Imagine yourself feeling the lowest you have ever felt. Facing significant trauma and intense depression, you believe the only way out is to end your life. You text a friend good-bye and attempt suicide. Revived by a team of armed, uniformed policemen entering your home, you are transported – confused, scared and restrained on a gurney – to the hospital, where a police officer and then a security guard continues to watch over you so you don’t flee. You feel like a criminal, like you’ve done something wrong by trying to end your pain. By the time you see a psychiatrist, you’re too traumatized to accept help. You leave the hospital as soon as you are allowed to. In shock and now even more distressed, you’re left wondering, how did this happen?
Mental health crises have been inextricably linked to policing and criminal justice. Attempting suicide was considered a crime in Canada until 1972. Psychosis, substance use and other mental health issues also have a long history of criminalization. But as health-care providers and service users, we understand that a mental health crisis is exactly that – a health issue, not a criminal one.
Non-police crisis response is a vital health intervention. The need for trauma-informed, culturally and psychologically safe crisis response is incredibly high and only rising in this pandemic.
The City of Toronto recently announced that its community-led mental health crisis response teams would be launched this March. Driven by organizations with strong roots in their communities such as the Gerstein Crisis Centre, this is an exciting and promising start to divesting mental health crisis care away from policing.
However, at the same time, Toronto Police have requested an increase in their budget of $25 million, citing that part of this funding will be used to expand the number of police officers who receive enhanced mental health training for crisis response. This is contradictory to what the public is asking for – Torontonians want police out of mental health crisis response, as per information gathered by the Reach Out Response Network in a 2020 community consultation.
We know that these teams can save money and lives and are wanted by the community – the way taxpayer dollars should be spent.
Although these community mental health response teams are a pilot project in Toronto, we hope to see them expanded province wide. Health care is typically funded by the province; if we want these teams to be effective, we need to fund them like the rest of our health-care system. Forcing groups to compete for municipal funding leaves it up to the discretion of each municipality and devalues the integral nature of mental health crisis response in our health-care systems.
It is crucial that police alternatives to crisis response calls be driven by peer support workers and regulated health professionals.
The community-led nature of this initiative is of utmost importance. As health providers, we recognize that the health-care sector is not far removed from the justice system, particularly when it comes to mental health care. Many people, including our peers and patients, are nervous around both police and mental health workers due to the imbalance in the power dynamics. This is not to take away from the expertise many mental health care providers hold; instead, we need to recognize that our collective ability to help those in crisis is strengthened by authentic collaboration with those who have first-hand experience.
For these reasons, we believe it is crucial that police alternatives to crisis response calls be driven by peer support workers and regulated health professionals such as mental health nurses, social workers and physicians, and we urge fellow health-care providers to advocate for the involvement of service-user experts in these responses.
With our collective expertise in the mental health-care system, we know there are gaps in mental health care. It is rare that individuals in crisis call 911 as their first method for seeking help. More commonly, it is the culmination of a slow and gradual process of being continually let down by the insufficient help that is available. We need to prioritize funding and accessibility of supports such as psychotherapy. We need to focus on preventing crises through other supports the community has been asking for, such as secure housing and fair wages, as well as easily accessible and adequately funded mental health care interventions, such as psychotherapy.
This is a large systemic issue to take on, but we can start with supporting the creation of these community-led mental health teams and funding them instead of more policing. You can take action today by calling your city councillor with your support of community-led alternatives to mental health crises.
The authors have no conflicts of interest to declare.