Police, handcuffs routinely involved for Ontario university students with mental health crisis: Study

At 26, Gina Nicoll felt her suicidal thoughts had become unbearable.

She went to her family doctor’s office for help. It was decided she would need to be transferred to hospital — but to get there, she would need to be escorted by police.

“I was concerned for my life at the time,” she said. “The last thing I wanted to see was police. It made a bad situation 10 times worse.”

That transfer was in 2016. In 2018, she would also be taken to hospital by police from her home, after she called 911 for help due to suicidal ideation.

“Being taken away by armed, uniform police and having to sit in the back of a marked police car, behind the bars, it felt humiliating and dehumanizing,” she said. She said she feared people she knew would see her being put in the car. “Like I had done something wrong just by being unwell and asking for help.”

Her experience as a young woman experiencing a mental health crisis led her to pursue mental health as a career and becoming a research assistant at the Center for Addiction and Mental Health. She’s a co-author on a study being published Tuesday that addresses police involvement in student transfers to hospital.

That study indicates that police involvement in mental health care for university students in Ontario is widespread — including the use of handcuffs at some schools.

The new research from CAMH, published in the Canadian Medical Association Journal, revealed that police policies have led them routinely using handcuffs on students who are seeking help for a mental health crisis on some Ontario university campuses when transferring them to hospital.

The reason police are relied upon in these settings is often a lack of resources and staffing implications due to long wait times in hospitals, the research indicates.

As the role of police in mental health-related care has been put into question, following civilian deaths in police presence including Regis Korchinski-Paquet, an Afro-Indigenous Toronto woman, researchers hope the study will prompt schools, governments and police to re-examine policies and ensure that students feel safe when seeking mental health supports.

Police interactions and the use of handcuffs on young people being transferred are traumatizing, especially for those experiencing a mental health crisis and particularly for racialized students, said Dr. Juveria Zaheer. Zaheer, a co-author of the study, is an emergency department psychiatrist, as well as the medical head of CAMH’s emergency department.

“People experiencing mental health crises often are feeling guilty and vulnerable,” said Zaheer, “and to enact violence on them through handcuffs that are unnecessary can make them feel even more ashamed.”

The study involved interviews with 11 physicians at nine university health clinics from July 2018 to January 2019. Another two clinics had their policies examined by researchers. Through the interviews and policy documents obtained from each school, researchers were able to determine that police were “commonly” involved in transfers in seven of the clinics, and “nearly all” or “all” transfers for five of the clinics.

Handcuffs were “always” or “almost always” used during the transfer at two clinics. The reasoning used to justify police involvement was related to “pragmatic” and “extramedical” factors, the study states.

They found within the interviews that major division emerged, as some doctors emphasized that police and restraints cause harm to students, while others said that restraint use is justified.

Zaheer said she was relieved to see that some universities did not use police and had other policies in place, including students being accompanied to hospital by health clinic staff or nonclinical support people.

But what surprised her is that when police were called, it often was not due to the student, but because of policies, or due to wait times at hospital or liability concerns, she said.

Dr. Andrea Chittle, a family physician and study co-author, said due to overall deaths in police custody during mental health crises, the public is asking, “is this the role of police or could these types of services be better delivered by community -based organizations?”

Chittle said people transferred by police to hospital and handcuffed end up staying silent about their mental health later on and that can “really fracture the therapeutic relationship, in addition to causing these harms.”

Under the provincial Mental Health Act, forced psychiatric assessments can be ordered by physicians (called a Form 1), and provincial guides on those assessments include information around police transfer as a seemingly regular part of mental health care.

Ideally, for those experiencing a mental health crisis, use of Form 1’s would be minimal and a transfer can be organized to a hospital without using a Form 1, said Zaheer.

“If someone is sitting calmly… is there a need to engage in (handcuffs)? If we can absolutely avoid it at all costs, I think it’s really important.”

If you are thinking of suicide or know someone who is, there is help. Resources are available online at crisisservicescanada.ca or you can connect to the national suicide prevention helpline at 1-833-456-4566, or the Kids Help Phone at 1-800-668-6868.

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