Police-Encounters-With-People-In-Crisis

103. The issue of sharing mental health information is a controversial and sensitive
issue. It would be useful if TPS officers were able to receive mental healthcare
information in situations involving a person in crisis, with the caveat that strict
limitations need to be placed on the use and subsequent disclosure of that information
in order to respect patient privacy. Some measures for information sharing may require
legislative or regulatory change. This is an area of cooperation that requires all
interested groups, including policing, civil liberties, mental healthcare, and people who
have experienced mental illness, to come together to find a way forward. Their common
goal should be to give the police access to all information that could enable them to help
people in crisis while respecting individuals’ privacy by limiting other uses of that
information.
104. As discussed above, it is clear that in certain circumstances, many of which arise
in serving people in crisis, the Toronto Police Service carries out a role that is integral to
mental healthcare services, and in effect, police officers become part of the care pathway
for people in crisis.
105. As discussed in Chapter 11 (MCIT and Other Models of Crisis Intervention), one
of the tensions in the MCIT model is that there are two separate sources of information:
the police database and the healthcare system. A point of uncertainty that warrants
resolution is whether people in crisis may benefit if MCIT officers and nurses are
permitted to share information with each other that they access from their respective
positions within the police and healthcare system. In practice, it may be impracticable
not to share this information if the MCIT unit is to function efficiently and in the best
interests of the person in crisis.
106. There are some circumstances, formalized through legislation, where individual
healthcare providers are permitted to share healthcare information among healthcare
providers. The Information and Privacy Commissioner of Ontario emphasizes the
concept of the “circle of care” that, while not a defined term in the PHIPA, is “commonly
used to describe the ability of certain health information custodians to assume an
individual’s implied consent to collect, use or disclose personal health information for
the purpose of providing healthcare.” 87 The key point is that, as a general rule,
organizations that are health information custodians, as defined in PHIPA, can share
individual healthcare information with other health information custodians for the
purposes of the provision of healthcare services. 88 This is one example of a situation
where people in crisis would benefit from interested parties coming together in a
constructive manner to build greater cooperation.
107. The recent Coroner’s Inquest into the death of Douglas Minty produced a
recommendation for an experiment that could assist people who may find themselves in
crisis to share their healthcare information with the police, while also respecting their
87
Ann Cavoukian, Circle of Care: Sharing Personal Health Information for Health-Care Purposes (Toronto, ON: Information and
Privacy Commissioner, Ontario, 2009) at 5, online: Information and Privacy Commissioner, Ontario
.
88
It may well require a legislative change for TPS to be considered a health information custodian and therefore eligible to be
considered part of the circle of care. Id. at 19.
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