable to consent to psychiatric assessment | Anyone can make an application to a Judge | Judge; Officer of the Peace | Assessment: 24 h; admission: 28 days, renewable for a maximum of 12 months | Yes; to the Review Board |
| Quebec, Canada | An Act respecting the Protection of persons whose mental state presents a danger to themselves or to others 2002 | Mental state that presents an immediate danger to oneself or others | Danger to themselves or others | A member of a crisis intervention unit, person having parental authority | Assessment. Practicing physician operating a local community service center; Officer of the Peace. Admission: Court | Assessment: 72 h; admission: 21 days | Yes; to the Administrative Tribunal of Quebec |
| Saskatchewan, Canada | The Mental Health Services Act 2006 | Mental disorder as a disorder of thought, perception, feelings, or behavior that seriously impairs a person’s judgment, ability to recognize reality | Person unable to make informed decisions about their need for treatment and care; risk to harm oneself or others; possible physical or mental deterioration | Anyone | Assessment: Judge of the Provincial Court warrant, Constable, Peace Officer; Admission on medical certificates | First admission: 21 days renewable; long–term detention: 1 year | Yes; to the Majesty’s Court of Queen’s Bench |
| Yukon, Canada | Mental Health 2002 | Mental disorder as a substantial disorder of thought, mood, orientation, or memory that grossly impairs judgment, behavior, ability to recognize reality | Threat or attempt to cause bodily harm to oneself or others; lack of competence to care for oneself, possible physical impairment | Anyone can request the Judge to make an order for involuntary examination by a physician | Validation: Judge; Officer of the Peace. Admission: physicians | Assessment: 24 h; admission: 21 days renewable | Yes; to the Supreme Court |
| Jamaica | Mental Health Care Act 2009 Parliament of Jamaica | – | Need for treatment, danger to society | Treating physician or relative of the patient (only in cases of emergency) | Director of a psychiatric hospital or psychiatric ward | 7 days, renewable | – |
| Argentina | Law nr 26/657 of 2010 | – | Need for treatment and danger to oneself and others | A member of the hospital team where hospitalization takes place and a psychiatrist within 48 h | Judge | 30 days, renewable. After the first 7 days, a judge sends the documentation to the Body responsible for the protection of psychiatric patients | – |
| Brazil | 1934 | – | Inability to care for oneself, danger and moral risk to society | – | – | Unspecified duration, there are many hospitals and community residential care clinics | – |