Police-Encounters-With-People-In-Crisis

with individuals with mental health concerns—this reinforces the notion that they are
dangerous when that is not true.” 73
82. Several examples of effective emergency department coordination with the police
exist. St. Joseph’s Healthcare Hamilton and Mount Sinai Hospital in Toronto have each
developed protocols to expedite the hospital’s procedures for assuming custody of a
person in crisis brought to the emergency department by the police. In addition, the
Human Services and Justice Coordinating Committee Ontario has published a guide to
implementing effective coordination.
83. Emergency departments in most hospitals will not assume custody over a patient
apprehended under the Mental Health Act until a physician evaluates the patient
brought in by the police. They take the position that the patient cannot be prevented
from leaving the hospital if the police have left and the doctor has not yet seen the
patient.
84. In 2012, the Hamilton Police Service and St. Joseph’s Healthcare Hamilton
developed a protocol to reduce lengthy police wait times in the emergency room, which
had averaged 3.5 hours nine times out of ten. According to the new protocol, after a 30-
minute wait in the emergency room, an officer can rate the individual’s risk level. If the
officer determines that the person is a low risk to her or himself, hospital staff, and the
public, the officer and an emergency room nurse can sign the form confirming transfer
of care to the hospital. The patient is then monitored by the hospital’s security staff. The
officer is on call to return to the hospital if the individual proves too difficult for hospital
security staff to manage. 74
85. Similarly, at Mount Sinai Hospital in Toronto, the emergency department
operates under a practice that they adapted from the Emergency Medical Services’
hospital transfer of care procedures. The physician does not have to assume care in
order to complete the transfer of care. Nurses can facilitate the transfer of care by first
asking the officer or MCIT unit to fill out a form with key details regarding the patient,
and then by asking that hospital security staff watch over the patient until the patient is
seen by a physician. This type of transfer is permitted except in rare cases where the
patient is incapable of being controlled by hospital security staff. The physician may call
the officers or MCIT unit that filled out the form with follow-up questions as they arise.
As a result, a majority of the time police officers or MCIT units at Mount Sinai Hospital’s
emergency department are relieved from waiting within 45 minutes of their arrival.
Similar practices are in the process of being introduced at some, but not all, of Toronto’s
psychiatric facilities.
86. Hospitals in the Toronto Central Local Health Integration Network (LHIN),
which comprise eight of the 16 psychiatric facilities to which the TPS brings people in
crisis, have recently agreed to a protocol outlining best practices for the transfer of care
73
Ibid.
74
Inspector Randy Graham & Sarah Burtenshaw, OT Reg (Ont), “Collaborative Projects: Hamilton Police Service and St. Joseph’s
Healthcare Hamilton” ( presented at the CACP/MHCC Conference, 25 March 2014), online: Canadian Association of Chiefs of
Police .
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