Every Tuesday, The duty offers a space to the artisans of a periodical. This week, we offer you an abridged version of a text that appeared in the journal Relationshipsspring 2023, noh 820.
The rise of neoliberalism and the erosion of the welfare state have contributed to undermining the social protections offered to the most vulnerable populations in our society. More than social and community responses, police and judicial responses are preferred […]. While governments are cutting public services and deploying strategies to deinstitutionalize or non-institutionalize people with mental health problems, the budgets allocated to security and police organizations continue to grow, despite the fact that crime has been on the decline since the 1990s.
This structural, institutional and budgetary dynamic is accelerating the withdrawal of logics of prevention and care for people in distress, leaving police organizations with the mandate to intervene in crisis contexts, without real expertise in mental health and according to a framework of intervention that aims to maintain or restore order rather than support and accompaniment of people in distress.
However, it has been shown that police interventions in this type of situation often aggravate the crisis, sometimes even leading to avoidable deaths. […]
In Quebec, as elsewhere in the country, the situation continues to deteriorate. The numerous criticisms and investigations by the coroner relating to various police interventions having caused the death of people in distress […] only led to the introduction of various measures. However, the latter – training in mental health or in techniques of de-escalation in crisis situations, for example – do not call into question the central and problematic place of the police in the intervention. […]
Mixed teams, a solution?
Other approaches, such as mixed teams, have been implemented in Quebec as elsewhere to address crisis situations differently. In these teams, police officers work with psychosocial workers to act with people in distress. However, the effectiveness of such a solution is limited. If mixed teams can play an important role upstream and downstream of the crisis, they can hardly intervene at the very moment when it takes place, because they are rarely on the front line and, therefore, in a position to respond to emergencies. . […]
Given these observations, why are the ways of doing things not changing in Quebec? As we know, criticism of the action of the police forces, in this area as in others, is difficult to say the least. […] The police forces are among the institutions most resistant to change, and this, without the political actors finding fault with it.
A matter of public health
However, other ways are possible. As part of a meta-analysis carried out in 2022 and published in the journal Health Social Care in the Communityresearchers Natania Marcus and Vicky Stergiopoulos have shown, by comparing police crisis intervention teams, mixed teams and social and community teams, that the latter would be preferred for intervening with people with mental health disorders […]. Only social and community teams take the time necessary to establish a relationship of trust and reassurance with people in distress. Prioritizing them makes it possible to recognize that this type of psychosocial intervention is not a matter of public safety, but a matter of public health.
It is in this perspective that the City of Toronto set up, in 2021, the Toronto Community Crisis Service, where a multidisciplinary team works to respond to crisis situations experienced by people with mental health problems. Although its mandate only concerns non-emergency situations, this service constitutes an alternative solution to inadequate police responses. Based on principles of harm reduction and trauma-focused approaches, this initiative aims to provide a community and psychosocial response to people in distress.
The Urgence psychosociale-justice (UPS-J) team, created in Montreal in 1996, also deploys this type of approach with vulnerable people in crisis situations. […].
While the models are multiple, involving various resources — organized either as a mobile first line present in the streets, or as a second line acting at the request of other actors — they all have in common, however, the recognition that the response to a situation of distress should aim at de-escalation, be supported by health and mental health professionals, and facilitate the voluntary care of the person in crisis by care services that meet their needs. It is high time to move in this direction and to review the role of the police when it comes to situations of vulnerability and interventions with people in distress.
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