Police-Encounters-With-People-In-Crisis

the time these officers are comfortable in their roles and have developed the appropriate
skill set, their tenure on the MCIT has ended. While there is value in disseminating the
knowledge and experience of MCIT officers throughout TPS, frequent turnover can
undercut the effectiveness of the MCIT itself. 21 It is not only a mental health training
program. It is an operational unit of the Service that needs to retain expertise.
37. As mentioned above, the role of the MCIT officer is not a highly coveted position
within TPS or one that is viewed as significantly helping career progression. The MCIT
is not perceived as being within the traditional duties of a police officer. However, in
light of the changing role of policing in our society, these perceptions must change
throughout the Service, from management to front line officers.
38. Coordination between the TPS and hospitals is also a significant issue limiting
the effectiveness of the MCIT program, as described in Chapter 4 (The Mental Health
System and the Toronto Police Service). When officers apprehend a person in crisis
under section 17 of the Mental Health Act, they must bring the person to a hospital for
examination by a physician, who will then decide whether to issue a Form 1 Application
by Physician for Psychiatric Assessment through which the psychiatric facility takes
custody over the individual. 22 As noted, although practices vary, in general, officers
cannot leave the hospital until the person in crisis is seen by a physician, with the result
that officers are often subjected to lengthy wait times in hospital emergency
departments. The wait can be up to eight hours, depending on a variety of factors,
including hospital staffing, availability of beds, patient volume and priority in the
hospital’s emergency triage system.
39. In theory, the inclusion of mental health nurses within the MCIT unit should
reduce emergency room wait times because nurses can provide assessments of people in
crisis. However, the information on this point is inconclusive. Opportunities to
streamline the hand-off process between the PRU or MCIT and hospital emergency
departments were discussed in Chapter 4 (The Mental Health System and the Toronto
Police Service). Since the MCIT is a relatively scarce resource, it may be useful to
implement a protocol under which PRUs or other officers relieve MCIT units from
having to wait in the emergency room, freeing them up to return to service and respond
to other calls. Ultimately, what would be most beneficial is for wait times for police
officers (including MCIT units) to be minimized.
8. Limitations of the MCIT model
40. A key limitation of the MCIT model is the fact that the officer-nurse pair can only
act as a second response. In this respect, it is unfortunate that police officers without
specialized training in mental health crises are required to make a crisis situation safe
before the professionals most capable of managing and de-escalating that crisis—the
MCIT unit—are allowed to intervene. It is highly arguable that the most capable people
should be engaged from the outset.
21
CRICH, MCIT Implementation, supra note 1 at 24-25.
22
Mental Health Act, R.S.O. 1990, c. M-7, ss. 15, 17.
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