Can I Enter Canada with a Mental Health History?
A mental health diagnosis, therapy, medication or a past hospitalization does not by itself make you inadmissible to Canada. IRPA s.38 asks whether a condition would endanger public health or safety, or might reasonably be expected to cause excessive demand on services. IRCC makes the health admissibility decision, and CBSA officers assess admissibility at the border.
90 days
To respond to a procedural fairness letter, from the date of the letter
12 months
How long immigration medical exam results are generally valid
5 years
The inadmissibility that misrepresentation creates under IRPA s.40
What does IRPA s.38 say about health and entering Canada?
Section 38 of the Immigration and Refugee Protection Act (IRPA) governs medical inadmissibility. A foreign national is inadmissible on health grounds if their condition:
- is likely to be a danger to public health;
- is likely to be a danger to public safety; or
- might reasonably be expected to cause excessive demand on health services or social services.
Under IRPA s.38(2), the excessive-demand ground does not apply to refugees and their dependants, protected persons, or family-class spouses, common-law partners and dependent children of a sponsor. These applicants can still be assessed for danger to public health or public safety.
The rule
IRPA s.38 turns on three questions: danger to public health, danger to public safety, or excessive demand on health or social services.
How does the excessive demand test work?
The "excessive demand" test has two parts. A condition causes excessive demand if the health or social services needed to treat it would negatively affect wait times for services in Canada, or if their anticipated cost exceeds a cost threshold.
The cost threshold is triple the average Canadian per-person cost of health and social services, over five consecutive years following the most recent medical exam. The test is about likely cost, assessed on the medical evidence, not a remote possibility. IRCC publishes the threshold for the current year, so this guide does not state a fixed number.
Excessive demand concerns are more likely to arise when a condition:
- Requires ongoing inpatient psychiatric care or institutionalization
- Requires government-funded residential care or supported living
- Has a high anticipated cost profile based on an IRCC medical officer's assessment
Where a cost concern arises, an applicant is normally given a chance to respond through a procedural fairness letter, within 90 days from the date of the letter, with new information on the diagnosis, the medication and services needed, and their cost.
Not everyone can give a mitigation plan: if it applies to you, IRCC invites you to send one, with a signed Declaration of Ability and Willingness. A plan can cover outpatient prescription medication or social services. You can't opt out of publicly funded health services, except for outpatient prescription medication in some provinces or territories, so a plan cannot cover the cost of health services.
An officer weighs that response before making a decision.
What do danger to public health and danger to public safety mean?
IRPA s.38(1)(a) covers a "danger to public health", where IRCC looks at certain infectious diseases, such as active tuberculosis or active syphilis. IRPA s.38(1)(b) covers a condition "likely to be a danger to public safety".
For danger to public safety, IRCC considers the risk of sudden incapacity (loss of physical and mental abilities) or of unpredictable or violent behaviour, and the decision is based on the results of your immigration medical exam. A past hospitalization or diagnosis is not by itself evidence of danger to public safety.
When is a medical exam required, and who decides?
Health admissibility for permanent residence is normally assessed through an Immigration Medical Examination (IME) carried out by an IRCC-authorized panel physician. The panel physician does not decide your case: they report findings, and IRCC makes the admissibility decision. Exam results are generally valid for 12 months.
Temporary residents need an immigration medical exam only in some cases. For a stay of 6 months or less, you generally don't need one unless you plan to work in certain jobs. For a longer stay, you need one if you lived in or travelled to a country or territory on IRCC's list for 6 months or more in a row in the year before you come, will work in a job where public health must be protected, or apply for a super visa.
- Voluntary treatment
- Therapy, outpatient psychiatry and medication management are private medical information held by your health providers. Most psychiatric hospitalizations are medical records, not criminal records.
- A police incident
- If police were involved in a psychiatric crisis, any record that results is a police-contact record rather than a conviction. What may be recorded or shared depends on local police practice and applicable law.
What can a CBSA officer ask, and must you answer?
CBSA officers at the border assess admissibility under IRPA. CBSA can ask about:
- Purpose of your visit to Canada
- Whether you have criminal convictions
- Whether you have completed an Immigration Medical Examination if one was required
- Your travel history and ties to your home country
IRPA s.16(1) requires you to answer truthfully all questions put to you for the purpose of the examination, and to produce the relevant evidence and documents an officer reasonably requires. Mental health is not an exception.
You do not have to volunteer your full medical history unprompted. But the visitor visa form and the eTA form each ask a health question, and if a form or an officer asks a direct question, including about a diagnosis, medication, treatment, or a required Immigration Medical Examination, the honest answer is the only safe answer.
How does medical inadmissibility differ from criminal inadmissibility?
| Feature | Medical inadmissibility (IRPA s.38) | Criminal inadmissibility (IRPA s.36) |
|---|---|---|
| Trigger | A health condition causing excessive demand, danger to health, or danger to safety | Generally a criminal conviction (or, on some grounds, having committed an act), assessed by Canadian equivalent |
| How determined | Immigration Medical Examination (IME) by a panel physician, then IRCC's decision | Officer's assessment of the offence against Canadian law |
| Can it be overcome? | Sometimes: a response to the procedural fairness letter, or a mitigation plan where IRCC invites one (it cannot cover health services) | Yes: TRP, Criminal Rehabilitation, or Deemed Rehabilitation |
| IRPA reference | s.38(1) | s.36(1) serious criminality; s.36(2) criminality |
Which free tool checks your own case?
- Admissibility ExplorerThe IRPA admissibility grounds, one question at a time
- Visa CheckerVisa or eTA, by passport and how you travel
Free, with no account. What you enter in a tool stays in your browser.
What do people ask?
Can I be refused entry to Canada because of my mental health?
Only on narrow legal grounds. IRPA s.38 allows a refusal when a condition would endanger public health or public safety, or might reasonably be expected to cause excessive demand on health or social services. Any finding must rest on specific evidence.
I was hospitalized for a psychiatric crisis. Will Canada know?
A voluntary psychiatric hospitalization is a medical record. Canada's health decision is based on the Immigration Medical Examination, where one is required, for example for a permanent residence application. It can also come up if police were involved in the crisis. The visitor visa form and the eTA form each ask a health question, and every answer must be truthful (IRPA s.16(1)).
Should I disclose my mental health history to CBSA?
If an officer asks, yes. IRPA s.16(1) requires truthful answers to every question put to you during the examination, with no mental-health exception. You are not expected to volunteer your medical history unprompted, but the visitor visa form and the eTA form each ask a health question. Withholding or misstating a material fact is misrepresentation under IRPA s.40, which carries a 5-year inadmissibility.
I take psychiatric medication. Does this affect my admissibility?
Taking psychiatric medication does not, by itself, affect your admissibility. Health Canada says a visitor may bring a personal quantity of a prescription drug: no more than a 90-day supply or a single course of treatment, whichever is less, in the package dispensed by the pharmacy or hospital, in the original retail package, or with the original label attached. Some medications, such as amphetamines, methylphenidate, clonazepam and lorazepam, are controlled substances: up to a 90-day supply based on the usual daily dose, prescribed by a practitioner, in a container labelled with your name, the prescriber, the medication and the daily dose, and you must declare it to customs when you arrive.
Is there an exemption from the excessive demand rule?
Yes. Under IRPA s.38(2), the excessive-demand ground does not apply to refugees and their dependants, protected persons, or family-class spouses, common-law partners and dependent children of a sponsor. These applicants can still be assessed for danger to public health or public safety.
How is the excessive demand cost threshold calculated?
The threshold is triple the average per-person cost of health and social services in Canada, and IRCC publishes the threshold for the current year. The assessment covers the expected cost of services over five consecutive years following the most recent medical exam. A condition can also cause excessive demand if the services needed would negatively affect wait times for services in Canada.
What happens if an officer thinks my condition might cause excessive demand?
You normally receive a procedural fairness letter that explains the concern and gives you a chance to respond before a final decision, within 90 days from the date of the letter. Your response can include new information on your diagnosis, the medication and services you need, and their cost. If a mitigation plan applies to you, IRCC invites you to send one, with a signed Declaration of Ability and Willingness; it can cover outpatient prescription medication or social services, but not the cost of health services. The officer weighs it before deciding.
Does a mental health condition need to be declared when applying for a visa or eTA?
Neither form asks for every diagnosis, but each asks a health question that can cover a mental health condition. The visitor visa form asks whether you have any physical or mental disorder that would require social and/or health services other than medication during your stay in Canada. The eTA form asks whether you have untreated syphilis, untreated drug or alcohol addiction, or an untreated mental health condition with psychosis. Where an Immigration Medical Examination is required, you answer its medical questions truthfully. Every form calls for honest answers to the questions actually asked, since misrepresentation under IRPA s.40 carries a 5-year inadmissibility.
Part of:Visiting Canada
- eTA vs Visitor Visa (TRV): Which Do You Need for Canada?
- Do I Need a Visa to Visit Canada? By Country
- Visiting Canada from the US: What Americans Need to Know
The textbook on this subject
Volume 1: Entering Canada $79
Six IRPA inadmissibility grounds (s.36 and s.38 to s.42), explained with the official text cited.
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This page is based on law and policy published by the Government of Canada.