Description of transfer process and policies at the clinics when Form 1 is issued, and representative quotes (n = 11)
| Type of process; institution no. | Transfer process | Police or campus police involved | Handcuffs used | Representative quote |
|---|---|---|---|---|
| Fixed | ||||
| Emergency response is activated, with police transporting student to hospital in most cases | ||||
| 1* | Campus police (special constables of municipal police) are contacted to transport student. In rare cases, 9-1-1¶ is called, and municipal police convey student. | Always | Formerly always; now discretionary use | We will contact our campus police service; they will come, and again, there will be … a joint assessment of the situation, and typically students are not needing to be handcuffed anymore. (Participant E1) They [police] don’t use any restraint procedures unless the situation indicates that, and it is done in as low-key and as kind of student-friendly and gentle a way as possible. (Participant E2) |
| 2* | Campus police (special constables of municipal police) are called to transport student. | Always | Almost always | They [police] mostly … 9 times out of 10, will apply handcuffs to a patient, which can be a very traumatic experience. (Participant D) |
| 3*† | Campus police (special constables of municipal police) are called to transport student. | Always | Always | Every time that I’ve called, they [police] have handcuffed the patient. And zero times did I think it was necessary. … I remember having a conversation … with the police officers to maybe consider not handcuffing, because the patient was totally willing to go, but … they said “no” in each circumstance. (Participant K) |
| 4*† | 9-1-1 is called, and police or paramedics, or both, convey student. | Almost always | Never | The nurse arranges [for] the police to come. (Participant B) That horrified me. … Handcuffs? … I hadn’t even thought of handcuffs. (Participant B) |
| 5*† | 9-1-1 is called, and a mobile crisis team (police and mental health worker) or paramedics, or both, convey student. | Majority of cases | Rarely | The time there was [handcuffs] … I think it was out of necessity. … The person was verbally resistant before … police arrived, but then, when police arrived, they were a little more physically resistant, so it was out of necessity they used restraints. … But otherwise it’s never been discussed because I think it was just clear it wasn’t needed. (Participant I) |
| 6* | 9-1-1 is called, and police or paramedics convey student. | Almost always | Rarely | We started specifically requesting for police instead of paramedics … and then our experience has been if that’s available, they do send a mental health officer, or an officer with some mental health training. And we have usually had pretty good success. (Participant A) I can’t ever remember handcuffs being used. (Participant A) |
| Emergency response is activated, with ambulance conveying student to hospital in most cases | ||||
| 7* | 9-1-1 is called, and student is most often transported by paramedics. In rare instances, where safety concerns are identified, police become involved in transfers. | Rarely | Rarely | [We] would call an ambulance, and usually they will come to the university and then they will take [the student] from there. If we have any concerns about [the student] wanting to leave, or [if we] feel unsafe, we call security, which is on campus. That has happened quite a few times where we have just had security waiting until the ambulance comes and takes the person to the hospital. (Participant H) Definitely no, nothing really that we have seen in terms of restraints or anything like that. (Participant H) |
| 8†‡ | Campus police (special constables of municipal police) are called. Campus police call 9-1-1 and wait in clinic until paramedics arrive. Paramedics convey student to hospital. | Not specified in protocol | Not specified in protocol | – |
| Flexible: students are often accompanied by clinic staff, with discretionary involvement of police or paramedics | ||||
| 9* | Student is accompanied to hospital by clinic staff in the majority of cases. Occasionally, student is accompanied to hospital by friends or family. In rare cases, on the basis of safety concerns, 9-1-1 is called, and police or paramedics, or both, convey student. | Rarely | Rarely | Usually what will happen if someone is really, really distressed, whether they’re certified or not, [clinic staff] will escort them over to the emergency department. (Participant C1) The options can be the patient going with one of our nursing staff, [taking] them over; the patient being escorted by the police; and the patient being escorted by a family member or friend. Those would be really the 3. Or when I say one of our nurses, also some other nonnursing staff, like a clinic manager will sometimes take students to the hospital on a Form 1. (Participant C2) |
| 10*† | Student is accompanied to hospital by clinic staff in the majority of cases. Occasionally, student is accompanied to hospital by friends or family. In some cases, on the basis of safety concerns, 9-1-1 is called, and police or paramedics, or both, convey student. | About 50% of the time | Rarely | For those patients who are seeking help and recognize that they need help and who accept our assessment that they should be [on a] Form 1, because they are a risk to themself or to others, we offer them … transportation that we arrange, and an accompaniment with one of our staff people. We’ll actually send a nurse with a patient to the [emergency department], and hand over the patient at the [emergency department] to a nurse and triage at the [emergency department]. (Participant J) |
| Form 1 not used | ||||
| 11ठ| NA | NA | NA | Р|