Peter McKnight: Crisis care should begin when people first seek help — with 911

Opinion: If mental-health services were integrated with 911, dispatchers could direct the call to appropriate help instead of to police, who are ill-equipped to handle such crises.

Only in politics can “change” and “new” be defined as “more of the same.”

And what exactly is the change to which Allam was referring? It was none other than the fulfilment of Sim’s main election promise: To hire 100 police officers and 100 nurses, all ostensibly in the interest of addressing the city’s twin drug-addiction and mental-health crises.

You are reading: Peter McKnight: Crisis care should begin when people first seek help — with 911

On Tuesday, Vancouver city council approved the plan by a 6-3 vote. Sim, who also subscribes to an odd definition of “new,” later tweeted that the investment “will set a new standard for policing across North America.”

The hires will reportedly assist with the Vancouver Police Service’s Car 87 program, which pairs a police officer with a registered nurse to assess and manage mental-health calls. So the “change” to which Allam referred involves beefing up the police response to the addictions and mental-health crises — in other words, exactly what we’ve been doing for years.

And exactly what has also been condemned for years, since police are ill-equipped to handle such crises. We frequently hear stories of police encounters that quickly go awry, resulting in injuries and deaths to both police officers and the people in crisis.

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This suggests that the change we need involves decreasing, rather than increasing, the role police play in crisis calls. This can be accomplished through the implementation of civilian-led, non police teams to respond to incidents that don’t represent a threat to public safety.

Although that would represent a change, and a much needed one, it’s not a new idea. In 1989, Eugene, Oregon’s, White Bird Clinic began the CAHOOTS (Crisis Assistance Helping Out on the Streets) program, which teams a medic with a crisis intervention worker to respond to calls related to addiction, mental illness and homelessness.

Various Canadian cities have followed suit, including in the Vancouver area. Together with community mental-health groups, the B.C. division of the Canadian Mental Health Association initiated the North Shore Peer Assisted Care Teams in November 2021.

The continuum must begin at the beginning, which is when people in crisis first seek help — with 911. Currently, if you call 911, you’ll be asked if you need fire, ambulance or police services, but there’s no option for mental health. Given these limited options, operators often have no alternative but to dispatch the police.

Police then have limited options, which frequently results in people being taken to hospital. But since many people don’t meet the criteria for admission, they’re ultimately released, only to experience another crisis. And through the revolving door they go.

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If, on the other hand, mental-health services were integrated with 911, dispatchers could direct the call to crisis lines and other appropriate services. In many cases, mental-health workers can de-escalate the situation, but if further help is needed, they, too, might have no option short of hospitalization.

In contrast, a crisis care continuum includes crisis stabilization care, which provides facilities, beds and other necessary support for people in crisis. According to the crisis centre, stabilization care has proven successful: In areas it has been implemented, 68 per cent of people “are discharged to the community and 85 per cent remain stable in community-based care.”

Needless to say, building this continuum requires funding commitments from all levels of government, not just from city council. But since police and hospital services are among the costly responses to crises, it’s ultimately a cost-saving — and life-saving — measure. Now that, rather than more police intervention, is the change we need.


Letters to the editor should be sent to [email protected]. The editorial pages editor is Hardip Johal, who can be reached at [email protected].

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