Mental Health Management and Toronto’s Police Services

In light of Toronto’s upcoming municipal election, the PPGR is dedicating this week to a special series of posts that focus on municipal policy issues. Be sure to check back tomorrow to read up on another topic of municipal interest.

Zachary Lewsen

Way back in 1987, after Memphis Police shot and killed an individual with mental illness, the city’s municipal leaders, mental health practitioners, and police officials came together to agree that police approaches to mental health needed to change. The result was the creation of Crisis Intervention Teams (CITs), an initiative providing 40 hours of intensive training on mental illness to police officers to better equip them to implement non-violent, de-escalation techniques when responding to mental heath-related emergencies. CITs also stress partnerships between officers and mental health professionals.

The Memphis CIT model has since been adopted in many North American cities, including Chicago, Los Angeles, and Vancouver. But municipal police forces continue to face challenges in dealing with mental health-related emergencies. The Toronto Police Service is dispatched to 20,000 mental health-related 911 calls on average annually; between 2002 and 2012, five of these calls ended in fatal police shootings of individuals with psychosis.

Attempting to manage a psychosis episode — in which a disturbance in brain functioning causes an individual to experience a loss of contact with reality — can be difficult for all parties involved. These episodes often leave the afflicted person with extreme feelings of disorientation, leading he or she to demonstrate behavior that could be perceived as hostile. Traditional police responses — “halt, put your hands where I can see them” — can often aggravate the condition and its associated behaviors.

In recent memory, the trauma associated with crisis situations may present itself most vividly to Torontonians in the shooting of 18-year-old Sammy Yatim in July 2013. Yatim was carrying a knife on board a streetcar, while yelling at fellow passengers. The streetcar operator stopped the vehicle and opened the back door for passengers to escape; when the police arrived, Yatim was alone on the streetcar. But instead of using de-escalation techniques, police fired nine bullets and a single taser-shot at Yatim, fatally wounding him. Yatim’s family later claimed that while he had displayed no signs of mental illness during his childhood and teenage years, it was clear that Sammy was in a crisis-situation the night of the shooting.

The Sammy Yatim shooting — and the public disenchantment it sparked — led then-Police Chief Bill Blair to call on former Supreme Court Judge Frank Iacobucci to commission an external investigation into the Toronto Police’s mental health management.

The subsequent report, which incorporated input from mental health advocates, psychiatrists, and family members of individuals afflicted by psychosis, delivered a wide range of policy recommendations. Iacobucci acknowledged the importance of Toronto’s Mobile Crisis Intervention team (MCIT), a team consisting of a police officer and psychiatric nurse who travel in pairs when responding to mental health emergencies, but recommended that it be adopted as a 24-hour initiative. He also called for the police to use two key considerations — mental health expertise and de-escalation ability — when recruiting or hiring new officers.

Iacobucci also suggested a partner program to help Toronto Police Service members to consult with, and garner advice from, their own designated mental health professional. Regarding interactions with the mental health community, the report stressed the importance of annual retraining in crisis communication and de-escalation techniques.

Frank Iacobucci has not been the only public figure to recommend policy changes to the Toronto Police Force’s mental health management — it has been raised as a point of concern in Toronto’s ongoing mayoral race. During the October 16th Town Hall debate, John Tory discussed why the city needs to address mental health; Olivia Chow’s platform explicitly calls for the expansion of “interdisciplinary teams to better deal with complex issues, like situations involving people with mental illness.”

The uncertain nature of psychosis trauma prohibits any perfect policy solution. But partnerships between police officers and mental health professionals do get results. Social work professor Amy Watson’s 2010 study of Chicago police officers offers one evidence-based example: when comparing officers who underwent a 40-hour intensive CIT training session with those officers who only completed the city’s minimum 5-9 hours of mental health training, Watson found that, when responding to a mental health emergency with a resistant individual, those who had completed the extensive training were far less likely to use force.

Mental health training has an additional benefit in that it gives police officers an opening to discuss their own mental health issues. Police work, characterized by high stress situations and exposure to trauma, can lay the groundwork for mental illness and suicide, and officers are often unlikely to talk to one another about these experiences. In a recent feature for The Walrus, one Memphis police supervisor observed that

“Police officers are like people in the military…they’re the last ones to admit a problem.”

In Memphis, CIT supervisors, who have received mental health sensitivity training, have used their skills to provide forums for junior officers to discuss anxiety and distress they experience on the job.

Regardless of who is elected mayor in Toronto’s upcoming municipal election, he or she must make police officers’ exposure to mental health training a priority. The Iacobucci report observed that “for those killed (in police shootings) and for their families, nothing can take away their loss… for people in crisis who have had negative experiences with police, self-evaluation by the police and the larger mental health field is meaningful if there is a real change.” Increased inter-disciplinary training needs to be a key part of that change.

Zachary Lewsen is a 2016 Master of Public Policy candidate at the University of Toronto and an Editorial Assistant with the Public Policy and Governance Review. He previously completed an Honours Bachelor of Arts degree in Political Science at McGill University, and has since interned for the NATO Council of Canada. A keen observer of provincial and municipal politics, Zach hopes to explore a career in urban, immigration, or economic policy.

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