New York City and California are struggling to get mental health interventionist programs for the homeless off the ground. It hasn’t been easy going for either initiative. On both sides of the country, the concept has been built around a process that will shift people on the streets to some form of institutional care1.
Ideas are still evolving about who will identify these chronically homeless people who appear to be a danger to themselves or who, by their actions represent a threat to the mental or physical health of companions, care workers and the general public.
What does self-endangerment look like? It might be an inability to serve their own basic needs, like dressing themselves or feeding themselves. It might involve drugs to the point of overdose. It might involve rage that targets themselves. As far as endangering others is concerned, those possibilities are a driving force towards at least temporary removal from the streets, but in a health care setting rather than incarceration.
Who is to evaluate these issues and take action?
The issue of anti-social behaviour has a long-standing universal public response. That’s when police traditionally get involved. To get these new mental health interventions off the ground, some form of psych training for police is under serious consideration. Police officers might then become, on top of any already difficult job, the ‘front line’ workers who would administer some form of preliminary psych evaluation, sending/escorting onwards those who don’t pass a risk evaluation to some form of more rigorous assessment and/or institutional care.
There are trust and fear issues that become involved when police interact with homeless people. These suggest there is value in considering other alternatives for gaining trust, performing a meaningful psych evaluation, and arranging for further care for the homeless as needed.
One of those alternatives might well look like an intervention pilot initiated in the City of Montréal, Quebec more than a year ago. The pilot is based establishing more trusting relationships, with the possibility of guiding some, if not all, homeless towards the help they need.
Watch a video on Montreal’s program, so far rated as a success and currently in the throes of expansion. Read/Watch at CTVNews: Montreal’s ‘EMMIS squad’ replaces police with social workers in homeless interventions
For examples of crisis outreach teams in other cities, try: Updated: Crisis Response To Mental Illness And Homelessness Without The Police
For those, with French language curiosity: ÉMMIS=Équipe Mobile de Médiation en Intervention Sociale
