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High-risk suicidal ideation — RCPSC EM MCQ

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HardPsychiatric emergenciesHigh-risk suicidal ideationRCPSC EM

In an Ontario ED, a 28-year-old reports command hallucinations to kill himself, has a specific plan and access to means, and refuses assessment or admission. What is the most appropriate legal disposition?

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Correct answer: C — Complete a Form 1 for involuntary psychiatric assessment and detention

The best answer is “Complete a Form 1 for involuntary psychiatric assessment and detention”. The described psychosis, plan, access to means and refusal create an immediate risk of serious bodily harm. In Ontario, when the statutory criteria are met, a physician may complete a Form 1 so that the patient can be detained, observed and examined in a psychiatric facility for up to 72 hours. A safety plan, family meeting or medication prescription does not substitute for immediate legal assessment and protection.

Reference: Ontario Mental Health Act, R.S.O. 1990, c. M.7: https://www.ontario.ca/laws/statute/90m07/v3