RCMP looks to expand its crisis teams to avoid violent conflicts during mental health calls

The call came in close to the end of RCMP Const. Lorri Kokkola’s shift on a cold, cloudy day in Red Deer, Alta.

“He has some delusions right now that are very real. They’ve escalated,” said the woman on the other end.

“His comment was, ‘Somebody’s gotta f—ing die before anyone believes me. So I have to kill myself.'”

Kokkola headed to the man’s apartment, but she wasn’t alone. Riding shotgun was John Obelienius, a psychiatric nurse with more than a decade of experience.

She and Obelienius make up what’s known as a PACT — a police and crisis team. Kokkola entered the man’s apartment first but Obelienius ended up doing most of the talking.

Inside, they found a young man deep in the coils of paranoia, rattling off conspiracy theories. His legs shook nervously as he lay back on his living room couch. 

“So last night, you made a decision to hurt somebody,” said Obelienius.

“I did,” the man responded.

The young man told Obelienius that he hadn’t been sleeping or eating, that he knew he was slipping.

“Just be honest with the suicide stuff, too, right?” Obelienius told him. “If you start feeling like you’re losing grip, you can call.”

They talked for more than 10 minutes. Obelienius and Kokkola left with a warning — making threats can get you into trouble — and a promise to check in after a few days.

And that was it. No trip to a crammed hospital ER or a police cell. Just a quiet chat and a conflict avoided.

“Police before, because they didn’t have the mental health training or access to a professional beside them, nine out of every 10 police calls would get apprehended and brought to hospital,” said Obelienius.

“Now I think we’re down to probably one out of every 10, right? That clinical expertise is able to help us avoid apprehension.

“When you go to be a psych nurse, who ever thought you’d be working with law enforcement or with the police in crisis, and trying to help individuals right in the moment of their mental health needs?”

When they’re on duty — they alternate day and night shifts weekly with another PACT — Obelienius and Kokkola respond to calls involving mental health issues. Sometimes they’re simple — someone calling in because they haven’t heard from a loved one in a while.

“Then we’ll get the extreme ones where they’re actually screaming or they have a knife, they’re locked in the bathroom, they’ve cut themselves,” said Kokkola.

The PACT model has been in operation in Red Deer for about 10 years. Now, the RCMP wants to replicate the model across Alberta.

“It is the future, I believe, truly. We have to modernize,” said Supt. Mike McCauley, in charge of outreach for the Alberta RCMP.

The push for more PACT-type units comes as recent high-profile cases of police officers hurting or killing individuals experiencing mental health crises are driving calls for changes to the way police react to mental illness.

A community in North Vancouver is still reeling after a 27-year-old was shot and killed by police last month. Dani Cooper was experiencing an episode of psychosis at the time.

That same month, a B.C. Mountie pleaded guilty to assaulting a nursing student during a wellness check back in January 2020.

Last year, a coroner’s inquest jury ruled a New Brunswick man’s death in a police shooting in 2020 was a homicide, and called for more police training on responding to mental health calls.

Rodney Levi, of the Metepenagiag Mi’kmaq Nation on the Miramichi River, was shot twice in the chest by RCMP Const. Scott Hait outside the residence of a church pastor on June 12, 2020.

Michelaine Lahaie, chair of Civilian Review and Complaints Commission, the RCMP’s oversight agency, has said she’s seen multiple cases of officers deploying “unreasonable use of force” during mental health wellness calls.

“Police are not always the best people to deal with mental health calls for service. However, there is a safety concern that makes it so it’s imperative that we’re there,” said McCauley.

“At the end of the day, we don’t apologize for having to do enforcement at times. And sometimes mental health calls do lead to criminality, or the point where we have to intervene as police officers. But where we can avoid that, obviously, we want to.”

‘We are overwhelmed’

Safe Harbour, a shelter in Red Deer, often leans on the PACT teams as it struggles with a growing number of clients struggling with addiction and mental health issues.

“We are overwhelmed. The hospitals are overwhelmed, the RCMP are overwhelmed. Everyone’s overwhelmed with need,” said executive director Kath Hoffman.

“If we had our druthers, [the PACT teams would] be here all the time.”

But not everyone is convinced the PACT model is a perfect solution.

Jennifer Chambers is executive director of the Empowerment Council, a Toronto-based non-profit that works with users of mental health and addiction services. She said response teams that pair police with mental health professionals can help to prevent violent confrontations — but they still involve risk.

“Police are sometimes excellent at de-escalating situations, but there is that possibility of use of force, including lethal force,” she said.

“Something that rarely gets considered when talking about alternatives to police is that the mental health system also uses force. They restrain people and they do it with racial bias. So it’s not actually an exact solution to use of force.” 

Chambers said she’d like to see more public funding go toward addressing the root causes of addiction and mental illness.

“Then you have more prevention of the crisis and less likelihood that the crisis is going to escalate,” she said.

The Centre for Addiction and Mental Health (CAMH), Canada’s largest mental health teaching hospital, said the evidence on whether mobile crisis intervention teams (MCITs) such as PACTs are able to prevent escalation or minimize injuries is limited so far.

In a 2020 report, CAMH said that “an evaluation of Toronto’s MCITs found that injuries occurred in only two per cent of interactions and that they were usually minor and self-inflicted.

“It is also uncertain whether or not MCITs are able to reduce hospitalizations (and whether or not this is actually a shortcoming if people who need hospitalization actually receive it), though MCITs are more likely to bring people with mental illness to hospital voluntarily than regular police units.”

Police and crisis teams aren’t offered everywhere 

In Alberta, the RCMP is able to roll out more PACT teams with support from municipalities and Alberta Health Services, the province’s health authority.

It’s a model both the RCMP and the Mental Health Commission of Canada want to see expanded across the country.

But setting up integrated mental health teams in Mountie territory outside Alberta would require provincial and municipal support.

“Mobile mental health resources are not available in all jurisdictions, leaving RCMP members to deal with these calls otherwise unsupported in the vast majority of cases,” said RCMP spokesperson Robin Percival.

“The RCMP, like other police agencies, is very supportive of a collaborative approach for mental health clients, and for individuals experiencing symptoms of distress or addictions.”

The RCMP detachments in Kelowna, B.C. and the Moncton area of New Brunswick also operate integrated mental health teams. But the piecemeal nature of the units’ staffing and availability across the country means someone dealing with addiction or mental health problems can’t be certain a health-care worker will accompany police on a call.

In New Brunswick, for example, teams integrating RCMP officers and health workers are offered in some but not all districts. And even in places that have PACT teams, limited resources mean the teams aren’t always staffed 24 hours. 

Back in Red Deer, after wrapping up one call, Kokkola and Obelienius drove to the new apartment of an 18-year-old client who left an abusive home and ended up in the local shelter system.

Kokkola and Obelienius took the young man to hospital just a few weeks ago after getting a report that he was suicidal. When they checked up on him again weeks later, he had his own place and job he likes, was taking his medication and was working to complete his high school credits. He wants to start training as an EMT.

“Big changes. That’s awesome,” Kokkola said, beaming.

After a short visit, it was back to the cruiser and the road for Kokkola and Obelienius. Scanner on, always ready for that next call for help.