As a tool to help those in crisis, COAST program gets positive early review

An early look at a program that uses fewer police officers and more care workers when it comes to dealing with people in mental health crises has earned a positive early review. 

Started in April 2021, the COAST program (an acronym for Community Outreach and Support Team) is a partnership between police, paramedics, St. Joseph's Health Care and the Canadian Mental Health Association. You can read about the program here, but the idea is to provide a more care-focused, less police-intensive response to 911 calls about someone in crisis due to mental health or addiction issues. 

On Thursday, two researchers from Carleton University presented an early evaluation of how the program is working to London's Police Services Board. 

Craig Bennell, a professor at Carleton, told board members the program is delivering positive results in a number of critical areas. Topping the list: Fewer mental health crisis calls that require a response from police patrol units, which are already overburdened with emergency calls. 

Cutting police call volume

Bennell said the COAST typically responds to between 100 and 150 client calls a month. Those calls would otherwise have required a response from patrol officers. 

"The data show that COAST is reducing the need for a front-line police response," said Bennell. "It seems to be leading to short-time diversion away from the police." 

Another upside: Bennell said the COAST program mainly received positive reviews from the clients who used the program. More than 80 per cent said they would use the program again, Bennell said. 

Also, 33 per cent of clients surveyed said they would have called 911 had COAST members not responded, while 28 per cent said they would have dealt with the crisis themselves. 

Better client outcomes

"The findings are that it appears to be providing a much better experience and outcomes for clients," he told board members. Bennell said many clients felt the COAST response was more therapy-focused than enforcement-focused, leading to better outcomes. 

And while the early look at the program is positive overall, Bennell said it's clearly not perfect. While it appears to be taking some weight off the police, there's no clear evidence it's leading to better treatment for clients who are taken to hospital. 

"While the COAST is appearing to have a localized, significant positive effect on clients, it perhaps isn't having a broader, more pervasive impact on how interactions with people in crisis in the community or in hospital are handled," the report says.

London's mental health and addiction crisis centre

2 years ago

Duration 2:52

The site at 648 Huron Street in London is a CMHA building that houses the COAST office, along with CMHA’s 24/7 Mental Health and Addiction Crisis Centre, Crisis Response Teams, Crisis Assessment Teams, our Crisis Stabilization Spaces, the Reach Out staff, and several clinical offices.

Can't get to all calls

Also, COAST members aren't always available when needed. 

"Our view is that all four member organizations should look at how it should be enhanced and increased," said Bennell. 

Bennell also reported that it's sometimes unclear who does what on the COAST teams. He said a communications plan for the public and staff in the member organizations would help clear this up. 

The program review also pointed to the need for a clear handover protocol for officers who take clients to hospital. Often officers are tied up while they wait for clients to be assessed or admitted. It's an offload delay problem similar to the one paramedics experience. 

The report Bennell presented to the Police Services Board on Thursday is a chopped-down version of a much more robust report about the COAST program which will be made public on Sept. 29.  

Although it wasn't identified in Bennell's report, the COAST program doesn't have a permanent funding source. 

In a statement to CBC News, a police spokesperson said COAST leadership is "actively engaged with Ontario Health to secure permanent funding, something we hope to be able to share in the near future."

For now, each of the partner organizations (St. Joseph's Health Care, Canadian Mental Health Association Thames Valley Addiction and Mental Health Services (CMHA), Middlesex-London Paramedic Service (MLPS) and London Police Service) have kicked in funding to support the program.

It's also operating with a grant from the London Community Foundation.