A move to make the Prince Albert Police and Crisis Team (PACT) the lead agency on certain mental health calls has resulted in less strain on the local health and justice systems, the Board of Police Commissioners heard Thursday.
PACT was formed in 2018 and is made up of two police officers and three social workers from the Saskatchewan Health Authority. Its mandate is to coordinate the two agencies’ services to effectively respond to people with mental illness.
“The main function is to deliver mental health services to the community with the least amount of impact on other resources,” said Sgt. Darren Androsoff, who oversees the PACT unit.
“(In policing) we war a lot of hats. We’re councillors, we’re mediators, we’re enforcers sometimes of the law — we are not doctors. A lot of times we had no other choice but to bring people to the hospital out of an abundance of caution. This unit and the partnership we’ve developed allows us to assess people in the field.”
Up until March 2020, PACT was a secondary resource, Androsoff explained. That meant that patrol officers on a call would call in PACT if they suspected someone was in a mental health crisis.
Since last year, though, PACT is the primary unit dispatched to mental health cases and attempted suicides. It also serves as a secondary resource to other calls and works with people who have been arrested on mental health warrants overnight.
A mental health act warrant allows someone to be arrested with the intention of getting them help if they become a risk to themselves or others.
“It simply allows them to get medical treatment or assessment with a doctor,” Androsoff told the board Thursday.
Additional patrol officers are also sent on some calls, he said, especially if there’s a risk of harm. Once the area has been made safe, social workers are able to make assessments and help out.
In the past year, PACT responded to 324 calls, or about one per day. They assessed 292 people and diverted 144 from the emergency department, instead connecting them to other services in the community. A further 122 people were taken to emergency, where they were often connected with psychiatric nurses on staff.
The calls are quite labour intensive, he said. The team, in addition to counselling people in crisis and securing the scene, also does research into both the law enforcement and medical history of the people it encounters. Depending on the results of that investigation, they’ll either take someone to the hospital or refer them to community agencies.
‘We’ve built awesome partnerships with a bunch of different community agencies,” Androsoff said, including the dedicated psychiatric nurses in the emergency department, the Rapid Access to Addictions Medicine (RAAM) clinic and team, the Community Response Team, mental health and addictions services and detox centres.
“When you put it all together, it elevates our level of service to people who are experiencing an active mental health crisis and really addressing the root problem … rather than putting a bandaid on it,” Androsoff said.
“We’re using real-time expertise of our professionals on both ends of the PACT unit to reduce the strain that these situations have not only on the police services but in the hospital the emergency department, the psychiatry department — really across the board.”
Androsoff said the team has had an additional impact, helping to build relationships and break down some of the “silos” everyone works in.
He gave a lot of credit to the team’s partners, such as the health authority, for helping to identify and fix areas where service was inconsistent.
One of those places, Androsoff said, was the emergency department. He said that having dedicated psychiatric nurses in that department has made a huge difference.
What would have happened three years ago without those nurses and without the PACT is the police would have brought someone into the emergency department who needed to be assessed, but without dedicated resources who know the officers or the subjects, who are familiar with the processes and with that direct link to psychiatry, people wouldn’t get the help they needed. Now, those nuses help to expedite the process and get the PACT back onto the streets.
Still, though, the team identified holes — such as in triage.
Working with the health region, PACT was able to set up almost like paramedics, calling triage staff ahead of time to inform them of the patient’s symptoms and condition ahead of their arrival at the hospital.
“Sometimes with people in crisis, they’re violent. They refuse to go to the hospital. Ther’s medication involved and additional security at the hospital,” Androsoff said.
“We
Re able to phone ahead and tell them what’s coming to expedite the process. They can get a hold of psychiatry, which is a bid deal,” he said.
Androsoff also identified gaps in the police service itself. During hours the PACT wasn’t working, officers wouldn’t always identify behaviours, commetns, symptoms or other details PACT would need to make an assessment. That gap in communication has been addressed so that assessments can have more details not just about someone’s history, “but what happened a few hours ago,” Androsoff said.
PACT has also identified a gap in addiction treatment. Psychiatry units, most of the time, won’t accept someone who is intoxicated, as their behaviour can be erratic and their intoxication can mask their mental health concerns. That means someone with an addiction and a mental health issue usually has to go through detox before they can be treated for mental illness.
That becomes complicated, he said, when someone is suffering from drug-induced psychosis, a side effect of drugs such as methamphetamine.
In some of those situations, Androsoff explained, PACT has become an advocate.
He identified a situation from last year where one woman had been arrested 17 times in three months for public intoxication by drugs.
She’d be in a public place acting erratically and putting herself at risk. Referrals to community agencies were met with little success.
Over two days, though, PACT worked with her and was able to advocate for her.
“It took a lot of attention,” Androsoff said.
The team spent two days with her, taking her home, evicting people partying from her residents, and making sure she had enough food. They were in conversations with the psychiatry department to try to get her help.
“We brought this information to them, saying ‘this isn’t a one-off scenario. She isn’t addicted to meth and this happens once in a while. This is happening every day,’” Androsoff said.
“Not only is it a mental health problem — if she keeps going on this track she is going to die. Nobody wants to see that happen. We want to get her the services she needs. A police cell is not the place for her.”
After some persistence, the woman was admitted to the inpatient ward of the mental health unit.
PACT hasn’t encountered her on a call since.
“If PACT didn’t exist, there is no solution to that problem,” Androsoff said.
“Our team was able to advocate for her, and ultimately, probably, save her life.”
Androsoff, who also oversees other units, said he would like to see more resources dedicated to PACT. It’s a question, though, of funding.
Currently, only three of those positions — the social work positions — are funded provincially. The city police had to create the policing part of PACT from existing resources. That means that some police resources are also split with other areas of responsibility, such as missing persons.
It’s also a question of legislation. While the mental health act means someone can be detained for mental health concerns and sent for treatment, that’s not the case for drug or alcohol addiction. While someone can be detained and detoxed, there are no provisions under current legislation that can commit them to a treatment program. Unless they can be assessed for mental health concerns, it’s up to them to seek treatment for their addictions.
Androsoff said the province is looking closely at PACT units across the province, and he’s ensuring his unit’s stats accurately reflect the team’s impact.
The Herald reached out to the Ministry of Justice and asked if they would consider funding the police officer positions or expanding the PACT units so they could operate for more than just 12 hours in a day.
The ministry sent one sentence in response — “the ministry strongly supports the work of PACT teams and continues to review funding options for this program.”
The SHA also expressed their appreciation for PACT.
“PACT has definitely increased the SHA’s ability to improve transitional care for clients as well as access for clients who may have been underserved by mental health and addiction services in the past,” they said in a statement.
“The PACT team has also grown our working relationships with police and community partners which has furthered opportunity for mental health and substance use education, awareness and holistic support for clients.”
Androsoff said the unit’s benefit is self-evident.
“Mental health and addictions is a chronic day in, day out thing,” he said, “And it’s not going anywhere.”
He said the multidisciplinary approach — one that gets people out of their silos — isn’t just working but is the way of the future.
“We have to look outside of our front door,” he said.
“Police are in a position where we deal with every situation under the sun. We’re a jack of all trades, but there are subject matter experts. In this particular circumstance … they’re health workers. It’s a service not only for the agencies involved but for the community to get people the help they need in a timely matter
“When you pick up the phone and have an emergency, you’re going to get the police. “The ability for us to have these resources and relationships at our disposal is invaluable.”
