Toronto police, 911 dispatchers need more confidence in crisis workers, advocate says

Police and emergency dispatchers need more faith in crisis workers employed through a city program that offers a non-police response to mental health needs, an advocate says. 

Jennifer Chambers, executive director of the Empowerment Council, a mental health advocacy organization funded by the Centre for Addiction and Mental Health, says there haven't been enough police referrals through the city's pilot program meant to divert mental health calls that don't pose a threat to the public or involve crime to non-police specialists.

Chambers serves as an advisor for the Toronto Community Crisis Service, a three-year pilot project that sends 911 and 211 mental health calls to specialized community partners in designated zones.

Although she's excited by the program's potential, Chambers says officers and emergency dispatchers should have more confidence that crisis workers — trauma-informed individuals with specialized training in areas such as de-escalation and harm reduction — can handle the matter they're called to serve.

Progress report released 

"There is not enough referral from police to the community crisis services right now," says Chambers.

Last month, the city released a progress report based on two community partners — Gerstein Crisis Centre and TAIBU Community Health Centre — which showed that the TCCS received 549 calls from March 31 to June 18. Most of the calls — about 461 — came from 911 and 211. Mobile teams were dispatched 438 times, the report says.

The 549 figure is barely a fraction of the calls mental health centres can receive. The Gerstein centre, for example, gets 40,000 direct calls a year, though a report from Toronto police showed emergency mental health calls in their area were only diverted 211 times over a six-month period.

The TCCS pilots, which cost $2.2-million each in 2022, were implemented after several deaths of people in crisis in the Greater Toronto Area where police interaction occurred, including those of Regis Korchinski-Paquet, Ejaz Choudry and D'Andre Campbell. The projects are part of a larger initiative called SafeTO, intended to address gun violence, victim support and data sharing. 

A real alternative to call 

Chambers said she suspects more familiarity with calling 211 instead of 911 could speed up the "gradually evolving process" of crisis workers being able to handle more calls.

"That would be the best outcome, I think, people having a real alternative that they could call," she said, noting some people are scared to call the police when a person is in crisis. 

While some situations involving a person in crisis might be deemed unsafe to attend, Chambers suggests crisis workers could, for instance, remotely provide de-escalation advice to police.

And as much as she wants more mental health calls diverted, the matter is more complicated than that, with crisis centres facing the same staffing challenges as other health-care services. 

"So, there's some concern that if they get a huge deluge of calls that they won't be able to meet them," she says.

'We're learning more and more' 

The Toronto Police Service receives about 33,000 mental health calls a year. Staff Supt. Randy Carter says a non-police approach to mental health calls is a learning experience that is slowly catching on, but he sees room for expansion. 

"We're building confidence in our [911] call takers to trust that this program does work and to recognize and understand that sometimes sending the police creates the type of scenario that we all worry might happen when the crisis workers go," says Carter. 

"And we're learning more and more that when crisis workers go…the same escalation is not present in those calls."

Carter says there was some apprehension from 911 dispatchers at the outset, for example, when a person in crisis is the caller. But he says there have since been instances where police officers have stepped back to allow crisis teams take the lead at calls they've both responded to.

"We're taking those stories and bringing them back into the fold and presenting them to other police officers to be able to build up their confidence that there is an alternate response to some of these events," Carter says.

What clearly falls within the scope of crisis workers will sharpen over time, he says.

"We're trying to find our confidence now to take a few educated risks, if we can, to be able to get somebody that we know to be better help than police that are showing up," Carter adds.

Even though Gerstein was able to add 18 employees for the TCCS, the centre operates at capacity. Overall, the centre itself receives 40,000 calls annually.

Amanda Coombs is a TCCS access facilitator at Gerstein. Of the 40,000 calls the centre receives annually, she can still recall one from a man who told her he wanted to take his own life.

He wasn't eating or working, and was thinking about suicide, she says. 

"He was feeling very hopeless and he just needed someone to come out to speak with him," says Coombs, who doubles as a crisis worker when needed. 

In this case, she accompanied the mobile response team to visit the man.

They spent nearly two hours with him, listening — a key component of the work, says Coombs, as people in crisis often report that family and friends aren't available.

"They want to know that they're being heard."

Trauma-informed approach  

Coombs says the man "left feeling very supported" after her team assessed the situation and created a safety plan. 

She says the man is now "thriving" and no longer requires service, crediting the effectiveness of a trauma-informed approach to make clients feel safe and supported.

TCCS clients receive follow-up assistance for three months. Clients choose when they want checkups because autonomy is empowering, she says.

While on the scene, crisis workers were able to support clients 61 per cent of the time, according to the TCCS progress report. An ambulance was only requested three per cent of the time and police were called two per cent of the time.

Gerstein community crisis worker Akinyemi Akinlade says that connecting with a client is critical as soon as he arrives at a call location.

Similar to Coombs, Akinlade says sitting and listening to build client trust is important. He says during that time, he's reading body language and attitude.

He says he's heard from community members that the initiative is "long overdue," and says having a relatable individual in street clothes approach a person in crisis helps de-escalate the situation.

"People just appreciate someone who is not in uniform to talk to them," he said.