The police chief in London, Ont., has made a public appeal for improved community mental health services to help lessen his officers' load.
Police Chief Brian Collins (who recently retired) says there has been an increase in the number of calls involving people with mental health issues since Ontario decided to downsize psychiatric institutions. The province intended to increase community services, but much remains to be done (CMAJ 2001; 164 [7]:957).
Collins stresses that these calls have always been part of policing, however a recent study found that almost 15% of London's police resources are now devoted to mental health issues. Collins says it's likely the same across Ontario.
The London force responded with a resolution, later endorsed by Ontario Association of Chiefs of Police, for increased community mental health funding.
The Canadian Mental Health Association (CMHA) commends Collins for his stance and urges others to follow suit. “The criminalization of the mentally ill has been an upward trend for 4 or 5 years,” says CEO Dr. Barbara Everett. “Police are frightening to people who are in a psychotic state, and police themselves are frightened of people in a psychotic state, so it's a recipe for disaster.
“It's horrifying for everybody involved: the family, the police officer, everybody.”
Police intervention also perpetuates the negative stereotype that people suffering from mental illnesses are dangerous.
Chief Collins concurs. “For a lot of these very vulnerable people, their avenue into the health care system is the justice system. I think that is intolerable.”
Community services have been shown to be effective, says Everett. A 30-month long CMHA study found that community mental health services reduce hospital admissions by 86% and crisis incidents by 34%. Everettt says a person with mental illness can be cared for in the community for $98 a day, compared to $468 in a hospital.
But with a waiting list of 5 or 6 months for case management, people aren't getting into the system.
Meanwhile, police officers receive only about a week's training in dealing with mental health problems, which Collins says is totally inadequate. “Really, the appropriate response is the medical one.”
But mental health doesn't appear to be a provincial priority. “We always seem to be the next thing they're going to get to, except they never get to it,” says Everett. “I think there's a lack or urgency around this. We still suffer from discrimination and stigma around mental illnesses.” — Lynne Swanson, London, Ont.