Provincial Spring Conference Alberta Association of Police Governance April 4,2009 POLICING AND COMMUNITY HEALTH Orrin Lyseng Executive Director Alberta Alliance on Mental Illness and Mental Health

Alberta Alliance on Mental Illness and Mental Health (AAMIMH) Alberta College of Social Workers Alberta Network for Mental Health (Fellowship) Alberta Psychiatric Association Alberta Association for Children and Families The Canadian Mental Health Association College of Registered Psychiatric Nurses of Alberta Society of Alberta Occupational Therapists The Organization for Bipolar Affective Disorders Psychologists Association of Alberta Schizophrenia Society of Alberta

Providing and coordinating service to the person with mental illness by police and mental health. 3 different types of interactions… Presentation will focus on …

First type … Traditional Roles-Responsibilities Mental Health vs Police Upsides - Both sectors know their role Efficient and not complicated Downsides - The separation of duties does not facilitate the ready exchange of personal information from the health care provider to the law enforcement officer and vice versa

Second type … Informal Collaboration at Front Line This is essentially case management in direction … While maintaining independent focus, the involved agencies work to identify how they can better work together to respond to the person in need Usually crisis or problem motivated Initial success promotes continuance Needs “champions” to set the tone

Front Line - Informal Collaboration (contd.) Upsides Greater understanding of each agencies role and strength begins to emerge Enables smoother transition from one agency’s responsibility to another Joint response begins to identify the needs of the mentally ill person

Front Line - Informal Collaboration (contd.) Downsides Fragile – loss of agency commitment due to shift in philosophy / work role or loss of “champions” due to move or transfer causes remaining group to struggle While work is rewarding, it is often done off the side of the desk of the person, resulting often in the stress of increased workload

Third type … Formalized Agreement & Processes for Collaboration All key stakeholders participate in developing and implementing cross-sectoral coordination processes. Organization’s management endorses and reinforces the processes for a collaborative response. Resources (human and fiscal) are committed to ensure the program's success – collaboration is not regarded as just an “additional expectation” Policies and procedures put in place to assist personnel in carrying out their respective jobs to better meet the needs of the mentally ill person in need.

Agreement to Collaborate (contd.) Upsides - Exchange of information about the person is timely and appropriate Increased opportunities for knowledge exchange / skill enhancement between the partnering organizations Building of mutual respect and trust between collaborating partners and their staff The response to the person in a mental health crisis is more effective as increasingly the focus is on the needs of that person

Agreement to Collaborate (contd.) Downsides - Initial work is time consuming, often many meetings required to get details worked out It is hard work – “same ten people” – need to make processes straightforward – simple but comprehensive You drink far too much coffee in the meetings

What do we need to do with this Cross- Sectoral Co-ordination? Based on language from Provincial Diversion Program - We need to, as appropriate, redirect individuals with mental illness who commit minor, low risk offenses or who are identified because of their behaviour as becoming at risk for greater involvement with the criminal justice system - back to mental health, social and support services. – to stabilize these individuals, connect or reconnect them to services and supports, e.g., community agencies, re- connect with family as appropriate – to reduce their involvement with the law and reduce the reliance on the criminal justice system.

Cross Sectoral Mental Health and Justice Coordination in Alberta Provincial – Example - Provincial Diversion Steering Committee – Established 2001 by Mental Health & Justice Partnering Deputies Committee, involving 7 Ministries, Police (RCMP & Municipal), AMHB, AADAC, SSA, CMHA and RHAs – Developed a Framework and Standards documents now on web at See “Publications”. – Diversion documents developed at a high enough level to allow for diverse community responses but still support provincial coordination

Cross Sectoral Mental Health and Justice Coordination in Alberta (contd.) Community Diversion Services Under Provincial Program – Post-charge Diversion Services underway in Lethbridge, Calgary, Edmonton, St. Paul – Post-charge Diversion being implemented in Medicine Hat, Red Deer, Ft. McMurray, Grande Prairie – Law Enforcement – key partner in each of these communities – identification of potential clients

Alberta's Provincial Diversion Framework “Reducing the Criminalization of Individuals With Mental Illness” Example of the critical role of law enforcement – Stats compiled for Provincial Diversion Program documents- – From 1998 to 2000, an average increase of 34% per year of “actual investigation files” by the R.C.M.P. in which the complaint involved an individual suspected of having a mental illness – From 1997 to 2000, an average increase of 22% per year in the "calls for service" for mental health complaints by the Edmonton City Police – From 1997 to 2000, an average increase of 31% per year for the “actual reports submitted” for mental health complaints by the Calgary City Police Impact of a Coordinated mental health – police – criminal justice response, e.g. Calgary Diversion Pilot project evaluation (2004) indicated that for the diversion clients who had their charges withdrawn – 86% drop in charges by police for these individuals

Critical Success Factors Per: Aggy King-Smith, Manager Provincial Diversion Program, AHS – Both provincial and community coordination are needed – Community cross-education needs to be ongoing, not just at implementation – Keep informed about community partners roles- and their limitations – key to understanding and “trust” – Ongoing, consistent community leadership from all sectors – mental health, justice, law enforcement – critical to have knowledge of Services passed on within each system: management to front line to new new recruits

Other benefits? Bill 31 – The Mental Health Amendment Act This will see the establishment of Community Treatment Orders (CTO). The same collaborative work demonstrated in Diversion planning and development will also be critical to the successful implementation of CTO programming in Alberta

Suggestions and Implications Suggestions Increase and foster the growth / continuance of collaborative processes Ensure adequate sustainable funding is in place to support these processes Build ongoing sustainable leadership Some Success Implications Appropriate and effective use of resources Improves potential for successful treatment outcomes Keeps people well in the community Increases more appropriate use of the justice system Interrupts the “revolving door” process Reduces burden on law enforcement having to deal with “Frequent Flyers”

Closing The AAMIMH is very supportive of the collaborative work that has taken place around diversion and in any process that increases collaboration between the justice and health systems regarding services to those living with a mental illness, and we would encourage these efforts to continue On behalf of the AAMIMH, my sincere appreciation to all who are involved in these initiatives and the service they provide to those in need. Your work will improve the lives of those struggling with a mental illness now, and for years in the future. Thank you for the invitation to speak at this conference