MP struggle to enforce mental health laws

[Ostrozac]

Agreed, this is quite an informative discussion. I do have one question, though, because I'm clearly missing something important. For the specific task of dealing with a member who is at risk of self-harm, why does it need provincial mental health act coverage? Isn't this a service offence that the member should be arrested for, to prevent the occurrence of said service offence? NDA 98 is "Malingering, aggravating disease or infirmity or injuring self or another".

Note that my knowledge of Service Discipline is only an inch deep -- I've done Unit Disciplinary Investigations and Summary Investigations, and I've been an Ops O, but I am absolutely not an expert, and I constantly seek the advice of experts. And I acknowledge that I'm missing some knowledge in this case.

 

[Haggis]

Agreed, this is quite an informative discussion. I do have one question, though, because I'm clearly missing something important. For the specific task of dealing with a member who is at risk of self-harm, why does it need provincial mental health act coverage? Isn't this a service offence that the member should be arrested for, to prevent the occurrence of said service offence? NDA 98 is "Malingering, aggravating disease or infirmity or injuring self or another".

NDA s 98 requires the "intent thereby to render himself .....unfit for service".  Pretty hard to establish specific intent at the scene unless the victim articulates it.

Second, NDA s 158(1) sets certain conditions for retention in custody which equate to what is colloquially known as the RICE rules, which were mentioned in an earlier post.  In short RICE stands for:

R = Is there a likelihood the offence will be Repeated?  If no; then
I = Can the Identity of the accused be established?  If yes; then
C =is the accused likely to appear in Court? if yes; then
E =Is there a need to protect or preserve Evidence which can only be met by retention in custody?

If all those conditions are met, under either the NDA or the CC, the arrestee must be released.

 

[trooper142]

Agreed, this is quite an informative discussion. I do have one question, though, because I'm clearly missing something important. For the specific task of dealing with a member who is at risk of self-harm, why does it need provincial mental health act coverage? Isn't this a service offence that the member should be arrested for, to prevent the occurrence of said service offence? NDA 98 is "Malingering, aggravating disease or infirmity or injuring self or another".

Note that my knowledge of Service Discipline is only an inch deep -- I've done Unit Disciplinary Investigations and Summary Investigations, and I've been an Ops O, but I am absolutely not an expert, and I constantly seek the advice of experts. And I acknowledge that I'm missing some knowledge in this case.

Arresting them, fine; but then what? We still don't have the authority at that point to transport them to a medical facility against their will. Not to mention civilians (often
dealing with them more than members!) Arresting someone who clearly needs medical help is not the solution.

The mental health act allows police to lawfully transport an individual to a medical facility to be assessed when it is the judgement of the police that they intend to harm themselves (among other things).

We, as MP, currently have an incomplete toolbox to carry out our duties. That is what this comes down to; MP having the authority and legal protections to help our members and members of the public in their time of need!

*edit* although we have no primary ability to act as peace officers and transport under the respective mental health act; there is an ability to detain that person for their safety; call a peace officer who has provincial status and tell them what's happening and if they ask you to take that person to the hospital for assessment, you are legally required to; as per sec 129 of the Criminal Code which states:

129 Every one who

(a) resists or wilfully obstructs a public officer or peace officer in the execution of his duty or any person lawfully acting in aid of such an officer,
(b) omits, without reasonable excuse, to assist a public officer or peace officer in the execution of his duty in arresting a person or in preserving the peace, after having reasonable notice that he is required to do so, or
(c) resists or wilfully obstructs any person in the lawful execution of a process against lands or goods or in making a lawful distress or seizure,

is guilty of

(d) an indictable offence and is liable to imprisonment for a term not exceeding two years, or
(e) an offence punishable on summary conviction.

Although this may be an interim solution to address the gap in the short term; the long term solution is clearly provincial recognition of Military Police in some way or another.

 

[mariomike]

Regarding, "MP struggle to enforce mental health laws" 

I'm not an MP. I'm not familiar with Mental Health Acts outside Ontario.

But, I would like to share some statistics regarding police apprehensions under the Ontario Mental Health Act ( OMHA ) that I found of interest.

Toronto Police only made 520 OMHA apprehensions in 1997.
( Considering Toronto has about 5,235 Police Officers, that was only about one OMHA apprehension for every ten officers. )
Back then, and as far back as I can remember ( 1972 ), OMHA apprehensions by police in Toronto were very infrequent, and only made as a last resort.

In 2013 - the last year I have seen statistics - Toronto Police made 8,441 OMHA apprehensions.
( OMHA apprehensions had increased to about one-and-a-half per officer. )

Hospital wait times for individuals under OMHA apprehension are a concern because mental illness complaints typically score a Canadian Triage Acuity Scale ( CTAS ) 3. ( CTAS 1 is highest priority. CTAS 5 is lowest. ) 

CTAS 3 can involve lengthy hospital wait times for police. Which means they are not able to respond to other calls in the community.

This may, or may not, be of interest to the discussion,

Toronto Police Service
POLICE ENCOUNTERS WITH PEOPLE IN CRISIS
July 2014

QUOTE

Emergency room transfer of care procedures

In addition to wasting scarce police resources, these extended delays aggravate the stigma associated with mental health issues by forcing individuals to wait under police supervision, often in handcuffs.

In certain divisions, the average emergency department wait time is in excess of two hours. The Review was told that wait times can stretch up to eight hours. The Human Services Justice Coordinating Committee Ontario has also reported two to eight hour waits for police officers in emergency departments. Regrettably, these long wait times can create a disincentive for police to bring people in crisis into the mental health system for treatment.

The stigma of being seated in an ER under police guard, often in restraints, adds to the stress of the situation.

END QUOTE

To reduce police wait times in hospitals, Mobile Crisis Intervention Teams (MCIT) now act as "second responders".
MCITs allow Primary Response Units to remain in service for calls in the community.

 

[trooper142]

Regarding, "MP struggle to enforce mental health laws" 

I'm not an MP. I'm not familiar with Mental Health Acts outside Ontario.

But, I would like to share some statistics regarding police apprehensions under the Ontario Mental Health Act ( OMHA ) that I found of interest.

Toronto Police only made 520 OMHA apprehensions in 1997.
( Considering Toronto has about 5,235 Police Officers, that was only about one OMHA apprehension for every ten officers. )
Back then, and as far back as I can remember ( 1972 ), OMHA apprehensions by police in Toronto were very infrequent, and only made as a last resort.

In 2013 - the last year I have seen statistics - Toronto Police made 8,441 OMHA apprehensions.
( OMHA apprehensions had increased to about one-and-a-half per officer. )
https://www.torontopolice.on.ca/publications/files/reports/police_encounters_with_people_in_crisis_2014.pdf

Hospital wait times for individuals under OMHA apprehension are a concern because mental illness complaints typically score a Canadian Triage Acuity Scale ( CTAS ) 3. ( CTAS 1 is highest priority. CTAS 5 is lowest. ) 

CTAS 3 can involve lengthy wait times for police. Which means they are not able to respond to other calls in the community.

To reduce hospital wait times, Toronto Police have developed Mobile Crisis Intervention Teams (MCIT) as "second responders".
MCITs allow Primary Response Units to remain in service for calls in the community.

Interesting statistics, and I'm not entirely surprised. In my own experience, I have only had one case where it took a lot of convincing to get the individual to go to the hospital, most go voluntarily. The argument is not that they happen frequently; the argument is that when they do happen, we need to have the tools to fulfill our primary mandate; preservation of life.

It is better to have a tool and not need it; than to need a tool and not have it.

I reject the argument "well it doesnt seem to be happening all that often, so whats the point in having this authority".

 

[mariomike]

I reject the argument "well it doesnt seem to be happening all that often, so whats the point in having this authority".

I'm not an MP, and did not make an argument about anyone's authority, or lack of. I hope you did not take it that way.

I simply wanted to point out that the number of OMHA apprehensions, in the city I was familiar with, ( it may vary across Ontario and Canada ) has risen dramatically over the years.

Also, to perhaps consider some possible solutions, such as MCIT, to deal with the increase in OMHA apprehensions, and reduce hospital ( Toronto alone has 16 psychiatric emergency departments ) wait times for police. So they can get back in service to the community ASAP.

 

[Blackadder1916]

Interesting statistics, and I'm not entirely surprised. In my own experience, I have only had one case where it took a lot of convincing to get the individual to go to the hospital, most go voluntarily. The argument is not that they happen frequently; the argument is that when they do happen, we need to have the tools to fulfill our primary mandate; preservation of life.

It is better to have a tool and not need it; than to need a tool and not have it.

I reject the argument "well it doesnt seem to be happening all that often, so whats the point in having this authority".

Evolving into an interesting discussion.  Like others, I will preface by stating I'm not, nor have I ever been, an MP or any other type of LEO.  I agree that those who do the job need the appropriate tools even if it is an infrequent occurrence.

However, on the matter of statistics, are there any available about the interaction of MPs with those presenting with mental health issues?  Do the MP keep such statistics?  Are their workload statistics (I assume they, like almost every other agency, accumulate and correlate such) able to be broken down into the reason for contacts with individuals?

I imagine this is nothing new, though it is likely that the requirement for involuntary admission to mental health services has probably risen in the military community just as it has in the wider population, however to a lower percentage.  As a reminder, the various provincial Mental Health Acts, deal with much more than the authority of police to apprehend individuals requiring psych assessment and hold; it also delineates the requirements of individual physicians, "designated" facilities, and to some extent courts among others.

It has been many years since I've personally been involved in situations that required the apprehension of individuals needing to be placed on a psych hold.  Back in the day when medics used to make actual ambulance calls to the PMQs (both overseas and in Canada) it was not unheard of for the MPs to get the medics to respond when it was necessary to physically restrain an individual due to a mental health issue.  While I can't remember under what authority we would have involuntarily admitted an individual (dependant/civilian especially when we were in Germany) it was one of those info items that I kept in my personal SOP references when I was a hosp adm later in my career, though the only time that I specifically recall dealing with a military patient under an Ontario Mental Health Act hold was an individual I escorted from NDMC to a designated facility in Windsor when he was released from the CF (that was in the 1980s).  Perhaps someone more current with how the CFMS (or whatever you call yourself these days) view this issue can chime in.

 

[trooper142]

I'm not an MP, and did not make an argument about anyone's authority, or lack of. I hope you did not take it that way.

I simply wanted to point out that the number of OMHA apprehensions, in the city I was familiar with, ( it may vary across Ontario and Canada ) has risen dramatically over the years.

Also, to perhaps consider some possible solutions, such as MCIT, to deal with the increase in OMHA apprehensions, and reduce hospital ( Toronto alone has 16 psychiatric emergency departments ) wait times for police. So they can get back in service to the community ASAP.

I didn't think you were arguing against increased MP authority, I've just heard that argument circulating over the last few weeks and it can be a bit frustrating!

As I said, I have personally dealt with 3 instances of mental health in one year, with one requiring more pressure to get them to go voluntarily. That is not to mention the 10 I know of, from the base I work at. All within the last year.

As for the amount of times we would require this power; I can't imagine it would be very frequent, but it would be preferable to begging with the subject and hoping they are not too far down the rabbit hole!

I think it's interesting to note that as a professional police organization, the MPs have only really been a true police service for 6 years or so! So as an organization of course there are growing pains! What is not acceptable in my view, is reinventing the wheel when other services have already been through this, we can learn best practice from them and adapt our policies accordingly!

 

[putz]

Evolving into an interesting discussion.  Like others, I will preface by stating I'm not, nor have I ever been, an MP or any other type of LEO.  I agree that those who do the job need the appropriate tools even if it is an infrequent occurrence.

However, on the matter of statistics, are there any available about the interaction of MPs with those presenting with mental health issues?  Do the MP keep such statistics?  Are their workload statistics (I assume they, like almost every other agency, accumulate and correlate such) able to be broken down into the reason for contacts with individuals?

I imagine this is nothing new, though it is likely that the requirement for involuntary admission to mental health services has probably risen in the military community just as it has in the wider population, however to a lower percentage.  As a reminder, the various provincial Mental Health Acts, deal with much more than the authority of police to apprehend individuals requiring psych assessment and hold; it also delineates the requirements of individual physicians, "designated" facilities, and to some extent courts among others.

It has been many years since I've personally been involved in situations that required the apprehension of individuals needing to be placed on a psych hold.  Back in the day when medics used to make actual ambulance calls to the PMQs (both overseas and in Canada) it was not unheard of for the MPs to get the medics to respond when it was necessary to physically restrain an individual due to a mental health issue.  While I can't remember under what authority we would have involuntarily admitted an individual (dependant/civilian especially when we were in Germany) it was one of those info items that I kept in my personal SOP references when I was a hosp adm later in my career, though the only time that I specifically recall dealing with a military patient under an Ontario Mental Health Act hold was an individual I escorted from NDMC to a designated facility in Windsor when he was released from the CF (that was in the 1980s).  Perhaps someone more current with how the CFMS (or whatever you call yourself these days) view this issue can chime in.

I do not have the link handy, however, the Provost Marshal does put out an annual report breaking down population served, types of calls for service, crimes etc.

 

[mariomike]

I do not have the link handy, however, the Provost Marshal does put out an annual report breaking down population served, types of calls for service, crimes etc.

Canadian Forces Provost Marshal Report - Fiscal Year 2015-2016
http://www.forces.gc.ca/en/about-reports-pubs-cfpm-annual-reports/2015-2016-fiscal-cfpm-annual-report.page