A large number of policing hours are spent dealing with mental health crises, according to a new report by Kingston Police Chief Scott Fraser. Still, the number of hours between the apprehension of individuals who are a danger to themselves or others and the time first responders pass that person into hospital care creates the most significant burden on police, the chief explained.
Fraser presented his report, “Mental Health Calls January 1 to November 30, 2024,” to the Kingston Police Services Board (KPSB) on Thursday, Dec. 19, 2024. Going forward, he intends to make such reports quarterly to help the board understand better and guide decision-making and advocacy.
The statistics not only track the number of calls but also delineate the number of individuals those calls were about, labelling them by contact frequency as “chronic presentations,” “repeat presentations,” or “new presentations.” Notably, the Patrol Division takes care of the vast majority of the calls, sometimes up to eight a day, with waits ranging from under 60 minutes to over six hours at the hospital.
Chief Fraser explained that the technology used by first responders during emergency mental health crisis calls is called HealthIM. Designed to promote safety for both the responder and the person in crisis, this software system is intended to improve outcomes for individuals suffering from unmanaged mental health challenges and to promote effective oversight.
A quick look at the HealthIM website provides an overview of the system.
Kingston Police cruisers each have a mobile data terminal (MDT), which officers use to access and enter information while in their vehicles. HealthIM is set up on the MDT to provide a pre-response safety briefing to the officers before establishing contact with a person in crisis. Responders review a brief synopsis of critical safety factors, including de-escalation techniques, known triggers, and contextual information compiled from any previous contact.
Once on scene, officers can complete a brief mental health screening (BMHS) using a phone application. The BMHS provides a rapid on-scene risk evaluation and uses clinically validated algorithms to evaluate the risk of harm and determine appropriate outcomes, according to HealthIM.
The main purpose of the chief’s report was to provide the Board with the Monthly HealthIM Analytics Report, which compiles key metrics and insights on the number and types of calls received.
Fraser noted the value of this information when planning and advocating on behalf of the Kingston Police with other agencies and the province. The detailed reporting shows the number of “new apprehensions,” he explained, “or the people we’ve never seen before,” versus the “‘‘chronic’ [apprehensions] for the people that we see all the time.”
Fraser noted that the tracker “still needs some fine-tuning because the current numbers are a bit conservative” due to some updates needed in the app. However, the numbers do give a “rough idea” of how many hours are spent on mental health calls, he explained.
HealthIM can also use secure community networks to facilitate wireless transmission of on-scene observations to hospitals, community mental health agencies, and other partner agencies. According to HealthIM, advanced notification before hospital transport facilitates improved transfer of care. However, based on Fraser’s report, this function does not seem to be well used yet in Ontario.
“One of our barriers is we’re spending a lot of time in the hospital,” the chief said, noting this is because officers need to remain with a patient until that patient can officially be handed off to the hospital staff. He said that police run into lengthy delays at the hospital due to the number of patients and severity of cases in the Emergency Room (ER). Kingston is not unique in this case, however. “In any community, the ER is a problem because that’s where the log jam ends and begins,” said Fraser.
Board member Christian Lepreucht asked if there has been any opportunity to reduce the amount of time officers spend at the hospital. In response, Fraser explained that, while there had been ongoing meetings with the heads of hospital security to work on improving the time spent by officers in the ER, more was needed.
“The Mental Health Act and policy of hospitals preclude us from [overcoming some of the long waits],” Fraser noted.
Police can bring someone to a hospital for a psychiatric assessment if they believe the person is likely to cause harm or get worse without treatment. However, only Ontario’s Mental Health Act outlines when someone can be admitted to a psychiatric facility, either voluntarily or involuntarily. A person can be involuntarily admitted to a “Schedule 1” hospital if a physician determines they meet the criteria under the Act. This can happen if the person is a danger to themselves or others or their condition deteriorates.
There need to be “a number of things done on the hospital’s end” to streamline the patient admission process, Fraser noted. And the most significant obstacle to police remains the ER.
“Bypassing the ER is a great option,” for police, the chief suggested. “So we’re continuing working provincially with committees that meet, trying to get the best answer… There are so many variables, but we try to address them.”
Fraser noted as an example that changes to the Police Services Act of Ontario now permit Special Constables to assist in apprehensions and allow them to take on some of that time spent with patients in the ER.
“So we’re looking at all those opportunities to get the officers back on the road as quickly as possible. It’s just something that we continue to monitor.”
Further, Fraser noted, Kingston Police generally follow up on cases with extreme delays to determine if anything could have been done differently to make things move more quickly. But in most cases, it is simply a matter of very unwell people in need of immediate attention before the person in custody, he explained.
Mayor Bryan Paterson followed up with this line of inquiry, noting that much advocacy was needed at the provincial level to make changes to legislation, “which is a challenge.” However, he said he wanted to understand if there was some way Kingston Police could work directly with local hospitals.
Fraser said that both are needed, noting Kingston Police has “a good relationship” with local hospitals, but “the legislation hasn’t been updated in a number of years.”
“We strongly believe that legislation needs to be reviewed again. With all of the new data that is available provincially and locally, and I think, indeed, across Canada, there probably is an opportunity [to] streamline efficiency — because whether it’s Hamilton, Toronto, Kingston, or Brockville, at the end of the day, it’s the same process and the same log jam,” the chief explained.
For that reason, tracking the data around mental health calls will be important in the future, Fraser concluded.
“Let’s get some eyes on it who could make some positive change, which may be a lot more efficient for all of us,” he said.
