‘It’s time for a change’: Toronto to launch service to respond to mental health crisis calls

Denise Andrea Campbell, executive director of social development, finance and administration for the City of Toronto, March 10. Campbell leads the city’s new Community Crisis Support Service.Nathan Denette/The Canadian Press

When a mental health crisis call arrives at 911 in parts of Toronto next month, a team of typically two people, such as a harm reduction worker and a nurse, or an Indigenous elder and a de-escalation expert – not the police – will be the first to respond.

The mobile unit will meet the person in crisis and determine what they need. Response teams will then check the person within two days and help organize further support, such as long-term counselling, if needed.

This is all part of a new approach to crisis intervention in Toronto that begins with the launch of a pilot program in a few weeks.

The City of Toronto – which plans to eventually implement the program in all neighborhoods – describes the effort as a community-led, trauma-informed alternative to traditional crisis response, with a focus on harm reduction. damage and problem prevention.

“The idea is that we don’t need a law enforcement approach when the problem is a mental health crisis, an addiction crisis, these are health issues, these are not criminal issues,” city executive Denise Andrea Campbell said. Director of Social Development, Finance and Administration, who leads the program.

“The appropriate response (is) health supports, not law enforcement.”

The pilot program will operate in four areas of Toronto where Mental Health Act arrests and 911 calls for people in crisis are the highest.

Initially, calls to 911 will be routed to the new Community Crisis Support Program, but eventually, Campbell said, mental health crisis calls can be routed directly to 211 — the hotline. assistance from Ontario Community and Social Services.

The new program is the product of community consultations and research into similar models in 50 jurisdictions around the world, Campbell said. With that research and community feedback, the city decided to go with a non-policing crisis response model, she said.

A team will only call for police support if its members are unable to de-escalate a situation and a crisis call turns violent. But Campbell said evidence from similar patterns has shown this is almost never the case.

“For example, in New York, their B-HEARD teams, in their first six months, responded to 564 calls and only 6% of those calls required (police) assistance,” he said. she declared.

Initially, the pilot program will be launched in the northeastern and central-eastern parts of the city next month. In June, two more pilots will be launched in a north-west and mid-west area.

The city said the pilots will allow it to test, evaluate and revise a non-police-led crisis response before implementing the program on a larger scale. Citywide implementation is expected by 2025 at the latest, Campbell said.

TAIBU Community Health Center, which provides programs and services to Black communities in the Greater Toronto Area, will be responsible for leading the Northeast pilot.

Executive Director Liben Gebremikael said the center is in the process of hiring staff for the program, noting that the region’s mobile crisis team will be made up of people with lived experience of mental health and addiction issues, anti-black racism and racism specific to Indigenous peoples. or other forms of discrimination.

These team members will be able to “connect to people better” given their lived experience and will work to build trust with community members to provide early interventions, Gebremikael said.

“Our kind of ultimate ideal goal is for people to be able to seek out and find support before they get to a crisis. If people have arrived at a crisis situation, it is already too late,” he said.

“Obviously, we are still going to have a response to the crisis. When we get there, our goal is for our service to be a culturally and community appropriate response that would take into account people’s lived experiences and other social determinants. of health and would provide a warm and enveloping response.

Dr Andrew Pinto, a family physician at St. Michael’s Hospital in Toronto, said a community-based approach to helping people in mental health crisis is “long overdue” and has the potential to save lives.

Pinto said it could lead to more support for those living with mental health issues and could prevent instances where they harm themselves or others. In the long run, he said it can help people engage with health and social care and other resources.

Since the police are not going to confront someone who is in a mental health crisis, the risk of “the police committing violence and actually killing someone” could also be reduced, he said.

“I think this type of approach can make a difference for people. And I think a really rigorous evaluation will help confirm (that),” Pinto said.

TAIBU’s Gebremikael agrees, saying the new service is “a long time coming”.

“It’s really time for change,” he said.

“Unfortunately, the painful experience of incidents like the (murder of) George Floyd…has sped things up a bit. It’s in the wake of some painful experiences the community has had, but at least we’re here today the city has really gotten stronger, and it’s time to really test that.

This story was produced with the financial assistance of Meta and the Canadian Press News Fellowship.

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