A 45-year-old man sends pictures via Facebook of him cutting himself. The Mobile Crisis Rapid Response Team (MCRRT) of the Hamilton Police Service (HPS) responds to assess the male, who has a substance abuse problem. Based on the mental status exam, he is not apprehended. Uniformed patrol would have taken him to hospital.
The subject of a missing person search during a cold-weather warning, a 13-year-old has hidden in a backyard doghouse wearing only a light jacket. MCRRT attends to the scene and is able to talk him out and back indoors.
A personal support worker calls 911 to report that a female client wants to jump off her balcony. MCRRT responds, assesses and the client is determined not a candidate for apprehension. Uniformed patrol would have taken her to hospital.
These three incidents are only too common to police, right across the country. In Hamilton, Ont., mental health apprehensions were taking place at a rate of about 2,000 per year. Translate that into resources used. But, maybe more importantly, translate that into meeting the needs of the person in crisis. Not unlike most police services, a disproportionate amount of resources were being used, while the needs of persons in crisis were not being met.
Faced with this on a daily basis, the HPS developed its MCRRT — the first of its kind in Canada — to provide direct, rapid support of persons in crisis, by pairing a uniformed officer with a mental health professional to respond to these individuals.
The goal was to reduce the number of those suffering from a mental health crisis from being taken to St. Joseph's Healthcare Hamilton's emergency psychiatric services by police officers and to divert those in crisis by connecting them with mental health service providers or partners.
How it works
The MCRRT proof-of-concept strategy consists of a dedicated mental health professional (MHP) assigned to divisional patrol working Monday to Friday from 10:00 a.m. to 10:00 p.m. The downtown patrol area was selected as it had the most number of mental health apprehensions.
The MHP is partnered directly with a uniformed police officer and is responsible for and dispatched to all in-progress 911 calls that involve a reported person in crisis.
The MCRRT strategy has already seen positive results with a reduction in the amount of time uniformed patrol officers are standing by in emergency rooms awaiting assessments from doctors. Individuals in crisis are receiving an immediate frontline response and receiving the care they need on scene in partnership with the MHP.
The initial target was to assess 250 clients in one year. Soon this was revised to 500, as the team was set to quickly surpass the original target number.
Results
The MCRRT was mobile for 291 shifts and responded to 842 individuals in crisis between Nov. 25, 2013 and Jan. 31, 2015. Of the 842 individuals seen, 226 were apprehended by the MCRRT under section 17 of the Ontario Mental Health Act for assessment at hospital. Of those, 42 were youth not included in these statistics.
Of the remaining 574 individuals, 500 were immediately connected to other available services and 60 were apprehended on the basis of the Mental Health Act and required no further assistance.
Of the apprehensions that do take place, more of the people who are apprehended go right into medical or psychiatric care instead of coming into police custody.
With MCCRT, apprehensions have fallen, diverting more than 400 from hospital and people in crisis are getting the level of care and assistance that is necessary and required.
The outcomes are very impressive and the HPS has been able to solidify this project even further. Since April, the program has expanded its daily hours of operation from 10:00 a.m. to 1:00 a.m., seven days a week — across the entire city.
In law enforcement, we know that mental illness is not criminal behaviour. But with the addition of the MCRRT, people in crisis are getting the right care at the right time.