Build an alternative to calling police
ASANTE HAUGHTON AND RACHEL BROMBERG
Someone you care about is struggling and you don’t know what to do. Perhaps they’ve been hearing distressing voices, or thinking about suicide and they need help. You’ve tried talking to them, offered suggestions, listened. But nothing has worked. It’s getting worse. Your loved one needs more than you can offer. So you call 911. Within minutes, police are at your door. They knock in the loud way only police officers knock. Your adrenalin rushes, a response usually reserved for encounters with danger. You open the door to find two officers. You notice their Kevlar vests, their hands by their belts, unnervingly close to their weapons. They fire off a barrage of questions to confirm the facts they’ve received from dispatch. You’re not sure you’re answering adequately; you’re afraid and you’re distracted by the officers’ authoritative presence, their weapons.
They thank you and conclude the encounter abruptly, signalling with their tone and body language that the conversation is over. They walk past you to your loved one, and your anxiety spikes. Will these officers be able to help? Will your loved one be safe with them? Are these cops some of the “good ones”? History has taught you that the individuals mandated to protect safety don’t always do so.
When they fail, the consequences are traumatic and sometimes deadly.
You wonder why police are the middlemen between people in crisis and psychiatric help. Why are those who fight crime also responsible for intervening in mental health crises? Isn’t there an alternative? There is. Across the world, cities are building civilian teams of mental health experts to respond to people in crisis.
From Stockholm, Sweden’s Mental Health Ambulance to Eugene, Oregon’s CAHOOTS program; from Denver, Colorado’s STAR teams to North Yorkshire’s mental health triage nurses; from the Bay Area’s youth crisis services, to Austin, Texas’s EMCOT teams, to crisis teams under construction in Oakland, Portland, San Francisco, Albuquerque and New York City, cities are recognizing that mental health crisis is a health crisis, not a crime, and should be treated accordingly.
Toronto must do likewise. As the largest, most diverse city in Canada, Toronto must lead the way in a paradigm shift away from forceful, coercive crisis intervention, toward a community-based, anti-oppressive, trauma-informed response that promotes individuals’ dignity, autonomy, self-determination and resilience.
Toronto must create a fourth emergency service, led by mental health clinicians and peer workers from the communities they serve, to respond to mental health crises. This team must be incorporated into municipal services and accessible either through 911 or through an easy-to-recall number like 811. It must be available 24/7, with response times equivalent to police and ambulance response times.
This team will provide a variety of essential services, such as on-the-spot risk assessments, de-escalation and safety planning for clients in crisis; referrals to community resources; transportation to hospitals, shelters, or other community services; and followup to ensure clients remain connected with services. By taking on these important tasks, this team will enable Toronto policing resources to be more effectively directed toward solving crimes, rather than providing social services.
Toronto police respond to approximately 30,000 mental health calls annually. The Toronto Police Service’s mobile crisis intervention teams (MCIT), which pair a mental health nurse with a specially trained police officer, only have the capacity to respond to approximately 25 per cent of these calls. A civilian-led team could respond to the 75 per cent lowest-acuity mental health calls involving no significant safety risk, thereby freeing Toronto Police MCITs to respond to the 25 per cent highest-risk calls and distributing resources more efficiently to match the needs of individuals in crisis, while also reducing costs.
Civilian-led teams are much less expensive than police-partnered teams; Eugene’s CAHOOTS program saves the city approximately $15 million (U.S.) per year. Toronto’s cost savings would be even greater.
A crisis team that saves money, fights mental health stigma, frees up police resources and respects the dignity of individuals in crisis will greatly benefit Toronto. The moment to act is now.