Toronto Mobile Crisis Intervention Team – Outcome evaluation report

Background

Police are often first responders to mental health crises that take place at home and other community settings. To provide more appropriate mental health crisis support, the City of Toronto Mobile Crisis Intervention Teams (MCITs), comprising a mental health clinician and a police officer trained in crisis intervention, were implemented to act as secondary responders to crises. MCITs are dispatched to situations not involving violence, usually at the request of police officers already on the scene.

The MCIT program currently includes nine teams based out of six hospitals. Each team covers one to three Toronto Police Service (TPS) divisions. Recent improvement and expansion of the MCIT program was informed by an implementation evaluation completed by CRICH in April 2014.

The Toronto Central Local Health Integration Network and MCIT Steering Committee recently engaged researchers at CRICH to complete a mixed-methods outcome evaluation to examine client experiences and outcomes related to crisis interactions with MCIT and Primary Response Unit police teams (PRUs). We also explored MCIT’s role in Toronto’s crisis response system. A summary of the report’s findings are provided below. The final report, including 17 program-specific recommendations, can be downloaded here.

Key Findings

People who have experienced MCIT and PRU crisis responses:

  • Reported more positive experiences when MCIT and PRU were flexible, responsive to their needs and preferences, and offered non-criminalizing, measured, and appropriate responses.
  • Emphasized the value of de-escalation and calming communication, which is possible when more time is invested in an interaction.
  • Preferred having a choice of hospital when transport to hospital was indicated. Current policies encourage MCIT to offer this choice.

The role of MCIT in the broader mental health crisis response system:

  • MCIT is a small but valued component of the broader crisis system.
  • As a component of TPS crisis response, MCITs are valued for the expertise of mental health nurses and the team’s ability to complement the work of existing police services.  However, there are limitations to MCIT’s effectiveness within TPS due to lack of shared understanding  of MCIT’s mandate, limited staffing and hours of operation, and challenges in supervising and supporting MCIT officers.

Outcomes of MCIT interactions (July 2014 to March 2015):

  • MCIT attended 2,774 crisis interactions and completed more than 525 follow-up contacts, compared to 16,226 crisis interactions attended by PRU, between July 2014 and March 2015.
  • MCIT facilitated approximately 1,256 connections to community-based services.
  • 29% of MCIT crisis interactions were with repeat clients.
  • ED wait times were shorter for MCIT, who reported a mean wait time of 56 minutes, compared to 85 minutes for PRU.
  • Though comparable data on PRU interactions were not available, MCIT interactions demonstrate positive outcomes in several other key indicators. Injuries occurred in only 2% of MCIT crisis interactions, and were largely minor and self-inflicted.  Charges were laid in less than 2% of MCIT crisis interactions.
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