Police-Encounters-With-People-In-Crisis

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for service, providing voluntary transportation to a hospital for treatment, or apprehending the person for psychiatric assessment under the Mental Health Act. 5 11. The MOUs specify that the MCIT is a second response. A two-officer Primary Response Unit (PRU) must first be dispatched to all calls involving a person in crisis to assess safety issues, any need for criminal charges, and the suitability of the situation for the MCIT to attend. Under the MOUs, the MCIT cannot be a first response because of the presence of the nurse who, as a civilian, cannot be put in harm’s way. However, the MCIT and PRU will often arrive at a call simultaneously to expedite this process. 6 In practice, MCIT units do act as first responders when the call as dispatched clearly is not dangerous. 12. TPS Procedure 06-04 “Emotionally Disturbed Persons,” sets out the circumstances under which the MCIT should be involved in a call. The policy mandates that, in responding to a call involving a suspected person in crisis, the PRU should take all necessary steps to make sure the situation is safe, determine if there is a need for immediate apprehension, and consult with the MCIT, if available. If a person in crisis does not need to be arrested or apprehended, the officers must contact the MCIT, if available. 13. In October 2012, the Toronto Central LHIN established an MCIT Coordination Steering Committee to examine the current state of the MCIT program, and design a system to standardize its practices across hospital partnerships. The Steering Committee’s goals are to oversee an MCIT program that provides coverage in all areas of Toronto in a manner that meets the needs of the population, and to develop an MCIT model that efficiently integrates into the continuum of available healthcare services. 7 The Steering Committee is co-chaired by TPS Deputy Chief Michael Federico and the CEO of Toronto East General Hospital, Rob Devitt, and includes voices from the policing, emergency response, and mental health treatment communities. The Committee also seeks input from community members living with mental illness. 8 3. Existing MCIT coverage 14. After the Service’s initial partnership with St. Michael’s Hospital in 2000 to cover 51 and 52 Divisions, the TPS expanded the MCIT program by establishing partnerships with the following healthcare centres to provide coverage for 14 of the Service’s 17 divisions: 5 Steering Committee, Coordination, supra note 2 at 12. 6 Toronto Police Service, Unit-Specific Policy Communications Services, C-06-04, “Emotionally Disturbed Persons” (Toronto: Toronto Police Service, 2011); Steering Committee, Coordination, supra note 2 at 11. 7 Toronto East General Hospital, Briefing Note: Development of a City of Toronto MCIT Program (Toronto: Toronto East General Hospital, 2013) at 2; Steering Committee, Coordination, supra note 2. 8 The Steering Committee includes voices from TPS, current MCIT members, representatives from participating LHINs, Emergency Medical Services, the Acute Care Alliance, mental health and addictions services, and the City of Toronto Mental Health Promotion Program. In preparing its 2013 report, MCIT Coordination in the City of Toronto, the Steering Committee also consulted with the Empowerment Council, the Toronto Police Services Board’s Mental Health Sub-Committee, and Toronto East General Hospital’s Withdrawal Management Services. Police Encounters With People in Crisis |219
(a) (b) (c) (d) (e) St. Joseph’s Health Centre in 2005 to cover 11 and 14 Divisions in Central- West Toronto; The Scarborough Hospital – General Campus in 2006 to cover 41, 42, and 43 Divisions in Scarborough; Humber River Regional Hospital in 2008 to cover 12, 13 and 31 Divisions in Northwest Toronto; Toronto East General Hospital in 2013 to cover 54 and 55 Divisions in Central-East Toronto; 9 and North York General Hospital in 2014 to cover 32 and 33 Divisions in North York. 10 Figure 2. Toronto’s MCIT Service Areas and Partner Hospitals STEELES AVE W STEELES AVE E 33 42 z 54 DANFORTH AVE Legend Division Boundary Healthcare Facility and Associated TPS Divisions 9 St. Michael's Hospitat. Divisions 51, 52 9 St. Joseph's Health Contra Divisions 11, 14. 22 9 The Scarborough Hospital - General Campus: Divisions 41, 42, 43 9 Humber River Regional Hospital; Divisions 12, 13, 23, 31 9 Toronto East General Hospilei: Divisions 53, 54, 55 9 North York General Hospital: Divisions 32, 33 9 For further information on MCIT operations, divisional partnerships and geographic coverage, see Steering Committee, Coordination, supra note 2. 10 Ron Fanfair, “MCIT Expands to North York” TPSNews (7 April 2014), online TPSNews . Police Encounters With People in Crisis |220
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POLICE ENCOUNTERS WITH PEOPLE IN CR
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ACKNOWLEDGEMENTS There are many ind
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EXECUTIVE SUMMARY
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(viii) best practices and precedent
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18. Chapter 3 provides a commentary
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exercised with that zero target in
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G. Recommendations 48. The 84 Recom
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viii. conducting routine monitoring
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CHAPTER 6: SELECTION OF POLICE OFFI
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CHAPTER 7: TRAINING Recruit trainin
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(b) (c) Exposure: providing officer
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(j) Valuing the Role of Debriefs: m
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De-escalation requirements RECOMMEN
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(b) (c) (d) (e) (f) (g) (h) increas
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RECOMMENDATION 51: The TPS encourag
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iii. iv. the disciplinary and train
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eports detailing any circumstances
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cooperation from other organization
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PART 1 The Independent Review
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9. Third, it is important at the ou
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23. As I emphasize in the Report, t
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CHAPTER 2. MANDATE, INDEPENDENCE, S
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(ii) (iii) (iv) (v) (vi) (vii) TPS
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20. The act of engaging in professi
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mental crisis and whose behaviour e
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(l) (m) (n) (o) (p) (q) (r) (s) a f
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3. Police College site visits 44. T
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Mike Creek Bethan Dinning Julian Fa
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CHAPTER 3. CONTEXT Table of Content
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service by the public. 1 The front
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society must bear. One result is, I
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perceived uncertainty as to whether
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Figure 2. Toronto Police Service or
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Command includes Communications (i.
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65. The objective of the course was
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78. Some may consider a statistical
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that period. These other deaths wer
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F. The legal context 100. Before pr
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(j) The internal disciplinary proce
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CHAPTER 4. THE MENTAL HEALTH SYSTEM
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Chapter 4. The Mental Health System
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police may reencounter the person i
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them to available resources, provid
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3. Accessibility of information reg
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how to recognize common mental illn
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mental illness can be impossible. T
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contains a section that addresses t
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60. When Communications Services re
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scene from its central location. Th
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with, and apprehension of, “emoti
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of people in crisis from TPS to the
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92. Procedure 06-04 directs Divisio
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103. The issue of sharing mental he
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under the Mental Health Act, as any
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III. Recommendations 120. Before se
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ii. iii. iv. providing cross-sector
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CHAPTER 5. POLICE CULTURE Table of
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7. It is for this reason that, alth
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officers against vulnerable citizen
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I want to impress upon you the nece
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policing. That is an unfortunate at
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(a) (b) (c) (d) (e) (f) (g) (h) A c
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Chapter 6. Selection of Police Offi
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of a police constable. Furthermore,
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4. Education 19. A number of indivi
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1. The Emergency Task Force 29. Psy
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elationship with a TPS member, the
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positions are directed to demonstra
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CHAPTER 7. TRAINING Table of Conten
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policing as compared to the data re
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services identified in the Police S
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my view, police training should aim
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25. When recruits return from the B
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However, the Review also heard that
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(d) (e) (f) (g) (h) (i) Use of Forc
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CHAPTER 8. SUPERVISION Table of Con
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can be considered for further promo
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13. The TPS provides a two-part sup
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(a) (b) (c) (d) (e) (f) (g) (h) (i)
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30. All TPS members are trained in
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the TPS must participate in an annu
Page 172 and 173: (a) Misconduct 49. Pursuant to the
Page 174 and 175: Further, a hearing officer may impo
Page 176 and 177: II. Overview of Issues Highlighted
Page 178 and 179: (j) Valuing the Role of Debriefs: m
Page 180: De-escalation requirements RECOMMEN
Page 183 and 184: Chapter 9. The Mental Health of Pol
Page 185 and 186: B. Workplace mental health standard
Page 187 and 188: 20. As discussed in Chapter 5 (Poli
Page 189 and 190: TPS member or a group of TPS member
Page 191 and 192: 45. If an officer is subject to a f
Page 193 and 194: II. Overview of Issues Highlighted
Page 196 and 197: CHAPTER 10. USE OF FORCE Table of C
Page 198 and 199: and Effectiveness of Police Service
Page 200 and 201: Figure 1. The Ontario Use of Force
Page 202 and 203: 19. Although it is beyond the scope
Page 204 and 205: 28. The Criminal Code limits the ac
Page 206 and 207: 36. The Use of Force Procedure auth
Page 208 and 209: primary response officers is to con
Page 210 and 211: Table 1. IACP Model Policies v. Ont
Page 212 and 213: armed units—approximately 10% of
Page 214 and 215: 65. Communication is central to eve
Page 216 and 217: well-being of the subject and encou
Page 219 and 220: CHAPTER 11. MCIT AND OTHER MODELS O
Page 221: officers serving as first responder
Page 225 and 226: crises occur at the same time, in a
Page 227 and 228: 32. Second, mental health nurses po
Page 229 and 230: 41. Clarification of the MCIT’s r
Page 231 and 232: Table 1. Mobile Crisis Teams and Ot
Page 233 and 234: 1. Vancouver’s Assertive Communit
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Page 237 and 238: for those with serious mental illne
Page 239 and 240: advocacy community. These forums ca
Page 241 and 242: RECOMMENDATION 46: The TPS should a
Page 244 and 245: CHAPTER 12. EQUIPMENT Table of Cont
Page 246 and 247: (a) Batons 5. Provincial guidelines
Page 248 and 249: to incapacitate a person so that po
Page 250 and 251: 20. The guiding principles of the C
Page 252 and 253: Reports 40 —as they relate to the
Page 254 and 255: e used in practice as alternatives
Page 256 and 257: 48. The absence of definitive resea
Page 258 and 259: when collision sensors are triggere
Page 260 and 261: attachments (which adds an addition
Page 262 and 263: 75. Many of the stakeholders who ho
Page 264 and 265: (d) (e) (f) (g) (h) (i) any medical
Page 266 and 267: RECOMMENDATION 65: The TPS carefull
Page 268: PART 3 The Next Stage
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Report should not simply fade from
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H. Ongoing review 26. Finally, effe
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C. Leadership RECOMMENDATION 77: Th
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Appendix A List of Individuals Inte
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Name Position Institutional Affilia
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Basic Principles on the Use of Forc
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Ellen M. Scrivner, Controlling Poli
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Extract from the Minutes of the TPS
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Henry J. Steadman, et al., “Compa
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Leslie Sinclair, “Crisis Interven
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Ministry of Community Safety and Co
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Ronald J. MacDonald, The First Year
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Toronto Police Service, Professiona
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• North Bay Police Service • Or
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Appendix C List of Stakeholders tha
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Appendix D Selected Legislative Pro
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(a) he acts in good faith; and (b)
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Mental Health Act, R.S.O. 1990, c.
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(c) is apparently suffering from th
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Duty of attending physician 20.(1)T
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1. Crime prevention. 2. Law enforce
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it was not of a serious nature, the
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Employment record (9) The chief of
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11. requiring territories without m
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Regulations Adequacy and Effectiven
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Member of the board PART I OATHS AN
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Third-Class Constable Fourth-Class
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1. Expressing views on any issue no
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(b) being a member of the municipal
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(3) Before the chief of police may
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(e) (i) BREACH OF CONFIDENCE, in th
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Conduct and Duties of Police Office
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Equipment and Use of Force, R.R.O.
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Public Complaints - Local Complaint
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Regulation under the Mental Health
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PROVINCIAL INVESTIGATIONS 06 - 04 E
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Form 47 MHA means an ‘Order for E
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• conduct a Person Query, includi
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• give the original Form - MHA an
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22. Upon receipt of an original For
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TPS Policy & Procedure Manual R.O.
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DIV HOSPITAL ADDRESS REMARKS 13. 53
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Associated Service Governance Numbe
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NOTE: The surrender of Service issu
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Unit Commander 15. Upon becoming aw
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• assess fitness for duty • if
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TPSB ER-004 Major Incident Command
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Communication Strategy In order to
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• notify the divisional officer i
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Incident Commander 15. When respond
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− − the on-call EM&PO member th
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15 - 01 Use of Force USE OF FORCE A
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Training Ontario Regulation 926/90
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Additionally, members are required
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NOTE: Batons are the only impact we
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• ensure the scene and all eviden
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26. In addition to the duties descr
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Procedure 15-01 - Appendix A Provin
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Force Framework. As conceived by th
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• intoxicated vs. under the influ
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• personal experience • skill/a
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Considerations. Based on the office
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08-06 Hazardous Materials, Decontam
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• conduct a spark test at the beg
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• package the expended air cartri
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