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Sgt Study > 06-04 Persons in Crisis > Flashcards

06-04 Persons in Crisis Flashcards

1
Q

Rationale
The Mental Health Act (MHA) provides for the treatment and apprehension of persons in crisis. While it is not the role of
police officers to diagnose mental health or substance use issues, it is their role to respond appropriately to the ——
and circumstances they observe. This Procedure addresses situations where officers observe verbal cues, behavioural
cues or other behaviours that provide them with reasonable cause to believe a person is apparently experiencing a mental,
emotional or substance use crisis. The following process governs police interaction with and apprehension of persons in
crisis and their subsequent admission to psychiatric facilities.

A

behaviours

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2
Q

A person in crisis means a member of the public whose behavior brings them into contact with ——– services, either
because of an apparent need for urgent care within the mental health system, or because they are otherwise experiencing
a mental, emotional or —— use crisis involving behavior that is sufficiently ——- , threatening or dangerous that emergency services are called in order to protect the person or those around them. This includes persons who may require assessment under the MHA.
The Toronto Police Service (Service) is committed to preserving the lives and well-being of people who may be experiencing mental health and/or substance use issues, while working towards the goal of ——- deaths and ensuring the well-being, safety, rights, and dignity of individuals and communities. In every encounter, the Service is committed to taking all reasonable steps to assess, ———- and safely resolve the situation

A

emergency
substance
erratic
zero
de-escalate

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3
Q

Supervision

 Supervisory Officer attendance mandatory for calls for service when there is information that a persons in crisis is ——or may be armed with a weapon
 Supervisory Officer notification mandatory if detained at a psychiatric facility for more than —— Procedure
An eReport must be completed for
 all MHA apprehensions; and
 circumstances where the location of the person named on the Form – MHA is unknown and every effort to locate the individual has been made.
 Note: Officers may consider completing an eReport for any circumstances where the details of the incident would assist officers in resolving conflicts in any —– crisis related contacts.

A

armed
one (1) hour
future

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4
Q

Section 17 MHA – Action by Police Officer
Section 17 of the MHA states that Where a police officer has reasonable and probable grounds to believe that a person is acting or has acted in a —— manner and has reasonable cause to believe that the person,
(a) has threatened or attempted or is threatening or attempting to cause —— harm to himself or herself;
(b) has behaved or is behaving violently towards another person or has caused or is causing another person to ——-bodily harm from him or her; or
(c) has shown or is showing a lack of ——- to care for himself or herself,

A

disorderly
bodily
fear
competence

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5
Q

Section 17 MHA – Action by Police Officer

and in addition the police officer is of the opinion that the person is apparently suffering from mental disorder of a nature or quality that likely will result in,
(d) serious bodily harm to the —–;
(e) serious bodily harm to ——- person; or
(f) serious physical ——- of the person,
and that it would be ——to proceed under section 16 (———for Examination, Form 2), the
police officer may take the person in custody to an appropriate place for examination by a physician.
 Note: There is no longer a requirement for a police officer to actually observe the person’s behaviour and may use information obtained from a —— party in order to form reasonable and
probable grounds for apprehension. Police officers should obtain and record as much information as possible in situations involving third party reports and request that the complainant sign the officer’s memorandum book.

A

person
another
impairment
dangerous
justice of the Peace Order
third

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6
Q

Section 33 MHA – Duty to Remain and Retain Custody

Section 33 of the MHA directs
A police officer or other person who takes a person in custody to a psychiatric facility shall —— at the facility and retain custody of the person until the facility takes ———-of him or her in the prescribed manner

A

remain
custody

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7
Q

————-Program and Referrals to Community Supports
There are many community service providers available to assist police with persons in crisis. Members are encouraged to access the TPS Mental Health Referrals Guide for information on the safe bed program, system navigators and other community referrals or supports available. Connecting community members to supports may improve their quality of life and/or ——the likelihood they will require emergency services in the future.

Officers have access to assistance from the ——- (CMHA) via their Community Referral Police Access Line – ——–. This line is for police officers only, and is available 24/7 to provide officers with
assistance when dealing with:
 any person — the age of sixteen (16) who is believed to be experiencing a mental, emotional or substance use
crisis;
 has become involved with police and/or is at risk of involvement with the criminal justice system; and
 who has not been ——-under the MHA.

A

Safe Beds
decrease
Canadian Mental Health Association (CMHA)
(416) 248-0200
over
apprehended

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8
Q

Safe Beds Program and Referrals to Community Supports

When making a referral for a safe bed through the Community Referral Police Access line shall:
 proceed only on the —– of the person in crisis
 with the consent of the person in crisis, provide only the name, date of birth and phone number of the person
being referred to the call taker. The CMHA will obtain all other personal information directly from the person being referred to their services upon arrival at the central intake location.
 provide any ——– that could impact the safety of staff and other patrols while at the safe bed location
 provide ——for the person being referred to the safe bed location
 ——- at the safe bed intake site until CMHA staff complete the triage process

A

consent
information
transport
remain

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9
Q

Safe Beds Program and Referrals to Community Supports

 Note: The CMHA will accept individuals who can be —-supported in the community. This means that the individual does not pose a threat to the safety of the public or is not at serious
risk of harming ——-or others. Prior to providing support, the person in crisis must ——agree to the services being provided and any other required conditions for admittance (i.e. pandemic screening and testing, wearing of personal protective equipment, etc.).
The CMHA also hosts a separate Referral Line that is accessible to the general public – (———- Officers may
provide this number to community members who may benefit from CMHA programs (including safe beds), but who wish
to do so on their own ————.

A

safely
themselves
voluntarily
416) 248-4174.
timeline

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10
Q

Mobile Crisis Intervention Team (MCIT)
The MCIT program is a collaborative partnership between participating hospitals and the Service bound through a
———————. The MCIT program partners a mental health nurse with a police officer with additional training in working with persons in crisis that will respond, or assist in the response to calls for service involving individuals experiencing a mental, emotional or substance use crisis.
The MCIT response will assist with:
 ————the situation
 attempting to ———and diffuse the crisis
 providing supportive ———-as needed
 connecting the individual to appropriate ——–services
When feasible and consistent with officer and public safety, members with MCIT training and/or additional mental health
training should take the lead role in situations involving a person in crisis.

A

Memorandum of Understanding
assessing
stabilize
counselling
community

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11
Q

Race and Identity-Based Data Collection
As outlined in Procedure 16–07, the Toronto Police Services Board Policy entitled “Race-Based Data Collection, Analysis
and Public Reporting” requires the Toronto Police Service (Service) to collect, analyze and publicly report on data related
to the race of those individuals with whom Service members interact.

A

awareness

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12
Q

Police Officer
1. Where a police officer investigating a person in crisis observes verbal or behavioural cues (e.g. mute, passive, suicidal,
yelling, hearing voices) OR receives information that would lead the officer to believe that a person is apparently experiencing a mental, emotional or substance use crisis, they shall be guided by s. 17 and s. 33 of the MHA.
2. When responding to a complaint of a person in crisis shall
 request notification and attendance of the — if available
 conduct a Person Query, including a CPIC and —- check
 determine if the person in crisis owns, possesses or has access to weapons, firearms, ammunition, explosives
or the related authorizations, licences, certificates or permits and comply with Procedure 05–21
 obtain the type of information contained in Chapter 5, Appendix A to help determine whether reasonable grounds
exist to believe there is a threat to safety

A

MCIT
CFRO

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13
Q

Police Officer

 request the attendance of a supervisory officer when there is information that a person in crisis is armed or may
be armed with a weapon
 request notification of the —————–in accordance with
Procedure 10–05, when:
 there is information that a person in crisis is armed or may be armed with a weapon
 background checks indicate that the person in crisis has a ——of violence or use of weapons
 the incident involves a barricaded person
 the incident involves a person who by their position has placed themselves or others in immediate ——(i.e. person located at height on a balcony, bridge, etc.)
 Note: It will be at the discretion of the ——Officer – ETF as to whether they will attend.  consider using the search and seizure provisions contained in ss. 117.04(2) CC to minimize any subsequent risk to the person in crisis or any other person.
 comply with Procedure 09–03, if applicable
 request to obtain sufficient backup officers

A

Specialized Emergency Response – Emergency Task Force (ETF)
history
jeopardy
Supervisory

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14
Q

Police Officer

  1. When encountering a person in crisis shall
     take all necessary steps to ensure the situation is safe
     determine the need to immediately apprehend under the MHA or arrest under the applicable statute
     Note: Keeping in mind officer and public safety, officers may use discretion when determining whether to handcuff an individual as it may not be practicable or necessary in all circumstances
    (e.g. due to a person’s medical condition, age, disability, pregnancy, or frailty).
     consult with the MCIT, if available
A

awareness

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15
Q

Police Officer

  1. When a person in crisis has committed a criminal offence shall
     assess the surrounding circumstances
     consider ——- the person under the applicable statute
     if no charges will be laid complete the applicable eReport outlining the details of the offence
     complete the applicable — Detail page
A

charging
MO

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16
Q

Police Officer

  1. When attending a scene where the risk of contact with blood or body fluids exists shall
     take the necessary ——— to minimize the risk of exposure to communicable diseases
     comply with Procedure 08–07
A

precautions

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17
Q
  1. If the person appears on CPIC in the Special Interest to Police (SIP) category as being the subject of an ——- Warrant shall comply with Procedure 02–12.
  2. When receiving a complaint or coming into contact with an elopee, including a person wanted for a terminated
    ———————-(Form 47) shall comply with Procedure 06–05
A

Ontario Review Board
Community Treatment Order

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18
Q

Police Officer

  1. When the person in crisis, is eighteen (18) years of age or older, and has not been apprehended under the MHA shall
     consider making a ——— to a community support agency, after consent is received from the person in crisis,
     record the referral information
     in the memorandum book
     in the eReport, including referral type and referral agency, if applicable
     comply with direction contained in the Safe Beds and Referrals to Community Supports section of this Procedure,
    if making a referral for a safe bed
     comply with Item 19, if applicable
     Note: Members are encouraged to access the TPS Mental Health Referrals Guide when considering a referral to a community support agency.
A

referral

19
Q

Police Officer

  1. When the person in crisis, is sixteen (16) or seventeen (17) years of age, and has not been apprehended under the MHA shall:
     make a referral to a ——– while in the presence of the youth;
     in this age range, CAS involvement is on consent only, however, CAS will follow up if the youth does not want
    immediate support from their agency;
     follow the direction provided by the CAS social worker;
     if no immediate action is to be taken by the CAS, advise the youth that the CAS social worker may follow up with them at a later time and how they can reach the CAS if they would like assistance;
     if the CAS does not provide direction, make a referral to a ————–support agency, after consent is received
    from the person in crisis, and
     record the referral information
     in the memorandum book
     in the eReport, including referral type and referral agency, if applicable
     comply with direction contained in the Safe Beds and Referrals to Community Supports section of this Procedure
    if making a referral for a safe bed
     comply with Item 19, if applicable
A

Children’s Aid Society (CAS)
community

20
Q

Police Officer

 Note: Members are encouraged to access the TPS Mental Health Referrals Guide when considering a referral to a community support agency.
10.When the person in crisis is under —– years of age shall
 record the information in their memorandum book
 determine if this is a child in ——–under the Child, Youth and Family Services Act (Contact the ——)
 comply with Procedure 04–41, as appropriate
 in consultation with CAS, refer the child in need of protection to a community support agency as required
 record the referral information
‒ in the memorandum book
‒ in the eReport, including referral type and referral agency, if applicable
 Note: Members are encouraged to access the TPS Mental Health Referrals Guide when considering a referral to a community support agency

A

Under 16
need of protection
CAS

21
Q

Police Officer

11.When there are sufficient grounds to apprehend a person in crisis under s. 17 MHA shall
 comply with item 2, if applicable
 apprehend the person
 ensure the dwelling and any valuables are ——for safekeeping in compliance with Procedure 09–01, if
applicable
 transport the person to the ——–psychiatric facility listed in Appendix B
 take any ——currently prescribed to the person and turn over to the nursing supervisor upon arrival at the psychiatric facility
 notify the next of kin or ——–, if necessary
 recommend next of kin attend the psychiatric facility to provide additional information regarding behaviours and symptoms that may assist attending physicians in their assessment
 comply with Procedure 09–03, if applicable
 complete the applicable eReports
 complete the applicable MO Detail page
 add the next of kin information as an alias/associate in the entity section of the eReport

A

secured
nearest
medications
public trustee

22
Q

Police Officer

12.If the person is an outpatient of, or has recent history with a more distant psychiatric facility, may use discretion and
transport the person to that psychiatric facility where practicable.
13.When detailed to apprehend a person in crisis under a Form – MHA shall
 obtain the —-Form – MHA
 ensure the Form – MHA is still ——
 obtain background details from the complainant
 comply with item 2
 attend the address of the person in crisis
 comply with items 11 and 16
 give the original Form – MHA and a list of any medications currently prescribed to the person to the nursing
———-at the psychiatric facility

A

original
valid
supervisor

23
Q

Police Officer

14.Where the location of the person named on the Form – MHA is unknown and every reasonable effort to locate the individual has been made shall
 complete the applicable ——-, including the applicable MO Detail page
 complete the Missing Person Details page
 Note: Records Management Services – Operations (RMS – Ops) will enter the person on CPIC, and create and post a BOLO.
 scan and attach the Form – MHA and relevant memorandum notes to the original eReport
 submit the original Form – MHA and eReport number to the ——–

A

eReports
Officer in Charge

24
Q

Police Officer

15.If the person in crisis has been apprehended under a Form – MHA after an entry has been made in CPIC shall
 add supplementary information to the original eReport, detailing the circumstances of the apprehension
 complete the ———section of the Missing Persons details page
 Note: Upon receiving and transcribing the person located/found update, RMS – Ops will cancel the BOLO, and the missing person from CPIC.
 comply with items 11 and 16

A

Located/Found

25
Q

Police Officer

16.Upon arriving at the psychiatric facility shall
 complete a TPS 710 and provide the report to the nursing supervisor
 remain with the patient until the psychiatric facility accepts custody
 advise a supervisory officer if detained or expect to be detained at the psychiatric facility for more than ——
 Note: Custody occurs when the hospital arranges for their staff to take charge of the individual, or when the person is taken for an assessment. With a supervisor’s approval, a police officer may
remain at the psychiatric facility if it is in the public —-, requested by hospital staff or charges against the person are being considered, and a decision on whether or not to admit the person
has yet to be made.
 if items 14 and 15 do not apply, complete the applicable eReport, outlining the details of the apprehension and
include the information contained in the TPS 710
 complete the applicable MO Detail page
 notify or arrange for notification of the ——

A

one (1) hour
interest
Next of Kin

26
Q

Police Officer

17.If difficulty is experienced when having a person examined/admitted to a hospital
 may request a —-opinion from another physician or psychiatrist on call
 may attend another hospital, if necessary
 shall submit a TPS —- to the —— detailing the problem
 Note: Within reason, an officer may transport the person to more than one (1) psychiatric facility
if the officer feels it is in the public interest to do so. Officers must be prepared to ——-their reasons for taking this course of action.
18.Where there are safety concerns for officers attending an address in the future shall complete a TPS 228 to activate
the Special Address System in compliance with Procedure 17–08.

A

second
649
Unit Commander
articulate

27
Q

Police Officer

19.Notify the ————- (DMHLO) of any cases requiring further support or follow-up,
including referral to —————– (FOCUS) Toronto.
 Note: All information about a person’s psychiatric or medical condition is classified as personal information and cannot be disclosed or used for an ——-purpose.

A

Divisional Mental Health Liaison Officer
Furthering Our Communities Uniting Services
unrelated

28
Q

Supervisory Officer

20.Upon being notified that a call for service involves a person in crisis shall
 ensure notification and attendance of the MCIT, if available
 ensure compliance with Procedure 06-13, if applicable
21.Upon being notified that a call for service involves a person in crisis that is armed or may be armed with a weapon
shall
 attend the scene as soon as possible
 provide guidance and assistance through the course of investigation
 ensure the ETF has been notified in accordance with Item 2 criteria, if applicable
22.When attending officers have apprehended and transported an individual to a psychiatric facility, shall ensure the
prompt and appropriate relief is prioritized.
23.When a call for service involves a traumatic critical incident shall ensure compliance with Procedure 08-04

A
29
Q

Divisional Mental Health Liaison Officer (DMHLO)
24.The DMHLO shall
 ——-divisional community mental health needs through community service providers, including but not
limited to a situation table such as a local FOCUS table
 coordinate with internal divisional resources and community mental health professionals to formulate a plan designed to support individuals identified as high —–users of emergency services due to a suspected mental, emotional or substance use crisis
 review Mental Health related events and occurrences, and identify opportunities to make referrals to external community mental health agencies
 coordinate with the Divisional FOCUS representative (where one exists) to identify those situations that could be brought to the local ———–
 coordinate with the ——-(CRO) to engage the FOCUS table interim process to connect the individual to supports when in a division absent of a FOCUS situation table
 liaise with Community Partnerships & Engagement Unit (CPEU) – ———–
 ensure that hospitals within the division have a sufficient supply of blank TPS 710 forms

A

coordinate
frequency
FOCUS situation table
Community Relations Officer
Community Partnerships & Engagement Unit (CPEU) – Vulnerable Persons

30
Q

Officer in Charge

25.Upon being notified that a call for service involves a person in crisis shall ensure compliance with Procedure 06-13, if
applicable
26.Upon becoming aware that a call for service involves a person in crisis that is armed or may be armed with a weapon,
shall ensure a supervisory officer has been notified and attends the scene as soon as possible
27.When in receipt of a TPS 228, or when notified of
 an MHA apprehension
 the location of the person named on the Form – MHA is unknown and every reasonable effort to locate the
individual has been made shall
o ensure all required reports are accurately completed and submitted
o approve and sign completed forms, as necessary
o ensure every effort has been made to locate a next of kin
o ensure appropriate entries are made in the Unit Commander’s Morning Report (UCMR)

A

Reviews 228

31
Q

Officer in Charge

28.When requested by the Toronto Emergency Medical Services to transport a violent person in crisis from a residence
or hospital to a psychiatric facility shall ensure
 an——————— (Form 1 – MHA) has been signed by a physician
 sufficient police ——
 the ETF is notified prior to the officers attending the address
 Note: It will be at the discretion of the Supervisory Officer – ETF as to whether they will attend.
29.Upon receipt of an original Form – MHA, which has not been executed shall ensure
 compliance with item 14
 every effort is made to apprehend the person in crisis named in the Form – MHA
 the original Form – MHA is maintained at the —-desk until the person in crisis is apprehended or until the Form– MHA has —–

A

Application for Admission
escort
front
expired

32
Q

——— (CTO) means an order with conditions issued by a ——to a person which provides that person with psychiatric treatment in the community that is less ——-than being detained in a facility.

A

Community Treatment Order (CTO
physician
restrictive

33
Q

Disorderly means behaviour that appears to the police to be “to some extent ——although not —–”. [Source: R
v. O’Brien (1983), 9W.C.B. 270 (Ontario County Court)]

A

irrational
unruly

34
Q

Divisional Mental Health Liaison Officer means the police officer responsible for coordinating all Mental Health Act needs and/or concerns within the ——; usually the ——- or the ——-liaison officer

A

division
Community Relations Officer
FOCUS

35
Q

Form 1 MHA means an Application by Physician for Psychiatric Assessment signed by a doctor within seven (7) days of
———–the person, giving any person authority to take the person named on the application to a psychiatric facility. A
Form 1 is valid for ———-days from and including the day it was signed.

A

examining
seven (7) days

36
Q

Form 2 MHA means a ————directing police officers to take the person in custody
to an appropriate psychiatric facility where a physician may order the person detained for examination. A Form 2 is valid
for ——– from and including the day it was signed.

A

Justice of the Peace Order for Examination
seven (7) days

37
Q

Form 9 MHA means an ————issued by a psychiatric facility which authorizes a police officer to return the person without their consent to the psychiatric facility. A Form 9 is valid for a period of —— after the person is absent without leave.

A

Order for Return of an elopee

38
Q

Form 47 MHA means an Order for Examination issued by the physician who issued the person a ———-and
a) Has reasonable cause to believe the person has failed to comply with the ——-under the CTO,
b) the CTO subject or substitute decision–maker has ——consent to the CTO and the subject fails to permit the physician to review their condition within ———- and the physician believes the subject may cause harm or suffer deterioration.
A Form 47 authorizes a police officer to take that person into custody and return them to the physician promptly and is
valid for a period of ————-.

A

Community Treatment
Order (CTO)
conditions
withdrawn
seventy two (72) hours
thirty (30) days

39
Q

Mental Disorder means any —-or disability of the mind. [Source: Mental Health Act, ss. 1(1)]
A person suffering from a mental disorder may have to live with a long–term breakdown of coping skills including ——, decision making and problem solving abilities.

A

disease
perception

40
Q

Person in Crisis means a member of the public whose behavior brings them into contact with ———, either
because of an apparent need for urgent care within the mental health system, or because they are otherwise experiencing
a mental, emotional or substance use crisis involving behavior that is sufficiently erratic, threatening or dangerous that
emergency services are called in order to ——-the person or those around them. This includes persons who may require
assessment under the Mental Health Act.

A

emergency services
protect

41
Q

Physician means a legally qualified medical ——–.
[Source: Health Protection and Promotion Act, ss. 1(1)].

A

practitioner

42
Q

Psychiatric Facility means a facility for the ——–, care and treatment of persons suffering from a mental disorder
and designated as such by the regulation contained in the Mental Health Act. See Procedure 06-04, Appendix B for a list
of designated psychiatric facilities

A

observation

43
Q

Traumatic Critical Incident means any incident during which a member experiences, witnesses, or is confronted with
serious injury, death, or ——casualties; any incident in which the member’s life has been ——- or threatened; or
any situation which is recognized at the time to have the potential to significantly interfere immediately or at a later time
with a member’s ability to function professionally or ——-

A

mass
imperilled
personally

44
Q

Need to keep reading divisional mental health liaison officer duties in this section!!!

A

To remember

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