From right, Windsor police Const. Jordyn Thompson and Windsor Regional Hospital nurse Abbas Haidar speak with Mike Mosten about the social support services that are available to him at the Downtown Mission homeless shelter in Windsor, Ont.Dax Melmer/The Globe and Mail
Nurse Abbas Haidar and his Windsor Police partner were nearing the end of their shift when a group of panicked teenagers burst from an alley and ran toward their cop car.
“You could tell they were so distressed,” Mr. Haidar said. “All they could say was, ‘Hey, our buddy is dying.’”
Grabbing his medical bag, Mr. Haidar sprinted down the alley to a park, where a police officer was applying pressure to the abdomen of a 16-year-old boy who had been stabbed after an argument with a stranger.
Mr. Haidar packed and dressed the wound, then turned the victim over to tend to a laceration across his back. “I’m glad we were there,” he said, recalling the incident a few weeks later. “We were able to dress him up and hold it down till EMS arrived.”
Mr. Haidar, who normally works in the emergency department at Windsor Regional Hospital, was available to provide crucial first aid in a park at midnight because of a unique partnership between the city’s police department and its largest hospital.
Const. Jordyn Thompson checks in with a client of the Downtown Mission shelter.Dax Melmer/The Globe and Mail
In May of 2023, Windsor, a city of 230,000, began putting teams of ER nurses and police officers on the road together. The goal was to divert patients with mental illness and substance-use struggles from the city’s two overwhelmed emergency departments by offering them medical care on the streets, with police on hand to keep the nurses safe.
So far, the teams seem to be making a difference. In the first year of the pilot operation, nurse-police pairs handled 1,786 calls for service, treated 129 drug-use-related wounds in the community and diverted 608 potential visits to the ER. Armed with a list of frequent ER visitors with mental-health challenges, the nurse-police pairs pro-actively offered them medical care and social-service referrals, cutting their trips to the emergency department nearly in half over the 30 days after their interaction with the team.
“Their impact was so immediate,” Windsor Police Chief Jason Bellaire said of the nurses. “It really was shocking in such a great way. It just made that big a change for our members and made that big a change for the hospital.”
Several Canadian cities have programs that pair cops with mental-health or social workers, but adding ER nurses to the mix seems to be unique to Windsor. Chief Bellaire isn’t aware of any other programs like it, and Laurie Freeman, a University of Windsor nursing professor hoping to study the program, couldn’t find its equal in any published research.
On May 29 – four days after Mr. Haidar responded to the stabbing – Chief Bellaire and Windsor Mayor Drew Dilkens announced the nurse-police program had been expanded to seven days a week, up from three. At the same event, the chief said two long-standing programs pairing police officers with social workers from another local hospital, Hôtel-Dieu Grace Healthcare, would be merged into a Crisis Response Team. The social work-police teams, like the nurse-police teams, have already begun patrolling every day, up from five days a week under the old models.
Windsor, like many places in Canada, has been forced to rethink how it provides policing and health care services amid rising homelessness and a mental-health and addictions crisis that has grown worse since the COVID-19 pandemic.
The city and the surrounding County of Essex saw a record 115 opioid-related deaths last year, up from 112 in 2022, 85 in 2021 and 71 in 2020. Until the pandemic, Windsor-Essex’s opioid-related death rate per 100,000 roughly tracked that of Ontario, but the trend lines have diverged since 2021. Provincial rates fell while Windsor-Essex’s rose.
Windsor police, meanwhile, received more than 3,000 calls for service from people in crisis last year, an 11.3-per-cent increase over the year before.
“What we’re facing,” said Bill Marra, the chief executive officer of Hôtel-Dieu Grace, ”is really an evolving change with the social determinants of health. The needs are different. And what’s happened is service providers are catching up to where we need to be with providing support for patients or clients.”
The mental-health and substance-use crisis was hampering the ability of police and emergency department staff to do their jobs, Chief Bellaire said in an interview. Windsor has just two emergency departments, only one of which – Windsor Regional’s Ouellette campus – is located downtown, where homelessness is most visible.
Windsor police Const. Jordyn Thompson and and ER nurse Abbas Haidar attend the Homelessness and Housing Help Hub (H4) in June.Dax Melmer/The Globe and Mail
Police officers who apprehended people experiencing mental-health crises were often waiting with them at the Ouellette ER for between three and 11 hours until patients could be handed off to hospital staff. Some nights, as many as 10 officers were stuck in the ER, Chief Bellaire said, compromising police’s ability to respond to crimes and emergencies.
In late 2022, Chief Bellaire and Windsor Regional Hospital’s chief executive officer, David Musyj, met, along with senior staff members, to address the dilemma. Chief Bellaire recalls Mr. Musyj – who began a stint as acting CEO of London Health Sciences Centre in May – saying, “let’s just stay in this boardroom until we have this problem solved.”
After crunching the numbers, Windsor police saw it made sense to post an officer in the Ouellette emergency department 24 hours a day to handle mental-health hand-offs. Hospital brass vowed to expedite care for people experiencing mental-health crises, beginning with code announcements that treated patients in mental distress with the same urgency as those with serious physical injuries.
Taken together, the changes reduced the time patrol officers spent in the emergency department to less than 30 minutes per hand-off.
That initial success prompted police and hospital leaders to try a deeper collaboration, one that would allow emergency nurses under the protection of police to offer basic medical care to high-needs patients before they landed in hospital. As a bonus, the nurses could provide advanced first aid in emergencies, as Mr. Haidar did for the stabbing victim and for a suicidal man who threw himself in the Detroit River in June of 2023.
Both organizations agreed to shuffle existing funds to launch a three-day-a-week pilot project. “For the police, we had nothing to lose,” Chief Bellaire said. The force was already playing the part of a de facto social service agency, he said, because when people on the street are in distress, “everybody just calls the police.”
The work of a nurse-police team isn’t always as adrenaline-fuelled as it was on the night of the stabbing. More often, the teams help Windsor residents through repeated small-scale interactions they hope add up to a big difference.
On one Friday in June, Mr. Haidar and his partner that day, Windsor Police Constable Jordyn Thompson, started their 12-hour shift with a visit to the Downtown Mission of Windsor, a 96-bed shelter. Const. Thompson was dressed in her patrolwoman’s uniform, a gun at her hip. Mr. Haidar wore a white T-shirt under a black vest emblazoned with his job title: Nurse.
The pair circulated through the fenced-in yard of the Mission, where a mostly male crowd sat smoking and talking at wooden picnic tables. Const. Thompson gently shook awake a grey-haired man in a ball cap who was slumped over a cement chess table. “Hey bud, you doing okay?” she asked. When he came to, he seemed puzzled – but not unhappy – to find a police officer there just to check on him.
Meanwhile, Mr. Haidar talked with shelter staff about a client named Thomas who had a telltale symptom of jaundice. “He just keeps turning more yellow and yellow and yellow every day,” said Jody Perron, a service support worker. “We’re pretty sure something’s failing inside him but he doesn’t want to get checked.”
Mr. Haidar found Thomas inside and tried to persuade him to go to the hospital. Thomas declined.
That’s not uncommon for shelter clients, said Brittany Lavin, the Mission’s manager. Despite some homeless people being frequent visitors to emergency departments, others are reluctant to seek care for chronic medical issues such as wounds arising from injection drug use.
“A good portion of our clients do have abscesses that go untreated, due to what they say is getting treated poorly in ERs,” Ms. Lavin said. “So they try to avoid going to get help, which ends up going bad. It just kind of trickles down from there.”
Jonathan Foster, vice-president of emergency and mental health at Windsor Regional Hospital, oversees the health side of the nurse-police program.Dax Melmer/The Globe and Mail
ER nurses in the nurse-police teams try to prevent that trickle-down effect by cleaning and dressing wounds, sometimes in a makeshift nursing office at the Mission. The nurses occasionally remove stitches. They often hand out kits of the overdose-reversing drug naloxone and strips to test street drugs for fentanyl, the potent synthetic opioid fuelling a national overdose crisis.
They also carry hospital laptops that allow them to register patients and review medical records without their patients having to set foot in the hospital. “We really treat this as an extension of the ER out on the streets,” said Jonathan Foster, the Windsor Regional vice-president who oversees the health side of the nurse-police program.
Sometimes, the nurses act more like social workers. “I really want you to look at this because, honestly, I think this is going to help you,” Mr. Haidar said as he handed a pamphlet about mental-health services to Mike Mosten, a man leaving the Mission’s food bank with a wagon full of groceries.
Mr. Mosten stopped Mr. Haidar to ask what it meant that he had been told to “present” at hospital after a psychiatric referral expired. He received the referral after attempting suicide. Mr. Haidar showed him all the ways he could get mental-health support without having to sit in an ER first. Then he handed Mr. Mosten a gift card to help him on his way.
The Mission and Waterworld, a housing and health resource hub inside a defunct indoor waterpark downtown, are two regular stops for the nurse-police teams. When not doing outreach, they respond to police calls as secondary units to see how they can help.
Much of Mr. Haidar and Const. Thompson’s Friday in June was taken up by helping the victim of an Airbnb scam. A 70-year-old man said he’d paid $1,300 for a room in a house for a month to a third party who had vanished. The owner of the Airbnb home, who knew nothing about the scam artist who rented out the room, gave the man four days to pack up and leave before calling police.
Const. Jordyn Thompson and ER nurse Abbas Haidar attend a call at an Airbnb rental where an elderly male is being evicted.Dax Melmer/The Globe and Mail
For more than an hour, Const. Thompson, Mr. Haidar and two other officers waited for the man to leave. He didn’t want to go. He threatened the owner. Const. Thompson sensed the man didn’t like cops, so she waited at the bottom of the stairs until her nurse colleague coaxed him outside and into a cab to his brother’s place.
“That’s where it pays to not have police written on your chest,” Const. Thompson said.
For Const. Thompson, a police officer since 2021, an unexpected benefit of the program is the way it has broken down barriers between front-line officers and ER staff. “I think, selfishly, I love it the most because of the relationships that we’ve made with the nurses,” she said.
Mr. Haidar, who has been an ER nurse for about six years, agreed. He and Const. Thompson’s easy rapport was clear when she prodded him to talk about how he helped police officers pull the drowning man from the Detroit River last summer. Mr. Haidar found a faint pulse and delivered chest compressions, reviving the man.
“He saved someone’s life,” Const. Thompson said. For that effort, Mr. Haidar became the first non-police officer to be awarded an Honour in Service Coin by the Windsor Police Service.