Une évaluation de l'effet du modèle d'intervention policière du Service de police de Laval (SPL) sur la prise en charge des personnes présentant un risque suicidaire

Context and objectives. The “Service de Police de Laval” (SPL) introduced a new protocol in February 2016 to improve police response among people considered at risk for suicide. This protocol provides a co-response from a police officer and social workers hired from “Division Urgence Sociale” (DUS). According to the protocol, police officers must contact a social worker when intervening in suicide-related situations. The social worker assesses the person’s suicide risk and makes recommendations about the case management (e.g. refer to community resources, stay home with a friend or family members, transport to the hospital). When necessary, the worker also assists on the scene to offer immediate psychosocial support to the individual, while police officers provide a safe and secure environment. The objective of this research is to assess the effect of the protocol on six outcomes: (1) transport to the hospital; (2) referral to or use of community resources; (3) stay in his/her natural environment with a third-party (e.g. partner, family member, or friend); (4) arrest; (5) enforcement of Act P-38.001; (6) use of force.  Methodology. To assess the effect of this protocol, a method known as propensity score matching was used to reproduce conditions of a randomized control trial. Data were collected from 381 police interventions with suicidal people. Observations in the control group observations were collected from police reports (n=130) for the period prior to the implementation of the protocol (February 1st, 2014 to January 31, 2016). The data for the experimental group came from event summaries classified in the DUS computerized database (n=251) for the period following the implementation of the protocol (February 1st, 2016 to January 31, 2018). Propensity score matching techniques were used to obtain balanced control and treatment groups. Subsequently, an average treatment effect (ATE) — i.e. the effect of the protocol — was calculated.   Results. The results show that the protocol improves the management of suicidal people and reduces the pressure on the healthcare system. The protocol was associated with significant decreases in hospital transports (ATE= -0.79; p≤ 0.01) as well as in the enforcement of the Act P-38 (ATE= -0.11; p≤ 0.05). The effect of the protocol also led to a significant increase in referrals to and use of community resources (ATE= 0.36; p≤ 0.01). Individuals treated with the protocol were also more likely to stay with third-party caregivers (ATE= 0.57; p≤ 0.01). The protocol had no significant effect on police arrests and the use of force.  Conclusion. Results demonstrate that the implementation of a protocol involving a co-response by police officers and social workers among people at suicide risk improves their management, especially through a timely referral to community resources. The protocol permitted to reduce transportations to the hospital, hence reducing pressure on the healthcare system. Further studies are however needed to fully understand processes involved within interventions and to estimate their costs and benefits.

Keyphrases: Police