Mobile units could reduce ER visits: Health P.E.I.
Questions remain about staffing challenges, involvement of law enforcement
The province’s planned mobile mental health units could reduce the frequency of emergency room visits by Islanders in crisis.
But staff shortages are also delaying the implementation of these units. And questions are being raised about the involvement of law enforcement personnel in the delivery of mental health services.
Officials from Health P.E.I. spoke before the standing committee on health and social development Wednesday about plans to implement the mobile units. The program would involve both a mental health phone line and a pairing of mental health clinicians and plainclothes law enforcement personnel, who could visit homes of individuals in crisis.
P.E.I.’s model will involve three units – one for each county. Staff will respond as needed to mental health crises in vans that do not bear the intimidating symbols or flashing lights of police cruisers.
As of 2018, there were over 1,900 mental health crisis calls to P.E.I. RCMP. Local police often escort individuals to emergency departments.
"Right now, we're seeing about 4,000 emergency department visits per year from mental health and addictions, and that's very cost-intensive. It's also clinically not the most effective place for some of these folks to be getting care," Amanda Hudson, director of mental health and addictions research, told the standing committee.
"It addresses a gap along our continuum of services," she said, referring to the mobile mental health units.
Most other provinces in Canada have implemented similar programs.
In New Brunswick 90 per cent of individuals who had contact with mobile mental health units did not require hospital admission. In the Huron Perth region of Ontario, which has a similar population to P.E.I., a similar service receives about 8,300 calls per year; 97 per cent do not require hospital admission.
However, it remains unclear when the service will be fully operational in P.E.I. Lorna Hutt, manager of community mental health and addictions (west), said the full model would involve staffing a central phone line 24 hours a day, seven days a week. However, she said it would not be full staffed before the end of March.
“Due to staffing challenges, we are looking at rolling out a phased approach to our mobile crisis response service,” Hutt said.
The province intends to staff the mobile units from noon until midnight, seven days a week.
It is unclear when there will be enough staff for the mobile mental health teams to scale up to operate during these hours.
Green MLA Trish Altass raised questions about the involvement of law enforcement personnel within the mental health units.
A Health P.E.I.-commissioned steering committee recommended against including plainclothes police officers in responding to mental health calls.
"Why was it decided to go against the recommendations of the steering committee in having police be a core component of the teams in every case?" Altass asked.
"I think the reason for that is we wanted to prioritize safety," Hudson said.
Hudson said there are many models of mobile mental health teams employed across Canada.
She said the model recommended by the steering committee would still have involved uniformed police, in patrol cars, responding to calls requested by mental health staff.
“In those cases, it would have been more of an intrusive response than if we had dedicated officers in the teams responding in the mobile crisis vehicles, which are very discreet and less intrusive," Hudson said.
Liberal MLA Heath MacDonald asked about the limited hours for the units.
"We have heard, 'why are we not doing this 24-7?' Is there a specific reason for that we're not doing it 24-7?" Macdonald asked.
"The full model of anticipated 12 hours a day, seven days a week was based on call volume,” Hutt said in response.
“We're looking at those hours being our primary focus."