Feb 2/08: Mentally Ill Overwhelming Police and Their Resources: Report ...

30% of Vancouver police calls involve people who have fallen through cracks of health-care system.

It's shocking and tragic and stomach-churning. It's an indictment of a mental health system unable to help those who need it most. It also may be the most powerfully written document ever to come out of the Vancouver Police Department.

A new groundbreaking report done by the VPD - released to The Sun Friday - painted a portrait of a police force overwhelmed with the needs of the mentally ill because the mental health system was failing them.

It's graphic stuff. More than a dry recounting of systemic failures, the report incorporates horrific stories of the mentally ill who have fallen through the cracks - the hardest to house, the violently schizophrenic, the addicted. The stories of people living in human filth, or of being driven to suicide, are not for the tender-hearted.

The report, the first of its kind in Canada, found that over 30 per cent of police service calls city-wide involved the mentally ill, with that number approaching 50 per cent in some neighbourhoods.

Those figures are definitely on the conservative side, VPD personnel say, since they represent only those calls that were recorded in the report's research.

The report, written and researched by Det. Fiona Wilson-Bates of the VPD's Special Investigation Section, is entitled (a little wordily) Lost In Transition: How a Lack of Capacity in the Mental Health System is Failing Vancouver's Mentally Ill and Draining Police Resources.

Six months in its research and writing, the report quantifies for the first time exactly how much of the VPD's resources are consumed by dealings with the mentally ill.

Its genesis came about after a spate of suicides and disturbances involving the mentally ill early last year. These incidents caught the attention of the VPD command.

Were these statistical anomalies, they wanted to know, or typical? What caused them? How much time and resources did police have to devote to service calls involving the mentally ill?

Wilson-Bates, a bright young officer who had served in the Downtown Eastside, was given the job of answering them.

She started trying to compile data by analyzing dispatch calls, which proved impossible. Those calls often gave no hint that a person with mental illness was involved.

So she randomly selected two officers from each of the city's 44 patrol squads, and instructed them to fill out cards for every service call they attended, and mark on those cards "when the incident involved one or more people whose mental health was a contributing factor in police attendance."

This methodology required some assumptions on the VPD's part, most especially that police, better than most, can recognize when mental illness plays a role in a service call.

"It was . . . assumed that the officers who carried out the data collection had the personal and professional experience necessary to make accurate determinations of mental health involvement in the calls they attended."

"After all," Wilson-Bates said in an interview Friday, "our officers are trained in this, and run into it daily, and under the provisions of the Mental Health Act, we are placed in the position of having to determine if people should be apprehended because their mental illness may prove a danger to themselves or others.

"And let's be clear, these cases we're talking about are - as I instructed the officers and as I say in the report - must be 'readily apparent and would likely be obvious to any lay person.'"

(An alarming figure that gives a graphic sense of the rise in mental-illness-related calls to the VPD:
In 1999, there were 360 incidents when an individual was arrested under provisions of the Mental Health Act.

In 2007, there were 1,744.)

The data collection for Wilson-Bates' report took place over a 16-day period from Sept. 9, 2007 to Sept. 24.

In total, officers recorded 1,154 calls.

City-wide, data showed 31 per cent of the service calls "involved a person who the attending member believed was suffering from poor mental health to the extent that a police response was required."

District-wide, there were differences. In District 2, which includes the Downtown Eastside, 42 per cent of calls involved the mentally ill. In District 1, the downtown peninsula, it was 30 per cent. In District 3, east Vancouver, it was 20 per cent, while in District 4, the west side, it was 26 per cent.

But those percentage numbers are even higher when the VPD factored in only contact calls, those calls in which police actually made contact with an individual.

City-wide, that average came to a whopping 36 per cent, or over one-third of all police calls.

"What is clear," the report states, "is that an alarming percentage of all police calls that patrol officers currently attend in the city of Vancouver are in response to people in mental health distress. This fact is supported in current literature where it is widely accepted that 'the police are, by default, becoming the informal "first responders" of our mental health systems' (Canadian Mental Health Association BC division, 2003, p. 5)."

In effect, Wilson-Bates asserts, police have become the keepers of the asylum, and our jails the new Bedlam.

The cost of this is enormous, Wilson-Bates said, and she calculated that almost 154,000 police hours would be required to deal with such cases annually, or the equivalent of 90 front-line officers working full time. The direct wage cost for those officers would be $9 million, but that does not include ambulance, hospital or court costs, or costs related to stolen property or lost productivity.

As contributing factors to this dysfunctional state of affairs, Wilson-Bates cites what is now a litany of causes:

The historical deinstitutionalization of long-term health care; the subsequent lack of such long-term care in the Lower Mainland; an overcrowded and overburdened hospital system in which mentally ill patients are shuttled in and out of emergency care daily; a lack of supportive housing; a shocking lack of care for dual-diagnosed patients who are both addicted and mentally ill; a Mental Health Act that makes it difficult to get the mentally ill off the streets and into extended care (giving a whole new meaning to the phrase "right to die"); and an almost complete lack of information sharing on patients' medical histories between hospitals and health officials.

The result: A revolving door that spews the worst cases back out on the street - about 2,100 individuals, Vancouver Coastal Health estimates, with no permanent housing and who "exhibit behaviour outside the norm."

One of the several cases Wilson-Bates cites: "Bill Taylor" - a fictional name used to protect his identity.

"Bill lives in the Downtown Eastside. He is a crack cocaine addict and is diagnosed with both schizophrenia and bipolar disorder. In 1977 Bill was found not guilty by reason of insanity for attempting to kill someone in Victoria. He spent 10 years in a psychiatric facility as a result of this incident and was then released onto the streets of New Westminster where he wreaked havoc until 2003 when he moved to Vancouver."

Between 2003 and 2007, she reports, Bill notched up 145 documented incidents with police.

Disabled, and with a personality disorder, he often waits outside the VPD jail and assaults passersby in an effort to get arrested and get put in a cell. He's banged on cars at street lights, shouted obscenities, exposed himself and urinates regularly in the lobby of the building he's housed.

A calendar recording Bill's involvement with the law is thick with dates of those days he spent shuttling between jail and the psych ward.

"But you know what's interesting?" Wilson-Bates said.

"What's interesting is the time he's spent released out on the street, not the time he's spent in custody."

The report has gone to the provincial government. VPD deputy chief Doug Lepard, who edited the report, said the VPD has had meetings with several provincial ministers who had been shown the report.

"And to be fair to them," he said, "they really expressed a desire to fix these problems. So we're very hopeful something might be done to do that soon."

Wilson-Bates made the following recommendations in her report:

* Open a mental health facility that can accommodate moderate to long-term stays for those with chronic mental illnesses.

* Create an "urgent response" centre where patients can be assessed and triaged according to their needs.

* Increase services for those dual diagnosed with a mental illness and substance abuse problem.

* Provide additional supportive housing in Vancouver.

* Streamline the admission process at St. Paul's and Vancouver hospitals for police officers who have arrested someone under the mental health act.

* Collect more data on all police calls related to mental health issues to fuel further research on the topic and track change.