Policies and procedures for patient transfers from community clinics to emergency departments under the mental health act: Review and policy scan

Neilson, Shane; Chittle, Andrea; Coleman, Terry; Kurdyak, Paul; Zaheer, Juveria

doi:10.1016/j.ijlp.2020.101576

Cited by 3 publications

(29 citation statements)

References 35 publications

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“…Police involvement and use of restraints in the provision of crisis mental health care relate to limited system resources; gaps in comfort and training; notions of risk and safety; and concerns about liability. 8 Police involvement and restraint use can be traumatic, with the death of people in crisis occurring in the worst-case scenarios. [5][6][7][8][14][15][16][17][18] People may experience fear and stigmatization when police are involved and handcuffs applied, which can engender mistrust and deter future helpseeking.…”

Section: Discussionmentioning

confidence: 99%

“…This group advocated for the adoption of flexible processes for crisis mental health transfers at the University of Guelph, authored a commentary in Canadian Family Physician challenging routine use of restraints for such transfers, 9 and performed a literature review and policy survey of transfer policies. 8…”

Section: Author Reflexivitymentioning

confidence: 99%

“…using key concepts derived from the literature review and policy scan. 8 A.C. distributed questionnaires to participants via email. Participants with odd enrolment numbers were asked to complete the questionnaire before the semistructured interview and those with even enrolment numbers were asked to complete the questionnaire after the semistructured interview.…”

Section: Participant Questionnairementioning

confidence: 99%

“…3 However, the processes for such transfers are an underresearched topic, part of a larger gap in research surrounding the conveyance of people experiencing a mental health crisis to hospital from communitybased points of care. [4][5][6][7][8] There is substantial heterogeneity in transfer processes when a Form 1 is completed for students pre-senting at university health clinics in Ontario. In particular, the involvement of police and use of physical restraints for transfers vary between institutions 8,9 and have been the subject of media scrutiny.…”

mentioning

confidence: 99%

“…13 Opponents of routine police involvement and restraint use contend that such practices are traumatizing and stigmatizing, and perpetuate the criminalization of people with mental illness. [7][8][9][14][15][16][17] Given…”

mentioning

confidence: 99%

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Physicians’ perspectives on processes for emergency mental health transfers from university health clinics to hospitals in Ontario, Canada: a qualitative analysis

Chittle

Neilson

Nicoll

et al. 2022

cmajo

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Postsecondary students confront many stressors that may contribute to the emergence of mental illness. 1 Longitudinal data suggest that rates of mental illnesses are increasing among Canadian postsecondary students, with more students reporting self-harm, suicidal ideation and suicide attempts over time. 1 When a student presenting at a university-affiliated health clinic is assessed to be at imminent risk of harm, legislative tools may be used to mandate emergent psychiatric assessment. In Ontario, Canada, under the province's Mental Health Act, 2 a "Form 1 Application by Physician for Psychiatric Assessment" can be completed to initiate this process. When a Form 1 is issued, students must be transferred to a designated hospital facility for evaluation.Although robust data are lacking, the annual number of student mental health transfers on some Ontario university campuses has increased substantially since 2014. 3 However, the processes for such transfers are an underresearched topic, part of a larger gap in research surrounding the conveyance of people experiencing a mental health crisis to hospital from communitybased points of care. [4][5][6][7][8] There is substantial heterogeneity in transfer processes when a Form 1 is completed for students pre-senting at university health clinics in Ontario. In particular, the involvement of police and use of physical restraints for transfers vary between institutions 8,9 and have been the subject of media scrutiny. 3,[10][11][12] These issues are important questions confronting health care professionals. 9 Some have argued for police involvement and use of restraints on the basis that they provide a type of safety to patients themselves, to health care professionals and to those transporting patients to hospital. 13 Opponents of routine police involvement and restraint use contend that such practices are traumatizing and stigmatizing, and perpetuate the criminalization of people with mental illness. [7][8][9][14][15][16][17] Given

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