Ex-chief: Cops can’t replace mental health workers
Sen. Vern White says communities would be safer with better services
Police officers can be trained to be better at handling mental health calls, but the way to make communities safer is spend more money on mental health services, not more cops, says Sen. Vern White, a former Ottawa police chief.
“We can train a police officer that if they get into a certain situation you don’t raise your voice. You can train them to recognize (mental illness), but to suggest that you can train them to be a mental health worker is naïve,” White said. “And I think it’s disrespectful for mental health workers.”
How Ottawa police deal with mental health calls has come under scrutiny with the fatal shooting of a mentally ill Indigenous man, Greg Ritchie, at Elmvale Acres Mall on Jan. 31, and the ongoing manslaughter trial of Const. Daniel Montsion in the July 2016 death of Abdirahman Abdi.
Ritchie was shot in a confrontation with police outside the mall, where he had gone to pick up his medication. Ontario’s Special Investigations Unit has said Ritchie was carrying a weapon at the time, although few other details have been released. Abdi died of a heart attack after he was tackled and punched by police responding to a call that he had sexually assaulted patrons at a nearby coffee shop. His family said that Abdi, too, suffered from an unspecified mental illness.
The Justice for Abdirahman coalition has demanded that Ottawa police do a better job dealing with those with mental illness.
“The tragic deaths of Abdirahman Abdi and Greg Ritchie are clear indications that something is deeply amiss and must be urgently addressed,” the coalition said in a statement released as Montsion’s manslaughter trial began. “The OPS, in response to our efforts, has proceeded at a snail’s pace.
Trainings for police officers for mental health and racial equity remain at worst non-existent and at best grossly insufficient.”
Some Canadian police services say that one in five calls for service involves a mental health issue, a problem White says began in the 1990s when the province closed its residential psychiatric hospitals in favour of delivering services in the community. There were legitimate problems with those institutions that needed to be fixed, he said, but provincial governments didn’t follow up with providing adequate services in the community.
“It’s not just whether the resources are available. It’s whether the clients were engaging,” White said. “You have someone with schizophrenia who does not stay on their meds, does not see a social worker and pretty quickly you have a potentially tragic event happening.”
Ottawa police have a six-officer mental health unit that works alongside The Ottawa Hospital’s mobile crisis team to try to keep ahead of the problem, following up with people with mental illness who’ve had encounters with police and responding, when possible, to 911 calls involving mental illness. But with such a small unit, it’s impossible for the MHU officers to respond to every call. And it’s impossible for the officers to follow up on every case.
“They probably should have had 25 officers and 25 mental health workers because they were not coming close to keeping up,” White said.
“Whether police like it or not — and whether certain health professionals like it or not — police are part of mental health delivery,” said Dr. Peter Boyles, a psychiatrist with The Ottawa Hospital emergency department who has worked with the police mental health unit. He has also helped to train officers how to recognize and deal with mental illness, which is part of every officer’s annual useof-force refresher training.
When the police MHU has an encounter with someone who is mentally ill, an electronic “flag” is put in the system that will alert officers when they are called to a particular address or to deal with a particular person that it could be a mental health call. The information is limited to preserve patient confidentiality, but it’s enough to put officers on alert.
“They don’t need to know their diagnosis, they don’t need to know they’ve been on meds — but just knowing they’ve been involved with the mental health unit can be enough,” Boyles said. “And the moment they know this, my feeling is that police will do a great job.” But is it good enough? “Police agree that mental health is an important area, but in this day of budgetary constraints, they’re left with hard decisions to make,” Boyles said. “If you give more money to mental health, then you have less money for guns and gangs and then you have neighbourhoods furious. They can’t win.”
Compounding the problem is the lack of services for the mentally ill, Boyles said, echoing White’s complaint.
“Our hospital is always over capacity with mental health. We have people housed in the emergency department waiting until they get a bed. I can’t remember the last time we had open beds. It puts pressure to discharge people maybe a little quicker than you used to ... and if people aren’t fully stable, they’re going to be more likely to have an interaction with police. It’s a domino effect.”
In June 2016, just a month before Abdi’s death, Ontario’s ombudsman delivered are report on the fatal shooting of Sammy Yatim, a mentally ill man who was wielding a knife on a Toronto streetcar in the summer of 2013. Yatim was alone on the streetcar, surrounded by dozens of Toronto officers when he was shot eight times by Toronto Const. James Forcillo.
“When you look at all the resources that arrived at the streetcar, unless I missed it, nobody there was a mental health worker,” said White, who was a special adviser on the ombudsman’s report.
The report, A Matter of Life and Death, made 22 recommendations for Ontario police, primarily aimed better training for officers on how to de-escalate encounters with the mentally ill. For example, the standard police challenge — “Police! Don’t move!” — doesn’t work well for people in a mental health crisis, who can become more agitated when treated aggressively.
“If you lower your voice, they’ll lower their voice,” said White. “But if you say, ‘Cross this line, here’s what’s going to happen’ there’s a really good chance they’ll cross that line. So instead, focus on what they can do themselves to de-escalate, rather than what you will do if they don’t.”
All Ontario police officers receive basic training at the Ontario Police College on de-escalation as well as how to recognize serious mental illness and strategies to use when dealing with someone who is mentally ill. Ottawa officers get additional in-house training from the mental health unit.
When de-escalation works, the interactions can be magic. In one encounter Boyles watched while on patrol with the mental health unit, a man was clearly in crisis, screaming and swearing and brandishing something in his hand.
“One officer asked him, ‘Are you thirsty?’” Boyles recalled. “He said yes. So the officer went into a store nearby, got a can of pop and gave it to him. He calmed right down. It was a beautiful display of thinking on your feet about how to de-escalate.”
The problem, of course, is that police often don’t have that advanced knowledge, arriving at a potentially violent situations with just seconds to react.
“Essentially the poor police arrive and have to come up with a full treatment plan without knowing what’s going on. They don’t have the luxury at time,” Boyles said. “We at the hospital may have an old chart we can review: What calms them down? What do they like to talk about? What medications are they on? Police have very little of that.”
When de-escalation doesn’t work — or isn’t attempted — tragedy is often the result. But it’s a myth that the mentally ill are more dangerous than anyone else, Boyles said.
“It’s that when they do something it’s usually quite bad and it makes the media,” he said, citing the horrifying beheading of a passenger on a Greyhound bus in Manitoba by a mentally ill man in 2008 as the most blatant example of a mental health crime that received worldwide attention.
“Schizophrenia affects one per cent of the population and you don’t have hundreds of thousands of those events. But when they do happen, you hear about it. No one reports on the good interactions.”