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Unarmed mental health crisis response saves lives and money
220 Plays2 years ago
Host Duncan Kinney sits down with Dr. Jamie Livingston of Saint Mary's University to discuss why UCP's wrongheaded approach to centering police in mental health care and addictions and why we need well-funded, community led, civilian-led, unarmed mental health crisis response programs yesterday.
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Transcript
Introduction and Guest Background
00:00:12
Speaker
Friends and enemies, welcome to The Progress Report. I am your host, Duncan Kinney, and we're recording today here in Amiskwitchi, Wisconsin, otherwise known as Edmonton, Alberta, here in Treaty 6 territory on the banks of the mighty Kasiska-Saw, one a Sippy, or the North Saskatchewan River. Joining us today is Jamie Livingstone, an associate professor of criminology at St. Mary's University in Halifax, Nova Scotia. Jamie has been studying and teaching about issues at the intersection of mental health,
00:00:38
Speaker
substance use and criminal justice systems for over 20 years and led the very first study in Canada to examine the experiences of people with mental illnesses and their interactions with police. Jamie, welcome to the Promise Report. Great. Thanks for having me.
00:00:54
Speaker
So thank you so much for coming on. I've followed your work for some time now.
Mental Health Crisis Response
00:00:59
Speaker
You might call me like a bit of a fan boy, but like, as you may have guessed listener from the like intro and like the work that Jamie does, we're here to talk about civilian led kind of mental health crisis response and crisis diversion work. And
00:01:20
Speaker
you know, dealing with mental health calls. You know, this is an issue that comes up over and over and over again, right? Where police show up to a mental health call and far too often kill the person that needs help. And that's why it was so bizarre to me.
Critique of Police Integration in Mental Health Care
00:01:44
Speaker
when I saw this, I was just following your Twitter account because I follow you. And there was, you were reacting to something that our associate minister of mental health and addictions, Mike Ellis was saying, there was a press conference that we're doing. And I think this is as good of a way to introduce the concept of what we're talking about as anything. So here's the quote that got you furious. Here's the quote from Mike Ellis.
00:02:05
Speaker
We know that the police must be an integral part of the recovery oriented system of care that we are building, said associate minister of mental health indexions, Mike Ellis. We are creating a comprehensive system of care that has included police at the center of the process. And so why did that make you, as you said, on your Twitter account, furious?
00:02:26
Speaker
That is terrible. It's a terrible idea and it is just so consistent. Like I've been following what the UCP party has been doing in Alberta since they came into power because of my interest in various issues, including like the drug poisoning crisis, etc.
00:02:43
Speaker
But, you know, the idea the idea that police are the center of a care system is probably the worst idea I've ever, I've ever heard, and anyone who has any knowledge of how mental health and substance use systems work would never be saying such a statement.
00:02:59
Speaker
unless they have deep investments in police and want to see, you know, police powers expanded, police budgets expanded, and really their base is supporting these ideas. So there's like political opportunity that comes along with some of these really terrible ideas.
Community Mental Health Resources vs. Policing
00:03:18
Speaker
I've been working in the mental health system for over 20 years. Before I became a professor, I worked in the health system in the BC government. This is just such a terrible idea because we'll get into the reasons why it's so terrible, but I think it's not hard to figure out what the problems are. When I saw it, my jaw dropped and I felt like throwing my computer out the window.
00:03:46
Speaker
Benjamin Perrin, former Stephen Harper, criminal justice advisor, I think a law professor now, he had a very funny kind of reply to this, which is like, there's simply no other part of the healthcare system where you would
00:04:01
Speaker
where police would be at the center of it, right? Like, would you put police at the center of, like, your cancer care system at your, like, uh, you know, nephrology unit? Is there any other part of the, like, mental health care system where police would be at the center of it? Like, it is bizarre to even think of.
00:04:21
Speaker
It's really, really bizarre, but it's a consequence of 50 years or more of our community systems being so under resourced and people with mental health issues being so neglected.
00:04:38
Speaker
And so, you know, with certain social problems and health issues that were formally just hidden away and locked up in psychiatric units when people started, you know, living in communities without adequate services and resources, what were, like, what are health issues became issues of policing and social control.
00:05:01
Speaker
That was kind of allowed by our health care system and has continued for at least 50 years of persistent neglect of people in our communities that don't have various needs met. And when those needs are met, then the police are turned to for the solutions.
Rise of Civilian-led Crisis Programs
00:05:21
Speaker
And what might have been kind of an accidental kind of situation is now certainly used by certain political
00:05:30
Speaker
parties in order to win elections and to see police as the solution for these social problems. When in fact, I'm a criminologist, I know that police are not the solution to these problems and actually cause a lot of harm when we see them and design systems such that they're perceived to be the solutions to some of these issues.
00:05:52
Speaker
So let's get back to one. So like, okay, Mike Ellis and the UCP want for some reason, want police to be at the center of the like mental health care system and the crisis response system. But you know, what you've been working on is, you know, there's been an explosion recently kind of post George Floyd of civilian led, you know, unarmed groups that are doing pre hospital mental health care crisis response work. And
00:06:23
Speaker
That is one of the big reasons why I wanted to bring you on. You were posting about how these new programs have exploded. But before we even get to that, why don't you walk us through the biggest issues that you see as a criminology professor when police are involved in mental health crisis calls?
00:06:46
Speaker
Oh boy, it's a long list. But I think at the top of that list should be fatal police shootings. So people in crisis have relatively high risk of being fatally shot by police and the risk is even greater. People in crisis are Black, Indigenous or belong to other racialized groups.
00:07:07
Speaker
And so of course that's the harm that springs to great significance and importance around this area. And then every year we see corner inquest after corner inquest here in Canada investigating problems with police response to mental health crises or wellness checks. And that had ended in a person, typically a person who's racialized being fatally shot.
00:07:32
Speaker
And I see most, if not all of these deaths as being preventable. So, you know, number one big issue is that occasionally, they often, because more often than not, these encounters don't end in, of course, a fatal police shooting, but when they do, it's entirely preventable, I think. The other, you know, really, really big issue when police are involved
00:07:58
Speaker
is that there's always a chance that things will escalate into violence when police are present or involved in crisis situations. And in part, as numerous coroner inquests have underlined, it's a product of how police are trained. They're trained to rapidly contain and control situations.
00:08:17
Speaker
that they perceive to be dangerous. And I want to emphasize that they perceive to be dangerous because there's stigma that's contributing to this. And then this leads police to act in ways that are unhelpful for resolving crisis situations like shouting commands, deploying tasers, using physical restraints, handcuffing people as a default practice to handle situations, which is the opposite of how we know to effectively respond to crisis situations.
00:08:46
Speaker
And then the other reason why things escalate quickly into violence is because people often react negatively to police for a variety of reasons, and those reasons are sometimes connected to their own trauma.
00:09:00
Speaker
or their own negative experiences with the police or the fact that they belong to communities that have had long histories of collective trauma involving the police. But also because sometimes fear and vulnerability is heightened when people are experiencing certain symptoms of mental illness. And so seeing police can make them automatically feel
Impact of Police on Mental Health Crises
00:09:23
Speaker
more unsafe and behave as though they're under threat.
00:09:28
Speaker
So you know the fatalities and violence but also the risk you know how this contributes police involvement contributes to stigmatization of people with mental health issues you know like reinforcing the idea that people are dangerous criminals and need involuntary criminal justice of course of forms of care but also contributes to criminalization of people with mental illness
00:09:51
Speaker
by paving the way for them to interact with criminal justice agents in ways that are unnecessary and are really arbitrary and can be done in other sorts of ways. So those are the kind of big, big issues. There's kind of a long list of them, but that's how I see them.
00:10:08
Speaker
Yeah, and the tragedy and the preventable tragedy part of all this is the saddest part, right? And wherever you're listening to this podcast, you probably don't have to go far too far back in the news to find a recent event where police have murdered someone or killed someone in the context of doing a mental health call or killing someone who was going through a mental health crisis. Like in Calgary, just recently, a man named Vlad George Tuol, a South Sudan newsman,
00:10:36
Speaker
was shot dead by police in front of everyone at a bus stop. And that was a couple of months ago. In Nova Scotia, I assume there's been something recently in the past few years, Toronto, Vancouver. These things, these happen, these tragedies happen all the time. And they're, again, preventable, avoidable. But if you want to prevent and avoid them, you have to have people who don't have guns on their hips
00:11:07
Speaker
to be taking care of these situations, right? Yeah, absolutely. And what is really, um, uh, I think, uh, terrifying, but also like makes me really angry is that healthcare systems can kind of watch this happen time and time again, and, and then not take responsibility for, or accountability for these kind of really horrible tragedies, um,
00:11:37
Speaker
for communities, for families, for, you know, all sorts of, of course, for people who are the victims of these fatal police shootings, but also, like, more than just the fatalities is the violence, and that is also completely preventable if systems were designed differently.
00:12:00
Speaker
And that's where I see, you know, like a lot of neglect from our healthcare systems by not preventing these things from happening in ways that, you know, they really should be taking responsibility for. Yeah. It's not just a police issue. It's a healthcare issue. It's a society issue. It's just that at the end of the day, it's the police that get called and they solve problems the way police solve problems, right? Absolutely.
00:12:30
Speaker
Yeah. So walk us through, you know, like what, um, you know, like presumably these systems have been set up in other
Non-Police Crisis Intervention Models
00:12:40
Speaker
places. What is a civilian led mental health crisis response program? You know, what do they look like? How do they work? I know there's a lot of variety in kind of how these programs are put together and offered, but kind of like what, uh, what's the, like the general scan of like, what are these things and how do they work?
00:12:58
Speaker
Yeah, I mean, as the they go by different names, sometimes there's civilian programs or mental health crisis response programs, and sometimes they're non police or community led or that sort of thing. But essentially, as the name suggests, it's crisis, like people who go to crisis situations and are dispatched to crisis situations in the communities without the police. And so you have unarmed civilians.
00:13:21
Speaker
responding to crisis types of situations. And as you mentioned at the beginning of this, it's so bizarre that we have police involved, like, and often, you know, the, as the default response to mental crisis situations. And it's really because like, you know, mental crises have become over time defined as public safety issues rather than health issues. And
00:13:50
Speaker
I know people have wild imaginations of what mental health crises look like because they read it in the news and that sort of thing. And normally a mental health crisis does not involve, you know, like the types of imaginary worst case scenarios that people's minds often go to, but it's often just someone, you know, who's having problem coping and they're feeling distressed, maybe having thoughts of suicide and just, you know, or feeling really down and feeling really vulnerable
00:14:20
Speaker
And so, you know, having police respond to that makes absolutely no sense, even though we've designed like we've enshrined police involvement in legislation. And we've designed our systems to center police and many of these crisis responses and
00:14:40
Speaker
Over time, this has become imprinted on our brains and our belief systems that crisis response requires police when we know that it can be a different way. And it often takes like a tragic event or a series of lawsuits or a social movement like Black Lives Matter to help us think differently and instigate change around these things.
00:15:06
Speaker
So kind of your question about what do these teams look like? They come in all sorts of shapes and forms. We've uncovered like more than 80 of these programs that are operating mostly in the United States, but some in Canada as well as elsewhere. But what these programs look like is that they're teams that come to someone, wherever they are, it could be their home or their community when they're experiencing a mental health crisis.
00:15:35
Speaker
The basic framework is very simple. Someone calls an emergency phone number like 911, but it's not always 911. Emergency dispatchers are sufficiently trained to identify when it involves a mental crisis. Here in Edmonton, we have like 211 is the number you're encouraged to call if you see someone in crisis.
00:15:55
Speaker
Right, so that that that's another you know alternative, especially for people you know 911 is often seen as being problematic by some people in communities because of their close affiliation with police.
00:16:10
Speaker
And so sometimes these programs create special phone numbers that don't have that kind of affiliation with police. And 211 might be one of those things. I don't know. But sometimes these crisis programs have their own numbers as well.
00:16:30
Speaker
And so whoever's taking the call decides, hopefully they have appropriate training to decide when something involves a mental health crisis. And they decide if it's appropriate to dispatch a civilian team when it exists in a particular community. And that's an important point, like when it's deemed appropriate for a civilian team instead of the police to respond to an event, because that takes all sorts of shapes and forms as well, like what's deemed appropriate, which I can touch on later on.
00:17:01
Speaker
But the civilian team itself is comprised of like a combination of a mental health service providers, peer specialists in some communities involves paramedics and some communities involves like other healthcare providers. And they basically go to a person who's in crisis and take care of the person's urgent crisis needs. And many of these programs also have the responsibility of supporting the person afterwards, which may involve connecting them with appropriate services as well as providing follow-up care.
00:17:29
Speaker
So that's kind of what the teams look like and you know the the best teams I would say or best programs are not standalone teams but are rather supported by like a good comprehensive crisis service system. So you have like crisis stabilization programs, you have residential programs for people in crisis, there's
00:17:50
Speaker
you know, good hospital-based services and transport services that don't involve the police. So there's kind of a continuum of services that these programs are supported by. And so what places have put in programs that, you know, have been successful, you know, civilian-led mental health crisis response programs, like where can we look to for places that have done good work on this?
00:18:16
Speaker
Um, I guess successful is difficult to talk about since many of these programs haven't really been fully evaluated and studied. Um, however, you're the academic. Yeah. We were talking about this earlier, right? It's all the money goes to, um,
00:18:31
Speaker
actually delivering the services and there's no money left over to actually be like, so what, yeah, like to do KPIs or like to do the kind of like management stuff, right? Yeah, I mean, the way the research has worked for the past decade has actually been to reinforce police involvement.
00:18:50
Speaker
in mental health crises. So you have quite a bit of research on things like crisis intervention teams or CIT, which is specialized training for police to respond to mental health crises. You have quite a bit of research on co-response teams in which a police officer is paired with another social worker or nurse. So the research is actually working in ways that reinforce this relationship
00:19:13
Speaker
and center the police and crisis response. So there's actually been very little research that I've reimagined this problematic situation in which police are the center of crisis response. But I guess you can think of success in terms of programs that have been around for a long time. And there are a couple of programs that people often think of in this space.
00:19:39
Speaker
that have been along for more than 30 years. So one of those programs is the acronyms or CAHOOTS, which stands for Crisis Assistance Helping Out on the Streets. This has been around since 1989.
00:19:54
Speaker
It's a program in Eugene, Oregon, and basically it's someone calls 911 and instead of sending police, another civilian team consisting of like a medic, like a nurse or an EMT emergency medical technician.
00:20:11
Speaker
paired with a crisis worker who works in the mental health field. Sometimes it's oppression with lived experience. So they're dispatched to attend to a variety of types of crisis situations.
00:20:25
Speaker
and they provide stabilization and assessment and advocacy and things like that. This has been going on, and as I mentioned, in Eugene, Oregon for more than 30 years, it saved millions and millions of dollars for that city. And now they're responding to over 20,000 calls a year.
00:20:49
Speaker
And they're diverting, I think the estimates are between five and 10% of calls from police. It should be more, but it's between five and 10% of all calls that police go to this team. And they've spent several decades building trust with the community and employing people with lived experience. And the success is in the fact that they've existed for such a long period of time, they're responding to,
00:21:16
Speaker
quite a high volume of calls. And that among these calls, very few actually require police backup to be called. I think it's less than 1% of all of these calls require like the police to intervene in situations in which there's concerns about safety. So it's like a US program that's been around for a long time that many people think of as being successful.
00:21:42
Speaker
The other program I think of is a place in Toronto, so it's closer to home. Well, I guess it depends where you are in Canada, but it's Canadian anyways, and it's called the Gerstein Crisis Centre, and it's been around as long as cahoots. It was established in Toronto in 1989.
00:21:59
Speaker
And it's a real community-based program that provides crisis services to people living in Toronto. So they have their own 24-7 telephone support line. They have a mobile crisis team. They have short-term crisis beds where they can actually provide people with services.
00:22:18
Speaker
And recently they are recognized by the Human Rights Watch as one of the best practices in non-coercive mental health services. So last year in Toronto, for example, the Gerstein Crisis Centre, despite the fact that they're totally underfunded, they engage with 35,000 people in crisis. It includes almost 2,000 mobile visits.
00:22:47
Speaker
And they're really like stand out in terms of their engagement with community and they're working with people who have lived experiences. So I would recognize that program as being successful in its own community, even though it hasn't been used to its full capacity.
00:23:06
Speaker
Interesting. Well, it's nice to know that other places have been doing this for a long time and have a lot of experience. I think it's going to be instructive to kind of walk our audience through the kind of cornucopia of programs that
Diverse Crisis Intervention Models
00:23:23
Speaker
all kind of do similar things here in Edmonton? So the corner co-operative programs, that's something. So I'm working on a project right now that's, first of all, trying to identify as many programs as we can. And that's really difficult to do because these, as you mentioned earlier, these programs are
00:23:45
Speaker
being, you know, like there's a proliferation of these programs quite rapidly, particularly since 2020, post George Floyd's murder. So we're seeing almost every week we're discovering kind of a new program. And they come in all sorts of shapes and forms. Some of them are like real, like mutual support, community-led initiatives that are completely detached from institutional systems. And I'm thinking of programs
00:24:12
Speaker
like it's called Mental Health First Aid that are in Oakland and Sacramento, California, I believe. This is like a black-led, community-led initiative in which people with specialized training that aren't necessarily part of the institutional system come together to try to provide a good solution for people in their community that doesn't involve the police.
00:24:38
Speaker
doesn't involve coercion and doesn't involve the medical system because of various issues related to that. So you have these kind of like mutual help programs that I think are really important alternatives for people, especially if they have reservations about engaging with the healthcare system because of various traumas and harms they made of experience in that system.
00:25:03
Speaker
And then you have something in between and then something that looks more like an ambulance on wheels, like a mental health ambulance on wheels. So instead of paramedics, you have mental health practitioners or clinicians that are part of the formal healthcare system and they're dispatched like a paramedic or ambulance would be. And they're very much clinically driven.
00:25:29
Speaker
professionalized, institutionalized types of responses to people in crisis situations that have really lost connection with community. And then you have lots of things, types of things in between.
00:25:43
Speaker
In Edmonton, we have it all. We've got the REACH crisis diversion team. This is a partnership between a couple of social agencies and the Canadian Mental Health Association. The cops are a stakeholder in REACH and this 211 thing, but it's not really clear what their involvement is. It is a 24-7 line. You can call 211.
00:26:09
Speaker
Uh, but it's like, it's, it's not ideal. They're obviously all of these, all of the things that are not cop related that we're going to be talking about right now are dramatically underfunded, especially compared to the cop stuff. Uh, but like.
00:26:23
Speaker
Yeah, that's what we have here. And that's been around for a while. It's been around for like five or six years. I'd have to go, I wasn't able to find the original date of when they started, but it's been around for a while. But then, you know, alongside that we have the police and crisis response team. And this is an Edmonton Police Service Initiative. And it's like, it's what you talked about, right? It's like police plus a nurse or a mental health therapist. And, you know, they get dispatched
00:26:51
Speaker
like through the 911 system, right?
00:26:56
Speaker
Yeah, I think the program that you mentioned earlier, which is access through 211 and may divert some police calls that would normally go to police, I think that's really an excellent model to build off of. And the problem is kind of the patchwork piecemeal type of services. I mean, you don't see that in police.
00:27:23
Speaker
No, they're just a one-stop shop. Call the police and the police show up, right? Yeah, absolutely. It's very simple. It's very coordinated. It's highly funded and lots of support and lots of from leadership. And so compare that kind of model to what may exist in many communities, which are often involved.
00:27:48
Speaker
community agencies doing what they can on top of their caseload and trying to serve their community. Trying to run a shelter, trying to have social workers. Yeah, exactly, right? I mean, this PACT team has been around for a while too, but a recent creation of the Edmonton Police and really the thing that they've spent a lot of time hyping up here at the Edmonton Police Commission and in the media has been the help team, the
00:28:12
Speaker
human centered engagement and liaison partnership. This is police. These are essentially teams of police instead of a healthcare worker with social agency outreach workers. They're operating out of a shiny new building right by the downtown arena, right by
00:28:28
Speaker
well, where Boyle Street Community Services is right now, but will soon be moving. And yeah, this is like police with social workers model as opposed to police with mental health care and addiction model, mental health care and addiction specialist model. I mean, and I think that's something that could be rethought or should be rethought. And I think a lot of lessons come from like defund the police type work
00:28:56
Speaker
an abolitionist type of work in relation to how we want to imagine our communities. And we don't want our communities to be police run, police states, coercive systems, carceral systems, but rather we want our communities to be functional communities in which we can support each other and we can have support that doesn't involve the criminal justice system.
00:29:22
Speaker
This program, this help team really was a reaction to like, you know, George Floyd and 20, what happened in 2020 and BLM and the largest mass movement in modern history. Right. And, and so it's like, okay, well, like they, the cops kind of understood and internalized that like, okay, maybe cops shouldn't go to every call, but like, we still want to go to every call. So we'll, we'll have a social worker with us. Uh, and we still want to be like there every step of the way, but maybe the like social worker talks to the person first, you know,
00:29:51
Speaker
Well, I mean, if you ask the police what the solutions are, they'll come up with police solutions. It's not that far of a stretch of the imagination to think of the types of things that police would recommend and support. And it would involve their kind of driving the ship and leading the way, or at least having a great degree of influence on what these things look like. And I think that's really, really problematic.
00:30:19
Speaker
you know, how these programs should be designed and operated, which is like, and it's what people want, you know. Our healthcare systems like to say that they're person-centered, patient-gauge, which is, which I think is a bit of a imaginary type of scenario because
00:30:40
Speaker
Very rarely are people with mental health issues asked about what they want and I can't think of any study in which people with mental health issues were asked about crisis services and they said they want the police involved. The studies and information I'm aware of in relation to
00:30:59
Speaker
when people with mental health issues are asked. You might be shocked about this but they want to be treated not as a criminal and they want to be treated as a human being who needs support and not like someone who's done something bad that requires police intervention with the potential harms that come along with that.
00:31:20
Speaker
Um, and so, and so I think there's, there's, um, I, I, I, I understand why please want, please lead solutions, but I think that really needs to be rethought. Yeah. This is a $3.3 million program. It's a two year pilot. Uh, we're, I'm going to do kind of a roundup of all the fun, any of these later, but, uh, now we're going to get into the, like the recent, recent creations, like the community outreach transit team here in Edmonton is like, I don't know, it was like six, seven months old, maybe.
00:31:46
Speaker
Uh, this is, this system is a transit peace officer. So, so like, uh, not a sworn officer, but like a transit kind of bylaw officer essentially and an outreach worker.
00:31:58
Speaker
And this program just got off the ground, uh, because of complaints about transit safety. This is, you know, another pilot project. Um, you know, the early returns were quite positive and council city council here gave them more funding and increased the amount of kind of like, even though it's quite small, uh, they increased the, you know, they would think they went from like two to three vans or something, you know?
Community Safety and Resource Allocation
00:32:20
Speaker
Yeah, that's not what we should be doing. When you think about community safety, that's not how community safety should be envisioned or how it should, you know, like there's like criminological theories around crime prevention through social development, it's called. And it's like building communities and supporting communities and properly resourcing communities.
00:32:44
Speaker
to create solutions that don't involve the police and don't involve the criminal justice system. And more and more, you're seeing programs that are embedding police in the solutions in ways that balloon police budgets and reinforce kind of police powers, which is the opposite direction of where we should be heading. And that's why I reacted so strongly to
00:33:12
Speaker
Mike Ellis claims that a recovery oriented system centers the involvement of police because most communities are moving in different directions than that and trying to find ways to decouple police from our community safety types of strategies.
00:33:33
Speaker
And the latest and greatest, again, of the patchwork of things that have come up on this, this is a overdose prevention response team. This just got off the ground here in Edmonton. It's a small $200,000 pilot mobile team. They do overdose prevention and recovery. So it's not necessarily mental health care crisis focus. It's just focused on overdose.
00:33:52
Speaker
and drug poisonings. And it's just like just healthcare workers. It's like, yeah, it's like paramedics and nurses. And yeah, that's like a pilot project between like social agencies and like the Downtown Business Association.
00:34:08
Speaker
Yeah, I mean, again, when you ask people what they want to see in the services, they're saying that they want, they don't say they want the police. They say they actually don't want the police involved when it comes to health care services, but rather they want somebody who can show compassion for their situation, somebody who
00:34:27
Speaker
helps them work through the situation that they're dealing with in mental crisis. It's the stress. They want someone who understands the trauma that they've experienced with various institutional systems, including the health care system, and knows how coercive interventions can exacerbate their trauma.
00:34:45
Speaker
And they ask for like peer oriented services that are designed and delivered by people with lived experience so that you have someone who can offer empathy and support in ways that are really helpful and constructive for someone to resolve the situations that they're dealing with.
00:35:06
Speaker
So, the more and more that those types of services that endorse and follow those types of values can be created, I think the more people may reach out for services, especially if they're culturally appropriate.
00:35:23
Speaker
aren't a one-size-fits-all type of program, but rather attends to people's needs, but also their worries about engaging with service systems. And so that's what I'm really pushing for in my work, is to create those types of opportunities for people. It's not a radical idea to provide healthcare services that meet the needs and wants of people.
00:35:51
Speaker
rather than pushing police delivered services down people's throats. Yeah. And back in 2020, you know, the height of the George Floyd stuff, Chief Dale McPhee here in Edmonton was in front of city council and said 30% of police calls aren't police work. But, you know, the Edmonton police budget is $485 million. And since that statement has come out, you know, there hasn't been an organization with the 30% of the Edmonton police budgets money.
00:36:21
Speaker
to come along and take care of the 30% of calls that aren't police work, you know? Yeah, I would say if the police are saying it's 30% of the work that can go somewhere else, it's probably a double that. Especially when you look at calls for services and what calls for services are normally consist of.
00:36:42
Speaker
And many of those calls for services, if appropriate alternatives existed, would be appropriately handled by people who aren't police. And recently in Halifax, our board of police commissioners funded a report that was on defining defunding the police and many of our leaders
00:37:07
Speaker
in the African Nova Scotia community here in Halifax, as well as other leaders in our community, spend some time talking to our community about the concept of defunding the police. And the report points to all sorts of different ways that the police work that's normally handled by police can be handled by other organizations and groups that don't involve the police. You know, things from traffic,
00:37:36
Speaker
And they draw from a lot of different models that don't involve the police to resolve incidents involving traffic, but also, you know, like social issues around homelessness and health issues around overdoses and.
00:37:52
Speaker
and mental health crises and all of those sorts of things. So I think if we really stretched our imaginations, you could see the majority of the calls that normally are dispatched to police handled by a well-resourced community.
00:38:09
Speaker
The defund the police argument brings up the like, well, how do you fund it?
Funding for Crisis Services
00:38:13
Speaker
I think you've brought up two ways to think about how these services get delivered. One is through the healthcare budget and the other is through taking money from the police, defunding the police and putting that money into the civilian led mental health crisis response teams.
00:38:33
Speaker
however they look like, but just the fact that I think you've walked us through what those mental health crisis response programs should look like. The police budget is so enormous, nearly half a billion dollars for one mid-sized Canadian city to run a police force.
00:39:01
Speaker
And, and then when you look at the money spent on crisis diversion, like, uh, you know, that the, the community outreach transit teams, which still have a transit peace officer attached to them, $1.4 million, you know, like the reach two on one line, I wasn't able to find exact dollar figures before, uh, we started recording, but like at most it's like two to $3 million. Uh, you know, this, this, uh, $200,000 for the O just, just for overdose prevention response, like.
00:39:28
Speaker
We're talking about crumbs compared to a half a billion dollars. And in the context of a healthcare budget, it's like we spend like $22 billion on healthcare in the province of Alberta.
00:39:43
Speaker
Yeah, so there's a, there's a number of ways that these things can be funding but it's, it's important to acknowledge that when you deal with crises in ways that don't involve the police or actually, and this is like proven out in places that where these programs have been around for a long time.
00:39:59
Speaker
you can actually save money by doing things by looking at like root cause types of solutions rather than waiting for things to escalate into crisis and potentially, you know, like criminal types of events where you're spending an inordinate amount of money processing someone through the criminal justice system. So there's pleasing cause, court cause, and then the cost associated with the penal system as well. But rather than doing all of that,
00:40:29
Speaker
And then rather than waiting for someone to need a transport and stay at an emergency room, there's so much money that can be saved through prevention types of efforts. And these types of mental health crisis programs, civilian mental health crisis programs can save money and through that money can be funded through the types of money saved to cities
00:40:58
Speaker
provinces and territories and that sort of thing. But it will take new investment and I think pulling that 30% or whatever percent from the police is definitely one way to go about this. It's not only about reallocating resources, but it's also about reallocating power.
00:41:18
Speaker
that comes along with these sorts of efforts and actually investing in things that we value. But the healthcare system and our federal government and the way it sends money to the provinces to pay for our healthcare system, I think more and more should go towards mental health services and substance use services so that people
00:41:41
Speaker
aren't having to access only access services when they're in crisis, but can have access to services when they need it, like responsive services.
00:41:52
Speaker
Yeah, and I think if I'm going to drill down and kind of look at Edmonton and where I'm at, the problem I would diagnose would just be that crisis diversion is run off the side of a desk of a handful of nonprofits that are dealing with trying to run shelters or employing social workers or trying to feed people.
00:42:14
Speaker
There's no single dedicated organization that only does mental health crisis response. And I think that might be useful. The Toronto example seems very instructive. The cahoots model seems to be very instructive. And if I was to drill down, and also, I just have to leave you with this, Jamie. So our police chief,
00:42:41
Speaker
who just got exactly what he wanted when it came to a police funding formula from City Council here. It was actually in front of City Council saying, you know, I've looked at cahoots. I've looked at Denver. We're way ahead of them. People are coming to us to learn about what Edmonton's doing. You know, he's kind of specifically referencing these help teams that he's, you know, trying to holding up as the kind of paragon of what he's doing.
00:43:07
Speaker
And I mean, police chiefs are always going to say things that benefit police chiefs, but I like, what would your response be? What would you want to tell those Edmonton city councilors when a police chief stands in front of them and says, we're doing a great job on mental health crisis response?
00:43:24
Speaker
Well, I would ask them to ask people who have experienced a crisis in their local communities to find out the adequacy of mental health crisis response, because that's ultimately what we should be hearing from as people who've experienced a mental health crisis.
00:43:46
Speaker
and the challenges they face in the existing system and also how the existing system often contributes to their needs not being met and a whole host of harms. But on top of that, there's many people who have just disengaged from systems because they didn't find them helpful.
00:44:09
Speaker
They didn't find them responsive. They called and no one showed up. Or they found the services to be overly coercive and not spousing, peer-oriented, community-led types of values.
Limitations and Community Involvement
00:44:23
Speaker
So I would really problematize that statement that things are working well.
00:44:28
Speaker
when I'm not aware of any sort of evaluation or study that has actually asked the community whether or not things are working well for them. Even in communities that have these civilian programs, there's a host of problems associated with these programs and limitations with these programs.
00:44:47
Speaker
So like limited hours or people don't find the services to be useful or they're overly connected to the police or the types of calls that they respond to are too narrow so that police end up showing up for all sorts of calls that they shouldn't be showing up. So I think, you know, I'm not aware, and I've been doing this for a number of years, I'm not aware of
00:45:15
Speaker
Edmonton as being a particular standout in relation to best practices when it comes to civilian mental health crisis response. I'm aware of other communities that have really demonstrated that over decades and have really built trust with communities that they are legitimate programs that care for people in communities and really are trying to disassociate themselves from police because of recognizing the types of
00:45:46
Speaker
that involving police can create? Well, that's a fantastic place to leave it, Jamie. I think the kind of final thing we get to before I ask you how people can follow along with your work is that if you see someone who is having a mental health crisis, I would say, don't call the cops unless you absolutely have to. In Edmonton here, Alberta, call 211, right?
00:46:13
Speaker
Yeah, I think that's a good message, but also like, you know, often those people are in our own lives. So I've supported the people in my own life who struggle with mental health crises and the conversation needs to be what works for that person. What does the person find supportive?
00:46:33
Speaker
What does the person find helpful in trying to work within that person's wants and needs is really the way to go. But also making yourself aware of what may be available within your own community in relation to outreach services and non-police types of services that you might be able to draw on.
00:46:52
Speaker
if you encounter a situation in which someone may need some external help. And that person has likely had difficult experiences with police and with healthcare systems. So acknowledging that's really important. And I haven't gotten this yet. I'm looking into it, but I'm looking into getting mental health first aid training as well. So I'm unfamiliar with, I don't know how familiar you are with those programs, but
00:47:21
Speaker
Yeah, I think some people who are working in this space are really working hard at sending the message that this type of work involves trying to build capacity in communities for us to take care of one another, rather than relying so heavily on our institutional systems. So over time, we've become de-skilled in caring for one another.
00:47:48
Speaker
And so it's quick for people to turn to institutional systems and call 911, when often, you know, what's required is a neighbour to take care of another neighbour and support one another. So I think building skills like through mental health first aid, but also about learning about resources and becoming familiar with people who are already working in the community in this space, like NGOs, is really important stuff to do.
00:48:14
Speaker
Mm-hmm. Agreed. Well, thanks so much for this conversation, Jamie. I think it's been very useful. I really do appreciate it. What's the best way for people to kind of follow along with the work that you're doing? Probably by on Twitter. So you can find me at Jamie Livingstone. I don't know what my handle is or anything like that, but I'm regularly... We'll put it in your shop. Don't worry about it.
00:48:37
Speaker
I use Twitter as a vehicle for informing people. If they can stand all the other nonsense that I tweet about, then I often tweet about the projects that I'm working on. Yes, great follow. Thanks so much for coming on. Folks, if you like this podcast, support it. Join the 500 or so other folks who help keep this little independent media project going.
00:49:00
Speaker
There is a link in the show notes, or you can go to theprogressreport.ca slash patrons, put in your credit card and contribute. We would really appreciate it. Also, if you have any notes or thoughts or comments, things you think I need to hear, I am very easy to get ahold of. I am also on Twitter, uh, far too often at, at Duncan Kinney. And you can reach me by email at Duncan K at progress, Alberta.ca. Thank you to Jim story for editing this podcast. Thanks to cosmic family communist for our theme. Thank you for listening and goodbye.