What happens when police and mental health workers respond together to mental health crises?

Shapiro GK, Cusi A, Kirst M, O’Campo P, Nakhost A, Stergiopoulos V. Co-responding Police-Mental Health Programs: A Review. Adm Policy Ment Health. 2014 Sep 20. [Epub ahead of print]

Background: A lack of mental health resources in the community means that police officers in jurisdictions including in Canada and the US are often called to respond to mental health emergencies. In Toronto, Mobile Crisis Intervention Teams (MCITs) follow a ‘co-response’ model, pairing a police officer with a mental health nurse. There are currently six MCITs in Toronto, and they are available seven days a week, and, depending on the team, as early as six am and as late as 11 pm. Currently, MCITs in Toronto are not first responders, and are only called in if responding officers decide there is no threat to safety.

What we did: We looked at academic literature and reports related to jurisdictions using the ‘co-response’ model to respond to mental health crises in the community. We found literature related to jurisdictions in Canada, the US and Australia.

What we found: There is mixed evidence related to the ability of current co-response models to meet goals like: reducing use of force; linking people to community services; avoiding criminalization; and, improving officer perceptions of people dealing with mental health problems. The literature points to several components with the potential to assist co-response programs in meeting these goals:

  • Strong collaboration between police and health partners, including during program development;
  • Appropriate mental health training for police officers;
  • Strong organizational buy-in from all partners;
  • Engagement with community services, and ability to make timely and barrier-free referrals;
  • Outreach and transparency related to the role of the program so that stakeholders and the public understand the role and parameters of co-response teams;
  • Adequate coverage in terms of geography and hours, including at night;
  • Quick transfer times into hospitals when hospitalization is required;
  • One study demonstrated that follow-up calls greatly increased the rate at which people accessed community services.

It is also important to note that co-response teams are only one of several components of an adequate mental health crisis response system. Additional responses include distress lines, crisis intervention teams (without police), and mental health crisis centres with adequate capacity and streamlined intake processes.

Click here for a recent evaluation of the implementation of Toronto’s MCIT program, and here for a plain language summary of the evaluation.

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