Community outreach program in London, Ont., takes proactive steps to support those in mental health crises
The health-care led and police-supported dyad is a collaboration of all of London's emergency services
A local outreach program in London, Ont., that provides proactive support to people experiencing or at risk of mental health and addiction crises can reduce some of the strain on frontline emergency staff since launching last year, its team members say.
The Community Outreach and Support Team (COAST), is made up of health-care led and police-supported dyads aiming to build relations within the community, while facilitating access to health-care, said Deb Gibson, mental health care director at St. Joseph's Health Care London.
It's a joint venture between St. Joseph's, Canadian Mental Health Association Thames Valley Addiction and Mental Health Services (CMHA), Middlesex-London Paramedic Service (MLPS), and London Police Service (LPS).
"By having a proactive response and interacting with the individual where they're at within the community setting, the hope is to de-escalate and engage in problem-solving with the individual so that it avoids an unnecessary hospital visit," Gibson said.
CMHA says from April 2021 to April 2022, COAST had 1,415 interactions and served 713 unique individuals. The calls mainly pertain to mental health symptoms, suicide ideation, relationship problems, addictions, and housing challenges.
Referrals to access COAST's services come through LPS or CMHA. Another one of its goals is to de-escalate interactions between police and distressed individuals while ensuring they get the care and support they need.
'Meeting people where they're at'
Every service call that comes to COAST involves one police officer paired with a health-care worker, either from St. Joseph's, MLPS, or CMHA, depending on the nature of the call. When attending calls, officers are not in uniform and travel in unmarked cruisers to keep a lower profile.
LPS officer Danielle Zapfe is a full-time member of COAST, and she finds this role to be a trauma-informed approach for connecting with individuals in order to best support them.
"A big piece for COAST is meeting people where they're at, and part of our subdued attire and minimized use of force is to help people feel comfortable and build that rapport," she said.
"So really just help them be part of the problem-solving process so figuring out what their strengths are, what they're needing and really help them guide the process for their care."
Zapfe has found that in her COAST role, interactions with the public have been quite positive because they feel seen and heard, and their desire for privacy is also respected. She believes this program allows police to walk alongside people so they can articulate what their needs are.
"We don't want to see anything become bigger than it already is, and when someone's in a crisis, it's really important to just slow everything down and be that calm presence for them," she said.
Inspector Blair Harvey echoes the importance of slowing down because he believes it's not always about coming to a fast solution but more so about taking the time to build relationships with community members.
Officers assigned to COAST have specialized training that helps them deal with people experiencing mental health crises, and its collaborative nature is really making a difference and reducing police-led responses, Harvey said.
"We're not necessarily waiting for people to be in crisis," he said. "We're putting resources, techniques, and approaches in place so that, yes, we can respond when necessary, but more importantly, we can proactively make contact with people to prevent things from happening."
Data obtained by CBC News show that calls for LPS COAST members between August and March have been on the rise. CMHA says 467 calls were diverted from a police-led response from patrol officers to a healthcare-led response via COAST.
LPS is no exception to staff shortages and high call volumes happening across Ontario, but according to Harvey, COAST can help prevent the strain that's being felt by various emergency services.
"The beauty of COAST is when we can take a call from the police queue that's specific around a mental health crisis, we're diverting two uniform officers, possibly EMS and possibly diverting from hospital, which is a huge resource saving, so if we can connect with someone and spend a little bit more time with them to divert future crises. That's a win all around," Zapfe added.
Keeping people out of hospital
Registered nurse Anthony Rotulo has been part of the COAST team since it launched last August. He says as more people become aware of the program, they're getting an influx of referrals.
"It's important for people to be aware of the resources that exist and sometimes navigating the health-care system can be challenging, so it's been a pleasure offering those services to people."
Rotulo's team intervenes prior to hospitalization and directs people to services they need.
"Our mandate is to keep people out of the hospital, so we'll follow them in the community, offer them daily medication, support, long-acting injectables, and assess them," he said.
Rotulo says the pandemic has increased call volumes significantly, but through programs like COAST, the burden can be reduced to one particular emergency service with ongoing staffing shortages and long wait times.
COAST will continue building on accomplishments and lessons learned from its pilot phase and will strengthen the relationship built within the community, CMHA said.