Police agencies in Canada and
elsewhere have received much criticism over how they respond to persons with
serious mental disorders. The adequacy of training provided to police officers
on mental health issues and in particular on recognizing indicators of serious
mental disorders has been a major concern.
This paper describes the process
that led to the development of a new brief mental health screener (interRAI
Brief Mental Health Screener, BMHS) designed to assist police officers to
better identify persons with serious mental disorders. The interRAI BMHS was
developed in collaboration with interRAI, an international, not-for-profit
consortium of researchers. The government of Ontario had previously partnered
with interRAI to develop and implement the Resident Assessment Instrument for
Mental Health (RAI-MH), the assessment system mandated for use on all persons
admitted into inpatient psychiatric care in the province. Core items on the
interRAI BMHS were obtained through analysis (N=41,019) of RAI-MH data together
with input from representatives from health care, police services, and patient
groups.
Two police services in southwestern Ontario completed forms (N=235) on
persons thought to have a mental disorder. Patient records were later accessed
to determine patient disposition. The use of summary and inferential statistics
revealed that the variables significantly associated with being taken to
hospital by police included performing a self-injurious act in the past 30days,
and others being concerned over the person's risk for self-injury. Variables
significantly associated with being admitted included abnormal thought process,
delusions, and hallucinations.
The results of the study indicate that the 14-variable
algorithm used to construct the interRAI BMHS is a good predictor of who was
most likely to be taken to hospital by police officers and who was most likely
to be admitted. The instrument is an effective means of capturing and
standardizing police officer observations enabling them to provide more and
better quality information to emergency department (ED) staff.
Teaching police
officers to use the form constitutes enhanced training on major indicators of
serious mental disorders. Further, given that items on the interRAI BMHS are
written in the language of the health system, language acts as common currency
between police officers and ED staff laying the foundation for a more
collaborative approach between the systems.
Full article at:
By:
- 1Ministry of Community Safety and Correctional Services, Ontario Police College, 10716 Hacienda Road, Aylmer, Ontario N5H 2T2, Canada; Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L, Canada. Electronic address: Ron.Hoffman@sympatico.ca.
- 2School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
- 3Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada.
- 4Department of Statistics and Actuarial Science, School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
- 5Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R, Canada; Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada.
- Int J Law Psychiatry. 2016 Apr 1. pii: S0160-2527(16)30044-9. doi: 10.1016/j.ijlp.2016.02.031.
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