Psychiatric exam under court order apropos of patients who refuse to submit to a psychiatric exam

Abstract

In this retrospective study 52 patients who had not committed any offence were examined against their will by Court order in the emergency department of a psychiatric hospital. They were compared with a control group of patients reflecting the usual clientele attending without compulsion the emergency department of the same hospital. This research reveals it is the immediate family rather than medico-social agencies that took the initiative in arranging the Court-ordered psychiatric examination. Such patients were no different than the usual patients seen in the emergency department as to age, sex, marital status and past psychiatric history. It was at the level of symptomatology and diagnosis that such patients differed from patients in the control group. The patients refusing to submit to a psychiatric examination not only were more agitated and aggressive, but they were more disorganized, more delusional, and had more hallucinations than the patients in the control group. They were in fact grossly psychotic patients with paranoid and manic features dominating the clinical picture. Our study demonstrated that as far as Montreal is concerned flagrant abuse of civil rights is far more the exception than the rule. Furthermore, if society had to abandon compulsory measures in some cases, it would be the seriously mentally ill who would suffer.