Public health nurse Tanya Hansen and Edmonton police officer Kevin Harrison speak to a client on the phone before heading in to deal with another mental health issue Dec. 7, 2011.
Police training on how to deal with the mentally ill varies across Canada from just a few hours to intensive week-long courses involving mental-health workers.
Shortages in the health-care system have resulted in officers increasingly answering crisis calls, and having the techniques to de-escalate situations makes the interactions between the mentally ill and police safer for both. One training program that is gaining popularity in Canada originated in Memphis, Tenn. In that city, the number of officers injured during "mental disturbance" calls has dropped 80 per cent, according to the National Alliance on Mental Illness. Albuquerque, N.M., which adopted the Memphis program, has seen a decrease in crisis-related police shootings.
While some police forces say they lack the resources for extra training, others, such as Ontario's York Regional Police and the Edmonton Police Service, are making it a priority.
YORK REGION
A small group of police officers and dispatchers sit in a classroom listening to a recorded mix of swearing, shouting and clicking noises for 45 minutes. They're trying to solve Grade 3 math problems and do reading exercises at the same time.
The recording is supposed to mimic symptoms of schizophrenia, the voices and noises meant to show police why some people with mental illness have difficulty following directions and become agitated and aggressive.
"It will probably help you be able to better communicate with those people in the future," said Constable Mark Kowalchuk, one of two officers running the crisis intervention training for York Regional Police. "There is only one rule. … Somebody that's suffering auditory hallucinations can't switch the hallucinations off, so neither can you."
It's the last day of a new weeklong training program for the York officers, who police five communities north of Toronto. They have toured mental-health wards, talked to someone diagnosed with a mental illness, acted out response methods and learned how to recognize and respond to someone in crisis. Last year – the first year of the new training – more than 100 officers participated and there is a waiting list to get on the next course.
More and more officers find themselves responding to calls involving "emotionally disturbed" people. The number of calls logged as such grew in York from 1,301 in 2006 to 2,015 in 2010. The number of suicide attempts in York Region have also grown, from 653 in 2006, to 969 in 2010. These numbers just scratch the surface – not all the calls are flagged as crises.
The training model originated in Memphis, where the community reacted with outrage after a mentally ill man was shot in 1988. There, officers who demonstrate compassion on the job can apply to become a Crisis Intervention Team officer and, after being trained, are flagged for certain calls. It's since been adopted by communities in more than 35 states, parts of Australia and is picking up steam in Canada.
Constable Chris Drummond, who usually teaches use of force, first pitched the idea to get the Memphis-model training. "It just doesn't make sense knowing that in the United States they've been running this program for 20 years," he said. "Mental illness is mental illness whether it's in the United States or Canada, police officers are police officers.... If we know it works, why aren't we doing it here?"
Major Robert Vaughan, who runs the CIT at the Memphis Police Department, says the key to the program's success is its immediate response. "Any delay could subject the person who is mentally ill to trauma."
Unlike other programs which pair a mental-health professional with an officer – but require other police to secure the scene, like Toronto – officers with Crisis Intervention Training are the first to get there.
Sarah Burtenshaw, a mental-health worker who works with police in Hamilton, brought the training program there in 2006. She estimates there to be about 10 such programs in Canada, with most in Ontario and one in Halifax.
"It's not rocket science, none of this is rocket science," she said. "It's about understanding what the symptoms are and how to respond."
The program in Hamilton and four nearby forces, which Ms. Burtenshaw said costs about $4,000 per class, is funded by the provincial Ministry of Health through the Local Health Integration Network. She said it's cheaper than mobile crisis teams, which only respond to crisis calls.
Ms. Burtenshaw also works with Hamilton's mobile team, called the Crisis Outreach and Support Team (COAST), which pairs her with an officer to respond to police calls. Unlike similar programs, including Toronto's, COAST runs 24 hours a day out of an unmarked police car, which can alleviate concerns about a cruiser being parked outside the person's home.
Combining COAST with the Memphis model is necessary, Ms. Burtenshaw said.
"I think we need both."
Just a few weeks after the training, York Constable Patrick Mahon said he answered a call to a paranoid schizophrenic man who believed he was a victim of witchcraft. Constable Mahon said he knew to ask if the man was hearing voices or noises and how he was feeling.
"It's all just in the perception of what the problem is," Constable Mahon said, noting that the man told him he was tasered and physically restrained in a previous interaction with police.
"We need to be treating people a little differently so that we're not taking the wrong people to jail," he said.
EDMONTON
A man is convinced a radio DJ is operating a prostitution ring, and begins warning young women at coffee shops. An elderly German couple living in squalor say they're under attack by their neighbours. A bankrupt man fears the Mexican government is after him.
The strange scenarios are designed to open the minds of new police recruits, but they're not fiction – each is a specific mental-health case Edmonton's Police and Crisis Team (PACT) has dealt with.
A partnership between the province's single health board and the Edmonton police, the initiative sends two-person teams – a cop and a mental-health specialist who is either a nurse or a social worker – to respond to police calls involving the mentally ill.
At first, police and health officials had to craft a unique privacy agreement so that the officer and nurse could even discuss the details of each case. But it has expanded: Edmonton's PACT is now joined by an inner-city and rural unit.
Constable Kevin Harrison is on one team along with nurse Tanya Hansen. They serve together as first responders, case managers and referral agents, striking a nuanced approach to mental-health services in the city. Constable Harrison and Ms. Hansen dealt with the radio DJ, German retirees and bankrupt conspiracy theorist. They bicker like a married couple – she cringes when he uses the phrase "mentally retarded," while he steals the vegetables she packs for a lunch on their 10-hour shifts.
The Edmonton PACT had 2,112 calls in 2010, 60 per cent of which came from police or 911 calls. They roll in around the clock. "Sometimes our phone doesn't stop ringing," said Constable Harrison.They also train recruits. Recently, they spoke to a class of 33 young officers, handing them written pages of the strange scenarios and testing their responses. The Edmonton Police Service is trying to better equip all its officers – PACT units aren't on duty around the clock.
Constable Harrison and Ms. Hansen preach compassion in dealing with the mentally ill, particularly those who are elderly. "There's no glory in fighting with an 85-year-old lady," Constable Harrison tells the recruits.
The range of cases comes as a shock to many young officers, Ms. Hansen said.
"It's 'criminals, right? I'm dealing with criminals?' They didn't realize they'd be dealing with social issues, alcohol issues. A lot of them didn't realize, I think, those issues that make their job so much more difficult," she said. "Part of my job is exposing them to the medical culture, not just the police culture."
In many of their cases, clients with obvious illnesses have never accessed mental-health care. "We try very hard to bridge people to other services," Ms. Hansen said. However, those services are often tapped out.
Internal Alberta Health Services memos leaked late last year cite a "critical" shortage in inpatient mental-health beds and an "acute shortage of psychiatrists" in the Edmonton area. It often leaves Constable Harrison and Ms. Hansen waiting in the emergency room for the majority of their shift, trying to secure a bed for the first or second call of the day.