Enhancing Mental Health Response

By Kevin Masterman, Toronto Police Service Published: 10:57 a.m. September 4, 2020

The police and hospital leadership of the Mobile Crisis Intervention Team (MCIT) program are hoping to expand their mental health crisis services as part of a broader spectrum approach to serving those with mental illnesses.

A group of four people in front of an MCIT van
MCIT Constable Mike Scott and Nurse Jennifer Derbyshire with Michael Garron Hospital President & CEO Sarah Downey and Deputy Chief Peter Yuen

Deputy Chief Peter Yuen and Michael Garron Hospital CEO and President Sarah Downey met recently with members of the 32/33 Division MCIT, Const. Mike Scott and North York General Hospital Nurse Jennifer Derbyshire, to talk about their work.

Deputy Yuen says the Service plans to have more MCITs on the street for longer hours, thanks to support from the community, the Police Command, Hospital leadership and the Toronto Police Services Board.

“We get over 32,000 documented calls for persons in crisis, we certainly need to have more teams out there and coverage in terms of hours,” says Yuen, noting that the MCITs are only one facet in an evolving conversation about serving those with mental illnesses. “There are a lot of good conversations out there that mental health response should not be a police response and I totally agree with that. The MCIT steering committee is working with stakeholders and other levels of government so some of these calls can be triaged so they don’t need a police response. It could be nurses or crisis workers and we’re open to all of that.”

MCITs are dispatched to calls to support primary response officers as well as first responders to calls for people in a crisis. Registered Nurses from Toronto hospitals are paired with police officers to counsel a person in crisis and triage whether they can stay at home and seek community supports or visit a hospital. 

Downey, who co-chairs the MCIT Steering Committee along with Yuen, says the partnership with police is one small part of a broad response to mental healthcare and is encouraged by the ongoing conversations.

“From a hospital perspective, MCITs ensures a smooth transition to care, just as we would when an ambulance and paramedics bring a patient into emergency department. There is a shared understanding,” says Downey, as she embarked on a ride-along with Derbyshire and Scott.

“At a community level there are other options for people, a lot of clients never require the service of a hospital. It’s been so wonderful for these two partners, police and hospitals, to come together to treat people with compassion and understanding and respect in their mental health assessments, triaging, referring to appropriate services when a call has been made to 9-1-1.”

She says that the program provides a great service to a community in need of support.

“It’s a part of a comprehensive response to mental illness, people sick enough to call 9-1-1 or require crisis intervention and it’s a specialty service. I think the larger system question about how to serve all the mental illness communities in what is a very fractured system of care for people is a much larger conversation we need to have in our society and most importantly with the clients,” says Downey.

She supports the expansion to a 24/7 MCIT response.

Nurses and police officers bring our professional backgrounds together and meet somewhere in the middle to negotiate the best response or intervention for the patient in crisis

“I think it has potential to expand because we’ve done the evaluations to know that it is an effective service,” she says.

She notes that hospitals and police have filled in gaps in the healthcare system because of the 24/7 nature of their work.

“The Toronto Police Service is engaged and open to exploring models that don’t require police,” says Downey. 

Yuen says working alongside healthcare experts has been a great learning experience and the program continues to evolve, noting that he plans to change officers’ uniforms so people in crisis are less intimidated and enhance training and accountability for officers. 

“We are always looking to improve this service, to improve our training, our accountability so we can get to a better state for the people we serve.” 

Scott and Derbyshire were happy to share their work with the leadership of their organizations.

Derbyshire says police officers and nurses complement when working in MCITs because of the wide breadth of experience and expertise they bring to supporting someone in a mental health crisis.

“Nurses and police officers bring our professional backgrounds together and  meet somewhere in the middle to negotiate the best response or intervention for the patient in crisis,” she says.

Scott says having a nurse as a partner enhances the response greatly.

“I come away a lot of the times knowing we helped somebody because of the work that Jennifer has done,” says the 17-year policing veteran, noting that many times a person in crisis gets a community referral for support instead of a hospital visit. 

Both are encouraged to hear a broader conversation about mental health in the public realm.

“I think it’s time that these issues have come to the fore – there are so many calls that are mental health and addiction related that police are trying to manage,” Derbyshire says.

Primary response officers welcome the MCITs and nurses specifically, Scott says.

“There is so much positive feedback,” he says, noting that the teams help keep down unnecessary visits to hospital emergency rooms, reduce the number of calls for service to police and deliver better services to people in crisis.

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