Denise Campbell has less than one year to do something that’s never been done in Toronto: build a team that will respond to mental health calls without involving the police.
It’s a herculean task that involves mental health experts, multiple organizations, building community goodwill and close co-operation with the police force. That burden of responsibility, Campbell said, can be overwhelming.
“When this was directed my way, I felt a sense of terror — excitement (too) because I think it’s required,” said Campbell, the executive director of social development at the city. “But the terror of it is real.”
Given the nod by city council on Feb. 2, Campbell now has until January to introduce pilot projects that will pave the way for responding to the thousands of mental health-related crisis calls in Toronto. Until then, Torontonians experiencing a mental health crisis are still not getting the professional support that can help defuse highly tense situations — situations where police may not be the best to respond.
The pilots come on the heels of a painful year for Black and Indigenous residents and people of colour in Toronto. The teams were unanimously approved by city council after growing protests against police brutality, following the death of Regis Korchinski-Paquet, an Afro-Indigenous woman who died after police were called to her apartment for a mental health crisis in May 2020.
Shortly after, Ejaz Chaudry, a 62-year-old Mississauga man also suffering from a mental health crisis, died after he was fatally shot by police in June 2020.
“The current system, where police are the default mental health providers, is not working,” Campbell said. With these crisis calls being a matter of life and death, Campbell added the pressure to build the pilots quickly and correctly is mounting.
“The more people push, the more I feel like I have to stay grounded,” Campbell said. “People’s lives are at stake if we get this wrong.”
Important details still need to be ironed out, like who will be running the pilots, whether Torontonians will call 9-1-1 or a separate line to access crisis support, and what role the police will play — if any — in funding the teams moving forward.
For Campbell, the work has often meant 12-hour days, stopping to pick up her twin boys from daycare before resuming a packed schedule of evening meetings.
The Star spoke to her about the big decisions ahead, with other community members weighing in about their long-held vision for the pilots — set to be transformative in the city’s quest to provide equitable care for those suffering from mental illness.
9-1-1, 2-1-1, or both?
How residents will access the pilot programs is still a question that Campbell and her team are trying to answer.
Calling 9-1-1 is the leading option, as people typically turn to it in an emergency.
“The model will simply not work if there isn’t effective 9-1-1 integration,” said Rachel Bromberg, a co-founder of the Reach Out Response Network, a coalition of stakeholders in Toronto that began working on building a civilian-led mental health emergency service in 2020.
But Bromberg added that for some community members, 9-1-1 isn’t a safe or trustworthy line to call as it is run by Toronto police — a point that Campbell agreed with. For this reason, Bromberg’s strong recommendation has always been a “no-wrong-door” approach, and ideas like integrating 2-1-1, the city’s community and social services help line, as an additional access point are also being considered.
It’s an approach that Campbell said she agrees with, but she added “it’s too early to say” how the city is leaning.
Matters are further complicated as separate conversations take place between the city and police on whether 9-1-1 should be taken out of Toronto police’s jurisdiction entirely and operated by an independent third party.
“Removing the responsibility for 9-1-1 from the police service is a complex discussion with legislative impacts,” police spokesperson Meaghan Gray said by email. “It needs to be considered thoughtfully with all options evaluated equally and community safety being the only acceptable measurable outcome.”
Consultations with Toronto police
Another crucial task on Campbell’s agenda is working with the police to define the crisis teams’ parameters, funding, and the triage process that determines who responds to what call.
Based on community consultations and recommendations to council, the city said its pilot teams will consist of crisis workers with training in mental health and de-escalation, who will respond to “non-emergency, non-violent” calls instead of police.
The pilot teams are estimated to cost $7.2 million to $7.9 million annually, the city said. But there was a request from council for staff to work with the police on a “potential reallocation of funds” from the police’s budget to ensure the costs of the pilot “will not result in a new financial burden” to Torontonians.
Police do have their own Mobile Crisis Intervention Team, which consists of trained police officers and crisis nurses who have typically responded to mental health crisis calls.
Gray said Toronto police are fully supporting the city with implementing the pilots, and both entities are working on issues like triage and funding.
“But there is not one right answer,” Gray added. She said that of the 33,000 crisis calls police respond to every year, officers made apprehensions in 36 per cent of the cases, “meaning the police were absolutely needed.” The police acknowledge that in many other cases, a community response would have been best suited.
Gray said the police are also working with other partners and considering adding crisis workers to work alongside 9-1-1 call-takers to help with the response.
As for funding, Campbell knows the creation of the non-police pilots stemmed directly from mounting calls to defund the police in the aftermath of the death of George Floyd, a Black man killed at the hands of Minneapolis police last May. She added it is why the pilots continue to emphasize having a safe place for BIPOC communities (Black, Indigenous and People of Colour) to call.
As the alternative crisis response service grows, Campbell said police have to grapple with the idea that the funding may come directly from their budget. Gray said police are working on reallocating some resources, but “investments in policing should not come at the expense of other services.”
“The Toronto Police Service will continue to do the responsible thing and find ways of doing more with less,” Gray said. “However, we need to have conversations about whether less is too little.”
Tricky details remain, Campbell said. But the overall goal is for Torontonians to trust that both the city and police have ensured “the right people are trained to be able to take the call” when the service goes live in January.
‘Non-emergency’ versus ‘crisis’
Language has been a point of contention both for the city and for community members who have long worked toward launching a non-police crisis response service.
The city has officially labelled the crisis teams as responding to “non-emergency, non-violent” calls in a press release announcing the pilots’ approval. But Campbell said despite the word non-emergency, the goal is that the pilots will respond to calls as quickly as an ambulance.
Asante Haughton, another co-founder of the Reach Out Response Network, said the language here is important, especially when it comes to spreading awareness about the service. The perceived urgency of the calls plays into the level of investment into the teams, he said.
“It’s important that we end up defining these things,” he said. “We need to look at these situations in which people are in crisis as situations that require high-priority, immediate response and a robust amount of resources.”
Campbell said there are “more nuances to work through” on language, as well as how the service will operate. At the moment, the city has defined it as a “non-emergency response” service for calls related to mental health and substance use, and other incidents.
The “other” still needs to be defined, Campbell said, as the city does not want to risk making the teams’ mandate too broad.
The Indigenous Pilot Program
Three of the pilot programs are divided geographically to serve each high-priority area of the city: Northwest Toronto, Northeast Toronto and Downtown East.
The fourth will serve the city’s Indigenous community, recognizing intergenerational trauma and lingering effects of colonialism, as well as a negative history with police.
Campbell stressed the need for continued consultations with Indigenous stakeholders on shaping the fourth pilot. Native Child and Family Services hopes to lead it, but executive director Jeffrey Schiffer said other organizations have expressed interest in doing some of the work as well.
Schiffer did express some concern, however, about the pilots’ funding limitations.
“The effort that the city has put into this in terms of funding and the magnitude of the work is disappointingly small,” Schiffer said, adding he believes council’s decision to implement these pilots is not significant given the limited funds allocated.
He added he understood the city’s slow rollout to test the pilots, but “people are dying.”
“We have all the data to show us that we need transformation on a grand scale now, and I feel like the city could’ve done a lot more.”
Other big details
As the summer draws near, Campbell’s focus is on selecting the community organizations to run the pilot programs in their geographical areas. She said the city will soon begin taking expressions of interest.
A Project Oversight Committee is also in the works, Campbell said, which will include people with mental health and crisis response experience, who will help guide the creation of the pilots and serve as a sounding board.
Campbell has also added lobbying for more resources to the broader mental health system in Toronto to her to-do list. She said the success of the pilots hinges on having connected services in place so that those who are in crisis can find long-term support, and ultimately avoid being in crisis again.
“We’re building a model that requires a robust system that doesn’t yet exist,” Campbell said.
“The long-term success of this model is about ensuring people have viable treatment and support option,” Campbell added, and it’s up to more than just the city to achieve that goal.
Nadine Yousif, Local Journalism Initiative Reporter, Toronto Star