New Westminster wants to help change the way communities respond to mental health issues by shifting away from a criminal response to a health model.
City council has approved the city’s participation in the Peer Assisted Crisis Team (PACT) pilot project, which is managed by the Canadian Mental Health Association and includes the City of Victoria, the City of North Vancouver and the District of North Vancouver. Council also approved $65,000 toward the implementation of the first phase of the pilot project in New Westminster.
“We are really trying to add to the existing response,” said Jonny Morris, CEO of the Canadian Mental Health Association, B.C. division. “We are trying to expand the continuum of care.”
Morris said the association has been calling for reform in the way that people living with a mental illness or a substance use problem connect with the justice system, whether that’s with police, corrections or others. To do that, he said, a “paradigm shift” is required.
According to a staff report, the New Westminster Police Department responds to an average of four mental health-related calls each day. The report stated the New Westminster fire department is also responding to an increasing number of calls related to overdose events and other health-related concerns and the city’s bylaw enforcement officers have reported a 93% increase in calls related to homelessness and poverty in the past year.
Morris said there are cases involving safety risks where a police response will still be needed. But he explained there are cases where the crisis are driven by issues related to shelter/housing, food security, family conflict, alcohol/substances, depression/anxiety or loss and they could be better served by a community-based response.
Currently, people experiencing a crisis are transported by police to police jail cells or the emergency department, neither of which is well-equipped to address the complex issues leading to the crisis, Morris said.
“Police are responding to many, many crises,” he said. “The coroners service actually identified the police as a default response in a panel report that was released a number of years ago.”
A new model
PACT is proposing a mobile crisis team that’s staffed by mental health specialists, such asa clinical care counsellor, an occupational health therapist, a psychologist or a registered social worker. They would be paired with trained peer crisis responders, who are people with lived experience with mental health or a substance issues and systems.
“We are hoping to expand the range of mental health supports available in your city,” Morris recently told council. “A big part of this working is working with partners like the police, like first responders, like Fraser Health Authority and community-based agencies, and perhaps most importantly, people with lived experience, people who have had those experiences who can help co-design a service that is going to be as responsive as possible.”
According to the staff report, the service will have a new dedicated number that people can call for mental health and substance-use crisis events. The program would operate 24/7 every day of the year.
A staff report noted CAHOOTS, which has been operating in Eugene, Oregonsince 1989, provides teams of civilian crisis responders to health and social service-related 911 calls. The teams are trained to provide a wide range of care, such as wellness checks, mental health crisis interventions, substance use-related de-escalation, family conflict mediation and basic medical treatment.
“In 2019, the teams responded to more than 24,000 calls or approximately one-fifth of total 911 dispatches, and only called for police backup 1% of the time,” said the staff report. “The model has been cost-effective. The Eugene Police Department estimates that the cost of dispatching police is $800 per call. CAHOOTS reduces the need for police response, saving an estimated $8.5 million each year.”
The number of police contacts, apprehensions under the Mental Health Act, arrests, repeated offense and incarcerations is expected to decrease when the service is operating, said the staff report.
Mayor Jonathan Cote believes the model being piloted in New Westminster has a lot of promise and makes sense on many different levels.
“Today is really the starting point to launch us down that journey,” he said. “I am certainly really looking forward to it and excited about the opportunity. I think we are going to be far better served as a community because of this work.”
The report to council said the project will begin in November with the formation of a community planning table (including NWPD, the city, Fraser Health, First Nations representatives, community agencies, and people with lived and living experience of mental illness, substance use and interactions with police). In early 2022, CMHA BC will engage with key stakeholders, including frontline responders, community services providers, urban Indigenous communities and people with lived and living experience and their families, regarding a civilian-led mobile response team.
“We are really looking at engagement,” Morris said. “We know that plopping a team into a community without engaging is a recipe for disaster.”
That engagement work will help guide the development of a civilian-led mobile crisis response team for the city’s consideration next summer.
Once approved by the city, CHMA BC will facilitate a request for proposals to determine an appropriate community agency to lead the pilot project in New West.
It’s anticipated PACT will begin in the fall of 2022.
Morris said there’s a need to balance the urgency of launching the program with the need to do it right.
Cote agreed it takes time to get these types of things done right.
“I’d love to snap my fingers and have this model in place tomorrow or next week helping our community, but we recognize that this type of work does require a process,” he said. “I think we have known for many years that our current system for dealing with social issues, dealing with addiction, dealing with homelessness, dealing with mental health issues, unfortunately, is not serving the community and is not serving vulnerable members of our community.”
Police on board
Cote, who chairs the New Westminster police board, said the NWPD has acknowledged that it’s taken on duties and had to respond to calls where policing isn’t the best form of community response.
“Even though this conversation has been circulating for a number of years, it’s been hard for anyone to really kind of say, ‘OK, what is the path forward?’because it involves different levels of government, different jurisdictions, in putting those pieces together,” he said. “I think that is what is so exciting about this is we are now starting to build that table and put those pieces together.”
Chief Const. Dave Jansen said he is “super excited” about the pilot project and the NWPDfully supports the initiative. He noted there are many times when people have no option but to call the police if they have a family member is in crisis, even though they may not be the best response.
In February, city council approved a motion in support of the development of a new model to address crisis health management, with a goal of creating a community-based pilot project. A police reform working group also prepared a submission to the Special Committee on Reforming the Police Act.
“It is clearly stated that no amount of change to the Police Act and the Mental Health Act alone can replace the need for greater structural change to reduce the criminalization of poverty, and the deficits in coordinated, regionwide approaches to housing, health care and community services,” said Denise Tambellini, the city’s intergovernmental and community relations manager. “The report concluded that bold steps are needed to lift up the most vulnerable, especially those experiencing mental health crisis, poverty and homelessness.”
In its submission to the province, the city is calling for new “non-carceral alternatives to respond to behaviors, situations and crimes caused by poverty and desperation – including homelessness, addition and mental health emergencies.”
While that work has been taking place locally by the task force in New West, Tambellini said the Canadian Mental Health Association has been advancing a new model of community-led, mobile crisis response based on best practice. She said the pilot projects with Victoria, North Vancouver and New Westminster provide an “an exciting opportunity” to create a new direction in crisis response that shifts from a criminal model to a health model of community-based delivery.