Police Intervention in Emergency Psychiatric Care: BluePrint For Change

Please click on the linked pdf file to follow for the 2006 Report produced by the British Columbia Schizophrenia Society on issues relating to mental health and policing. (Excerpt below) Blueprint for Change – Police Intervention in Emergency Psychiatric Care

POLICE INTERVENTIION IN EMERGENCY PSYCHIATRIC CARE: A BLUEPRINT FOR CHANGE

A couple of years ago I found myself at a dinner at Rideau Hall in honour of recipients of the Order of Canada. I found myself seated next to a police officer who was in charge of the police precinct in a downtown area of Toronto where people were poor and crime was high. “What”, I asked the officer, “is the biggest challenge you face?” I expected him to reply that his biggest problem were all those defense oriented Charter rulings the Supreme Court of Canada kept handing down. But he surprised me. “Our biggest problem,” the officer answered,”is mental illness.”

– Chief Justice, Supreme Court of Canada (2005) 1

BACKGROUND

One of the most common difficulties encountered by police who intervene in psychiatric emergencies is the lack of available hospital emergency room space and long waiting times for intake procedures. It is critical that people in a psychiatric crisis receive timely medical assessment and treatment and that British Columbia police officers are not made to wait for unacceptable lengths of time, often hours to release the person to the hospital’s care.

Early in 2005, Vancouver Police Chief Jamie Graham reported that his officers were experiencing substantial hospital emergency room waits, with 7 or 8 hours being the norm. Acting RCMP Commander Gary Forbes reported that his officers in Surrey were facing waits of 10 to 12 hours, and Ward Clapham, Officer in Charge of the Richmond RCMP concurred that this was a significant problem.

Not only is such a situation unacceptable in terms of timely access to appropriate medical care, it is unnecessarily costly in terms of salaries and benefits to deploy police the officers to stay with the patient. Police resources are invaluable. Having the police remain for lengthy times with psychiatric patients in hospital emergency is just one example of where police resources currently allocated to dealing with the mentally ill might be better utilized in other areas. For instance, there is an identified “capacity gap” for crime fighting and the prosecution of gang related crime in BC. In March 2005, a comprehensive report to the Attorney General of British Columbia on street crime identified people with mental illness as a major concern within the justice system. Consultations by the Justice Task Force’s

Working Group with a wide variety of stakeholders confirmed:

  • The justice system is not the appropriate place to deal with mentally ill offenders.

  • There are high numbers of mentally disordered offenders in the criminal justice system.

  • There are a significant number of mentally ill residents and many of them are not receiving needed support in the community.

The Justice Working Group concluded that

Fundamental changes are required to the culture of the criminal justice system, and to the way that health, social and justice system agencies interact. This approach has attracted support within the health and justice system for the kind of collaboration recommended and demonstrated by the Working Group itself.

Among the key recommendations to the BC Attorney General is that the Provincial Government should establish a Community Health and Justice Committee to oversee the cross-agency implementation of recommendations contained in the Working Group’s report.

To ensure more timely access to medical assessment and treatment for all people with mental illness, a comprehensive provincial strategy needs to be developed and implemented in British Columbia that includes services delivered by Regional Health Authorities, acute care hospitals, social services, justice officials, and the police. Otherwise, our jails will continue to become the default mental health system for people who are in a psychiatric crisis and needing care and treatment. The development of such a strategy will result in procedures that would both ensure timely medical care and shorten the wait times at hospital emergency facilities for police.

Focusing on a province-wide basis and working mainly with provincial agencies, efforts in preparing this report for the Provincial Health Services Authority also dovetailed with a Canadian Mental Health Association (CMHA) BC Division community project using six site-specific models in BC to improve interactions between police and people with mental illness.4 Vancouver, Delta, Richmond, Nanaimo, Cranbrook, and Williams Lake were chosen for the project. One of the major goals was to share these communities’ learnings provincially, which has resulted in a set of helpful Fact Sheets to provide information on various aspects of community interaction between police and mental health consumers.

The CMHA project clearly identified three major priorities:

  • Hospital emergency wait times

  • Lack of communication and information sharing protocols and systems

  • Need for systematic continuing education on mental illness and crisis response

Possible remedies have been explored for this report through the existing research and literature on these topics and provincially with the BC Association of Chiefs of Police, individual police officers, hospital administrators, psychiatrists, psychiatric nurses, emergency mental health service professionals, and mental health patients and their families. (for more see the full report: Blueprint for Change – Police Intervention in Emergency Psychiatric Care)

Topic area: Advocacy


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