Police-Encounters-With-People-In-Crisis

The CIT program enables the Hamilton Police Service to provide an expert first
response to the roughly 75% of calls to which COAST is unable to respond.
63. Finally, in 2013, the Hamilton Police Service established a Mobile Crisis Rapid
Response Team, similar to Toronto’s MCIT, but pairing a police officer with a mental
health worker instead of a nurse. This initiative was designed to address the large
volume of mental health calls in downtown Hamilton. It can provide a more informed
response that is better suited to connecting individuals with mental health system
resources than can be expected of a CIT officer. 53
64. In addition to employing the COAST, CIT, and MCIT models of crisis response, in
2012 the Hamilton Police Service and St. Joseph’s Healthcare Hamilton developed a
protocol to reduce lengthy police wait times in the emergency room. As discussed in
Chapter 4 (The Mental Health System and the Toronto Police Service), according to the
new protocol, after a 30-minute wait in the emergency room, an officer can rate the
individual’s risk level. If the officer determines the client, under the supervision of
hospital security staff, poses a low risk to her or himself, hospital staff, and the public,
the officer and an emergency room nurse can transfer care of the patient to the hospital,
and the officer can leave.
4. Comparing the other models to Toronto’s MCIT
65. The lack of a specialized first response to crisis calls in Toronto is the most
significant current gap in the Service’s capability to respond to people in crisis. These
events often unfold quickly, and therefore a skilled first response is an indispensable
part of ensuring that a compassionate, informed and proportionate resolution is
possible. Most police shootings occur within minutes of the police attending a call.
66. As noted, a key difference between the Memphis/Hamilton CIT model and
Toronto’s MCIT model is that, because the CIT model trains first responding officers, a
large majority of calls involving a person in crisis are attended by an officer with
significant expertise in interacting with people in crisis (for example, 90% of such calls
in Memphis, and 75% of calls in Hamilton), while to date only approximately 11% of
these calls in Toronto have been addressed by the MCIT. 54 The CIT model is the only
model studied that has the potential to bridge this first response gap in a significant
way.
67. A skilled first response can be put in place by implementing, on a pilot basis, the
CIT model in Toronto. TPS already possesses key aspects of the 10 core elements of a
CIT program. Through the MCIT Coordination Steering Committee, Toronto has
established a partnership mechanism with the professional mental health treatment
community. The Mental Health Sub-Committee of the Toronto Police Services Board,
furthermore, provides the TPS with a mechanism for partnering with the mental health
53
Tran, “Data Collection”, supra note 51.
54
Henry J. Steadman, et al., “Comparing Outcomes of Major Models of Police Responses to Mental Health Emergencies” (2000) 51
Psychiatric Services 5; For a useful summary of existing research on the effectiveness of CIT, see Compton, Collaboration, supra
note 37, chapters 8-11.
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