For as long as I can remember, there has been a controversy over police handling of mental health calls and demands for change. The impetus for much of this has been because of the times when the police mess up and someone dies. I’ll say more of that later but I do think we should realize that this is a complex issue with no simple solution.
I personally first became aware of the role of the police many years ago when I had friends who had a brother with schizophrenia. He absconded from hospital numerous times and initially from what was then the Clarke Institute for Psychiatry. I lived nearby so he came to see me and insisted that I take him to what had been the Toronto Asylum for the Insane renamed the Queen St Hospital. I did but they refused him as he had escaped from the Clarke and therefore “was not their problem”. Now they are both the Centre for Addiction and Mental Health.
He eventually got his wish and went to Queen St where he continued his exploit of frequent escapes. When he again showed up at my place, I called the hospital and told them to come and get him. I was probably naive enough to expect a couple of guys in white coats to arrive but, instead, two very large cops appeared and when I opened the door, they were flat against the wall on either side of the door.
Probably very sensible and although he was not violent, he could get very agitated so it made sense. When I told them he had left, they said they knew him and would drive around to find him. I was still a bit perplexed at why cops came but it did make sense. Police are available 24/7, they have cars with radios all over the city so they can get places quickly when they have to and call for extra resources if they need to.
I lived about 10-15 km from the hospital so if they sent someone, they would first have to find a couple of people, get a car and drive over. It was impractical. And that was then when there were fewer mentally ill wandering around because we had more resources. Thanks to deinstitutionalization and mental health budget cuts, fewer beds, few supported housing spaces, we have way more people wandering our streets with untreated mental illness.
That was the point made by retired Mountie, Ryan Chaplin, writing in the Vancouver Sun. He said “If those people had been given the right support in their mental health struggles, or addictions supports, they would likely never make it to police attention. Those supports are at best inadequate in many parts of Canada, if not nonexistent. Thus, it falls to the catch-all police.”
Not only do we have insufficient resources to treat people with a disease which in itself is shameful but it is near impossible to get service for someone who is homeless with untreated mental illness. Just look at what the Bryenton family had to go through to get their son off the streets of Toronto where he might have frozen to death this coming winter.
Andrew’s mom, Marlene, went to court six times to get a form 2 so the police could take him to hospital. Three times, the hospitals spit him back out onto the streets until the fourth one kept him and treated him. Keeping Andrew safe and keeping his mom in Charlottetown informed of his whereabouts took hundreds of kind strangers in Toronto who let her know, gave him food, drinks, clothing and money. Thanks to a petition and the threat of a demonstration at the PEI legislature, Andrew is being medically transferred back to PEI. As his mother said at the end “No parent should have to endure this torture test. Many will die if the system is not improved.” (search for Bryenton on https://dawsonross.wordpress.com/)
Multiply that by the thousands of untreated mentally ill living on the streets all over Canada. It is despicable and not consistent with the actions of a so called civilized country. But, let’s get back to the role of the police.
Unfortunately, there have been times when the police have messed up and innocent people have died. It should not have happened, but it has. The one case in Toronto that those who complain about the police cite is the death of Regis Korchinski-Paquet. Her death was a total tragedy but the police acted with remarkable restraint as I pointed out in an earlier blog. This was not even a mental health call and the police did not push her off a balcony.
Over the years, I’ve had occasion to interact with police over mental illness calls and I’ve met and sat on panels with cops who are involved in this work. Each and every time, they act with tremendous professionalism. If it is believed that there is more violence when police are involved but we need statistics to demonstrate that. There aren’t many but the issue is simply the old man bites dog story well known to journalists. No one reports on the times a dog bites a man because it is not unusual but they will when a man bites a dog. There are countless interactions between police and those with mental illness that end well but all we ever read about are those times when they do not.
A couple of studies reported that fewer than 1% of contacts with police result in the use of force although people do state they have experienced some level of force like being pushed, punched, having a baton used or conducted energy weapon deployed in the process. Those incidents may or may not be appropriate but there are few deaths.
There are good reasons that the police are involved and should be along with some impressive statistics on what they do.
Legislation allows police to apprehend someone and to take them to the nearest psychiatric facility. Nurses and social workers do not have this power granted to them. Police also have the legal authority to “apprehend a person with a mental illness (PMI) who are under a warrant or other authorization ordering them to be apprehended and transported for assessment, examination, and (or) treatment”. No one else has that authority.
As that same article states “Under public safety, we identify three ways in which police interact with PMI: (i) conducting apprehensions under provincial and territorial mental health legislation; (ii) investigating reports of PMI who have been reported missing from home, shelters, or from hospitals or in-patient facilities; and (iii) conducting wellness checks, including responding to reports of individuals who are at risk of suicide.”
Evidence shows that calling the police is initiated by health care providers (29%); family (28%); strangers nearby (27%) or the mentally ill person themselves (16%).
The potential for violence is rarely mentioned but it is a big reason why the police need to be involved. A pilot program in Toronto that hopes to provide an alternative to police stresses how those with mental illness are less violent than the general population and that is likely true if they are treated but not if they are untreated. People with untreated psychosis can be very violent and even kill those they love when sane. For that very reason, cops come with backup to these calls and have the ability to call for even more backup if needed.
Non-police medical professionals can precipitate violence as well as I wrote about a few years ago. My friend Douglas went to the hospital because he was very depressed but then decided he wanted to leave. Staff would not let him and he got into an altercation with a social worker and a nurse so they called the police. Violence erupted, Douglas was subdued, punched and tasered and then charged with a slew of criminal charges.
When the case finally got to court, the judge was appalled, said he did not believe the testimony of the hospital staff or the cops and tossed the charges out. You can read the full details here and here. After his few years of hell with criminal charges hanging over him, Douglas sued both the police and the hospital and told me he was very happy with the settlement.
The Toronto pilot program that may be extended city wide will ensure that the peer workers who respond to a call will look like the caller, share similar cultural backgrounds, speak the same language and be people “who understand the unique traditions, practices, and world views of their own community’s culture”. See Page P5-6.
How do we do that? With all due respect to the work that went into this project, it sounds like a Monty Python skit:
Dispatcher: OK you need help but what colour are you, what is you native language, what pronoun do you go by, religion? Great, let me try to find someone.
Toronto is a multi-cultural city (as is much of Canada) so if you call the cops, you might get a male or a female, a Black, an Asian, a white person, a South Asian, what ever. How do you staff for what the report suggests is needed and how long would it take.
From the report they published, it seems that calls will go to the 911 operator who will decide if police should be dispatched or if the call should go to the civilian 3 digit number. It is hoped that there will be enough teams available 24/7 to have a rapid response and cars will have a radio network tied into the emergency dispatch system. The full report for this proposed service can be found here and I have tried to be as objective as possible but, I am skeptical. Hamilton, where I live, has had a civilian crisis team for a number of years and I don’t know anyone who likes it. Often, they don’t answer the phone but they do return messages if left very quickly. Unfortunately, it usually takes them a few days to respond so people end up calling 911 anyway.
The one thing that twigged in the final report of this civilian proposal was this: “The service should integrate traditional healing practices and social life frameworks of the communities being served” (P 89)
Does this mean that an indigenous person in crisis should be taken to a healing lodge if they want? Or maybe someone will want vitamins or to go to an alternative hospital in Tijuana? .
Me, I call the cops and they are great! In fact, I’ve seen more empathy from the police than I’ve seen from many mental health professionals.