Patient Progress

Patients admitted to the Institut national de psychiatrie légale Philippe-Pinel are usually transferred from another psychiatric hospital centre. These patients are placed in units that meet their needs. Their stay focuses on getting stabilized and diminishing their potential for dangerousness so they can be returned to their original hospital centre and treatment team.

In some cases, a return to their original hospital may not be possible for medical or safety reasons. In that case, the patient will be transferred to another care unit at the Institut or redirected to external resources, for example when they are discharged.

Patients are sent to the Institut from the courts, as well as other prevention or detention centres. These patients are confined at the Institut for legal expertise, and stay an average of 30 days in one of our specialized units: H-3 or H-4. When a judicial decision is made, patients may be admitted to another unit at the Institut or transferred to another health facility or penal institute.

Care units allow us to treat patients in a safe and therapeutic environment. Every patient admitted undergoes a specialized evaluation, enabling us to determine their health needs (physical and mental) as well as their potential for violence and rehabilitation. A care plan is then put together in partnership with the multidisciplinary team, which includes psychiatrists, doctors, psychologists, criminologists, social workers, occupational therapists, pharmacists, socio-therapists, psycho-educators, and nurses. Patients have access to a wide range of programs and activities to determine their specific needs, which our care model is designed to address. This allows us to target therapeutic activities essential to a patient’s well-being as well as follow their rehabilitation progress.

This model is divided into 7 pillars that cover the different life spheres of a person requiring forensic psychiatry services:

1) physical health,

2) mental health,

3) addiction (alcohol or drugs),

4) behavioral issues,

5) personal care and daily activities,

6) education, work, and creativity, and

7) family and social networks.

Most patients come to us through a court order from the Review Board for mental disorder after being found non-criminally responsible. They are seen on an annual basis by the Tribunal administratif du Québec (TAQ), who review the legal framework based on the patient’s progress.

Social reintegration begins during hospitalization, as clinical progression and legal status allow. Outings—both accompanied and autonomous—are planned from within the care unit. Patients are encouraged to participate in therapeutic activities within the community, and collaborative work between the treatment team and partner organizations is undertaken to support social reintegration. When the patient is ready to leave the Institut, they are directed towards their local hospital or referred to an environment that best meets their needs (group home, supervised apartment, autonomous apartment, etc.). The responsibility for monitoring is given to services outside the Institut, where a new treatment team will take over. Patients are encouraged to participate in community activities, and a collaboration between the treatment team, partner organizations, and social/family network helps foster social reintegration.