Targeting mental illness

When cadets arrive at the RCMP Training Academy, they know they joined to serve and to protect Canadians. But once they become officers, they learn some calls are tougher to handle than others.

That's especially true for people in mental distress.

"When we signed up for this job, it was to help people where we can. And when we can't, it's very frustrating," says Cst. Patrick McPhee, who works in Grande Prairie, Alta.

McPhee, a nine-year RCMP veteran, was referring to the challenges he faced as a general duty officer responding to some calls where it became clear that the person was suffering from a mental-health crisis, and he didn't feel fully equipped to deal with the situation.

Contact between police and people with mental health issues can be challenging — as officers may not be aware of an individual's medical condition. Also, that person may not be receptive to direct commands from police.

According to the Canadian Mental Health Association, a shift from institutionalized to community-based care has also resulted in more persons with mental illness in the community and more contact with police.

Challenges spark innovation

In Grande Prairie, a Police and Crisis Team (PACT) — consisting of an officer and a psychiatric nurse — was created in 2009 to support individuals experiencing a mental-health crisis in the community.

"Our mandate is to divert people in crisis," says team member McPhee, who notes both members spend a significant amount of time engaging with community partners to proactively address the needs of high-risk clients. "We want to help direct those people suffering from mental illness and addictions into the proper channels so they can get help."

In 2017, the team responded to 553 calls. A study by the Grande Prairie Regional College found that in 2016 and 2017, 66 per cent of the team's calls were de-escalated on scene. A second team was established in 2016.

Mcphee says once people are referred to the psychiatric nurse, the root causes of their problems or criminality can often be identified more accurately.

"There's often an underlying reason for why we're called," says McPhee. "So we need to find it. They could be on some medications and it needs to be adjusted. Maybe if we can change their medication, we can alter their behaviour."

There's also an economic payoff to the team's work because the same college study reported that the PACT program produces a value of $3.70 to the community for every $1 invested.

Helping those in need

RCMP efforts to understand and help people struggling with mental illness extend across the country, and the benefits are two-fold: they provide assistance to those in need more quickly and they free up resources so officers can deal with other policing issues.

Cst. Valerie Conroy is the RCMP's social chronic program co-ordinator in Chilliwack, B.C. Although all RCMP members across the country are taught about crisis de-escalation and mental health incidents, Conroy has received extra training on mental health disorders and assessing people to connect them with more appropriate resources.

Conroy, who has done the job for almost seven years, works regularly with community outreach resources at Fraser Health to conduct risk assessments on clients and develop response plans.

"I try to make a difference by identifying high-risk and high-volume clients and focusing on identifying the resources that can best support those individuals," she says. "There are many avenues to navigate within our health care system and learning that system and developing relationships has proven very beneficial and time saving. It becomes a more efficient process."

Conroy says that experience and knowledge of the various systems has allowed her to become familiar with many clients, to know what their needs are and how to better support them.

She also reviews mental health files referred to her by general duty police officers. Conroy says an officer may recognize a serious concern or a person who has been involved in a high number of police interactions that appear to have a mental-health component.

"If there wasn't a social chronic co-ordinator, general duty members might continually be responding to calls for the same client," she says.

Working with partners

In Surrey, B.C., Cst. Kelly Thompson works with the Police Mental Health Intervention Unit. The team helps people with mental health needs who have come into contact with police and require emergency care.

"We often deal with clients whose perception of reality is altered, whether by their mental state, substance use or in some instances both," she says, adding the unit works with a variety of other organizations. "We have a reliable network with our community partners to advocate for these individuals. We can use the connections we have and help those clients get to the services they need."

For example, the unit is involved in a partnership called Car 67, where a specially trained RCMP officer and a clinical nurse provide on-site emotional and mental-health assessments for people, crisis intervention and referrals to appropriate services.

In 2017, the Car 67 team conducted 652 mental-health crisis assessments, 94 mental-health apprehensions and 822 phone consultations to help and advise front-line officers while they dealt with distressed individuals.

So far in 2018, the Car 67 team has conducted 431 mental-health crisis assessments.

"Our unit deals with high-risk clients and we deal with a high volume of calls," says Thompson, who admits while the job is very rewarding, it can often be dangerous.

"Most clients have had some sort of violent interaction, often when police are involved, and most carry some sort of weapon for protection. I expected to deal with this some of the time but certainly not to the scope I encounter in this line of work."

As a result, Thompson says she's extra vigilant during her encounters with clients — always conducting a pat down and simply asking people if they're carrying any weapons.

In Portage La Prairie, Man., the RCMP are partners in the Hub Model. It's a risk-detection and crime-prevention program that includes community groups, such as school boards, child and family services, mental-health advocates, probations workers, provincial housing staff and others.

The partners meet regularly to discuss individual cases.

Cst. Sean O'Keefe says the model, which is in place in other communities across Canada, identifies people at risk so they don't find themselves in the justice or health-care systems.

"If someone is in imminent harm, information can be shared to de-escalate the risk so we can then get in front of the problem and prevent an emergency," he says.

When it comes to frequent police dealings with distressed individuals, O'Keefe says those calls are placing a growing strain on police resources. He says the hub model can help identify and direct them to the mental-health services they really need.

"Before, officers didn't have the time to sit with a client to figure out what's going on," says O'Keefe. "The (hub model) process helps unmask what's going on so our first responders can go in and know if, for example, a person has mental-health problems."