The study is considering policies for transferring students with mental health emergencies from college to hospital.

According to a new CAMH-led qualitative study published today in the journal, the likelihood that police will be involved in the care of students seeking mental health help on the campus of the University of Ontario’s clinic depends on which university they attend. .. CMAJ open..

The study is the first in the world to conduct a detailed interview with a doctor to investigate policies and processes for moving students experiencing a mental health emergency from a university clinic to a hospital. It is being considered. Investigators said that some Ontario universities require students to use police restraints in all situations that require urgent mental health hospital care, while handcuffs are the last. Some have a policy of using it only in rare situations as a means.

“We wanted to identify a university policy that would facilitate the most dignified transfer from campus to hospital for students in need of urgent mental health care. We hope that such policy will serve as a model for other universities. I wanted it, “said the lead author, Dr. Andrea Chittle, a family doctor. Those who have worked in a university clinic. “I’ve learned that handcuffs are used every time at some universities. In any situation, it’s common to take students to the hospital with handcuffs.”

This task is particularly timely, as post-secondary students in Canada are experiencing an increase in mental illness and mental health transfers. General.

The author interviewed 11 doctors at nine university health clinics in Ontario between July 2018 and January 2019. The interview was confidential and the clinic was not identified so that doctors could speak openly about transfer policies for students with mental health emergencies. In five of these clinics, police were always asking for help if a student needed to be transferred to a hospital. In two of these clinics, police policy was to use handcuffs on a daily basis when transferring students to the hospital.

Doctors surveyed in clinics, where student handcuffs are common, have expressed concern that they may be traumatized in a way that discourages seeking mental health support in the future.

“Handcuffed and loaded into a police car is brutal and traumatic for the patient and sends all the wrong messages about a compassionate and supportive environment,” said one interviewer.

This study is the third collaborative study of co-author Drs. Andrea Chittle, CAMH Emergency Psychiatrists Juveria Zahir and Shane Neilson, Physicians at the Student Health Clinic who are considering a mental health transfer policy at the University of Ontario.

Their first dissertation identified the issue of handcuffs by police in mentally distressed students as an area of ​​concern. The second paper reviewed policies and processes for moving people experiencing a mental health crisis from community-based clinical settings to hospitals. This latest study considered the decision to involve police during the transfer of mental health and use handcuffs, as well as alternatives to that practice.

Researchers have found that the use of police involvement and detention when students need to be transferred to a hospital for psychiatric evaluation is often an understanding of staff roles and responsibilities, resource constraints, and human resource constraints. I found that it was due to non-clinical factors such as staffing, which means that the emergency department has a long waiting time.

“Before I entered the system, I wasn’t aware of how the police were intertwined with mental health,” said a college student who had experience with mental illness, including being transferred from the police to a hospital for evaluation. Contributor Gina Nicole said. “I felt really disappointed, defeated, and helpless. I felt like I was doing something wrong just because I was sick, and I was guilty of it.”

The authors conclude that routine police involvement in the transfer of students to hospitals for mental health is detrimental. They suggest calling police only in rare situations where students are rated at high risk of escape or violence during a transfer to a hospital. They have state-wide policies to minimize the use of police detention during the transfer of mental health from the University of Ontario clinics for university administration, local governments, hospitals, police stations, and mental illness. We encourage you to work with experienced people to develop it.

As an emergency psychiatrist, I see people on the worst days of my life. Those who are experiencing suicidal ideation. People who are experiencing mental illness. They may be afraid. They may have trauma. They may not want to be there. Similarly, in a college environment, there are people who are faced with distress and crisis in a variety of ways, including students who are racist and have experienced oppression and negative interactions with the police. It’s not necessary to use restraints, but it’s rarely used as a last resort and should be wise. It shouldn’t be the default, as it’s stigmatized and scary. We need to be traumatically safe and minimize restraints, just as we need to do in every medical setting... “

Dr. Juveria Zahir, Principal Research Author and Emergency Psychiatrist, Addiction and Mental Health Center

Dr. Chittle added that a public debate about the role of police on campus hopes to convince the university to consider policies and processes for students in mental health crisis. She has more flexible procedures for hospital transfer, following a previous study in which she and her co-authors investigated the routine police practices and routine use of handcuffs at the University of Guelph. It states that it was developed. At the same time, changes in police policy have allowed police to use detention at their discretion when engaged in transfers.

“I think we’re seeing society move farther away from police involvement in mental health care,” said Dr. Chittle. “There are several pilot projects underway that are non-police models of mental health crisis care. I hope this is where we are heading.”