(Ottawa) While patrolling in their car a few blocks from ByWard Market, Officers Taryne Smith and Vanessa Parsons from the Ottawa Police Service’s Mental Health Unit received a 911 call. A man who has been treated for schizophrenia for years and recently stopped taking his medication is breaking furniture in his home on the east side of the city. Frightened, his wife fled to the sidewalk and called the police for help.
Posted at 5:00 am.
Agents Smith and Parsons set off. Other colleagues arrive on site before them. In vain: the man left the crime scene.
Police speak to the woman as her husband returns to their home. He is no longer aggressive, but he remains confused. Despite this apparent return to calm, the officers took him to the hospital against his will.
A situation that could have been handled differently if it had taken place a few kilometers away: Even if a simple river separates Quebec from Ontario, mental health laws apply there differently, explains psychiatrist Mathieu Dufour. The latter is well placed to talk about it: he worked in Ontario for a long time and is now head of the psychiatry department at the Philippe Pinel Institute in Montreal. So he navigated through both systems.
PHOTO OLIVIER JEAN, THE PRESS
Intervention by Officer Taryne Smith and the Ottawa Police Service Mental Health Unit
A drama that leads to change
In 2000, Ontario completely overhauled its mental health laws following the murder of sports journalist and former National Hockey League player Brian Smith. The 54-year-old man was shot dead by a man suffering from schizophrenia on August 1, 1995 as he left his workplace.
While previously a person had to pose an “imminent” danger to themselves or others in order to be taken to hospital by police against their will, this criterion of immediacy, which is still found in Quebec law, has been deleted, explained Dr. Dufour.
So if an Ontario police officer has “reasonable grounds to believe” that a mentally ill person “is acting or has acted disorderly and will cause serious physical harm to themselves or others” or that they “demonstrate an inability to do so is”. “If she takes care of herself,” she may be taken to the hospital against her will to have her condition assessed.
The Ottawa Police Service’s head of mental health, Sergeant Dodd Tapp, says police officers in Ontario previously had to witness the danger virtually first-hand in order to act.
PHOTO OLIVIER JEAN, THE PRESS
Sergeant Dodd Tapp, head of the Ottawa Police Service’s Mental Health Unit
Now we just need to have reasonable grounds for believing that it has happened or that it will happen.
Sergeant Dodd Tapp, head of the Ottawa Police Service’s Mental Health Unit
Éric Lefebvre, head of management of the crisis intervention program at the CIUSSS du Centre-Sud-de-l’Île-de-Montréal, points out that in Quebec there is nothing in Law P-38 that specifies the “immediate” nature of the danger . However, in practice, a period of more or less 48 hours is generally taken as a basis, says Mr Lefebvre, who believes that this word is “not necessarily binding”. But the president of the Association of Psychiatrists of Quebec, Dr. Claire Gamache, reiterates that “someone has to be almost dangerous or have been dangerous the day before to be able to stay in hospital in Quebec”. “Could we […] something more in the expectation of decay and acts of violence than in the immediate danger? “, She asks.
PHOTO OLIVIER JEAN, THE PRESS
Officer Taryne Smith of the Ottawa Police Service’s Mental Health Unit
Known users
In addition to not taking into account the immediate nature of the danger, Ontario passed Bill 68 (also called “Brian’s Law”) in the early 2000s, which specifically allows compulsory community treatment to be imposed on certain people with severe and persistent mental health problems.
Patients who have already been admitted to hospital twice due to their illness and whose condition has improved through treatment can be subject to a “community treatment order (CTO)”. A person taking OTC lives in the community but must adhere to its treatments. If she doesn’t show up for an appointment or stops taking her medication, she may be taken to the hospital by the police. And that even if it doesn’t pose an immediate danger to anyone.
The aim is to reduce the “revolving door” phenomenon based on the patient’s “need for treatment,” explains Dr. Dufour. These restrictions do not apply to all patients with mental disorders, but rather to a small proportion who require a lot of care and are often the cause of numerous calls to the police.
PHOTO OLIVIER JEAN, THE PRESS
Sergeant Dodd Tapp talks to police officer Taryne Smith during an operation
Sergeant Dodd Tapp reminds that despite legislative changes in Ontario, “not all crisis patients are taken to hospital against their will.”
In September, 540 calls to 911 in Ottawa identified people in crisis with mental health disorders. Of that number, 42% were not transported to the hospital, the sergeant explains.
La Presse was able to attend a morning meeting between Sergeant Dodd Tapp’s team and the Ottawa Mental Health Crisis Team. The two teams work closely together and this type of meeting takes place every week to coordinate the interventions.
This morning, the speakers at the table discussed the case of a citizen suffering from schizophrenia who no longer takes his medication. The man begins to worry his neighbors. He screams a lot. He doesn’t let anyone into his house, which is becoming increasingly run down. The man hasn’t been seen by a doctor for months. During the conversation, the question arises: Does the man pose a danger to himself or to others? The answer: not really. The psychiatric police officers simply walk past the resident’s house on their daily rounds. But they won’t approach for now.