The committee met at 1:02 p.m.

[D. Routley in the chair.]

D. Routley (Chair): Good afternoon, everyone. My name is Doug Routley. I’m the MLA for Nanaimo–North Cowichan. I’m Chair of the Special Committee on Reforming the Police Act. This is an all-party committee of the Legislative Assembly.

I would like to acknowledge that I am joining today’s meeting from the traditional territories of the Malahat First Nation.

I would like to welcome all those who are listening to and participating in our meeting.

Our committee is undertaking a broad review with respect to policing and related systemic issues in B.C. We are taking a phased approach to this work and are meeting with a number of organizations and individuals over the fall to follow up on input we’ve already received and to learn more about new models and approaches that have been drawn to our attention.

For today’s meeting, we will be having discussions about Peer Assisted Care Teams as well as hearing from the B.C. Psychological Association and Dr. Craig Norris.

As a reminder to our presenters, all of the audio from our meetings is broadcast live on our website. A complete transcript is also posted there after the meeting.

I’ll now ask the members of the committee to introduce themselves. I’ll begin with my North Vancouver friend Karin Kirkpatrick.

K. Kirkpatrick: Hi, there. I’m Karin Kirkpatrick. I’m the MLA for West Vancouver–Capilano, which is half of North Vancouver.

I am very proud to be here on the traditional and beautiful territories of the Squamish, Tsleil-Waututh and Musqueam First Nations.

G. Begg: Hi, everyone. I’m Garry Begg. I’m the MLA for Surrey-Guildford.

I’m coming to you today from the traditional territories of the Coast Salish peoples, which includes the Katzie, the Kwantlen and the Semiahmoo First Nations.

H. Sandhu: Hello, everyone. I am Harwinder Sandhu, MLA for Vernon-Monashee.

We are located on the traditional Syilx territory of the Okanagan Indian Nation.

Great to see you all. Thank you so much for being here today again.

[1:05 p.m.]

G. Lore: Hi, everybody. I’m Grace Lore, MLA for Victoria–Beacon Hill.

I am calling in from the territory of the Lək̓ʷəŋin̓əŋ peoples of the Esquimalt and Songhees Nations.

I’m really glad to see some familiar faces and thrilled to hear from you today. It’s important for this work.

R. Glumac: Hi. I’m Rick Glumac, from the riding of Port Moody–Coquitlam.

I’m on the traditional territory of the Coast Salish peoples.

R. Singh: Rachna Singh, the MLA for Surrey–Green Timbers.

I’m joining you from the shared territories of Kwantlen, Kwikwetlem, Katzie and Semiahmoo First Nations.

D. Routley (Chair): I’m not sure if our Deputy Chair, Dan Davies, can have audio right now or not, but he is with us. The same, I think, is true for Adam Olsen of Saanich North and the Islands. He’s with us, but he may not be able to connect with audio right now.

Thank you, Members. We may have one other member come in later.

Now, assisting our committee today is Karan Riarh from the Parliamentary Committees Office — Karan is an invaluable resource to our committee, as is the office; and Amanda Heffelfinger from Hansard Services.

I’d now like to introduce Jonny Morris — he’s the CEO of the Canadian Mental Health Association, B.C. division; and Julia Kaisla, the executive director of the Canadian Mental Health Association, North and West Vancouver, who are here to discuss Peer Assisted Care Teams.

They are joined by Chief Del Manak of the Victoria police department; Sarah Potts, councillor, Victoria city council; and Denise Tambellini, from the city of New Westminster.

I really am grateful for all of you joining us here today.

With that, I’d like you to take it away. I’m not sure what order we’d like to go in.

Presentations on Police Act

PEER ASSISTED CARE TEAMS

J. Morris: Thank you, Chair, MLA Routley. Thank you very much, indeed, for the warm welcome. A pleasure to be here with you and the fellow committee members. It sincerely is such an honour to have been invited back in to present to your committee with a more detailed update on some of the work that is currently underway under this banner of peer-assisted crisis or care teams.

I do want to acknowledge I’m joining you from unceded and ancestral Lək̓ʷəŋin̓əŋ territories today. I’m very privileged to be speaking to you from these lands.

We worked with Karan to kind of set up a bit of a flow here. Julia and I are going to brief you as a committee for about 15 minutes or so. Then we’re very, very grateful to have witnesses join us from different vantage points and municipalities to respond more deeply to questions you as committee members may have about our work.

Julia and I, as staff at the branch level, with Julia and me at the division, are happy to take your questions as well.

Hopefully that sounds okay to you, Chair, as we go forward.

D. Routley (Chair): Yes. Absolutely. Please go ahead.

J. Morris: In your slide deck…. I know we can’t screen-share with you, but I know you’ve had materials for a couple of days.

Our objectives here, over the next 15 minutes or so, are to respond, I think, to an inquiry from your committee about the background on the concept, the development, the implementation, the systems that we’re trying to join together related to this concept of Peer Assisted Care Teams, as they’re known in North Vancouver, or Peer Assisted Crisis Teams, a civilian-led model of response to mental health crisis.

I think with our witness colleagues here, who are joining us to really hear from the municipal, the police perspective, on the need for an alternative to a police-only response to 911 calls…. Councillor Potts, Chief Manak and, at the staff perspective, Denise Tambellini have lots to offer there from their vantage points.

When I was last here, you heard lots about who we are. I’m not going to linger on this slide, which is the third slide about the Canadian Mental Health Association. But what I think has become clear since we last briefed you at the committee level is the strength of the partnership between us as a non-profit, with presence across 14 communities here in B.C. with branches, and the provincial office, in building these partnerships, these nimble, agile partnerships that are starting to flourish within North Vancouver, the city of New West, Victoria.

We just got off a call with the city of Vancouver too. There’s lots and lots of interest in what’s happening, particularly given that the first team has recently launched in North Vancouver, led by Julia Kaisla, which is very, very exciting.

[1:10 p.m.]

Hopefully, you know enough about us, but I wanted to underscore that the partnership between us as a community agency and the health system, police systems, other community agencies and people with lived experience. The province has been incredibly helpful in us getting as far as we’ve gotten with this innovative work.

When I last briefed you as a committee several months ago, we kind of hinted at opportunities for you as a committee to look at reform in some key areas. What we have done since then has been trying out and implementing this civilian-led work as an addition to the mental health response. I didn’t get into this detail when I last was with you, but we are really trying to respond, on the fourth slide here, to drivers of crisis on the right-hand side.

We recognize that our police colleagues, led by folks like Chief Manak here, have a real role to play in addressing criminal risks, threats of violence to self and others. In the middle, there is such an opportunity for health to respond — with police, on occasion — to suicide attempts; very severe mental health crises, like psychosis; major injuries; and overdose.

The pitch I made several months ago is that community agencies, when well aligned and well linked in with systems like first responders and the health system, have such an opportunity to support you in responding to these kinds of crisis drivers: isolation, grief, bereavement, loss, depression, anxiety, minor physical injuries. What’s happening in North Vancouver — and Julia will give some of this detail in her presentation — is we are responding to these kinds of drivers. Interestingly, responding to families or people who are concerned about others who are experiencing some of these drivers on the right-hand side of the screen….

We’re not trying to do the work of the police, and we’re not trying to do the work of the formal health system, in some ways. We aren’t trying to do the work of a community agency in responding to some of these drivers of crisis that you see on slide 4.

We’ve been pitching to the Ministry of Mental Health and Addictions and other partners this work as part of a grander vision of crisis care reform in the province. The province’s recently released budget consultation report featured testimony from our organization around how we can support these pillars that sit in front of you in trying to rethink crisis care in community, particularly given that we are at the sharp point of crisis increasing amongst folks due to the pandemic, due to climate-related anxieties, due to the complexities of the ongoing drug poisoning crisis here in this province.

There is a moral imperative for us to start to think through the transformation in crisis care that is required. It’s so exciting to be able to report to you as a committee that there is action happening against three out of these four pillars.

There is active work around strengthening the crisis lines right now. Crisis lines are so, so vital to this work. Their security as agencies, going forward, amongst the crisis line network is pivotal, because they are some of the best dispatchers of care, some of the best diverters of crisis care in the province right now. There is work underway, and we are aligned with trying to support and strengthen the crisis line network.

We have launched a civilian-led team. You’ll hear a bit more about that from Julia, and we are starting the process of launching additional teams in the city of Victoria and the city of New Westminster during the course of this next year. We are adding to that mental health response continuum that we shared last time.

There is work underway right now around supporting health care systems to provide enhanced crisis care. Suicide-safer care. There is some of that work underway right now.

No. 3, we can chat about at another point in time, but it’s really about: how do we provide community-based crisis care outside of the emergency department? I know that MLA Olsen here has often talked about this in various forms around crisis care in the context of emergency departments and where that can be very, very challenged. There is an opportunity to think about crisis care in community. I’d be happy to share that at another time as to some of that thinking and progress we hope to make in that space.

Really, germane to your questions: what is a civilian-led mobile crisis team?

[1:15 p.m.]

Civilian-led mobile crisis teams really are teams composed of mental health specialists integrated with systems of care like police and emergency responder systems and are dispatched to crisis events to de-escalate and provide ongoing, continuous support in some ways, to people experiencing distress.

In other implementations of this model, particularly in Eugene, Oregon…. It has also been implemented in Edmonton. It’s about to be implemented in the city of Toronto. It has been implemented in a few jurisdictions.

It’s been shown to save money. It’s been shown to free up police resources, hopefully allowing for their reallocation to other needs and purposes. It decriminalizes responses to mental illness. It enables a health response to health emergencies. It allows for a restructuring there of the kinds of responses we send, recognizing that there are occasions when police are absolutely required.

It reduces stigma. I think we’re starting to, hopefully, see evidence of this in North Vancouver, or we anticipate seeing evidence of this. It helps populations who are reluctant to call 911 or access emergency services to access mental health care. It can help divert people from emergency department use. Crisis lines already do this. They help keep people out of emergency departments by de-escalating the crisis in the moment. It can also help people be better connected to services, going forward.

I’m going to be turning to Julia in just a second here. What we’ve been up to recently. We have a launch that’s underway in North Vancouver right now of a peer assisted care team, one of the first of its kind in B.C., and we are at a point of initiating the design process in Victoria and New Westminster to get this work underway.

We’re very keen to implement this service in a phased way. Over time, what we anticipate with this model is — and Julia will address this in a few moments — having a service that’s accessible to the public directly for a phone line, so people don’t have to navigate the E-Comm system to get care, but with very strong police awareness and paramedic awareness about what we’re up to.

We are in the process of doing this in North Vancouver, and this is the heavy lifting of the paradigm shift that’s required here of developing the referral protocols that are required to enable PACT to be part of the response continuum. We’ve been in active discussions with E-Comm 911 about what this could look like long term, as they also reimagine their role in crisis care dispatch.

What would it look like if you called into 911 and were offered police, fire and ambulance but also a dispatch directly to a team like this or a crisis line service? That’s where we hope to get to in time — a 911 dispatch that includes a mental health option.

This would really be about reducing that reliance upon police. We almost have a fait accompli in our dispatch system, where police are put forward as the only response, when alternatives or a more nuanced response could be provided if we could round out that dispatch process. That is not the work that’s going to take place tomorrow, but it is work that is definitely part of the strategic vision for the crisis care reform agenda that we are planning out with our systems-level colleagues, and many of them are here around us at this presentation.

I’m going to turn to Julia Kaisla, my dear colleague at CMHA North Vancouver, to kind of speak to a little bit about what her team looks like in North Vancouver, the key components here. Then she’ll hand it back to me to set up the next little bit of material before we round out our presentation.

Julia, I’m wondering if you might add some detail here about the team you’ve built with your colleagues over at your branch.

J. Kaisla: Sure. Thank you, Jonny.

I’m calling in from the unceded territories of the Tsleil-Waututh, Musqueam and Squamish people.

I use the pronouns she and her.

I’ve been the executive director here of this particular branch for the last five years. Prior to that, I worked with Jonny at a provincial level.

Our branch serves the North Shore community as well as the Sunshine Coast and the Sea to Sky. We are very focused on this particular pilot. I know we all use North Vancouver as the term, but Karin will know that it’s very important to include West Vancouver in this presentation. We are referring to it as the North Shore pilot, because we will be serving communities from Horseshoe Bay to Deep Cove, quite a large geographic region but an important consideration as we start to look at these pilots in more rural communities, when other elements will need to be included. Right now we’re still in quite an urban setting.

I’m so pleased to share with you a little bit about our pilot here. It has been a long time in the making. We convened a community planning table early in 2021, and at that point in time, we had started having conversations with different cultural communities, with our Indigenous community partners and with others about how the current crisis mental health response felt to them in terms of a supportive, family-centred response.

[1:20 p.m.]

I think we saw an opportunity to consider a different way of doing things. Those initial conversations really did start with the RCMP, with our partners at North Shore multicultural services, which is now called Impact North Shore. Again, the West Van police department came to us and said: “Hey, we want to be a part of all of these conversations. We’re struggling with the same things that the RCMP is struggling with, and we really want to look at this as a North Shore–wide initiative.”

Where we’ve landed. I’ll speak a little bit about the process, but I think what’s really important to keep in mind, the most important piece around PACT, is that it partners a mental health professional — a clinician, a social worker or another mental health professional of sorts — with a peer support worker, so somebody who has lived experience of mental illness or apprehension who can speak to being either a family member supporting someone or an individual having experienced that personally to really share a message of hope.

When I present on this, I really talk about it as a partnership between help and hope, because the mental health professional there can provide that help and that assistance, and usually they have a really good sense of some of the different supports that exist. We’ve done great training with them at the emergency room department and with mental health services on the North Shore so they can provide that help.

The peer is so essential in this process because it provides a sense that there is hope, that recovery is possible, that this is a moment in time. Often families are coming to us in this moment of crisis, and they don’t see a way out. I think what we are able to offer when we have a peer joining in that response is that there is a way out, and it does get better, and there are ways through this.

I really want you to keep that in mind — that this is what makes this program unique. It’s about help, and it’s about hope. Our team is very well trained in terms of providing trauma-informed care. But what we heard from all of our community consultations….

Jonny, did you want me to delve into a little bit about the process that we went through?

J. Morris: Yeah, I would say so. For the little bit of time we have remaining for the presentation, the process and a little bit about the access into that team. Then I’ll frame up Victoria and New West at the end, Julia.

J. Kaisla: Perfect. Yeah.

It really started with this community planning table, and that is the model that we’re looking at for these teams as they’re built across the province. It was really an opportunity to bring together representatives from our local First Nations, from the municipalities.

We had councillors who were showing up as independents to voice their concerns about the current crisis response system and to look at a different way forward. We had representatives from the West Van municipal police, as well as the RCMP, and they’ve been wonderful allies through this whole process.

We had connections into the health authority. As CMHA, we offer many programs in partnership with the health authority, so we know them well and work well with them. We had different community agencies. We also had individuals with lived experience and family members as well.

Everyone had an equal voice at the table, and we started to consider what we could build together and where the gaps were. Then we began an entire process of community engagement, and we asked our table about who we should be speaking to and how best to reach families, counsellors in schools. Who were the other groups that we needed to speak to?

We’ve held about up to 40 community consultations with different individuals or with community agencies or larger groups that have been brought together by our partners. We learned so many things. They had so many questions. They were, generally, over the moon about a program like this.

Especially for families that feel so isolated as they’re going through this process, the fact that we would be able to come to their homes, sit with them, have tea, potentially provide support in their first language…. I think this was the turning point for them to say: “Okay, maybe I’ll invite someone in. Maybe I’ll pick up the phone. Maybe I’ll look at this differently. Maybe there is hope.”

We provide the services in Farsi, as well as in English. We do hope to expand to providing services in Mandarin as well, because those are the key languages that need to be considered.

One of the other key issues is really around cultural awareness and diversity. We have struggled to find mental health professionals who can speak the languages that are needed, but once we start to have those conversations with the communities, we’ve seen so many people come forward and say: “I want to be part of this. I want to do my part.” So we are able to offer the services in two different languages, and we hope to expand that. We also do an extensive amount of cultural awareness training.

[1:25 p.m.]

As we move through the process, we will continue to evaluate the services to see whether or not we need to add different individuals with lived experience to share their knowledge. We will also get a sense of what the hours of service are. Right now our service is offered from 6 p.m. to midnight, Thursday, Friday, Saturday and Sunday. We do offer a couple of days for follow-up so that our team can then reconnect with individuals during the week and connect them to community agencies.

As we go forward, we will continue to look at this model and figure out: what are some of the gaps that we’re missing? How can we further integrate this with current systems? As well, how can we expand the hours as needed?

J. Morris: That was excellent. Thanks, Julia.

I think we’re just at the tail end of our formal 15-minute brief here — of course, Julia and I — and then we have our additional witness colleagues, who can address any additional detail that the committee would like to inquire about.

Just to level set, what Julia has just encapsulated there is kind of the future of what will happen in New West and Victoria. Julia’s a number of months away with the North Shore implementation, including West Van and the communities that she described, having gone through that community process and now moving into launch. She has a team of peers and mental health professionals who are responding. In the latter part of your briefing packet, you’ll see some of the entry points into the North Shore service there. So that has launched. It launched several weeks ago, very softly, and it’s underway.

We are very grateful to the province. A portion of that money came through the civil forfeitures grant. Some of it has come through another funding source as well, a foundation grant. And also, actually, some dollars were raised from a law firm that was very interested in donating into it. So we’ve got these cobbled-together funds for the service Julia has just described.

The city of Victoria. We are at the point of moving into our community design phase that you just heard Julia describe. We’re very grateful to the UBCM’s strengthening communities fund there, the work of Councillor Potts and others at the city of Victoria, the support of Chief Manak, as well, and the Island Health Authority in starting to underpin that consultation work that’s underway.

Within the context of this calendar year — I was just briefing their council about four or five weeks ago — we anticipate a team that’s fit for purpose for the city of Victoria to launch here. It won’t be exactly the same as the team Julia has described, because it’s got to align with the community context here. There’s not a one-size-fits-all. But we’re very, very grateful for that support and the partnership with senior leaders like Chief Manak and elected officials like Councillor Potts, her colleagues and, of course, Mayor Helps in bringing that work to life. That’s picking up speed as we speak.

Then, in the city of New West, recently, there was a council resolution, I think — hot off the press, two or three weeks ago. Denise is here. I should acknowledge that Councillor Nakagawa is here as well. They’ve pledged some funds to launch their own community-designed process for this team.

You can see, as a committee, that there’s a growing, organic momentum around this work. We’ve been in an active conversation with the province around how to sustain this work, going forward, once these pilots have run their course.

I’m going to stop there and meet my commitment of only speaking for 15 minutes. We do have representatives from the city of New West, city of Victoria, and of course, we’ve got the North Shore implementation here too.

Maybe I’ll hand things, of course, back to you, Chair. All of us can take questions from the range of perspectives. It would be great to hear from Chief Manak and Denise and also Councillor Potts on their perspectives, at some point. But back to you, Chair.

D. Routley (Chair): Thank you very much, Jonny. That was a great presentation.

Thank you, Julia.

I would also like to bring members’ attention to the fact that we are joined by city of New Westminster’s Nadine Nakagawa as well.

Thanks for joining us.

I guess with that, I’ll hand it off to members for questions.

K. Kirkpatrick: Thank you very much. That was really interesting. And thank you, Julia.

I’ve been kind of watching as this was unfolding here. I went on a West Van ride-along recently, and every response that we had was a mental health–related response or a poverty response, which is obviously connected. But it was interesting to see.

[1:30 p.m.]

A question is…. I wasn’t completely sure. The referral into PACT on the North Shore: is that through a crisis centre call, or is that through the police dispatch? It’s not E-Comm, I understand. How is that connecting and coming to you — or will be connecting and coming to you?

J. Kaisla: Right now we have a separate phone line so people can call us. We have a website, northshorepact.com. We’ve shared the information through many social media platforms and also in community agencies across the communities. People can call us directly. They can text us. We did hear from very many community members, especially youth, as well. They wanted a different way to connect with us that wasn’t…. They weren’t always safe in the spaces that they were in to make a phone call. So those are the two ways.

What we’re finding right now is that there are a lot of referrals coming to us from the police. West Van police, for example, will make a phone call. They’ll ask the individual if it’s okay for them to call us so we can come and be with them in that moment. Also, community agencies are making referrals to us.

Lastly, the emergency room is so busy right now, I know, across the North Shore, across every community. But definitely, Lions Gate Hospital is struggling. So the emergency room has all of our information, and it’s making referrals to us when they need someone to come and be with the individual during that time, even while they’re waiting.

Those are the different means. We do hope for an inte­gration into other services, other phone numbers. We’re connecting with 211 and the crisis lines as well, but we’re not quite there yet.

K. Kirkpatrick: Thanks, Julia. I appreciate that.

G. Lore: Thank you, everyone, for the presentation.

I’m not sure if this question is directed at Councillors Potts and Nakagawa or to folks at CMHA. My question is about the benefits of this kind of organic local development process and also, maybe, potentially, the challenges of the possibly patchwork nature of it and whether that limits ability to have that 911 option as opposed to the direct calls. I’m just thinking. We’re tasked with a provincial look here, but I’m just wondering if you could speak to the benefits and the challenges that it might pose.

J. Morris: I wonder. I think, between both councillors and Chief Manak and Denise, you might get a few comments from each. Then I can round it out with some of the advice we’d offer as a provincial agency. I turn to my colleagues to respond to your excellent question, MLA Lore.

D. Tambellini: Well, I’ll start. Thank you very much for allowing us to present.

Our police department and the city are working closely as we start out on this journey. They are estimating about 25 percent of their calls are mental health related. I believe that, as we move forward…. I’m not exactly sure that we want to equate it to money, but we do want to equate it to the quality of care that people are getting and relating the needs of our community to the right care and the right responses too.

I think from my perspective, that’s one of the significant benefits to moving in this direction. We’ve created a process that will be made in New Westminster, so we’ll understand the service providers not only that are there but what is needed as we move ahead.

I’m sure Councillor Nakagawa has some other things to add, but that’s kind of, I think, the most important, as we move ahead.

N. Nakagawa: Maybe I’ll just add quickly to that. Maybe Sarah wants to speak as well.

I was speaking with a colleague, a city councillor in Smithers, and they were interested in this idea as well. But they were talking about the fact that they have basically…. They’re hiring one police officer in Smithers. That’s a big investment for them, sort of reflecting that I don’t know much about Smithers as a community, but what is true for New Westminster certainly is not true for them and is not true for Victoria, which is a more comparable city.

The real advantage, then, I think, is we really target it to what our service needs are. We’re not duplicating resources. I think this model of targeting it to the specific community is the ideal. I think that we can take lessons from it, but then we can roll it out and make it specific to each community.

[1:35 p.m.]

As far as the connection to E-Comm, maybe I’ll allow CMHA to speak to that, because that definitely is a concern. We want it to be well known. We hear from businesses all the time that they don’t know who to call when they have, maybe, somebody who’s sleeping in their doorway or somebody who is experiencing a mental health crisis, so we want to make it really easy to access. But I do think it’s important that it is targeted to our specific community and what the demographic is of people who are using the service.

S. Potts: I think that Nadine and Denise really covered most of that really well. I just wanted to add in that we started this process in Victoria, before connecting with Canadian Mental Health Association, with a task force of lived and living experience community members and their families to really talk about what could help generate community wellness, individually and across the community. From that, we did see the outcomes, some very broad outcomes that we are aware of across communities. But then there was quite a degree of specificity to the city of Victoria too.

Within that work, we’re understanding where we can make those linkages and where we can bring people together to respond. The need for…. You know, gaps in health care and access to that is probably felt across the province. But just knowing who the players are in our municipalities and who we can connect with to generate those outcomes was really beneficial.

If you look at the Toronto model, they are looking at a kind of spoke-and-hub model, where they’re looking at different existing providers and ways to link together to create greater reach of care. There are some exciting opportunities there, as well, when we look at each of our municipalities alone. Again, the challenges are fairly broad and fairly consistent from municipality to municipality.

D. Routley (Chair): Thank you.

I see Chief Manak has his hand up.

D. Manak: I’ll just add to that. I think that the benefits…. I liked how Julia put it, talking about the benefits, about a message of hope and, perhaps, a message of help and hope. I think that that’s possible in any community across this province. I certainly really support programs that really look at early intervention and support and can prevent somebody from coming into a full crisis where the police are responding. Police are the only ones who can respond in those types of instances. Why are we waiting for people to decompensate to that level, where the police are responding?

The other thing I wanted to just comment on is the competent and reputable organization that the Canadian Mental Health Association is. In the Victoria police department, we know that in order for this to work, there has to be systems integration. This kind of leads to my two challenges.

The first one is that people will move. Not necessarily everyone, but a lot of people move up and down the spectrum of where perhaps there might be threats of violence, there may be violence, there may be a weapon, to the point where there’s not. So you have to have the police engaged at certain levels if it becomes an overwhelming response for a civilian team to respond to. Or vice versa — you have a co-response team where a mental health worker attends with a police officer in plain clothes, the situation stabilizes, the police officer backs up, and the mental health worker is able to then intervene.

The other challenge, I think, is going to be getting this information out on what number the community can call. Right now everyone knows that you call 911. What we want to do, as Jonny had said earlier…. These are mental health calls that we want to make sure there’s a mental health response to. These are not criminal calls. If we can divert those calls away from the police right from the get-go, I would certainly advocate for that. But that may be a challenge — just informing the public and educating them on what number to call and how to reach this mental health team.

R. Singh: Thank you to all of you. I see some familiar faces here.

Sister Nadine, welcome. Always a pleasure to hear from you.

I think this is a wonderful model that you have presented. But my concern is also with what Chief Manak has said about how to make it…. We are moving from one system to another one. We know about some jurisdictions where people have the capacity to call a different number instead of calling 911. But the move to that one….

[1:40 p.m.]

My question would be for Jonathan here. What challenges do you think of for the Canadian Mental Health Association, because you are going to be the key partner in these two cities. What we are seeing is that you are partnering and — really good, I think — catering to the needs of those communities. But when we are going for the broader provincewide model, what are the challenges? What are you seeing in there?

J. Morris: MLA Singh, thanks so much for your question.

I think that one of the roles that we’re assuming…. My heart filled when I heard Chief Manak’s comments. It’s incredibly supportive to hear a leader like Chief Manak say that here, in this context, about our organization. We recognize that, also, we’re not the government. We aren’t the ministry or the government.

One of the challenges and opportunities — and that’s why it’s such an honour and an opportunity to present to this all-party committee today — is how to work alongside the strategic direction-setting of, for example, the Ministry of Mental Health and Addictions and the Ministry of Health in trying to move the pieces of systems change that are required, so they are happening organically. I mean, there’s a very live conversation right now happening between the executive of E-Comm — their vision for E-Comm at large — and how deepening the systemic response to crisis calls will come underway.

We are a broker. We’re a backbone organization. We can steward and apply funds. We have credibility and community, and we’re very, very grateful to be a partner of the province and other agencies. But the great opportunity is to work in close concert with government, because you have the ability, through health authorities and other settings, to set standards, set expectations and manoeuvre the systemic change that’s required.

I often think of this work as a hinge. There’s the top-down approach, and then there’s the kind of grassroots approach. That hinge is where change happens. We’re kind of leading some grassroots approaches here, with all of the precautions that we can take as community agencies to avoid unintended impacts and make sure we’re not leading to any confusion.

The ideal future state goes back to that slide I had of those four pillars of care. Really good air traffic control — we know when and how and where to send crisis care. We are a ways from high-quality air traffic control in dispatch, because we’re starting to build those relationships. These teams will hopefully proliferate. There will be the question: does every municipality get a team like this? There’s a funding issue. There’s a geography issue there. But let’s try and test this out like other jurisdictions have done.

I think that MLA Olsen has talked about this before, as I hinted earlier. How do we get out of the poles of police jail cells or emergency departments as the two poles of where people in distress can go? We need to build that community response, and then we need to improve the quality of crisis care in our systems.

We’re making some progress against those pieces. But having entities like the Ministry of Mental Health and Addictions…. And they very much are at the table. They are receiving our briefings. We’ve seen great leadership from within that organization. That will be key so that this doesn’t die on the vine or become a pilot project that kind of just fizzles out without money and resources.

We are talking about a paradigm shift here. We absolutely are. So when you have actors like Chief Manak and the elected and staff and this group listening to this, we are a part of the change here together, which is very, very exciting. It’s going to take, I think, both this piloting and testing and systematically building out the framework, going forward, to make sure that we don’t end up with a patchwork or peer-assisted crisis teams by lottery in the province. We really want to find a way to make this as available for as many people as possible.

Thanks for that great question, MLA Singh.

R. Glumac: There’s some great work that you guys are doing.

I may have missed it, but…. Victoria already has an integrated mobile crisis response team. Is that what you’re working with, or are you collaborating with that existing team when you’re talking about the work you’re doing in Victoria in particular?

J. Morris: Chair, may I take that question?

D. Routley (Chair): Yes, please go ahead.

J. Morris: Chief Manak, you might want to weigh in here too. I know that we don’t have Island Health here today.

MLA Glumac, that’s a great question.

What we are trying to do is that if you think of a kind of spectrum of care, you’ve got police responding on their own. You’ve got IMCRT, which is the emergency mobile crisis response team, in Victoria. There are actually a number of other teams in and around that. Where there is as gap is civilian-led or civilian-only teams, where it’s a peer and a mental health professional.

[1:45 p.m.]

What we’re proposing is not duplicating a co-response model. Chief Manak had a great example of where co-response works. Like in a dynamic situation, you can back off or advance the kind of response. What Julia described is, actually, that there’s no police presence. There may be police awareness, but civilian-only. So we’re actually adding to one part of the spectrum.

What we would argue is that for the best kind of crisis care to be available, you need that full spectrum so you can deploy different parts of it at different times. Now, of course, underneath that is that it’s not available in Smithers. It’s not available in Kitimat. It’s not available in some communities. But in urban areas where we’re testing this, the fuller we can do on that spectrum, the better so that we can reorient the system.

CAHOOTS, the model out of Eugene, in Oregon, has shown — they’re civilian only, with lots of police integration — a significant lack of need to deploy the police. So they’ve actually been able to recalibrate things significantly there.

We’re adding rather than replacing or duplicating, and in Victoria, we actually anticipate being able to kind of tie the thread between our team and the team you just mentioned, MLA Glumac. Did that help?

R. Glumac: Yeah, definitely.

D. Routley (Chair): Chief Manak, please go ahead.

D. Manak: I’ll just add a couple of things to that. I think that’s a great question.

I think that key for the committee to know is that this isn’t any type of duplication. This is enhancing the current mental health response continuum. We don’t have a competent, professional, civilian-led team in the city of Victoria. We need that. What this will do is to add to it.

I just want to draw your attention to slide 4, which had the three kinds of bubbles — of where the police respond, where there’s a co-response, a health response. Jonny touched, in his presentation, on the community-based response, which is missing. This would really, really help in an area that we don’t have the necessary help and support. It would actually divert calls from the police to a professional, civilian-led team. I believe it will lead to better outcomes. That’s why we’re on board with supporting it, right from the get-go.

S. Potts: I just wanted to add to the already fulsome comments that one of the additional items that this approach will bring is a 24-7 emergency response. We don’t have a 24-7 mental health response available to us, even though there are some different co-response teams available, primarily during the daytime hours.

J. Kaisla: I just wanted to add one quick thing, in terms of the committee consultations that we did hold and the calls we have been responding to. What we learned was that there are a significant number of people across our communities that are not calling 911, even in the case of a very serious mental health emergency. I think there are many reasons for this. We heard about lack of trust, either in police systems here or in police systems in the countries that people may be from. There is a fear around this impacting the custody of your children or your immigration status.

I think we also need to be aware that there are many people across our communities that are not receiving any mental health care at all. What this service is able to provide is also an option for people that are apprehensive about accessing our public systems and a way into them so that they’re not struggling in silence, struggling alone, or really deteriorating substantively, because those impacts on our society are notable.

We aren’t always sure about the entry points, and this provides another entry point. When we talk about prevention — and I really appreciate the Victoria police perspective on how we can get ahead of some of these issues — this is another way in. I would say that about half of the calls we’ve received so far are from people who would never make a call to 911 or a crisis line and who are making those calls to us because we do offer the services in another language.

A. Olsen: Thank you so much for this presentation.

I think it’s important to acknowledge that we’ve been sitting in this committee now, doing this work, for the past year — more than a year for some of us — and just the evolution in the services that have happened on the ground in the time that we’ve been studying and having these discussions. I raise my hands to all of you for putting in motion some of these ideas that we’ve been hearing about and that are on the ground elsewhere.

[1:50 p.m.]

I really appreciated the discussion. I recognize the confluence of the responsibilities of Mental Health and Addictions, the Ministry of Health and of Public Safety and Solicitor General, and the really important work that they have to do in communicating and coordinating these programs. I can’t help but think that the way that these pilots have been funded to date doesn’t provide the level of stability and longevity, perhaps, that pilot projects would need.

I’m also quite concerned — I’m very happy that they’re in place; don’t get me wrong — that normally, for pilot projects, you contemplate them in a variety of different communities with a variety of different circumstances to get the best understanding of what you’re looking at. With New Westminster, Victoria, North Vancouver and West Vancouver, there are a lot more similarities than there are difference, and I would really like to see how this program rolls out in rural British Columbia.

We’ve got a massive province. I can’t help but think about my colleague Dan Davies’ riding or my riding — Salt Spring Island, as an example. How do these programs get delivered in those communities?

I really look to the work that you’re doing to help inform us. However, I also recognize the reality that the work that you’re doing in these three communities is not reflective of what most of British Columbia looks like. I’m really hopeful that one of the outcomes of this work that you’re doing is a recognition that stable, reliable, long-term funding — to really do a good job on those pilot projects, to get a good cross-section of this province — is what’s needed.

Finally, I’ll just leave this: I don’t know that we as a province can leave this up to the Canadian Mental Health Association. You’re doing a great job, Jonny and Julia and your team. You’re doing a great job. However, the provincial-level coordination that needs to be done here is not lost on me. I really hope that we can get that leadership at the provincial level to bring all of this work together and work with you to make sure that your programs and projects are funded.

G. Lore: I really appreciate those comments, Adam. They might speak to some of my questions about the limitations of the organic, community-based start of these things and what communities happen to get. I’ll start with them.

I have, I think, what is the total opposite to the comment Adam was making in terms of the diversity of the province. Mine is more on whether folks have thoughts on the artificial boundaries of municipalities in places like New Westminster or here in Victoria. I really appreciate the responses to my last questions around the importance of community knowledge and expertise. That said, in Saanich or Oak Bay right there and, it seems to me, all the Saaniches, there’s plenty of overlap across these arbitrary lines in the CRD and Metro Van, and limitations there, possibly — for what side of Finlayson you’re on, for example. Do folks have thoughts on that?

J. Morris: I would say that part of this lines up with MLA Olsen’s very pragmatic and, I think, deeply meaningful set of comments that, hopefully, the worlds will…. I’m optimistic they will be. We’ve definitely had an opportunity to sit with both Ministers Farnworth and Malcolmson, and they’ve signalled very, very real interest. I know that there’s a lot of alignment with budget cycles and what have you coming forward. So we’re really hoping to get to that provincial air traffic control and coordination that MLA Olsen was just describing.

[1:55 p.m.]

We are very grateful to be leading this work. We also very much recognize that we are limited, given our agreement and mandate, to realize the vision that MLA Olsen described.

To your comment there, MLA Lore, absolutely, I think these are very artificial jurisdictions. I think part of it is wanting to make sure that we don’t bite off more than we can chew and to set up what we can for success. I think Julia is leading beautiful work around collapsing those distinctions between municipal boundaries. She has got the district, the city, North Vancouver and West Van kind of working together in some concert. That’s no mean feat — to be bridging across that.

I think in Victoria, we’re wanting to tread carefully, recognizing that if a call were to come in Victoria, the team would take that person wherever they needed to go, whether that be in Saanich or in Esquimalt, for example. But we would only be responding to calls in the region until we can get to what MLA Olsen was describing as the state of funding that would mean that we wouldn’t be creating cracks in the system that people could fall through. We don’t want to create more fragments in an already fragmented system. We want to be additive, augmentative and complementary.

We will keenly look at what’s happening in the city of Toronto. They are about to launch, or have launched, regional teams in that region to respond the diversity of that city, including an Indigenous-led team. Through our work and through Councillor Nakagawa’s interest, we’ve learned…. Actually, Smithers has an all-clans team, an Indigenous-led civilian team, that’s doing some profound work in the community, too.

I think these are very artificial jurisdictional boundaries. Mental health crises don’t care if you live in Esquimalt or Saanich. They happen where they happen, and they often happen at four in the morning — to the 24-7 comment that Councillor Potts made. That is something we’re very mindful of. Hopefully, we can channel the expertise of policy-makers, decision-makers, people like yourselves, in making this truly a provincial effort. We want to take the lottery out of this. We want to make sure that it is responsive to rural British Columbia at some point in the future.

D. Routley (Chair): Go ahead, Denise, please.

I’d draw everybody’s attention, in the chat, to a comment by Chief Manak.

D. Tambellini: Thank you very much. I guess my only comment is about…. I can only speak to New Westminster, and I’ll be brief, because I understand the time.

We will only move ahead with everyone working together and collaboratively. This is not about us defining our project based on our limited boundaries. We’re a group of people that will work with the leadership of CMHA, with our police, with the First Nations community. This is about creating a strong project that will include our networks. Those networks aren’t along city boundaries. Granted, our police force is within our city boundaries, but we need to be collaborative with our work. I think that we will continue to do that as we move ahead with this innovative project.

D. Routley (Chair): Karin has suggested that the chief may want to read his comments into the record. I think that’s a good idea. Then they’ll be in Hansard.

If you could, Chief Manak.

D. Manak: Thank you for that, Chair.

What I was just responding to is MLA Lore’s question about municipal boundaries. What I said is yes, they exist and will create inequitable service and response in mental health care. There’s no doubt about that, but we recognize that we have to start somewhere. That somewhere is within the jurisdictions where we’re starting. What we’re looking for, perhaps, is to prove that these programs of civilian-led mental health response do provide better mental health care for British Columbians that aren’t even calling in to the police, as you’ve heard.

Then we can look at expansion from there. I look at it as a starting point, not an end point, right now. It’s always a bit clunky when you start off. We get smoother and expand that service once the concepts are proven.

D. Routley (Chair): I would add that not only do they occur where they occur; they can often occur in more than one jurisdiction, as people move. Who is responsible? It’s very, very complex.

[2:00 p.m.]

Also, we’ve heard from E-Comm about how long it takes to train emergency dispatchers, the 911 operators. I think it’s a 19-month process before they’re really independent. There would have to be quite a complex integration into that process as well, I imagine. As Jonny has said, it’s exciting to be witnessing this happening.

With that, unless anyone else has….

Go ahead, Jonny.

J. Morris: Chair, I just wanted to make one last comment for the record here.

The phrase “low-hanging fruit,” I know, is a bit clichéd, but we are looking for opportunities where immediate diversion can happen. It’s quite an interesting conversation happening around co-location of a mental health professional, a civilian, in a police dispatch control centre. We don’t know how quickly this will happen. It has been tried in Saskatchewan with the RCMP. They have a psychiatric nurse in the dispatch room, providing in situ civilian mental health support to guide dispatch decisions.

We recognize that there are multiple places where we can create the change that I think all of us are gathering around today, including on these teams. We’d be happy to keep you posted on that development. There seems to be some interest there in what situating mental health and substance use expertise right in the heart of dispatch can do when it come to diversion, and as Chief Manak said, getting a health response to people experiencing a health emergency.

Thank you, Chair. I just wanted to get that on the record too.

D. Routley (Chair): I very much appreciate that. We all appreciate your presence here — your return for some of you, first time for others…. We really appreciate your contribution to the work we’re doing. We feel very committed to this, and we want the best outcome for everyone. Thank you very much.

Okay, now I’d like to welcome to the committee Dr. Lesley Lutes and Dr. Jaleh Shahin, from the B.C. Psychological Association, for their presentation.

Thank you very much for joining us. I won’t take a whole ton of your time introducing everyone. We’ve done that earlier in the meeting.

I’m sure I’d ask the members to introduce themselves when they ask questions.

B.C. PSYCHOLOGICAL ASSOCIATION

L. Lutes: Thank you, Member Routley, for the introduction.

I am honoured to join you today from the Syilx/Okanagan Nation in Kelowna.

Thank you so much for asking us to come to speak to your committee today on this incredibly important issue.

Less than 90 days ago I was grateful to speak to the Select Standing Committee on Finance and Government Services, outlining the critical importance of having effective mental and behavioural health services within the primary care system.

Subsequently we spent three days in the Legislature the following month meeting with many members, including seven of whom are here today — Members Begg, Olsen, Halford and Sandhu — as well as being introduced on the floor by Member Sandhu, and as well as meeting with Hon. Mr. Eby, Attorney General. During that meeting, he requested a concrete proposal at the end.

I’m pleased to report that this past week we submitted a proposal for the primary care psychologist program to the Ministry of Mental Health and Addictions as well as the Ministry of Health. Next week I am honoured that we’ll be meeting with Minister Malcolmson as well as representatives from the Ministry of Mental Health and Addictions and the Ministry of Health, along with Dr. Matt Chow, president of Doctors of B.C., next week.

[2:05 p.m.]

That brings us today, which is very related: reforming the Police Act. We recognize that we are speaking to a group of individuals that have over 40 years of direct service in the RCMP, in the Canadian Forces, health service, education, public service and working in the Legislature to care for the health and well-being of British Columbians. Moreover, we respect the time you’ve already spent on this committee with the viewpoints that have already been shared so far.

Nobody walks this earth unscathed. Everybody has a history, everybody has a story, and everyone deserves to have access to life-saving treatments that can reduce pain, suffering, distress and trauma. This includes not just people in our province but also members of the police force. Also, who you bring to the table matters. Having the right people at the table makes all the difference in the developing of solutions that are based in truth, that are culturally responsive and that are most likely to improve the quality of life of individuals, systems and society — something we desperately need these days.

Therefore, I’m incredibly honoured to bring my colleague Dr. Jaleh Shahin to the table to speak with you today. Dr. Shahin serves as a consulting psychologist for Copeman health centres in Vancouver and Edmonton and is a registered psychologist in both British Columbia and Alberta. She previously held an academic position at the faculty of medicine at the University of Alberta, where she developed the faculty of medicine’s in-house mental health program, which was responsible for the provision of services not just to students in training but also to the physicians.

Dr. Shahin has extensive experience in working with RCMP officers and patients, seeing the horrifying impacts of the lack of access to evidence-based mental and behavioural health services, making her eminently qualified and the best person I can bring to the table with you today to speak. Therefore, without further ado, I want to turn the microphone over to my colleague Dr. Shahin.

J. Shahin: Thank you, Dr. Lutes, and thank you, members of the committee, for having me today.

I’m joining you from Treaty 6 territory in Edmonton, Alberta.

I’m incredibly encouraged and heartened by the work of this committee and the excellent recommendations the previous presenters have suggested so far.

My role as a psychologist for both the RCMP and individuals with mental illness and their families has given me a unique opportunity to learn from both sides of the intersection between the police and individuals with mental illness. I’ve come to better understand the systemic gaps and challenges that both the RCMP and individuals with mental illness face, which forms the basis of our recommendations today.

To best illustrate these challenges, I’d like to share with you my work with Constable Smith, an RCMP member, and Margaret, whose son has been battling schizophrenia and addictions for several years. To protect their privacy and confidentiality, I have removed any identifying information from their stories and have aggregated recurring themes.

Constable Smith had great reservations about therapy when we first met. He was reluctant to attend our sessions but did so at the urging of his partner. It became clear that Constable Smith was depressed and misusing alcohol to cope with his depression. He was spending days off in bed, unable to shower or engage in self-care. He felt overwhelmed by his work, spending days responding to very severely ill people who would recurrently be taken to emergency, only to be discharged with no care, waiting for the next crisis. When he started to cry in one of our meetings, he was overcome with feelings of shame because, to him, emotions were considered a weakness.

Constable Smith’s story touches on three key points: police culture, the role of police and police resourcing. As you have heard from Dr. Angela Workman-Stark, there is a need to address aspects of the police culture to create a healthier and more inclusive environment. She highlighted police officers feeling pressure to want to control their emotions, hide or downplay their own mental and physical health struggles and wanting to avoid perceived weakness and vulnerability in order to conform to a hyper-masculine culture.

We believe these cultural norms in the police force act as a barrier to access to mental health services for RCMP members who may need treatment or support. If our hope is to move towards person-centred and compassionate policing, it is critical that our police officers are healthy, well and empowered to be proactive towards their own mental health and well-being.

[2:10 p.m.]

Over the past several years, the number of calls for wellness checks and mental health have steadily increased. This has had a significant impact on the role of police in our community. They have, effectively, become first responders to mental health emergencies, a role that many have not signed up for; nor have they been provided with adequate training or resources to deal with it, which sets them up for failure.

As such, we echo the previous recommendations to promote cultural change, such as inclusion of leadership models that promote psychological safety, inclusion and justice; creating positive role models among police officers; rewarding positive police practices; supporting the officers; and a change in standards of selection, training and performance, as well as monitoring and evaluating of these measures and their outcomes. This has to be done in conjunction with enhanced partnerships with a sufficiently resourced and accessible health sector.

Third, on police resourcing. As discussed by several other presenters, police can spend a significant amount of time waiting in emergency rooms, escorting patients or returning patients from unauthorized leaves from treatment facilities under a form 21. This can keep officers from attending other calls. Policing is a specialized and expensive service, and it is critical that this resource is used efficiently. We support the B.C. Schizophrenia Society’s recommendations for modification of form 21 to include peace officers or other authorized persons to return a patient to a treatment facility.

The Canadian Mental Health Association of B.C. commented on the discrepancy between RCMP Mental Health Act occurrences and the involuntary admissions of the hospital. The data suggests that approximately only a third of those occurrences lead to involuntary admission, meaning that two-thirds of individuals may not be getting any treatment or support. This is a significant inefficient use of police time and resources and a tragic and unacceptable lack of service and treatment for those individuals who are severely mentally ill.

We strongly recommend a more robust, provincially funded plan to create better access to community and urgent care mental health services across the province. I’ll get more into this recommendation a little bit later on.

Let’s talk for a moment about Margaret. When I first met Margaret, she looked older than her age. I had noticed this being a pattern among many family members who have a loved one with serious mental health concerns. Margaret’s son had his first episode of psychosis in his forties. Before that, he had a fairly typical life, a job, friends and a marriage of 15 years.

Margaret shared her heart-wrenching journey of watching her son deteriorate. He went for seven years without getting a diagnosis or treatment and instead was escorted to the hospital by police several times, none of which resulted in an admission. He lost his job and his wife and began to cope with his paranoia by drinking. He became homeless, and Margaret had to watch him being taken to the hospital and discharged repeatedly without follow-up care.

Margaret’s horrifying journey highlights several systemic gaps and challenges, which include overly restrictive civil commitment and/or hospital admission criteria; pressures on hospitals with inadequate numbers of emergency and long-term beds; poorly funded and fragmented mental health and social services, both for the patients and their families; and improperly implemented deinstitutionalization policies which create a revolving door of patients being taken to the hospital and released. The cycle repeats itself without appropriate care or follow-up, leaving the police and families with the burden of managing and caring for individuals with serious mental health concerns and a sense of defeat, frustration and devastation.

This vicious cycle is negatively impacting the health and well-being of individuals with mental illness, their families, our RCMP members and the community at large. The systemic gaps and challenges must be addressed in order for us to set British Columbians up for success and a better outcome. As the Canadian Mental Health Association of B.C. highlighted in their talk, a health concern requires a health response.

[2:15 p.m.]

Therefore, taken together with previous presenters and in combining comprehensive reports from the Mental Health Commission of Canada, one of which included a survey of British Columbians, we urge you to consider the following concrete, actionable recommendations.

One, we need to ensure that RCMP officers can access mental health care if, when and how they need it. Despite having many resources available to them, we have seen that many RCMP officers do not make full use of them. We recommend that the RCMP undertake a survey to better understand and address the barriers that might exist to RCMP members accessing care.

Two, we need increased access to mental health and addiction services that support people living with mental illnesses. Provincial funding and access to dedicated community mental health and urgent mental health programs are essential. This includes access and availability to diag­nosis, treatment and ongoing care. The health, policing and criminal justice systems must work in concert with each other to address the needs of vulnerable people with mental illness.

Three, we need wellness teams that are appropriately resourced. This starts with how we triage calls. We recommend inclusion of regulated mental health professionals at the point of calls who can serve as a consultant, triage wellness calls and make recommendations on the best course of action. In some circumstances, if alternative urgent mental health care or community resources are available, they may in fact be the best course of action. In rural or remote areas, mental health professional consultants can be accessed remotely.

We recommend provincial funding and expansion of programs such as police health care professional crisis response teams to respond to calls involving mental health or wellness checks. A health concern requires a health response, and a health response needs to start with health promotion and prevention. Resources provided in a timely manner will likely reduce the need for wellness checks. These programs have successfully been implemented in parts of B.C. and other jurisdictions. We strongly recommend more consistent funding and implementation of these programs so these programs become the norm as opposed to the exception.

In rural or remote areas where access to mental health professionals is limited, a health care professional or consultant could be accessed remotely to support an effective mental health outcome. There are many other areas of policing where crisis intervention is managed within teams, some of whom are on site and some who are remote. With the pandemic and the shift to telehealth and telepsych services, we have evidence to show telehealth services can act as an effective resource.

The development of a well-resourced team must include the perspectives of all stakeholders, including people with mental illness and the family members who have been involved in a wellness check event. This could be achieved through focus groups or surveys of people that have experienced these wellness checks firsthand.

Four, we need to review hospital admission criteria to ensure that seriously mentally ill patients do not go without needed service. There are currently many people who go untreated because they do not meet the narrow admission criteria — for example, people who suffer from anosognosia, also known as lack of insight, which impairs their ability to recognize they are ill, leaving them unadmitted and untreated.

The British Columbia psychologists are eager to support the efforts of this committee, and we would be happy to continue to offer ongoing consultation and recommendations and further elaborate on any of the recommendations made here today.

Thank you, again, for having us. We would be happy to answer any questions. I think we’re at time.

D. Routley (Chair): Yeah. Very good. Thank you very much for that.

Members, questions?

R. Glumac: In some of your comments early on, you mentioned sort of reforming the way that police officers promote from within and things like that. I wonder if you could…. It wasn’t one of your direct recommendations necessarily, but I’d be curious to hear more about that.

[2:20 p.m.]

We did hear from a police force in Quebec. The community was Longueuil, outside Montreal. They’ve done some very…. I don’t know if you’ve heard of the work that the police chief is doing there, but it’s very interesting in terms of how they’re reforming their entire…. It’s how they work and how they integrate with the community and with organizations outside of the police force.

I’m just wondering if you could expand on that part.

J. Shahin: Absolutely. I’m not familiar with every single kind of innovative approach that different police sectors are taking. I do believe you’re absolutely correct in saying that there are initiatives being taken, and there is actually a real shift in the culture. It’s very noticeable, even for me, in practice, as I see the conversations shifting in my conversations with the different members.

There have been several programs that have been really successful, and they’re kind of done differently. In terms of the internal kinds of shifts to the police culture, we know that having effective leaders and other police officers from within that serve as a bit of a role model can make a significant contribution to culture change.

I think you probably recall from Dr. Stark’s conversations — because I think she went into a number of those models in a little bit more detail and certainly has more expertise in that — that there have been several kinds of shifts within the RCMP. She kind of commented on the change in the recruitment video even, as they’re shifting some of the standards of training and standards of recruitment for police officers.

I think, overall, there has been a shift in values throughout the RCMP, and there are a number of different programs across both Canada and the U.S. One of the examples that I came across I believe is called the MICT. I can double-check this, but it’s the Michigan…. It’s a program that was done in Michigan, and like I said, I can certainly pull up some of the more specific details.

They really kind of talked about this partnership between police and health care providers as they respond to some of the wellness and mental health checks. There’s almost kind of a few different layers here. There’s the internal shift in police culture that can be helpful, as police officers are more likely to then get access to mental health services for themselves, but there are also partnerships with the health care sector so that when they’re responding to some of these mental health checks, they can respond in a more effective way.

L. Lutes: Perhaps I can maybe just add to that. I just recently completed my role as president of CCPPP, which is of all Canadian clinical psychology and residency programs across the country. We spent two years with 168 psychologists across the U.S. and Canada to focus on being more socially responsive as a health service kind of field.

From that came a 152-page document that had 19 modules, from how we go from recruiting students to training them to our engagement with others in research, in teaching and in clinical application and community and program evaluation. That is an example of a document — incredibly comprehensive — with leaders across the field, all about focusing on changing culture and social responsivity that benefits everybody.

That would be a perfect example of a document that we could lay over top to say: “Okay. Now it’s not within clinical psychology. It’s within the RCMP.” Then those basic nine modules…. Again, we spent two years and 168…. We just unveiled this in September of this year, nationally. We’ve been leading this in Canada — to try and make programs more socially responsive. We’re addressing each module.

I’d be happy to share that with you. It’s a template and a concrete thing that takes you through. And how we could map this onto the RCMP I think would be an incredibly informative starting place to give us some ideas of just even the different layers and factors involved that go from how we recruit RCMP officers…. How do we promote them? That’s one within nine of the different areas and modules that we do, and I’m happy to share that document with you, because it was phenomenal. Leaders across the field that address…. It overlaps with a lot of issues that we’re talking about here today.

[2:25 p.m.]

D. Routley (Chair): Do I have any other questions from members? I don’t think so.

Thank you very much. We really appreciate the presen­tation and your willingness to help us. We really take very seriously, of course, the opportunity to improve outcomes for everyone involved. This has been very helpful.

L. Lutes: Thank you so much. We’re so grateful for the committee’s work. We are happy to give you any additional materials or anything that will help you in your recommendations. I know this is not an easy task, and this is not an easy time, so we are incredibly grateful.

D. Routley (Chair): Thank you. We are as well.

All right, Members. We now have our final presenter.

Is our final presenter in the waiting room?

K. Riarh (Committee Clerk): Yup, unless you’d like to take a five-minute break now.

D. Routley (Chair): Yeah? Okay, let’s do that. We’ll just take a five-minute recess, then, and be back with our last guest at 2:30. Thanks.

The committee recessed from 2:26 p.m. to 2:32 p.m.

[D. Routley in the chair.]

Follow-up Discussion to
Presentations on Police Act

CRAIG NORRIS

D. Routley (Chair): I’d like to call back to order our meeting of the Special Committee on Reforming the Police Act and, in so doing, welcome back to the committee our final speaker today, Dr. Craig Norris. He’s kindly agreed to join us again for a follow-up discussion. Members had more questions than we had time for at the time previously.

I think Dr. Norris expects that we will go straight into questions.

Is that your expectation?

C. Norris: Yes, absolutely.

D. Routley (Chair): Then would any members like to begin?

D. Davies (Deputy Chair): I’m just going to jump in.

D. Routley (Chair): Start. Yeah. There you go. I was about to.

D. Davies (Deputy Chair): Thanks for visiting us again. Since, I think, you last presented to us, I’ve had the opportunity to do a couple of ride-alongs — one with the Vancouver police where we did go out with one of their ACT teams, their Car 88 program. It was in the evening shift.

It was interesting. It was a plainclothes officer that attended with a psychiatric nurse, and they were doing mostly follow-up. It was actually quite an eye-opener to myself. Initially, when I started hearing about these ACT programs on this committee, it was a 911 call. Someone was in duress. They responded. But that’s not, in fact, how it works at all. It’s more of a preventative response.

One of the things that…. In speaking with some of the managers of the different SROs that are in the Lower Mainland who are working very closely…. I know that you said that, in many cases, these ACT programs are with the assumption that police need to attend.

[2:35 p.m.]

The managers that I spoke to at a number of these different housing units were very adamant that the police do attend with the psychiatric nurses. We often find that nurses would not attend some of these calls because they did not feel safe with the individual call, or they didn’t feel safe going into these homes by themselves.

I’m just wondering what that balance you spoke of, where we presume that we don’t need the police attending to where, from what I was seeing on the ground, very few opportunities allowed for the police not to be at least in close proximity…. Sorry. I hope you got my question out of all of that ramble.

C. Norris: I think so. I guess one thing to start off with is that an ACT team, assertive community treatment team, is different than a crisis response Car 87 or Car 88 type of program — 87 being the day shift collaboration between VPD and Vancouver Coastal Health and 88 being the evening shift of that.

So 87 and 88 are a formal partnership. The police officer is always with the psychiatric nurse. The psychiatric nurse is wearing a Kevlar vest. They attend. They will respond, like you said, always together, whereas an ACT team is a multidisciplinary team which, in some jurisdictions, have embedded police officers. In Vancouver, some of the teams have embedded police officers.

With those ACT teams, there are, right now, six in Vancouver, for example. Different jurisdictions have different numbers. There is usually one police officer that would be on, at any time, with those ACT teams. They do not always go with the police officer. An ACT team is for prolonged treatment, whereas Car 87 or Car 88 is more of an initiation of service — responding to do assessments, responding if there is a form 4 or a form 21, where an individual needs to be apprehended to be brought to a designated facility or a hospital. There’s a difference there, I guess, between the two different ones.

In Vancouver, in that jurisdiction, there is no other crisis response model. That is it. So you have one car for the entire city, going around, that is this partnership model and that can respond to these calls, and there is nothing in between. When someone needs to reach out, when they feel that someone is in a crisis, that’s what they’re calling for. That’s what they know. That’s what they’re asking for.

I acknowledge what you’re saying — that the SRO’s managers may have this opinion that the nurses wouldn’t attend without the officer, but when we’re talking 87 or 88, there is no other option there. I mean, that’s how it’s done. The nurses don’t go out alone. They go with their partner. They go in a police vehicle. They’re in plain clothes, and that’s how they respond to it. I hope I’m answering what you’re asking there.

D. Davies (Deputy Chair): You certainly clarified it. Obviously, I had some blurred lines between the two processes.

It is interesting. It’s still coming down. And you’re right. It is an opinion of the different managers. We went to about six different buildings that we visited, and they were all similar. I asked similar questions. I was grateful for the opportunity to be immersed, along with these folks, and to go into these buildings and have these conversations.

Like you say, it was certainly something where they were adamant that for most cases, for any calls or any whatever they were doing at these homes, the police would need to be in fairly close proximity just in case.

C. Norris: I guess I would take exception to that. While I do believe that programs like Car 87 and Car 88 and, in Surrey, Car 67…. In Kamloops and Prince George they have their own versions. I believe that there will always be that space for that type of service. I believe sending that type of partnership is better than a just-police response, in many cases, where it’s possible to have that kind of interaction. Some types of calls would be a police-only response, and that’s just how it is.

To say a blanket “This is the only way we can do it,” I think, is an inherent assumption about dangerousness, about risk. I also think it ignores the trauma that can happen in those types of interactions. In my research, one of the things I looked at was how that interaction actually is necessarily influenced by having a police officer there. So when you look at other jurisdictions, that’s not the only option. You do have other things that can go — a civilian response, a peer response. Those are all possibilities that could be there.

[2:40 p.m.]

It’s not that I’m saying that something like Car 87 or Car 88 shouldn’t be there — just the opposite. I think that it has great utility. I think more money for that makes a lot of sense. But I’m saying that we need a range of services. To assume that a police officer always needs to be at a mental health call, I think, is erroneous. I don’t think that that’s actually true.

D. Davies (Deputy Chair): I certainly don’t want to disagree with that. I agree with what you’re saying. We’ve had many of these discussions, here, with my colleagues on the screen. Even the police would be the first to tell you that they don’t want to do a lot of these calls, and they don’t feel that they’re required to attend. But the way that 911 works — and dispatch, sometimes — that is the case, where it could’ve been just dealt with, with a nurse or mental health physician or health worker.

I guess one of the issues goes back to — I’m going to touch on two bases — that 911 call, I think. We need to look at how those calls are distributed. Right now, if there is a mental health issue, it automatically goes in one direction. We’ve heard from different folks that that is maybe something that we need to be looking at.

The other piece is how we roll this out. I think it was asked by one of my colleagues to an earlier presenter today: how would we roll this out in smaller communities? The challenge in my community of Fort St. John — or Terrace or Burns Lake…. What are your thoughts on the recommendations for these smaller communities where (a) they might not have the professionals, or (b) let’s say, that call volume to keep someone full-time?

C. Norris: Well, I think that there is a lot of emergent evidence, for one, that it doesn’t necessarily have to be just a professional response. I know that Jonny Morris from CMHA talked about peer-led type programs. There’s an emergent one in Victoria that is running, now, called PACT, which is a peer-led crisis response. Evidence is building that that is possible. If you look at Sweden, instead of an automatic police response, they actually have an ambulance response, with a medic and an outreach worker together who would go to these. Their assumption is that this is a health call.

I think the other thing that’s important to acknowledge is that often, when we talk about a crisis response, we’re talking about a mental health crisis. That encapsulates a lot of things. We’re talking about people who are in a substance-use crisis, shall we say. We have someone who, for example, is homeless, who has experienced victimization, who hasn’t slept in days.

One of the ways I like to think about it is that you’ve got mental health and you’ve got mental illness. Mental illness is like a diagnosis. Someone has schizophrenia. Someone has a diagnosis of bipolar. You have someone who has a diagnosis like that. They can still have good mental health. And you can have someone who doesn’t have a diagnosis, who can have really poor mental health. Having a peer attend — someone who can de-escalate the situation, who can be there for them quickly, who can talk and who is not carrying a firearm; I mean, having those options — makes a lot of sense.

You’re right. I mean, I’ve actually lived in Terrace, so I can appreciate that it is a small community, and a solution there is going to look different. But I really think that we have a chance, at the provincial level, to shake things up and challenge some of our assumptions. One of the things you need is that access point. What’s it going to look like? Is it going to be 911? Are you going to have a provincial number that’s a crisis-response number for people who are experiencing mental health concerns? There has to be that up front: how are people going to reach out for what they want?

A lot of the calls that these car programs go to are what’s called a wellness check. Say that I’m concerned about my brother, and I haven’t heard from him for days. What do I do? Well, I reach out to non-emerg and I say: “I need someone to check and find out what’s going on for him.” Why does that need to be police? Where does that assumption come from that it’s the role of police to do that? If I say, for example, that he has a history of some kind of mental health concerns, why isn’t that a health response? Why isn’t that someone coming to check on his well-being?

I think that at the provincial level, we have a chance to really shake. Yes, police have certain powers under our Mental Health Act. Yes, they are the only ones who can do a section 28 and bring someone to hospital. But if you look at the proportion of calls that these cars go to, how many of them actually are involuntarily taken to hospital? It’s a small proportion.

What happens to those other ones? What happens when police go and there is no nurse with them? For example, for Surrey or Vancouver, there is one clinician going with a police officer at any given time. They can’t go to all the calls. What happens to those other folks? How do they get connected for services? What happens to them? What resources can they access? Where’s the right door for them to access support when they’re really in a crisis?

[2:45 p.m.]

In a small community, I think you’re seeing different models springing up already. They are going to look different in different cities and different towns, and I think that’s really good. At the same time, I think that we have the infrastructure with, now, a Ministry of Mental Health and Addictions. We have a Provincial Health Authority that looks at more of these bigger models of care. We have the infrastructure in place to look at how we can coordi­nate things, how money can come.

You look down in the States, and now, at the federal level, they’re looking at funding the CAHOOTS model through Medicaid. Now the federal U.S. government is actually looking at how they can come in and fund this so that it can go across the States. I think there are lots of options. I couldn’t get into the nuts and bolts in this of what it would look like in Hope, what it would look like in Terrace, Good Hope Lake, Atlin. All these places are different and have different resources.

I think that’s probably one of the keys to the non-police responses that come out. You look at CAHOOTS. You look at what’s happening in Toronto, with their model. Those types of non-police responses are very much resource-dependent. When you reach a person, it’s not just about de-escalating the conflict. It’s also about: do I have a bed where someone can detox and access it right now? Is there a place that this person that has experienced homelessness can go? Is there some type of peer group that they can get connected with? All these things.

It’s not just hospitals. Not just jail. There has to be something there for that person. That’s an important part of it — making sure. We have to have the willingness to have detox beds that are empty so that people, when they need that service, can access it right away. That takes a lot of, shall we say, acknowledgment that we’re okay with having empty beds so that people can get them when they need them. That type of resource, I think, is important.

D. Davies (Deputy Chair): Thanks for the details. I appreciate that.

G. Lore: Thank you, Dr. Norris. I wasn’t here in person for your first presentation, and I’m really grateful for the chance to hear from you a second time here.

I have a couple of questions. Maybe I’ll just start with one that is on something you said. I wanted to hear a little bit more…. Correct me if I’m wrong, but I think that in part of your response there you framed that the current, existing models are part of what creates the belief that police need to be present. It’s kind of what we’ve got; it’s kind of what we think. I wonder if you could just say a little bit more about that.

In particular, is this about it being hard to imagine what’s not there? Or is it about the situations that can arise or evolve with police present as opposed to something without police present?

C. Norris: I’ll start with the first part of that. Yeah, I believe that this is what we have, this is what we’ve known, this is how we’ve done it. So that becomes ingrained. There really hasn’t been, I would say, a lot of longitudinal analysis of those types of programs. Really, what are we comparing them with?

I would say that when we look at B.C., we have a different Mental Health Act than other provinces. We have different issues around complexity in different areas. It’s not lost on me that the Downtown Eastside was the epicentre of an HIV/AIDS crisis that was related to stimulant using, in this context. We are different. We’ve evolved in a certain way. We de-institutionalized Riverview much later than other jurisdictions shut down their centralized psychiatric hospitals. So I think it has kind of evolved the way it is.

To put it bluntly, I really think that gaps in care are a big reason why we ended up where we are here. The police stepped up, and they responded. They’ve acknowledged, for many years, that this is not the best way but that they want to be a part of the solution, for the most part. I think that’s a big piece of why we’ve gotten to where we’ve gotten. Has it taken a lot of planning at the provincial level? I’ll be blunt. I don’t think so. I think we’ve kind of fallen into this.

[2:50 p.m.]

We’ve done it a certain way, and there have been a lot of innovations. I think that programs like that that do pair a police officer with a nurse or a police officer with a social worker or however we’re going to do it…. Those were innovative. They’ve been around for many, many years now, and I think they still have a place. But we really haven’t exercised and tried some of those other things and kept up with what’s happening in our communities and the advances that are happening in other jurisdictions.

I hope that answers what you’re asking.

G. Lore: Yes.

Chair, I have a second question. It’s also a question I’m kind of kicking myself for not asking previous presenters today, but maybe we can start the conversation here.

What do we mean by “peer”? I can just think of, you know, in my community, on the 900-block of Pandora and the mental health and addiction overlap that’s common. For other folks, “peer” would look quite a bit different. The benefit of having peers meeting folks where they’re at and the relationality of it….

I’m just wondering. The diversity of peers — how can the kinds of peer-led civilian response meet that need? What, really, are we trying to get out of peer involvement?

C. Norris: A very good question. A very deep question. I think, generally, in the literature, when we talk about some type of peer-support specialist, usually the crux of it is a person with lived experience that’s relevant to the person who is receiving the service.

I’ll go back to the ACT teams, because that’s something my research was in. That is an area where a peer-support specialist is an integral part of the team. That’s a non-professional with lived experience of going through mental health and addiction struggles, and that’s a person who can bring that knowledge to the table with other professionals but also in interactions with clients.

We’re understanding “peer” much more broadly and nuanced now. We’re also including things like: “What is the impact of colonization on people who are experiencing mental health services?” So “peer” can look different for an Indigenous person living off reserve. It can look different for an Indigenous person living on reserve. By no means am I an expert to be able to talk about Indigenous issues, but I think that those are things that we’ll have to think about and talk about when we’re talking about peers.

It needs to be relevant. It needs to be someone who, I guess…. You know, think of it as: the bar is levelled. You don’t have a professional. You don’t have someone with more power. You have someone who’s been there. You’ve had someone who has bled, who has experienced this, who has been taken to hospital involuntarily and can relate to where you’re at.

A lot of the solutions…. They’re not going to come from a pill. They’re not going to come from spending overnight in a hospital. These are things that have accumulated over time, and having someone there who can understand it, I think, is really valued — who may have an understanding of the system and how to get through it and how to help.

A. Olsen: Dr. Norris, thank you for more of your time. This will be the third time that we’ve had the opportunity to chat, and I really appreciate all of the time that you’ve spent educating me and our committee on this important work.

I can’t help but just think of the pressure that needs to be relieved all across our society and how it’s building. I’ve just been introduced, since we last talked, to Peer Connect B.C., which is a fairly extensive training program that can help, I think, get all of us brushed up on how we can intervene. And I can’t help but think that part of the solution is going to be the de-stigmatization process eventually getting us to the point where we all recognize that we can be helpful to the friends and family in our lives, to some extent.

Of course, this is not to sidestep the responsibility that we have as a committee, or we as a government, to provide services that help broader society. But I really do think that part of this is going to be getting as much information into the hands of all British Columbians so that they can be part of the solution, going forward, to take the pressure off of the police services, the psychological nurses and the mental health practitioners in our communities.

[2:55 p.m.]

Just as I’m listening to you talk, I’m thinking of the role that we all can play, and I thought that I’d take this opportunity, in this forum, to just encourage everybody to recognize the important role that they can play in helping a friend or family member through a rough spot. You might not be able to have a solution for them, but you can certainly show them some love and some compassion and help them on their journey.

That’s all I have, Chair. Thanks.

D. Routley (Chair): Did you want to address that, Dr. Norris?

C. Norris: Yes, I wholeheartedly agree.

D. Routley (Chair): Okay, thank you very much.

With that, I would like to offer our appreciation once again to you, Dr. Norris.

A. Olsen: Garry has his hand up.

D. Routley (Chair): Go ahead, Garry.

G. Begg: Thanks, Chair, and thanks, Dr. Norris. I just want to comment on something that you said in relation to a question that was asked by MLA Lore and then followed up on by Adam.

I think you helped us — that is, this committee — focus again on how, essentially, we got here. Having spent all of my professional life as a policeman, I know it to be true: the police were and are the call of last resort. They were called because mental health professionals were at home in bed, sleeping, at three o’clock in the morning. The services that, ordinarily, the police would not respond to, were not available.

The police, I think — as you said, Dr. Norris — stepped up to fill a gap that they were not responsible for. I recall, over my own career, that many times I did that. I felt ill-equipped to do that. I did my best, and all of the results were favourable.

We should not be condemnatory of the police. Actually, we should be congratulatory to the police for the way they stepped up to fill the void that was created with the lack of other facilities.

That’s one of the challenges that was pointed out to this committee by the members from the Solicitor General’s ministry when they spoke to us. They talked about it. I checked it again. They talked about police agencies assuming roles outside of their core duties and expertise.

I don’t know that we’re getting any closer to an answer. I am suggesting that our partner agencies — partners to policing — have to step up and shoulder much of the responsibility, which is outside the scope and responsibility of us on this committee. But I’m sure that one of our strong recommendations will be that in areas where it is available, greater use, greater liaison, greater relationship-building be made by the various police agencies to make sure that that happens.

Thank you, Dr. Norris. You’re very articulate. I think you have — from my, I suppose, somewhat jaded view — a very good grasp of how we got here. The challenge for us, of course, is how we go from here to where we want to be. Thanks very much.

D. Routley (Chair): Thanks for that, Garry.

A previous presenter today, Dr. Shahin, used the phrase “police didn’t sign up for this.” I think that is also congruent with what we heard.

Thanks very much. It looks like we’re arriving at the end of our time. I’d like to thank Dr. Norris again, unless Garry’s hand is still up. I want to thank all the members for this interesting conversation. I know that everyone is very serious about arriving at recommendations that improve the lives of British Columbians through this committee.

You’ve helped us do that. Thank you very much, Dr. Norris.

Members, thanks. We’re at the very moment of the end of our meeting, without time to deliberate, and my computer battery having, it tells me, nine minutes left, and I don’t know where my charger is.

I would, then, ask for a motion to adjourn the meeting.

From Garry, seconded by Deputy Chair Davies.

Motion approved.

The committee adjourned at 3 p.m.