These mobile crisis workers are on a mission: offer an alternative to police-led mental health calls
Community members can de-escalate some emergency calls better than police, experts say
This story contains discussion of suicide and domestic violence.
Members of a new community care program in Toronto say they're providing a safer and more effective way to respond to mental health emergencies without going to the police for help first.
The Toronto Community Crisis Service (TCCS), a three-year pilot program, began in the spring. It was created following calls for reform after several deaths of people in crisis in the Greater Toronto Area where police interaction occurred, including Regis Korchinski-Paquet, Ejaz Choudry and D'Andre Campbell.
TCCS teams include community members trained in health care and mental-heath response, as well as peer support workers with lived experience that helps them empathize with people in crisis. Others are or were nurses, social workers and people who work at shelters and harm reduction sites.
Most importantly, they are not police — which is unusual, because in most jurisdictions police are usually the first responders to domestic violence and mental health emergencies.
Four organizations are partnered with the overall TCCS project, responding to 911 and 211 calls in their designated parts of the Greater Toronto Area: Gerstein Crisis Centre in downtown east, TAIBU Community Health Centre in the northeast, Canadian Mental Health Association in the northwest, and the 2-Spirited People of the 1st Nations in downtown west (Kamaamwizme wii Naagidiwendiiying).
While calling 911 connects people to emergency services, calling 211 instead connects them to social services, programs and community supports.
"We're not in official-looking, authoritative uniforms," said Mia Benight, a mobile crisis responder at TAIBU Community Health Centre in Scarborough.
"We need to kind of just fit into the community … because sometimes you go in, and people in crisis have had past experiences with TPS [Toronto Police Service], and that can be triggering."
TAIBU is a Kiswahili word meaning "be in good health." Before taking on the northeast pilot for TCCS, the not-for-profit centre has been serving GTA's Black-identifying communities for about 15 years with access to primary care, health promotion and disease prevention in a culturally-affirming setting.
As winter sets in, they've been travelling to the precariously housed, handing out food, personal hygiene products, naloxone kits and more.
"If you look at any health outcomes [or] social outcomes, the two communities that you would find at the bottom of the ladder there are the Indigenous and Black communities," said Liben Gebremikael, TAIBU's CEO and executive director. "Even compared to other racialized groups."
"So this is why the organization was established in the first place."
An urgent call arrives
White Coat, Black Art's host Dr. Brian Goldman and producer Jeff Goodes visited TAIBU in November. During their tour, an urgent dispatch request came in.
"We have a suicidal ideation and domestic violence situation," said mobile crisis responder Mia Benight. A mother has called, asking for help for her daughter, whose current condition is worsening.
Before heading out with fellow responder Dammie Olukoya in a plain, white mini-van with a Toronto Community Crisis Service logo on the side, Benight makes sure she is prepared.
"I'm putting on my fanny pack that has PPE in it, hand sanitizer, booties to go in to people's places, gloves, stuff like that. We also carry a naloxone kit with us," she said.
After being briefed about the situation, TCCS teams may request police and ambulance support, as they have in this case.
"A team is not allowed to go to anything violent," explained Raquel Hamlet, TAIBU's mobile crisis team manager.
"It's up to us to say, 'OK, we're going to go in and see how it goes,' or we're going to call 911 for a co-assist. So just in case, they'll be outside."
When they arrive, they park a discreet distance away from their destination to protect the identity of the client. Goldman and Goodes go along for the ride, but wait in the van while Benight and Olukoya go inside.
TAIBU's Gebremikael estimates the four TCCS groups have answered more than 2,000 calls since the program started.
"I think it was successful from the get to," he said.
But his team members and experts say more needs to be done. Depending on how long it takes to answer a call and help those in need, TAIBU's 10-person mobile crisis team might not be able to answer the next one in time; if that's the case, EMS might be dispatched instead.
"We're covering all of Scarborough; Scarborough is massive," said Benight.
Gebremikael hopes the pilot will be extended once its three years are up.
Kwame McKenzie is a community psychiatrist, CEO of the Wellesley Institute and member of the advisory board that helped start TCCS. He says it's just as important to have mental health support throughout the health-care system to prevent challenges from reaching a crisis situation in the first place.
He pointed to an announcement earlier this week by federal Minister of Mental Health and Addictions Carolyn Bennett for up to $18 million in funding for integrated mental health and substance use services across the country.
How to work with police
In the wake of the 2020 murder of George Floyd in the U.S., and the deaths of Korchinsky-Paquet and others in Toronto, there's been a growing call to defund the police — particularly as first responders to mental health crises.
Gebremikael strongly believes that TAIBU and other groups like it need to work with police and health-care organizations to build trust between them and marginalized populations.
"I think … that the past two or three years have provided us an opportunity for conversation. You know, a lot of institutions, both in the public sector and the private sector, have engaged with anti-Black racism in ways that we have not seen before," he said.
"We still have a lot of work to do, and we are here to work with all levels of government to make sure that is happening."
After the call
Some time later, Benight returns to the van. The situation is no longer an emergency, though she learned that both the mother and daughter needed more help than the initial call suggested.
Most importantly, she says, they're able to inform the pair that supports are available, and explain how to access those supports if they're needed. She's certain they've provided the family with more helpful information than they would have received if police had arrived first.
"I'm not the one that knows what she really needs to do next. I can only give her information. But if she can tap into that, which we were very successful in doing, she now has a choice," Benight said.
"And when people have a choice, they make way better decisions."
Benight is calm and focused as she relates to Goldman some of what happened during the visit. She says she feels good that she was able to help.
Her voice wavers slightly when she reflects on why this work is important to her — but it is also powered by what sounds like a raw sense of determination.
"People helping people; it's a huge deal to me," she said.
If you or someone you know is struggling, here's where to get help:
- Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).
- Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.
- Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.
- This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you're worried about.
- An earlier version of this story incorrectly identified one of the responders. It has been updated to reflect that Dammie Olukoya, not Afo Oyedele, was accompanying Mia Benight during the dispatch response.Dec 05, 2022 11:15 AM ET
Produced by Jeff Goodes