Who is reported missing from Canadian hospitals and mental health units?

• DOI: https://doi.org/10.1108/PIJPSM-12-2019-0191
• Pages: 525-540
• Published date: 10 May 2020
• Date: 10 May 2020
• Author: Lorna Ferguson,Laura Huey
• Subject Matter: Public policy & environmental management,Policing,Criminal justice,Juvenile/youth crime,Police studies,Health & social care,Criminology & forensic psychology,Criminology & criminal justice

Who is reported missing from

Canadian hospitals and mental

health units?

Lorna Ferguson and Laura Huey

Department of Sociology, University of Western Ontario, London Ontario, Canada

Abstract

Purpose –International literature on missing persons suggests that a significant volume of missing person

cases originate from hospitals and mental health units, resulting in considerable costs and resource demands

on both police and health sectors (e.g., Bartholomew et al., 2009; Sowerby and Thomas, 2017). In the Canadian

context, however, very little is known about patients reported missing from these locations –a knowledge

deficit with profound implications in terms of identifying and addressing risk factors that contribute to this

phenomenon. The present study is one such preliminary attempt to try to fill a significant research and

policy gap.

Design/methodology/approach –The authors draw on data from a sample of 8,261 closed missing person

reports from a Canadian municipal police service over a five-year period (2013–2018). Using multiple logistic

regression, the authors identify, among other factors, who is most likely to be reported missing from these

locations.

Findings –Results reveal that several factors, such as mental disabilities, senility, mental illness and

addiction, are significantly related to this phenomenon. In lightof these findings, the authors suggest that there

is a need to develop comprehensive strategies and policies involving several stakeholders, such as health care

and social service organizations, as well as the police.

Originality/value –Eachyear, thousands of people go missing in Canada with a large number being reported

from hospitals and mental health units, which can be burdensome for the policeand health sectors in terms of

human and financial resource allocation. Yet, very little is known about patients reported missing from health

services –a knowledge deficit with profound implications in terms of identifying and addressing risk factors

that contribute to this phenomenon. This manuscript seeks to remedy this gap in Canadian missing persons

literature by exploring who goes missing from hospitals and mental health units.

Keywords Policing, Hospital care, Mental health, Addiction, Missing persons, Police practices

Paper type Research paper

The phenomenon of going missing from hospitals and mental health units has been reported

in the literature for decades, yet has generated significantly less scholarly attention than

other types of missing person cases (Bartholomew et al., 2009;Stevenson et al., 2013). For

instance, decades ago, Niskanen et al. (1974) and Crammer (1984) noted increased rates of

harm experienced by those who leave from hospital wards without permission, and more

recently Hayden and Shalev-Greene (2018) observed cause for alarm in the professional care

practices regarding patients as a large number of people go missing from these locations.

High rates of individuals reported missing from hospitals and mental health facilities should

warrant concern, as it represents a significant health issue with substantial economic, social

and health impacts (Muir-Cochrane and Mosel, 2008). Some of these effects, for example, are

increases in suicide rates (Crammer, 1984;Niskanen et al., 1974), the potential for overdose

deaths (Bowers et al., 2003), missed or loss of treatments (Bowers et al., 1998;Dickens and

Campbell, 2001), self-neglect and self-harm (Hunt et al., 2010), loss of contact with health

services and increases in violence and aggression (Muir-Cochrane and Mosel, 2008).

Going missing from these locations also has negative consequences beyond the

individual, as fears for safety can impact other patients, family members and friends, as

well as service providers (Wilkie et al., 2014). For example, after a missing incident,

community and family members are reported as experiencing a decreased sense of confidence

Missing persons

from hospitals

and mental

health settings

525

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/1363-951X.htm

Received 16 December 2019

Revised 17 March 2020

Accepted 15 April 2020

Policing: An International Journal

Vol. 43 No. 3, 2020

pp. 525-540

© Emerald Publishing Limited

1363-951X

DOI 10.1108/PIJPSM-12-2019-0191

in the security measures and care being provided. There is also often a heightened perception

of risk to public safety after a missing incident, especially for those reported as missing from

these locations due to the high incidence of mental illnesses among these cases (Hayden and

Shalev-Greene, 2018;Wilkie et al., 2014). These episodes also have adverse impacts on the

health and public safety sectors involving, as they do, the consumption of time and resources

that are often at a premium (Hayden and Shalev-Greene, 2018;Muir-Cochrane and Mosel,

2008). In particular, hospitals and mental health units are reported as commonly without the

time, knowledge or resources to locate the missing person (Hayden and Shalev-Greene, 2018),

thereby often displacing this responsibility onto the police. As a result, the police are often the

first to be called to handle such incidents. Similarly, the police in many countries, including

Canada, are dealing with multiple resource demands and diminishing personnel and budgets.

Missing person cases can be time-intensive and may require costly resources, such as officer

time and the deployment of tracking equipment to find and return people. When we consider

that police may be called to hospitals and mental health facilities multiple times due to high

rates of people going missing repeatedly from these locations (Bowers et al., 1999;Smith and

Shalev Greene, 2015), we begin to see how much of a potential resource burden such cases

might represent for both systems. Factoring in competing demands for police responses, we

can see how some individuals who go missing or wander away might fall through the cracks.

Despite the concerns articulated earlier, there is a shortage of research examining who

goes missing from hospitals and mental health units, what factors may lead these

occurrences and what types of cases typically make up these reports in Canada. In light of the

current economic climate and rise in austerity policing (Huey et al., 2016), there is a need to

better understand the potential risk factors and vulnerabilities related to going missing from

these locations, as they require strategic partnerships with health services to develop

targeted, informed interventions. Additionally, there is a complex network of personal,

environmental and situational factors that may contribute to these incidents. As such, there is

a need for research on predictive variables for going missing to forecast the duration, severity

and chances of harm related to a missing episode from hospitals and mental health units.

Aim

Given this gap in the current literature, this paper examines whether any demographic,

health and/or incident characteristics of the missing cases reported to the police from 2013 to

2018 influence the phenomenon of going missing from hospitals and mental health units. By

drawing attention to these understudied cases of missing persons, we hope to provide a

framework for the development of a risk assessment that identifies the probability of a person

going missing from these locations, as well as offer information that may assist with

producing targeted initiatives aimed at reducing the overall volume of missing person reports

from hospitals and mental health units. We also seek to offer some first insights on the profile

of those missing from these locations, which can help with the creation of distinguished risk

profiles of who goes missing from institutional locations when compared to other location

types. Thus, looking at these strong patterns of institutional contact serves as an important

starting point for answering questions about who goes missing from these locations and the

factors related to these incidents.

Background

Recent figures on missing people in Canada estimate there are anywhere from 70,000 to over

100,000 missing reports generated each year (Canada’s Missing, 2018). Existing literature

highlights that most of these are, in fact, repeat missing cases, whereby people are reported as

missing to the police multiple times. Although there are no Canadian rates on how many

times people go missing repeatedly, international estimates from the United States (US), the

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