Section C: Mental Health Services should be accessible and credible

Our vision

• Mental health literacy and dialogue are increased.
• The stigma associated with mental health is reduced.
• The availability and ease of access of credible, meaningful and responsive services to support mental wellness is increased.

A complex problem requires a holistic approach

Mental health is a difficult topic for the general public, riddled with stigma, lack of understanding and opaque treatment options. This difficulty is amplified in policing, where the workplace experiences can be more intense and the workplace structure is often not well designed for response.

Mental health is difficult to understand – it does not necessarily have a clear cause and effect pattern, like a broken leg. It a complex causal web of personal attributes and life experiences and it looks different in every individual. As a society, we are only part way towards understanding mental health. As a result, we do not always have useful language or attitudes towards mental health.

Likewise, as a society, our services for people with mental health issues are complex, inadequate and patchwork. The OPP mirrors society in this regard – it does not have a perfect set of responses and supports for its members with mental health issues.

“I get sick of receiving pamphlets every time there is an incident, it is the same old pamphlet every time and is like lip service, handing it out to simply say we offered.” - OPP member

It is clear from both our discussions with OPP members and from the literature in this area, that the organization’s response to members in crisis has a significant impact on the likelihood of improvement. In other words, how the organization responds to individuals – through the credibility and expertise of services and through the support or stigmatization by peers - can either help or cause further trauma.^{footnote 1[1]}

Studies have shown that the costs associated with mental health disabilities are higher than those of physical disabilities and seven times more likely to reoccur. The reasons given for these costs include:

• the chronicity of mental illnesses
• the high rate of relapse
• greater focus on symptoms rather than level of functioning
• difficulties with work accommodations
• cognitive difficulties impacting functioning and RTW initiatives
• stigma
• difficulties accessing evidence-based treatment
• delays in receiving treatment
• limited support upon return to work^{footnote 2[2]}

The Panel is encouraged that leadership attention is focused on the urgent need for change in this area both in terms of organizational language and attitudes about mental health and the supports and services offered to members and families dealing with mental health issues.

Organizational awareness, support and service offerings must all be priorities and must be provided to members as part of a holistic approach to mental health. It is incumbent on all leaders and members to increase their own mental health literacy and to support their colleagues.

Evaluating services

The Panel was advised that evidence-based program review and evaluation of the mental health programs and services provided by the OPP has not been conducted. It is our view that this should commence as soon as possible, as a part of the mandate of the HWB.

We note that sometimes organizations use the process of program review as a reason to delay change. In this instance we encourage the OPP to resist this tendency and to make the immediate changes called for in this Report, the Mental Health Review, the OPP Suicide Report and the Chief Coroner’s Expert Panel Review, while the overarching review is ongoing.

Developing a common language

As discussed, there is a need for increased dialogue about mental health, to reduce stigma and encourage members to seek help. A dialogue requires a common language among participants in order to be successful. Indeed, a common language on mental health would be useful to the implementation of many of the strategies in this Report, including leadership, behaviour modelling and stigma reduction.

The Panel observed that the OPC training for all police recruits across Ontario relies on the common language developed through the Road to Mental Readiness program (R2MR). This program, originally designed by the federal Department of National Defence, is used by the Canadian military, a frequent source of new recruits for the OPP. R2MR has been adapted by the Mental Health Commission of Canada into training programs for police employees and leadership, to help reduce stigma and increase resiliency.^{footnote 3[3]}

While R2MR is part of the service offerings in the current Wellness Unit, it does not appear to have prominence as a driver of common language among members. Many members expressed that they are seldom exposed to the R2MR language on the job and that R2MR in-service training does not effectively assist them in continuing the training they received at Ontario Police College and OPP Academy, and effectively integrating the practice into their working lives.

The Panel encourages the HWB, in conjunction with the Provincial and Regional Wellness Tables, to explore the value of a common language in mental health discussions and to consider the tools already given to recruits as a valuable starting point.

Navigating the options

The Panel observed the complex and confusing maze of options and obligations that members face when seeking mental health supports. Members repeatedly described the maze as a barrier to accessing services. This is exacerbated when members are in a mental health crisis or are off work and isolated from supports. This has a chilling effect on members coming forward to seek help or accessing adequate supports.

Supervisors and managers also expressed understandable frustration with the complex and bureaucratic processes. They feel unable to make useful recommendations to their members and express unhappiness that their interactions with members off work are limited to discussions about paperwork, rather than genuine and humane support.

The need for navigation to help members and supervisors access support and increase the credibility of services is already recognized.^{footnote 4[4]} The Panel is encouraged by the Government and the OPPA’s efforts to provide ‘wrap-around’ services to members, including navigation.^{footnote 5[5]} When it is in place, it will be a valuable service.

It is the Panel’s view that the OPP, through the HWB, must provide its own navigation services to members as part of its responsibilities for wellness. This support should encompass all the options that are available to all members, including those under the existing insured benefits plans, the above-mentioned forthcoming enhanced services and many others. All members and managers need a ‘one-door’ approach to health services to help them understand the options and navigate the complexity. It is critical that the HWB provide more navigational resources.

At the appropriate time, the OPP and the OPPA will need to come together to ensure that their respective navigational services are complementary and provide the best possible support for members. Given the positive intentions of both parties and the nature of the current dialogue, the Panel has confidence in the outcome of these efforts.

Given the current flux in service delivery as a result of this Report and other efforts by the OPP, a navigation service should be an immediate priority.

Recommendation 5: A holistic approach to mental health programming is required

1. The approach to mental health literacy and programming should encompass a varied set of options, including in-person dialogues with trained peers and clinicians, online resources and group discussion. These options should be flexible and easily adapted to the various and disparate needs of members across the province. These options should be readily accessible and locally available.
2. As a part of the enhanced focus on mental health and wellness in the HWB, a program review and evaluation of the efficacy of current mental health services should be conducted, with input from the Provincial Wellness Advisory Table. However, this review should not delay or prevent immediate action to enhance the accessibility and quality of mental health supports to members including the recommendations for action in this Report.
3. The approach given to all recruits through the R2MR program and other widely applied programs on mental health literacy should be regularly reinforced and applied throughout the work life of members in order to ensure that a common language for mental health is available and used by all members.
4. Support for members seeking wellness services must include immediate access to an individual who can assist the member in navigating the available options. This support should be made broadly available as quickly as possible in order to assist members while the organization shifts some elements of its service delivery in response to this and other reports.

Mental health literacy and check-ups

Much of the focus of mental health is responsive, providing supports and services to members in crisis. However, a proactive and preventative approach to mental health is recommended.^{footnote 6[6]} Members should be encouraged to treat their mental health the way they would treat their physical and dental health – with knowledge, regular and proactive care, and check-ups and discussion with professionals.

A critical element in prevention is literacy. Significant work has been done in the general population to ensure that people have a high degree of literacy about, for example, the prevention, signs, symptoms and treatment of heart disease. In policing, there is regular and repeated training on aspects of the job for which literacy and capacity is required, such as the use of force.

“Ultimately, we need to erase the stigma of asking for help, which is never a sign of weakness. In fact, it is a sign of great strength. And, more importantly: It’s human.” - NYPD Commissioner James P. O’Neill, PERF Report, page 10

It is the Panel’s view that the OPP must place a premium on mental health literacy – wellness and resilience – for its members. The Panel recommends that members undergo regular, recurring and mandatory ‘in-service’ training on mental health with a recertification component, akin to use of force recertification.^{footnote 7[7]} The Panel urges the OPP to ensure that this training is active and engaging – prioritizing in-person delivery methods and not simply online training or distance learning.

As an additional step in mental health proactivity, the Panel urges the OPP and the Provincial and Regional Wellness tables to introduce regular psychological check-ups for all members. The Panel would also urge members to consider a psychological check-up upon retirement.^{footnote 8[8]}

In making this recommendation, the Panel considered other potential options, including recommending mandatory mental health assessments, a recommendation made in some other police services and favoured by some members in our group discussions. While this approach has some merit, the Panel’s view is that, at this time, the environment is not conducive to this recommendation, including that it is costly, there is a lack of trained clinicians and the exact value of the approach is debated. On the other hand, the Panel considered the approach taken in the Safeguard program, that targets particular high-stress positions. However, the Panel felt that this approach does not respond to the reality that no work in the OPP is immune from the potential psychological impacts, including traffic accidents, forensics and dispatch.

In urging a routine of regular psychological check-ups, the Panel is recommending that the OPP create an atmosphere in which members are comfortable with self-identification, managers and supervisors are trained to observe and recommend, and there are more services and opportunities such as embedded clinicians. The Panel hopes that the OPP will build on the Safeguard principles so that there is more acceptance of mandatory debriefs after critical incidents and expand its efforts so that all members seek regular psychological check-ups.

Support for families

The valuable role in wellness that families play has been emphasized by members and experts.^{footnote 9[9]} In order to foster and maintain that role, and to support the collective wellness of families, an increased focus on supports for families is required. Family support should begin at the time of recruitment and be ongoing throughout the employment and retirement of members.

Mental health literacy is as critical for families as it is for members.^{footnote 10[10]} The OPP, through the Wellness Tables, could explore community partnership options to provide this service to families of first responders and ensure that more online and other resources are readily available to families.

The Panel urges the OPP, in partnership with the OPPA and the OPP Veterans’ Association (OPPVA) to develop a family peer support network. The Panel is encouraged by stories of impacted employees and their families having opportunities to speak in public forums and to share their experiences. This concept should be part of the discussions at the Provincial and Regional Wellness tables.

Support for retirees

Retirement from policing presents a new set of challenges for members. Mental health issues do not simply disappear once a member retires and may indeed emerge for the first time or be exacerbated by the feelings of loss of identify and isolation.

In the survey, retired respondents indicated that they feel more isolated and unsupported than current members. They also indicated that in their last year of work they missed more work as a result of work stressors – an average of 16.4 days compared to the average of 7.7 for current members.^{footnote 11[11]}

Sadly, of the 17 members that have died by suicide since 2012, four of them were retirees.

It is the Panel’s view that the OPP should partner with the OPPA and the OPPVA to develop a robust set of retirement supports that includes information, consultation, peer support and active engagement with retirees in their first year of retirement. The Panel believes that there is a wealth of experience and expertise among retired members that could be of value in the development and implementation of this program. ^{footnote 12[12]}

Building awareness and resilience from the start

Both the OPC and the OPP Academy and Recruitment work with new recruits to socialize them to the realities of policing and to build their resilience. The Panel heard from a number of sources that an effort to assess and socialize potential recruits at an earlier stage would be beneficial.

Dialogue with and more rigorous assessment of candidates as a part of the selection process, including discussion about trauma and resilience, should be considered. The Panel supports the recommendation of the Mental Health Review that the selection process have a two person panel to better gauge a candidate’s psychological suitability for the work.^{footnote 13[13]}

The Panel also encourages the OPP to explore the early career wellness programs at TPS and York Regional Police, both of which introduce psychological assessment and follow up at the time of recruitment and throughout the first year.

Storytelling has value

A critical aspect of stigma reduction and the creation of credibility and open dialogue is storytelling by members with lived experience.^{footnote 14[14]} It is important for members to hear about the experiences of their colleagues as a means of building empathy and compassion, combatting stereotypes and strengthening their own resilience.

The Panel urges the OPP to incorporate storytelling across all aspects of its mental health engagement strategy.

Recommendation 6: Regular engagement with members and families is required to support wellness

1. Mental health literacy training for all members should be ongoing, regular and mandatory. Members should be required to engage in regular ‘resilience recertification’ akin to other operational training, such as use of force. It should include modules on recognizing the signs of strain, talking about mental health, providing support for peers and managing crisis.
2. Regular psychological assessments should be considered for all members, regardless of whether they have experienced a critical incident, as well as members upon their retirement.
3. An outreach program for families should be implemented, in collaboration with the OPPA, that stays connected to families throughout member employment, providing information on the challenges of police work, mental health literacy and opportunities for dialogue, community and peer engagement.
4. A collaboration between the OPP, OPPA and OPP Veterans’ Association (OPPVA) should result in robust retirement supports including a pre-retirement psychological assessment, meetings and information about available services, a peer network for retirees and a set of pre-determined check-ins with recently retired members.
5. Continue efforts at the OPP Academy and OPC to socialize new recruits and their families to the realities of police work and to build a foundation of mental health literacy. Peer support and in-person dialogues, including peer support programs for families, should be incorporated at this stage.
6. Recruitment of new members should include early dialogue on resilience and the realities of police work. Greater information on mental health and the potential to reactivate existing trauma, a psychological interview and a two-person interview panel should be considered as potential enhancements to the recruitment process.
7. Members with lived experience should be encouraged and supported to speak openly with other members about their experiences. This dialogue, while critical as a part of peer support for individuals, should also form part of ongoing mental wellness activities across the OPP.

There are insufficient mental health professionals available to support members

There is currently one psychologist on contract working within the OPP. In an organization that is grappling with a mental health crisis across thousands of employees and the geography of Ontario, that is patently insufficient.

“I think that the OPP finally focusing on the importance of Mental Health is a very positive thing. I hope that they continue to build on strategies that encourage people to come forward and begin to employ psychiatrists, psychologists, social workers, etc who specialize in mental health. Although I do think it’s great that our employees be educated, its going to be hugely beneficial to have trained professionals to go to if needed.” OPP member

The Panel recognizes the complexity associated with increasing the number of on-staff mental health professionals, including the availability/interest of experts, attraction and retention challenges that vary by geography, the cost associated with employment and, even with an expanded number, the difficulty of serving such a vast area.

Expanding the options

These hurdles are not insurmountable and should be dealt with in a creative and proactive manner. The Panel urges the Ministry of the Solicitor General and the OPP to immediately allocate funding for at least one specialized clinician in each region. The role of this individual should be to provide support for members in the region through the HWB and to develop additional regional and local support networks that expand the availability of quality services for members, expanding on the current community referral lists.^{footnote 15[15]}

There is a paucity of mental health clinicians across the province with specialized skills able to provide services to police, military and first responders. The Panel encourages the OPP and the Government to explore new educational opportunities and partnerships to expand the pool of service providers.

This exploration should also include partnerships with regional and local mental health providers and organizations. In this regard, the Panel has been encouraged by pilots in some municipal police services and OPP detachments partnering mental health clinicians with frontline officers to respond to mental health related service calls in the community. These partnerships have demonstrated a strong secondary benefit of increasing dialogue and referral opportunities for members experiencing mental health issues.^{footnote 16[16]}

As a means of increasing access to timely and credible mental health supports across the province, the OPP should explore opportunities to provide care through technology, including videoconferencing meetings between members and clinicians. While technology is not a perfect substitute for in-person meetings, it is far preferable to more limited or no access for members. Options could combine in-person and remote access meetings.^{footnote 17[17]}

The role of EFAP in providing access to mental health clinicians

The OPP, along with the rest of the public service, relies heavily on the EFAP, an external service that offers timely but limited access to mental health professionals and other expert supports, usually delivered over the telephone. Members consistently reported a lack of satisfaction with the nature of the service, citing service providers who did not appear to understand the particular challenges of policing or offered suggestions that did not engender credibility. As well, the service has a very limited offering, running out after as few as three sessions.^{footnote 18[18]}

According to the survey responses, EFAP was the service that most respondents used (at 38% of current member respondents) but was also the service that most users found unhelpful (at 65%).^{footnote 19[19]}

The Panel raises these concerns about the EFAP not because we question the quality of the services but because we question the prominence given to it by the organization as a response for mental health. EFAP has proven to be useful across the Ontario Public Service as a first point of contact and support for people struggling with addiction, family issues and other challenges.

However, given the complexity of mental health challenges associated with policing and the longer-term nature of the required response, EFAP may not offer the most effective service.

Consequently, as a part of the OPP’s overall efforts to increase member access to mental health professionals, the Panel urges the OPP to evaluate and potentially recast the role played by EFAP.

Recommendation 7: The number of clinicians and service models available to provide mental health services to members should be increased and new options explored

1. The Ministry of the Solicitor General and the OPP should allocate funding in the OPP budget for at least one specialized clinician per region, working with the regional HWB, and available to support members in the region.
2. Work with the appropriate medical and educational bodies to consider a wider group of professions, including nurses and social workers, able to provide different mental health services to police and other first responders across the province:
   • the HWB should partner with the training bodies in those professions to increase the number of individuals with training in police-specific trauma response
   • the Ministry of the Solicitor General and the Ministry of Colleges and Universities should explore targeted partnerships with universities and colleges in underserved areas, such as Lakehead and Laurentian in the North, to build regional and local capacity for mental health services
   • the Ministry of the Solicitor General and the Ministry of Colleges and Universities should explore the potential for mental health professionals to obtain specialized certification in the treatment of police, military and first responders
3. The Ministry of the Solicitor General and the Ministry of Health should allocate funding for service models that increase the availability of clinicians to members and the public, including embedding clinicians in detachments. These models could include regularized partnerships with service providers such as the CMHA to provide embedded clinician services.
4. The use of digital services including telemedicine or video conferencing for psychological support, should be considered as a means of supplementing in-person services and optimizing access to services and resources.
5. The role of the EFAP in the suite of available services should be reviewed in light of the recommendations in this Report, the OPP Suicide Review and the Mental Health Review to ensure that members receive services commensurate to their needs.

The value of peer support and enhancing access beyond critical incidents

The Panel heard from members across the province that peer support programs play an important role in mental wellness. Members place a high premium on the value of ‘lived experience’ and they frequently prefer the support of peers to that of mental health professionals, whom they generally do not view as being sufficiently able to understand the police experience.

The Panel agrees with the members that peer support is vital – and not just at the moment of a critical incident. Many members told the Panel about a delayed emotional response, potentially as long as months after an incident occurred and by which time they felt uncomfortable reaching out within the organization for support. The Panel encourages the expansion of peer support in a manner that recognizes that there are other high stress moments when peer support may be of value, such as following the death of a colleague or during a Professional Standards Bureau (PSB) investigation. Further, the Panel would encourage the expansion of peer support availability for those members whose experience is cumulative, rather than just at a moment of critical incident.

The Panel recognizes that improvements may be required to the current peer support program – CISR – and supports the recommendations in the Mental Health Review^{footnote 20[20]} and the OPP Suicide Review.^{footnote 21[21]}

This same principle, that mental health stressors may happen outside of the most critical or dramatic incidents, should apply to the application of the OPP Safeguard Program. While the Panel acknowledges that this program is currently under review, it encourages the OPP to retain the supportive principles that underpin the program and to expand those beyond the original application.

A pilot project to increase access to programs

The Panel heard from many members and understands the challenges with respect to privacy and stigma that members experience in seeking personal help either at the detachment or at the local health unit in the community. This is a challenge that has been experienced across the policing and first responder community.

The Panel is interested in efforts made by York Regional Police to respond to this concern by moving wellness services to a building away from the headquarters and separated from any other health services - a “Member House”. The Panel understands anecdotally that this move has increased the number of members and families who access support services.

While a single “member house” would not work given the geography of the OPP, the Panel encourages the OPP, through the HWB, to work with other first responders to explore a pilot program for an off-site service hub for members and families in one region.

Partnerships with Indigenous organizations for culturally relevant support services

There is a clear benefit to members in receiving culturally relevant support services. To this end, the Panel strongly encourages the OPP, through the HWB provincially and regionally, to explore partnerships with First Nations police services and Indigenous health services organizations to increase the availability of culturally relevant mental health support services for both Indigenous OPP members and Indigenous members of First Nations police services working with the OPP. The Panel is appreciative of the positive feedback from chiefs and deputies of First Nations police services with respect to the possibility of partnerships in this regard.

Recommendation 8: Targeted mental health programs should be supported and enhanced

1. Peer support programs, including CISR, should be evaluated and enhanced so that there is a greater number of trained peer leaders available to members. Peer support should continue to target debriefs and/or immediate support at the time of critical incidents and should be expanded to provide support beyond critical incidents, including following the death of a colleague and when a member is being suspended or investigated.
2. Recognizing that mental health stressors are not limited to certain types of police work or certain kinds of experiences, the principles of the Safeguard program should be taken into account in refocusing and expanding wellness efforts across the OPP.
3. The HWB in partnership with other first responder organizations should explore a pilot project to offer support services for members and families at an ‘off-site’ location.
4. The HWB should explore partnerships with First Nations policing services in Ontario with respect to mental health and member resilience. Partnerships at the program development, design and delivery stages will increase the availability of culturally appropriate mental health and wellness supports for Indigenous members of OPP and First Nations policing services working closely with the OPP.

The RTW process is flawed

The Panel heard extensively about the challenges with the current RTW and accommodation processes. Many members indicated to the Panel and as a part of the Mental Health Review process that the difficulties in returning to work kept them away from the workplace longer than necessary and exacerbated their injuries.^{footnote 22[22]}

The RTW process is an important part of the healing process for members. It is a time of extreme vulnerability, in which members who have been off work must exercise the courage to face their peers and to return to a stressful and potentially triggering environment. For many members, the process fails.^{footnote 23[23]}

There was extensive discussion about meaningful work options for those who are unable to return to full duties immediately following a leave of absence, both among members and in reports and studies on police work.^{footnote 24[24]} Members report that the options for modified work often fail to promote greater mental health nor do they promote the best use of the member’s skills to support their unit. Members find themselves underutilized at work, increasing their own feelings of isolation and worthlessness. These feelings are often compounded by the sense that a member’s accommodation also fails to reduce the operational strain on the other members of their unit.

“Management is by the book but the book is sometimes wrong, all mental illnesses are not covered in a book anywhere.” OPP member

Frequently, the expectations related to readiness to assume full duties are a barrier to returning to the workplace. While the objectives of evaluating functional abilities and limitations are sound – helping an employee perform their work activities safely and minimizing the risk of harm to the employee and others in the workplace – this task is particularly complex in a policing environment. Determining a member’s ability to return to operational police work may involve assessing the nature of potential triggers, the member’s access to use of force, the gap in understanding between mental health professionals and the requirements of policing, stigma and stereotypes about the capabilities of members with mental health issues, and a process that does not support caring and collaborative dialogue.

Members spoke about assignment to the OPP’s “Frontline Support Unit”, a unit that has a reputation of being a place to house accommodated members, further stigmatizing those who work there. Members also shared experiences in which they had to make up their own duties in the detachment and some spoke of not being able to return to work because there was no work for them to do. In contrast, the Panel also heard about detachments that had taken a creative and collaborative approach to exploring modified duties and accommodation options, resulting in more positive outcomes for the accommodated members and their colleagues.

As mentioned above, the RTW process is particularly fraught with stigma in the workplace. Members shared their experiences regarding comments and criticisms from their peers about the perceived value of their accommodated duties and their worth as a police officer. Members felt diminished, isolated, and struggled with the loss of their identity as a member of a team. These feelings were exacerbated by the removal of their use of force. Members also spoke about feelings of guilt and shame in not being able to support their team members.^{footnote 25[25]}

Members, including managers, spoke to the Panel about an adversarial relationship with Human Resources and the WSIB during the RTW process. Many members feel diminished or antagonized when Human Resources questions the sufficiency of information provided by their doctor or therapist and they expressed the sentiment that Human Resources prioritizes the bureaucratic process over members’ individual circumstances. Members are not able to appreciate validity in the actions of HR. Managers as well echoed the concerns, finding themselves caught in the middle as they attempt genuine support for members while delivering messages from Human Resources.^{footnote 26[26]}

Opportunities for improvement

The Panel is encouraged by extensive ongoing work in the policing sector, including by the RCMP and the Canadian Association of Chiefs of Police (CACP), to create useful guidelines and develop best practices for the RTW process.^{footnote 27[27]} The Panel was also heartened by sentiments shared during its five regional roundtables, where participants consistently reinforced the value of accommodated roles. What will be critical to improvement for the OPP is ensuring that the practical application of the RTW process is people-centred, collaborative, and inclusive. The clear priority must be on the best outcomes for the individual and the workplace.

The Panel supports the recommendation made by the Mental Health Review that complex RTW cases be considered by an interdisciplinary team supporting the member and the manager.^{footnote 28[28]} In every case, the inputs of the member, the manager and the health professional should be considered.

Specific attention should be paid to the use of force removal/return policy. The Panel encourages the OPP to engage in greater dialogue with experts, other police services and the Provincial and Regional Wellness Tables to refine the approach to the removal and return of the use of force. The policy must carefully balance the stigmatization and shame associated with the removal of the use of force (and therefore the chance that members will not seek help) with minimizing the risk of death by suicide. Greater dialogue with mental health professionals both on a case by case basis and as a part of the development of the policy will assist in strengthening understanding.^{footnote 29[29]}

The Panel encourages the OPP to develop clear messaging for members about the RTW process that highlights collaboration and respect and outlines clear pathways for returning with understandable roles and responsibilities. This resource should be readily available to members so that they are able to understand and prepare for a return to the workplace. Ongoing communication with members who are off work is critical to supporting members and reducing isolation.

The leadership of the OPP needs to communicate the value of different kinds of police work and encourage managers and members to be practical, creative and compassionate in planning RTW for its uniform and civilian members. Managers must model support and respect for members in the RTW process, communicating with both the member and their colleagues about the value of the member’s contribution while respecting privacy and confidentiality with respect to the member’s personal health information.

Recommendation 9: Accommodation and RTW must be de-stigmatized and meaningful

1. The HWB should immediately undertake a review and revision of the RTW protocol in accordance with best practices and with a clear aim to support the wellness of members. This work should be guided by the discussions of the Provincial Wellness Advisory Table.
2. Clear communications should be prepared and disseminated to all members with respect to the contents of the RTW protocol. Managers must be provided with training on the RTW process to help members return to the workplace without fear of stigma, ostracization or reprisal. Managers must clearly communicate the value of the work of accommodated members.
3. Managers and staff must be supported to find meaningful and valued work for members as part of a RTW protocol to support mental wellness and to reduce stigma. This must include developing options in collaboration with the impacted member and manager.
4. Regular outreach to members off work should be a mandatory part of the case management approach. Frontline and other operational managers should be provided with training and support to ensure their engagement with members is appropriate, meaningful and supportive.

Member death by suicide requires communication and support

The Panel has focused its attention and recommendations on increasing the dialogue, availability and access to support for members struggling with mental health issues and their families. In alignment with the OPP Suicide Review, the Panel is hopeful that recommendations for strengthening the quality of the workplace culture and the services offered to members while reducing stigma around mental health, will reduce the instances of member death by suicide.

However, it remains a tragic and ongoing reality for the OPP and all police organizations.

Across the organization, there is a significant impact on members when they learn of the death by suicide of one of their colleagues. 51% of respondents to the survey reported emotional impact as a result of the death by suicide of a member of the OPP, regardless of their personal knowledge of the individual.^{footnote 30[30]}

Colleagues of the individual experience even greater trauma, frequently accompanied by guilt as they question whether there was more they could have done to help. In communities where the OPP provides policing services, its members may be called upon to attend the scene of a colleague’s death. The emotional impact of this work cannot be understated.

Consistent and supportive communication about member death by suicide is required from the leadership both internally to members and externally to the public. The Panel heard from members about the negative impact of non-supportive public communications from leadership following a member death by suicide.

There are conflicting views about how a police organization acknowledges member death by suicide. In discussing death by suicide, some experts advise communication that honours the member’s service to the public, in an effort to reduce stigma associated with mental health, Others caution against communication that may have a ‘contagion effect’ through exposure to the discussion. Privacy concerns must also be considered.^{footnote 31[31]}

The Panel urges the leadership of the OPP to continue to refine respectful messaging to support members and families and reduce stigma associated with death by suicide.

The Panel also encourages the leadership to continue to refine their approach to honouring the memory of members who die by suicide, in collaboration with colleagues and families. Consideration could be given to a focus on the lives and contributions of the members, rather than solely on the cause of their death.^{footnote 32[32]}

Support for families and colleagues of members must be immediate and long-term, with a combination of peer support, expert psychological support, and immediate practical help to ensure families are financially stable following the death. Regular dialogue with families and colleagues should be part of the long-term commitment of the organization.^{footnote 33[33]}

The Panel supports the recommendation made by the OPP Suicide Review to create an ongoing suicide review process. This review process can collect and consider commonalities, themes and gaps in service in pursuit of improved prevention and support services. Continued understanding of the opportunities for greater intervention and support is critical.^{footnote 34[34]}

Recommendation 10: An organization-wide approach to member death by suicide should be developed and communicated

1. Service-wide, regional and local responses to member death by suicide should include clear internal and external communication that supports the reduction of stigma and reinforces the support for members and families.
2. An immediate and long-term support plan for families and colleagues should be easily activated and coordinated to include active, on-site engagement by clinicians and trained peer support as an immediate response, as well as regular dialogue with families and colleagues as a long-term commitment.
3. A collaborative dialogue, including members and families, on how best to recognize and pay tribute to members who die by suicide is an immediate priority.