Nearly six years ago, registered nurse Conny Stefan was on duty with a Toronto police officer as part of the Mobile Crisis Intervention Team (MCIT) in 14 Division when they received a frantic call from a mother seeking help for her troubled daughter.
With a delusion that she had worms and bugs crawling through her brain, the girl had previously tried to surgically remove them. Now, the mother feared she was going to try again.
“When we arrived there, the officer went into the bedroom and removed scalpels and knives which were close to the young girl, who was sleeping at the time,” recalled Stefan. “When I was ushered into the room, a computer was on showing how to perform brain surgery. Who knows what would have happened if we were not called to the scene?”
MCITs respond to calls involving people in mental health crises, including thoughts of suicide or self-harm threats, distorted or psychotic thinking, anxiety, overwhelming depression and temporary breakdowns.
The officer and the nurse will assess an individual's specific needs, provide intervention and support at the scene, de-escalate the situation and ensure the person is connected to appropriate services.
The MCIT provides a secondary response to 9-1-1 calls involving people experiencing a psychiatric or emotional crisis that requires intervention. The MCIT program operates in 14 of the Service’s 17 Divisions. In 11 and 14 Divisions, police are teamed up with St. Joseph’s Health Centre; in 51 and 52 Divisions with St. Michael’s Hospital; in 41, 42 and 43 Divisions with The Scarborough Hospital; in 12, 13 and 31 Divisions with Humber River Regional Hospital; in 54 and 55 Divisions with Toronto East General Hospital and in 32 and 33 Divisions with North York General Hospital.
What we have learned over the past year and a half confirms that the MCITs are a very important component of a comprehensive crisis response system
At a press conference at police headquarters on May 5, Deputy Chief Mike Federico – who worked closely with hospital representatives to get the initiative off the ground -- announced the program will be expanded this year to cover all 17 police Divisions.
“Working with the existing hospital partners, we expect that all areas of the city will be covered by MCITs," he said.
The first mobile crisis unit was formed 14 years ago as a pilot project with St. Michael’s Hospital. The program received a passing grade following an 18-month evaluation led by Dr. Vicky Stergiopoulos, the Psychiatrist-In-Chief at St. Michael’s Hospital.
“We worked with the MCIT steering committee to try to understand how the MCITs work in addressing the needs of people in crisis and also to look at what areas can be improved,” she said. “What we have learned over the past year and a half confirms that the MCITs are a very important component of a comprehensive crisis response system. The MCIT has the potential to provide much-needed and very appropriate interventions in the community and avoid arrests, criminalization and unnecessary use of hospital resources.
“…We have also heard that the teams and their leadership are very committed to organizing programming improvement through standardization and in developing practices where the teams learn from each other how best to serve the population, developing best practices in the process. In the case of the consumers, they really value what the teams offer in terms of providing them with an avenue for de-escalation by listening respectfully, by providing healing relationships, by creating an environment of safety and by providing them with empowerment and choice in how to take control of other crises.”
Toronto East General Hospital President and CEO Rob Devitt said the MCIT collaboration is a key part of the mental health service system.
“We have done something that I think is a little unusual in the health care space by having research at the table as we plan expansion and development,” he noted. “That way, decisions could be made based on evidence and not just on intuition and opinion. I am really proud of the collaboration that has gone into the creation of a city-wide approach to MCITs.”
Toronto East joined the program a year ago.
“We are already seeing a positive impact as a result of an MCIT and better care for people in moments of emotional crisis,” Devitt added. “We have served over 500 people through the work of our team. I think that’s tremendous and, as we now expand this across the rest of Toronto, all our residents will be able to get this value.”
St. Joseph’s Health Centre was the second medical facility to join the program in 2006. Stefan, a full-time nurse with the program, estimates the team serves between 30-50 clients weekly.
“We are helping people in crisis who are out in the community and really don’t know sometimes what’s available to them,” she said, of connecting people with resources they can turn to after MCITs leave.
Polly Gove, who works part-time with the St. Joe’s team since its inception, said the teams reach out beyond hospital walls to some of the most vulnerable. “Our area covers the Parkdale community, where we see people with chronic mental health conditions. For many of them, the interaction with us is the first time that they have been exposed to a mental health professional.”
The team works from 1 p.m. to 11 p.m. daily.