{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T18:58:59Z","timestamp":1785351539992,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Public Services and Procurement Canada"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In Quebec, the P-38.001 Act (P-38) allows police officers or crisis workers, under exceptional circumstances, to bring individuals at risk of harming themselves or others to the Emergency Department (ED) against their will. Data on the application of this Act remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to determine the prevalence of P-38 use among ED patients with mental health presentations and to compare their characteristics, clinical course, and outcomes with those who sought care voluntarily.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using a Public Health Agency of Canada\u2013approved mental health database. Patients aged \u226514 years presenting to 5 EDs for mental health reasons in 2020\u20132021 were included. The main outcome, enforcement of P-38, was abstracted from medical charts. Information on care trajectory and management was also collected. Relative risks (RR) were estimated using modified Poisson regression with robust variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 15,021 mental health\u2013related ED visits, 860 (5.7% [95% CI: 5.4-6.1]) involved enforcement of the P-38 Act. Mean age was 41.1\u2009\u00b1\u200916.5 years, with 46.1% aged 25-44, and 54.4% being male. Most lived independently (85.4%), arrived by ambulance (80.5%), and had a documented mental health history (92.2%). A higher proportion were materially deprived (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.020). Compared with patients who voluntarily consulted in the ED, those under P-38 were more likely to be restrained (RR: 1.68 [95% CI: 1.45-1.94]), placed under preventive confinement (RR 3.41 [95% CI: 2.96-3.93]), receive multidisciplinary assessment (RR: 1.70 [95% CI: 1.59-1.80]), and be hospitalized (RR: 1.36 [95% CI: 1.24-1.48]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Enforcement of P-38 accounted for nearly 6% of mental health\u2013related ED visits, disproportionately affecting materially deprived individuals in early to mid-adulthood with prior mental health disorders. Our findings suggest a reliance on coercive and short-term measures, underscoring the need for targeted policy efforts to expand community-based crisis intervention alternatives for this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437261468893","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:07:52Z","timestamp":1785161272000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["One in Twenty: Prevalence and Outcomes of Patients Brought to EDs Under Qu\u00e9bec's P-38 Mental Health Act\u2014A Retrospective Cohort Study: Un patient sur vingt : pr\u00e9valence et r\u00e9sultats chez les patients ayant \u00e9t\u00e9 admis au service des urgences en vertu de la loi p-38 du Qu\u00e9bec sur la sant\u00e9 mentale\u2014\u00c9tude de cohorte r\u00e9trospective"],"prefix":"10.1177","author":[{"given":"Marie-Soleil","family":"Dumont","sequence":"first","affiliation":[{"name":"Universit\u00e9 Laval"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3117-2177","authenticated-orcid":false,"given":"Val\u00e9rie","family":"Boucher","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier-Alexandre","family":"Tardif","sequence":"additional","affiliation":[{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9338-1408","authenticated-orcid":false,"given":"Ann-Pier","family":"Gagnon","sequence":"additional","affiliation":[{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8784-5273","authenticated-orcid":false,"given":"Axel","family":"Benhamed","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-859X","authenticated-orcid":false,"given":"Pierre-Gilles","family":"Blanchard","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey-Anne","family":"Dumais-Michaud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"VITAM\u2014Centre de recherche en sant\u00e9 durable"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-8110","authenticated-orcid":false,"given":"Marcel","family":"\u00c9mond","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"},{"name":"VITAM\u2014Centre de recherche en sant\u00e9 durable"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4365-2220","authenticated-orcid":false,"given":"Eric","family":"Mercier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval"},{"name":"Axe Sant\u00e9 des populations et pratiques optimales en sant\u00e9, CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Center"},{"name":"VITAM\u2014Centre de recherche en sant\u00e9 durable"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Statistics Canada. 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