A mobile, community-led crisis response team based in six communities across British Columbia is showing that police don’t have to be involved in mental health emergency calls. CRCL, pronounced “circle,” was previously known as the Peer Assisted Care Team program. It offers people 13 and older help during mental health crises, in Metro Vancouver’s North Shore, Victoria, New Westminster, Comox Valley, Prince George and Kamloops.
Since January 2023, five teams have responded to nearly 10,000 calls. Ninety-nine percent of those calls were resolved without involving police, Kim Mackenzie, director of policy at the Canadian Mental Health Association B.C. division, told The Tyee. The Kamloops team is just launching now, she added.
The CMHA developed and administers CRCL. The program is funded by the B.C. government. CRCL offers a break from how mental health calls unfold across the rest of the province, where police have become the default responder to mental health crises, Mackenzie said.
Involving police in mental health crises occasionally has devastating consequences. In 2015, Myles Gray, who was bipolar, died after being beaten by Vancouver police while he was possibly suffering from a manic episode, according to his sister. In 2019, Kyaw Din, who lived with schizophrenia, was shot and killed by Maple Ridge police as they tried to take him to the hospital. In 2021, Vancouver police shot and killed Chester Libo-On, who may have been delusional or suicidal. In 2022, North Vancouver RCMP shot and killed Dani Cooper, who had been diagnosed with schizoaffective disorder and was suffering from psychosis.
It’s not clear if these deaths could have been prevented if the people killed had had access to other mental health supports before they ended up in crisis. CRCL was created through advocacy from people with mental health and substance use challenges and people from Black communities, Indigenous communities and other communities of colour, who wanted a mental health-specific response to people experiencing crisis, Mackenzie said.
CRCL is not integrated into 911 services, although the Union of BC Municipalities and the CMHA have been advocating for a mental health response to be added as a fourth option to fire, police and ambulance. Instead, people can text or call their local CRCL team to request help. Phone numbers for each community can be found on the program’s website, CRCL.ca.
Some police refer calls to CRCL; RCMP does not. In some communities, Mackenzie said, police officers will refer calls to CRCL. And if a call involves a life-threatening situation, CRCL will escalate it to police, she added. But this happens very rarely. In the last two years, about one percent of calls CRCL responded to needed to involve police, she said.
In a presentation to the New Westminster Police Department, CRCL coordinator Nicole Sto Thomas said police can refer calls to CRCL when a person is in distress but not to the point where they could be detained under the Mental Health Act, or if a person is experiencing paranoia or psychosis and thinks people are breaking into their home when there is actually no threat.
It’s not clear to what extent police would refer calls to CRCL without any police involvement. In an email, New Westminster Police Department Chief Const. Paul Hyland said referrals could happen if officers have been asked to check on a person’s well-being and can confirm the person is not in danger, or if officers believe a person could benefit from CRCL’s services. Referring people to CRCL works to free up police resources to “respond to more appropriate calls for service, and that’s a benefit to the citizens we serve,” Hyland added.
The Victoria Police Department sends an officer and a mental health professional to respond to mental health-related calls whenever possible and will refer calls to CRCL once police can confirm there are no safety issues, Cheryl Major, spokesperson for the Victoria Police Department, told The Tyee in an email. Major added the VicPD has a “great relationship” with CRCL and is supportive of its work. Hyland said the New Westminster Police Department has a “positive and highly collaborative” relationship with CRCL.
The RCMP is the police force in Comox Valley, Prince George, Kamloops and North Vancouver. When asked by The Tyee what calls the RCMP might refer to CRCL, spokesperson Staff Sgt. Kris Clark said, “I can’t think of a situation where police would be in a position to defer such a call to another agency.”
“De-escalation must occur before any additional resources, such as a mental health nurse/practitioner, can be leveraged to assess the subject,” Clark added. “Every mental health-related call is unpredictable.” By law, all police in B.C. are required to take crisis intervention and de-escalation training every three years.
How a CRCL call works Mackenzie defines a mental health crisis as an acute, short-term incident where a person is no longer able to cope on their own, is unable to access the resources typically available to them and requires urgent intervention and support. This could include thoughts of self-harm, thoughts of suicide and/or extreme panic or anxiety.
Mackenzie said CRCL teams may refer calls to other emergency responders or work in collaboration with them if someone has a weapon and an intention to use it, or if there’s an overdose or an active suicide attempt in progress. Anyone can call or text CRCL to connect with a dispatcher who will assess or triage if necessary. They can dispatch a team who will respond in plain clothes and an unmarked car.
The goal is to offer a person-centred, compassionate, trauma-informed response, Mackenzie said. The team seeks consent from the person in crisis and works with them to provide safety and support until that crisis is resolved, she added. This can look like helping rehouse youth, helping connect people at supervised consumption sites with resources or helping an unhoused person who is clearly in distress without ever involving police, she said.
CRCL does a follow-up within 48 hours to check on a person’s well-being, to check if their safety plan is working well and to ask if they’ve connected with longer-term services like peer support, housing or community or mental health services. A CRCL team consists of a member with professional mental health experience and a member with lived experience who can say, “I’ve been there,” Mackenzie said.
All members complete 100 hours of training in de-escalation, mental health and substance use, situational awareness and scene safety, first aid and suicide intervention training. Mackenzie said crisis response teams are “typically much less expensive” than police-only teams. CRCL helps reduce health care-related costs by diverting unnecessary emergency department visits, paramedic resources and inpatient services, she added.
The age cutoff has been set at 13 because children and adolescents require a slightly different crisis response, she said. CRCL employs around 100 people in full-time and casual positions and could be expanded across the province if needed, Mackenzie said.
A Rankin Inlet mother is terrified that mental health services in the community are going to ignore her heartbroken pleas for help and let her daughter slip through the cracks. The mother, who is being granted anonymity, told Kivalliq News that her teenage daughter presents a danger to herself as well as others. Last month, her daughter tried to assault her with a large knife, she alleges.
In police custody at the time of the interview, the daughter has experienced drastic negative changes to her personality and behavioral patterns during the past year, according to the mom. She said up until the past year, her daughter was a very smart, very sweet girl. “I would make her hats and she would go down to the start of the town and work her way back up home selling these hats,” said her mom. “And, she knew how to manage money. She managed to make herself enough money in one day to buy herself a bike.”
“She came home with a brand-new bike and all hats sold. She’s very smart. I know she has lots of potential. She can do anything she wants.” The teen's mother said there have been acts of violence in the family home since the daughter started her downward spiral. She said one of the more traumatizing ones for her family was when her daughter burned her belongings in the porch with nine people still in the house.
“My daughter goes in and out of herself, so you can't really understand what she's saying or you can't really take it in what she's saying. Half the time she doesn't even know what she's doing anymore.” The mother said she has a son who is 18 now and started showing signs of mental illness in November of 2021 and was admitted into hospital in February of 2022 and diagnosed with cognitive behavioral delay, bipolar and schizophrenia.
“I could see in my daughter the same signs, and I told all the health officials that I don't want to wait. I don't want to fight for another three years to get my daughter help until it gets to the point where it's probably too late,” she said. “My daughter threatened to harm herself numerous times and was hospitalized down in Winnipeg this past June at the HSC Hospital psychiatric ward for two weeks because she tried to overdose. Both my daughter and my son were hospitalized at the same time in different wards.”
The mother said she's been fighting for help for so long that she knows the signs and can tell when her children are about to go into episodes. It takes about a day or two when she notices it. “I could take them into the health centre how many million times after they started their medication and tell them something's not right with my kid,” she said. “I've been dealing with [my son] and his schizophrenia for almost four years now and, as of March 10, he's been hospitalized for good and he's not coming home.”
“That makes me feel like [expletive]. I'm a Mom. I give up my life. I give up my body and my mental health to be a Mom. I didn't come from the best childhood upbringing you know, and, growing up, I didn't feel the kind of love that I should have.”
“So, I give up myself to have kids and to give them that love that I didn't have and for my kids to love me and give me that love back. With all the incidents that happened with my daughter, cops know all of it because cops were always involved when my daughter would have one of her episodes or whatever and do frigged-up [expletive] — the cops were involved.”
“They know the story. They know my daughter and they know she needs help. They, themselves, the RCMP, said they know she needs help — but mental health said to me that because my daughter doesn't want to talk, they can't help her.”
“But yet, the cops went in there themselves with my daughter a few times and told mental health that she needs help. But my daughter was always being turned away. Just recently, I talked to a supervisor over at social services and was told they couldn't do anything to help my daughter because mental health were not listening to them and were not helping them.”
