P.E.I. mobile mental-health crisis unit teams ready to roll in new year

Mobile mental-health units should be in place by early in the new year to respond to those in crisis across P.E.I.

Health PEI is in the process of hiring 12 new mental health professionals for the mobile crisis teams, said Verna Ryan, CAO of mental health and addictions for Health PEI.

There will be three units — one unit per county —  working seven days a week, noon to midnight, each one pairing a mental health professional with a police officer, working in conjunction with Island EMS. 

Ryan said officials are still confirming where they'll be based, but it will be with existing services in Montague, Charlottetown and Summerside.

Mental health advocates, police, and P.E.I.'s chief of mental health and addictions have all noticed a rise in the number of people struggling with their mental health in the province — a situation that appears to be escalating.

P.E.I. will be adopting a model used by the Centre of Addictions and Mental Health in Toronto, along with Nova Scotia and New Brunswick, said Ryan. Most major cities in Canada now have some form of these mobile units.

Islanders will be able to call 911 or a new toll-free 1-800 number to access the team. The phone line will be staffed 24/7 by staff at the EMS command centre in Charlottetown, who will triage and assess the situation.

Some situations will be handled over the phone, said Ryan, but for others, a unit will be sent out, whether it's to a school, emergency department or to the person's home. If the individual needs to go to hospital, though, EMS will be called in to take them, she said.

'More subtle approach'

Right now, police across P.E.I. are mandated under the Mental Health Act to respond to those in mental health crisis. They usually arrive in uniform in marked vehicles and often end up escorting people to hospital in handcuffs. 

The crisis vehicles, however, will be unmarked, and the teams won't be in uniforms offering "a much more subtle approach," said Ryan, which "will ease the family members' minds as well as the individual being responded to."

The P.E.I. teams will see the mental health professional take the lead, with the police officer in plainclothes offering backup and support if needed.

"Having plainclothes police officers and staff respond in a knowledgeable and compassionate way I think will help de-escalate situations right away, that people will feel supported, that people will be getting accurate information on their condition, on what's happening, and they'll be able to stabilize and stay home in their communities," said Ryan.

Charlottetown's deputy police chief agrees.

"Oftentimes we recognize that our mere presence will even escalate the situation," said Brad MacConnell.

Care in community

The teams will stabilize the situation, assess the individual and decide what support they need, which could mean connecting them with services in their own communities, rather than taking them to a hospital emergency department, Ryan said.

"I think they'll feel much more supported and have the service close to home," she said.

The intent is that we're never more than, you know, an hour or two away to any point in the province.— Verna Ryan, Health PEI

During the pandemic, the Unit 9 psychiatric unit at the Queen Elizabeth Hospital in Charlottetown was emptied of mental health patients to make way for potential COVID-19 patients. No positive cases required hospitalization, but in the meantime dementia patients waiting for a long-term care home bed were moved into the unit. 

Mental health patients in crisis were diverted to the psychiatric urgent care clinics at the Hillsborough Hospital and Summerside's Prince County Hospital, and more appointments were handled by psychiatrists via Zoom.

Regardless of the pandemic, trips to the hospital emergency room aren't always the best solution, said Ryan.

"There's lots of situations where family members get to a breaking point and they call on the police to come and help them. And they go through the process of having someone taken to the [emergency] department only to have that person kind of settle and be feeling OK," said Ryan.

"Then perhaps after a lengthy wait, they're discharged. And that's really chaotic and traumatic for family and for people. So we're hoping to avoid all that."

In addition to responding to crisis calls, the teams will be on the road doing wellness checks and followup appointments, including following up the day after a crisis call.

"The intent is that we're never more than, you know, an hour or two away to any point in the province," said Ryan.

Why police will continue to be involved

Police forces say they welcome partnering with mental health professionals. CBC News talked to officials with the RCMP, Charlottetown and Summerside forces, who all said they don't have the level of training that mental health professionals have to assess and handle those in mental health crises.

"It takes the onus off police officers to be the one to make the determination whether or not that person should be apprehended, that you've got people with better training making that determination," said Staff Sgt. Kevin Baillie of the RCMP.

With a team, the police officer can stay in the background, and provide backup if needed.

There have been calls in P.E.I. and in other areas to defund the police and let mental health professionals handle these calls alone.

Police say, however, they'll continue to play a role for public safety reasons.

"First of all, we were never asked at any point to be the front line for mental health triage in the world. But we got defaulted into that role and we've done our best to try to be professional and get to the best outcomes," said MacConnell.

"The reality is that once we arrive, because of the public safety risks, there's no option for us to leave," he said. 

"Sometimes these calls end up in unfortunate situations and I think we're always probably going to need the police presence because the person might be violent to themselves or others," said Sgt. Jason Blacquiere, with the Summerside police.

"We need to make sure that the counsellors and crisis workers are being looked after from a safety perspective."

Blacquiere said escorting a person to hospital takes two to three hours, and people often end up being sent home after being assessed there by medical staff "who actually have the proper training and expertise," so he's pleased there will be mental health professionals in the field doing the assessments.

While officers are trained in de-escalation skills, how to recognize when mental illness may be a factor and have access to a person's criminal record, MacConnell said they don't have access to the individual's medical history.

The new teams won't be sharing databases "but together they will come with more fully informed background to anticipate the situation that's unfolding before them," said Ryan.

Training the teams

Health PEI has already hired a team leader, psychologist Jonathan Dudek, who is creating the job descriptions and setting up protocols for the units.

The money for the units comes from a federal health accord agreement, which will also partially fund the police positions.

If this doesn't come to reality at the earliest opportunity, then we're going to have to look at finding ways to design our own approach.— Charlottetown Deputy Chief Brad MacConnell

In addition, the province has allocated about $1.5 million a year to cover the operational costs.

Health PEI needs to sign agreements with the police agencies, which will identify suitable officers for the mobile teams, said Ryan.

She said once staff are hired, they'll need special training, which will be done by members of existing units in Nova Scotia and Newfoundland and Labrador.

Units will be phased in

Ryan hopes the units will be set up province-wide by February, but she said they aim to phase-in the service, possibly by the end of this year. 

MacConnell said the capital city is at the crisis stage right now with a big increase in mental health calls to police in the last two years, and the mobile units can't come soon enough. 

"If this doesn't come to reality at the earliest opportunity, then we're going to have to look at finding ways to design our own approach," said MacConnell.

These people … are going to be specifically trained.— Ellen Taylor, mental health advocate

MacConnell hopes the collaborative approach not only offers more support for police officers, but also offers the individuals in crisis better support and access to services they need to get better.

Mental health advocate Ellen Taylor also looks forward to seeing the units up and running.

"These people in the mobile health units are going to be specifically trained to deal with mental health and addictions," she said.

"So you're not going to get somebody that has never dealt with it, or that doesn't really know what it's about or that's going to be judging these people."

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