“You are always welcome,” said the pretty octogenarian to the two SPVM police officers, the clinical nurse, the psychiatrist and her intern, who all arrived at her house on a chilly February morning. These members of the Echinops pilot project have been doing such home follow-ups since January 2022 to help citizens and connect them to mental health services. It should also result, they believe, in reducing repeated complaints to the police by—or for—those whose mental state is disturbed. The duty first accompanied this interdisciplinary team on the ground in Montreal.
Nothing suggests the difficulties of this smiling woman when she chats with Terri Cocco, socio-community agent at the SPVM and responsible for the Echinops project for the Saint-Michel district station. The agent questions her tactfully to check if she is oriented and if relatives are taking care of her.
“I’m not crazy,” she repeats from her anonymous building in the Saint-Michel district.
But she recently made several calls to the Service de police de la Ville de Montréal (SPVM): her neighbor entered her home to steal her personal belongings and “follows” her movements from one room to another from her apartment located on the upper floor. Questioned, she adds that the neighbor’s husband even stuck his fingers in the eyes of a child who was in her apartment. “He lost an eye. As proof, she shows a frame containing a photograph of a baby: her eyes have been completely scraped off, leaving a disturbing image.
Psychiatrist Luigi De Benedictis takes over: “What day is it? He inquires about the medications prescribed for him. Étienne Boucher, clinical nurse, examines them and checks if she really swallows them.
Shortly after, on the sidewalk, the team regroups to take stock of the situation, as is the case after each visit.
“There are elements of persecution, perhaps of hallucinations. There are a lot of inconsistencies in her speech, but she is oriented and organized,” sums up the resident doctor doing an internship in psychiatry, Marie Vincent-Tremblay.
They agree on the following: consult her hospital file to check if she is being followed by a doctor, otherwise “we will try to hang her up with the health services”, says the psychiatrist.
I never feel like I help people as much as on those days.
Every Thursday, the teams crisscross the Saint-Michel and Saint-Léonard districts, alternating, each time with the Dr De Benedictis, which is attached to the CIUSSS de l’Est-de-l’Île-de-Montréal, a stakeholder in this project.
“I never feel like I’m helping people as much as on those days,” sums up SPVM socio-community officer Julie Mazerolle, who is in charge of the Echinops team for “PDQ 42” in Saint-Léonard. .
Mental health calls galore
The observation of the police was as follows: there are more and more calls made to the emergency services for Montrealers whose mental health is disturbed. Nearly 80% of the calls, according to the head of the SPVM, Fady Dagher.
And if the police are not mental health specialists, they are often the first to arrive after a call to 911.
The idea for this project therefore germinated in the minds of the police officers and the psychiatrist who saw the difficulties in the field. “The police and social services, we are like two parallel systems that don’t talk to each other. We had to find a way to tie the two together and follow up to help these people,” explains Constable Mazerolle.
The Dr De Benedictis nods. He offered himself. “Why don’t we go visit them at their house?” »
“There are patients we were losing,” he sighs. We see them in the emergency room, but afterwards, we don’t see them again. And there are police officers who intervene more often with these people than mental health professionals. He has seen people barricaded in their homes for months and others who don’t seek help because they don’t understand they have a mental illness. The presence of the police is necessary during the visits, because patients can be “unpredictable”, it is explained.
It’s a win for everyone, adds Agent Cocco. People receive care, their mental health is assessed and the police receive fewer complaints: investigating takes time and police resources, she points out.
This is the case of this man, who blew out more than 80 candles: he filed multiple complaints against a bank and its employees. “They are thieves,” he repeated during the visit of the second Echinops team.
This team is made up of the same medical specialists, as well as Constable Mazerolle and a police colleague. They went knocking at his house, in Saint-Léonard. He opened the door, pleased with the visit. The man suffered strokes (cerebrovascular accident) and lost his memory. He can’t tell the day or the year. He does not remember having made withdrawals, explains the policewoman once outside.
Immediately, the psychiatrist and the nurse are worried: is he also forgetting to take his medication? They check every bottle. Does he have a family doctor? He does not know. “We’ll check,” said the orderly. He may need a social worker to help him manage his money.
In one year, only one person has refused to open their door, says agent Mazerolle: “The people we see, they need so much help. If we can influence their trajectory, that’s great. The police helped them before, but not in such an organized way as Echinops.
All team members hope that the initiative will be “exported”.
Echinops has aroused great interest from the start — even winning an award — and the current pilot project aims, among other things, to assess the possibility of extending it to other areas of Montreal, says the SPVM.
“It’s the future,” summarizes agent Mazerolle.