‘Meeting people where they’re at’: How mobile crisis-response teams work

In Thunder Bay, police officers and crisis workers respond to mental-health calls together — all part of an attempt to save time, promote de-escalation, and provide supports
By Charnel Anderson - Published on Mar 15, 2021
Crisis-response worker Victoria Laine (right) and Constable Jeff Elvish. (Courtesy of the Thunder Bay Police Service)

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Crisis intervention has been part of Victoria Laine’s professional life for the last few years. “Crisis response is something that I seem to lean into,” says Laine, whose last job was as a social worker at Hamilton General Hospital’s emergency department, where she worked with families experiencing things like “sudden, unexpected health events, accidents, injuries, sudden deaths.”

“You never knew what you were walking into on any given day,” she says. Today, Laine is a crisis-response worker with the Canadian Mental Health Association in Thunder Bay, where she reports for work at the police station as a member of the Integrated Mobile Police Assessment Crisis Team.

The IMPACT team consists of two people — a police officer and a crisis worker — who respond to mental-health calls together. Launched in January, the initiative is the result of a partnership between the Thunder Bay Police Service, CMHA, and Thunder Bay Regional Health Sciences Centre.

In 2015, Thunder Bay police grew concerned about the number of mental-health calls — in 2014, there were 1,055, and in 2015, 1,104 — which often left officers waiting with patients at the emergency department for hours until they could be assessed. “That’s when I went, okay, this is ridiculous, because if you have two or three mental-health calls, you have six officers at the hospital waiting,” says TBPS police chief Sylvie Hauth, who was an inspector with the service in 2015.

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Hauth reached out to CMHA and other community-service providers to devise a solution that would improve service for people experiencing a mental-health crisis, while simultaneously decreasing the length of time officers spent in the emergency room. Jennifer Hyslop, chief executive officer at CMHA in Thunder Bay, was one of the people to join forces with Hauth. “She and I began working together to kind of give birth to this idea,” says Hyslop.

The idea — a joint mobile crisis-response team that sees crisis workers meet police officers at the scene of mental-health calls — was launched in Thunder Bay in June 2018 as a pilot project. It was “highly successful,” Hyslop says, adding that the program had exceeded its annual target for the number of individuals served within three months of its launch. But, Hyslop says, “It wasn’t perfect.” The program ran only between 2 p.m. and 2 a.m., and sometimes the crisis worker’s arrival on scene was delayed, meaning that if the client had already been admitted to hospital, the crisis worker wouldn’t be allowed in to see them.

In December 2018, the Office of the Independent Police Review Director released a systemic review of the TBPS that included mention of an incident in 2016 during which a non-violent, vulnerable Indigenous man experiencing a mental-health crisis was punched in the face eight times by one TBPS officer and then hit again, five more times, by a second TBPS officer. (The incident led to findings of misconduct against the two officers involved.) The report’s author, former Independent Police Review Director Gerry McNeilly, encouraged the TBPS to “push forward with its work on a Joint Mobile Crisis Response Initiative,” calling it a “much needed” service.

A spokesperson for the TBPS tells TVO.org via email that "we cannot comment on the anecdotal comments within the report,” adding, “We have long recognized the importance of having appropriate responses to persons in crisis. Chief Hauth began a pilot project with the CMHA in 2015 which proved to be very successful. Our continued involvement in these programs underlines the need to have the right kind of support in place which allows police to better respond to incidents involving mental health issues.”

Hyslop says their goal back in 2015 was to develop a ride-along model. That came to fruition this year, after the organizations involved reached out to the Northwest Local Health Integration Network (which provided funding for the mobile crisis-response team), and everyone agreed to use the funding “a little bit differently” in order to launch the IMPACT team. Unlike its predecessor, IMPACT runs 24/7; instead of meeting police on scene, crisis workers ride with them.

a masked woman and man in a car
Victoria Laine (left) and Constable Jeff Elvish respond to mental-health calls together as part of the IMPACT team. (Courtesy of the Thunder Bay Police Service)

When the IMPACT team responds to a mental-health call, Laine says, they first assess the situation. “Depending on what we know going in, I might come in right away with the officers, or I might wait until they’ve done a safety check and cleared things,” she says. Eventually, Laine will sit and talk with the individual to find out what is going on. She’ll consider whether that person is in a safe place and can access supports — professional services or “natural supports,” such as family and friends.

The next steps depend on the IMPACT team’s assessment of the situation and what time of day it is, as “very few services in the city operate on a 24/7 basis,” says Laine. If the person is deemed a danger to themselves or others, they may be apprehended under the Mental Health Act and taken to the emergency department for evaluation. If they’ve committed a crime, they will be apprehended, though Laine says this is something she’s “rarely seen” during her time with the IMPACT team.

Often, the team is able to divert people away from the emergency department by referring them to community-based services, such as mental-health services, housing support, and detox and addiction treatment. “We can talk about what’s available for their needs,” says Laine.

According to statistics provided by TBPS, between January 4, 2021, and February 15, 2021, the IMPACT team had 190 face-to-face interactions. Seventy-two people were brought to the emergency room, and 37 were admitted for psychiatric assessment; 77 people — more than 40 per cent — were diverted away from the emergency room.

Police have become the de facto primary responders to mental-health calls following a policy of deinstitutionalization that saw psychiatric care move out of institutions and into communities without community-based mental-health services, explains Jacek Koziarski, a PhD student in the Department of Sociology at Western University. People with mental illness who come into contact with police, he says, have a “higher likelihood of experiencing use-of-force” and “a higher likelihood of being criminalized.” 

However, Koziarski, who has conducted research on joint mobile crisis-response teams, says initiatives such as the IMPACT team “are an extremely promising practice in terms of reducing the role of police in mental-health calls.”

According to Koziarski, mobile crisis-response teams are “associated with decreases in use of force and involuntary apprehensions under the Mental Health Act, decreases in unnecessary hospital transfers,” and “decreased costs in terms of mental-health calls for the police.” Koziarski says these teams also associated with “increased satisfaction” for people with mental illness who interact with the police and lead to increased engagement with community-based services.

Laine emphasizes that the goal of the IMPACT team is to “reduce police presence on mental-health calls and provide immediate support that is not police-based but rather crisis-response-based.”

“The majority of folks have come with us without any physical intervention needed whatsoever and without any escalation of the circumstances,” says Laine. “We’re meeting people where they’re at, and where they’re at is calling emergency services.”

This is one in a series of stories about issues affecting northwestern Ontario. It's brought to you in partnership with Confederation College of Applied Arts and Technology. Views and opinions expressed in this article are not necessarily those of the college.

Ontario Hubs are made possible by the Barry and Laurie Green Family Charitable Trust & Goldie Feldman.

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