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A Co-response Model Mental Health and Policing Mary C. Pyche, MSW, RSW  Health Service Manager  Mental Health Mobile Crisis Team (MHMCT) Susan Hare, BScOT, Program Leader, Crisis Supports, Capital District Mental Health Program Constable Angela Balcom, Halifax Regional  Police, MHMCT dedicated police officer
Mental Health  Mobile Crisis Team
MHMCT is a partnered crisis support service of Capital District Health Authority, IWK Children’s Health Centre, Halifax Regional Police and Department of Health Emergency Health Services . MHMCT services population base of 450,000 people
 
 
2010 Demographics ,[object Object],[object Object]
Prevalence of Mental Illness ,[object Object],[object Object]
Police Calls ,[object Object],[object Object],[object Object],Even though police are receiving more mental health calls since partnering with MHMCT, the average total time spent on scene for a mental health call had decreased by 49.07 minutes in year two
EHSNS ,[object Object],[object Object],[object Object]
IWK Mental Health Program ,[object Object],[object Object],[object Object]
Capital Health ,[object Object],[object Object],[object Object],[object Object]
Why we came together ,[object Object],[object Object]
Collaboration  is a process defined by the recursive interaction of knowledge and mutual learning between two or more people working together toward a common goal  typically creative in nature . Wikipedia
True interdisciplinary collaboration requires crossing professional boundaries into what is often unfamiliar territory. Interdisciplinary collaboration also challenges us to drop preconceived notions of other professions, learn new languages, and also see a problem through a new lens . Playing Well With Others — Interdisciplinary Collaboration  By Lenard W. Kaye, DSW, and Jennifer A. Crittenden, 2005 Social Work Today Vol. No. Page 34
Key Considerations Memorandum of Understanding Ministerial Authorization Steering/Operations Committee EDP’s referral form and process Police Training in Mental Health
It is all about context!
HRP: Time Spent on Scene ,[object Object],[object Object],[object Object],[object Object],[object Object]
Health Outcomes ,[object Object],[object Object],[object Object]
Monthly average for 12 months  816 919 16.0% 84.0% JANUARY/10 854 22.2% 77.8% DECEMBER/09 898 23.8% 76.2% NOVEMER/09 740 16.2% 83.8% OCTOBER/09  842 14.2% 85.8% SEPTEMBER/09  852 10.5% 89.5% AUGUST/09  884 16.3% 83.7 % JULY/09 794 11.9% 88.1% JUNE/09 785 18.3% 81.7% MAY/09 815 23.0% 77.0% APRIL/09 799 23.0% 77.0% MARCH/O9 610 22.9% 71.1% FEBRUARY/09  TOTAL # INTERVENTIONS YOUTH ADULT MONTH
 
Volume and Locations of Interventions 100 7553 100 5926 100 2806 Total 91.4% 6934 92.1% 5455 94.2% 2643 Telephone 8.6% 619 7.9% 469 5.8% 163 Community % N % N % N 2 yrs Post-MHMCT 1 yr Post-MHMCT 1 yr Pre-MHMCT  Location
Complement of 4 Halifax Regional Police (HRP) Officers dedicated to MHMCT on a minimum 2 year posting.  This allows a schedule rotation that guarantees an officer with the team from 1pm to 1 am 365 days a year and a second officer from for an overlap mobile time of 8 hrs.  These officers work in plain clothes  and HRP also provides 2 unmarked cars to the service.  An HRP constable goes out on all calls with a mental health clinician.
Clinicians with MHMCT are called crisis intervenors and have  a discipline background in either nursing, social work or occupational therapy with a minimum of two years mental health experience.  They work 12 hr shifts with an overlap of staff between the mobile hours of 1-1 so that there is always a clinician answering the phone and triaging calls and the potential for mobile response in the community from  1pm -1 am
MHMCT Goals   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MHMCT ,[object Object],[object Object],[object Object]
Youth and Youth related calls are generally initiated by parents and are largely around parent/adolescent conflict. Initial objective (least intrusive first approach) is to support the parent/guardian to get settled in the moment so they can remain engaged in de-escalating the presenting crisis.  First line of action is to support agency and autonomy and to support the parent to remain in charge. Clinical approach is to not undermine the parent’s authority or replace the parent’s role
Telephone crisis intervention  response 24 hours a day  within Capital Health District
Telephone crisis intervention  response 24 hours a day  within Capital Health District ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
A combination of both these models  provides the most comprehensive service for building capacity for a community response to mental illness (Study in Blue and Grey –BC CMHA- 2003) Mobile Crisis Teams partnered with Police Plus CIT trained law enforcement Equals  Improved Responses and Outcomes to People with Mental Illness in the Community
Initiative in our Home Province   Capital Health Innovation Grant Project – Police Mental Health Collaboration   Across Nova Scotia   Purpose of Project:  To facilitate the development of Police/Mental Health Collaborative Partnerships within the health districts and law enforcement agencies throughout Nova Scotia
Mental Health  Mobile Crisis Team Questions ?????

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A Co-response Model Mental Health and Policing

  • 1. A Co-response Model Mental Health and Policing Mary C. Pyche, MSW, RSW Health Service Manager Mental Health Mobile Crisis Team (MHMCT) Susan Hare, BScOT, Program Leader, Crisis Supports, Capital District Mental Health Program Constable Angela Balcom, Halifax Regional Police, MHMCT dedicated police officer
  • 2. Mental Health Mobile Crisis Team
  • 3. MHMCT is a partnered crisis support service of Capital District Health Authority, IWK Children’s Health Centre, Halifax Regional Police and Department of Health Emergency Health Services . MHMCT services population base of 450,000 people
  • 4.  
  • 5.  
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13. Collaboration is a process defined by the recursive interaction of knowledge and mutual learning between two or more people working together toward a common goal typically creative in nature . Wikipedia
  • 14. True interdisciplinary collaboration requires crossing professional boundaries into what is often unfamiliar territory. Interdisciplinary collaboration also challenges us to drop preconceived notions of other professions, learn new languages, and also see a problem through a new lens . Playing Well With Others — Interdisciplinary Collaboration By Lenard W. Kaye, DSW, and Jennifer A. Crittenden, 2005 Social Work Today Vol. No. Page 34
  • 15. Key Considerations Memorandum of Understanding Ministerial Authorization Steering/Operations Committee EDP’s referral form and process Police Training in Mental Health
  • 16. It is all about context!
  • 17.
  • 18.
  • 19. Monthly average for 12 months 816 919 16.0% 84.0% JANUARY/10 854 22.2% 77.8% DECEMBER/09 898 23.8% 76.2% NOVEMER/09 740 16.2% 83.8% OCTOBER/09 842 14.2% 85.8% SEPTEMBER/09 852 10.5% 89.5% AUGUST/09 884 16.3% 83.7 % JULY/09 794 11.9% 88.1% JUNE/09 785 18.3% 81.7% MAY/09 815 23.0% 77.0% APRIL/09 799 23.0% 77.0% MARCH/O9 610 22.9% 71.1% FEBRUARY/09 TOTAL # INTERVENTIONS YOUTH ADULT MONTH
  • 20.  
  • 21. Volume and Locations of Interventions 100 7553 100 5926 100 2806 Total 91.4% 6934 92.1% 5455 94.2% 2643 Telephone 8.6% 619 7.9% 469 5.8% 163 Community % N % N % N 2 yrs Post-MHMCT 1 yr Post-MHMCT 1 yr Pre-MHMCT Location
  • 22. Complement of 4 Halifax Regional Police (HRP) Officers dedicated to MHMCT on a minimum 2 year posting. This allows a schedule rotation that guarantees an officer with the team from 1pm to 1 am 365 days a year and a second officer from for an overlap mobile time of 8 hrs. These officers work in plain clothes and HRP also provides 2 unmarked cars to the service. An HRP constable goes out on all calls with a mental health clinician.
  • 23. Clinicians with MHMCT are called crisis intervenors and have a discipline background in either nursing, social work or occupational therapy with a minimum of two years mental health experience. They work 12 hr shifts with an overlap of staff between the mobile hours of 1-1 so that there is always a clinician answering the phone and triaging calls and the potential for mobile response in the community from 1pm -1 am
  • 24.
  • 25.
  • 26. Youth and Youth related calls are generally initiated by parents and are largely around parent/adolescent conflict. Initial objective (least intrusive first approach) is to support the parent/guardian to get settled in the moment so they can remain engaged in de-escalating the presenting crisis. First line of action is to support agency and autonomy and to support the parent to remain in charge. Clinical approach is to not undermine the parent’s authority or replace the parent’s role
  • 27. Telephone crisis intervention response 24 hours a day within Capital Health District
  • 28.
  • 29.
  • 30. A combination of both these models provides the most comprehensive service for building capacity for a community response to mental illness (Study in Blue and Grey –BC CMHA- 2003) Mobile Crisis Teams partnered with Police Plus CIT trained law enforcement Equals Improved Responses and Outcomes to People with Mental Illness in the Community
  • 31. Initiative in our Home Province Capital Health Innovation Grant Project – Police Mental Health Collaboration Across Nova Scotia Purpose of Project: To facilitate the development of Police/Mental Health Collaborative Partnerships within the health districts and law enforcement agencies throughout Nova Scotia
  • 32. Mental Health Mobile Crisis Team Questions ?????

Editor's Notes

  1. Often defaults to Emergency responders 911 and police front line to respond to mental health calls – speaks to the overlap of police and mental health
  2. Key considerations for collaboration
  3. Started offering CIT in Halifax in fall of 2008. We attended training in Winter of 2008 from Hamilton who had trained in the Memphis Model of CIT. We had a consultation trip to Memphis in April 2009 as quality assurance that we were consistent with Memphis model. We offer CIT to Halifax Police Force twice a year and are building capacity to have CIT as a model of response in HRM.