
A city such as Hamilton, Ontario, with a population of 560,000, fields an emergency call whose sketchy details suggest it might — just might be — triggered by a mental health crisis.
Who responds to the call?
A primary consideration in the past, and which will most certainly prevail in the future: who at the scene might need to be kept safe?
- Those directly involved in the incident: victims, perpetrators, intervenors.
- Quasi-official people who cannot easily walk away from the crisis — an emergency room nurse, a mall security officer, a bus driver in charge of a load of passengers.
- Casual passers-by who have wandered into the theatre of crisis.
- Emergency responders themselves who may have a specialty role in the incident: e.g. paramedics, firemen, but most particularly the police. These jack-of-all-crisis managers possess the legal authority mediate incidents and if necessary, impose law and order upon the scene. Their mandate is to keep safe not only all the other possible participants in the scene, but also themselves.
Hardly surprising that the first responders to calls that may involve mental health crises are the police, not the least because they are the only ones available to attend the scene.
However, of particular interest to the rough-sleeping homeless and their advocates, poor mental health is often associated with chronic homelessness. When this is the case, police are very likely to be untrained in how best to work with suffering individuals.
One consequence is police imposition of law-and-order authority upon those in a crisis. When mental health is involved, this exercise of authority can itself become threat to the successful resolution of the crisis. Police actions may become part of the problem.
When the police don’t receive expected responses to their imposition of authority, they may themselves feel threatened, escalating the incident to the point where unnecessary force, injuries, and deaths can result. Even without these catastrophic consequences, the outcome may involve dragging mental health sufferers into the legal system with all its attendant costs and miseries with no access to treatment.
One (highly impractical and expensive) solution to this problem is to train police as mental health professionals. A more useful solution, and implemented in Hamilton Ontario as a test program; is pairing a police officer and a mental health professional on emergency calls likely to require the skills of both. Read more about the program’s success in the CBC: Crisis response teams achieve 70% reduction in people taken into custody under Mental Health Act
Here are two other examples of the police and health professionals working together in mobile response teams. Try: Missoula, Montana Is Making Permanent A Mobile Mental Health Response Pilot and Orange County Teams Police Officers, Social Workers In Homelessness Pilot