1. Mobile Crisis Rapid Response Team A 911 Police/Mental Health Response
A/Sgt. Steven Holmes, Hamilton Police Service
Sarah Burtenshaw, Hamilton Mobile Crisis Rapid Response Team
Deb McGrath, Manager COAST Hamilton
Terry McGurk, LHIN 4 Lead for MCRRT
Sgt. Dave Tutte, Halton Regional Police Service

2. Crisis Intervention Team Training
CRISIS RESPONSE UNIT
COAST
Crisis Outreach and Support Team
MCRRT
Mobile Crisis Rapid Response Team
SNP
Social Navigator Program
Crisis Intervention Team Training

3. Zachary Antidormi Mary Popovich
When she died on October 23, 1992 at the age of 65, open sores covered her legs, and a hacking cough were symptoms of pneumonia, emphysema and bronchitis. Her death was a wake-up call to the community around lack of supports for homeless single women.
Zachary Antidormi
Mary Popovich

4. Crisis Outreach and Support Team COAST (1997)
Community-based mental health team responding to people in crisis
4 plain-clothed officers respond to calls in the community with Mental Health Clinicians (Social Workers, Nurses and OTs)
Unmarked police car to reduce stigma
Referrals from people in crisis, family members, community agencies
Housed in an office off site from the police station
COAST officers report to the station daily
Police reports are sent to the officer to review for followup

5. COAST Process
Call to COAST
Mobile Visit
Telephone Support
911 Call

6. COAST Benefits Divert people from the ER and 911 to community supports
Provides follow-up to police reports
Reduced stigma
Office is located in the community
2015/2016:
3,392 mobile assessments
13,981 telephone calls
738 taken to the ER
1:5 (80%) diverted from the ER

7. Crisis Intervention Team (2006)
40-hour mental health training program
2 sessions a year – 20 courses in Hamilton
332 officers trained to date (Goal: 100% of HPS)
CIT officers provide relief for COAST and MCRRT
Replicated in Halton, Niagara, Brantford, Norfolk police services

8. Social Navigator Program (2011)
Assist people with addiction and mental health issues who do not have the capacity to navigate the system alone
Paramedic, Police Officer and Case Manager
Goal: reduce reliance on judicial and health care systems while navigating clients towards the appropriate agency

10. The Solution: Transfer of Care Process
Protocol developed by committee of representatives from Hamilton Police Services and St. Joseph’s Healthcare Hamilton
Protocol allows police to leave a PIC if considered to be a low risk
Ongoing monitoring and support of this process

11. Mean Wait Time:
122 min ↓ to 63 min
90th Percentile:
240 min ↓ to 140 min

12. 2013
Problem: Uniformed officers continued to take a large number of PICs to hospital
Solution: Place a MHW in a cruiser to provide a 911 mental health response = Mobile Crisis Rapid Response Team

13. Mobile Crisis Rapid Response Team
Mental health worker paired with a police officer responding to 911 mental health calls

14. Mobile Crisis Rapid Response Team (MCRRT)
2015: 2 teams daily
4 officers/4 MHWs
10:00 – 22:00 hours 13:00 – 01:00 hours daily
MHW rides with a uniformed officer in a patrol car responding to 911 mental health related calls

15. Benefits of MCRRT Bring expertise of the MHW to the PIC within minutes
Divert from the ER to the appropriate resources
Redirect police back to other police work
On-road resource to police
Increased use of COAST service in the future before the individual goes into crisis
Police Satisfaction Survey: extremely satisfied with MCRRT
Replicated in Niagara, Halton, Brantford, Norfolk, Haldimand

16. Training Officers are CIT trained
MHWs have advanced practice and work in COAST for up to 6 months
4-day training for MHW and police to provide a singular knowledge base
Included a Defensive Techniques day provided by Hamilton Police Service Training Branch

17. Tuesday April 7th, 2015
Wednesday April 8th, 2015
Thursday April 9th, 2015
Friday April 10th, 2015
08:00 – 08:30
Welcome Chief DeCaire
Dr. Higgins, St. Joseph's Hospital
08:30 – 09:30
Development of MCRRT
History of COAST, CIT and MCRRT
How MCRRT works
9:30 – 10:30
Dr. Lori Triano- Antidormi
11:00 – 12:00
Privacy Presentation
08:00 – 12:00
Defensive Training
08:00 – 09:00
Overview of Psychiatric Disorders
09:00 – 09:45
Overview of Medications:
10:00 – 11:15
Risk Assessment
11:15 – 12:00
ER and Psychiatric Emergency Services
08:00 – 11:00
Administrative issues:
Scheduling
Policies and Procedures
Deployment Strategy for MCRRT
Documentation:
MCRRT assessments
Sharing of information
Niche
Development of log templates with measurable outcome measures
13:00 – 15:00
Overview of Mental Health Act and Related Issues
15:00 – 16:00
Mental Health Court Support Services
13:00 – 16:00
Suicide Intervention:
14:00 – 17:00
CPR
Vicarious Trauma
Susan Double, HPS
Barrett Centre (Crisis Beds)

18. Typical Calls MCRRT Attends
Suicide attempts
Person in Crisis
Neighbour Troubles
Family Troubles
Used as a resource for Negotiations
Respond to emergency responders
COAST provides secondary followup

19. Statistics April – December 2015
3,759 PIC calls in Hamilton
57% responded to by MCRRT (2,160)
MCRRT
Uniformed Patrol Officers
Section 17 Apprehension
19% = 413
75% = 1629
Average Wait Time in ER
60 minutes
(1 officer)
80 minutes
(2 officers)
Hours in ER
413 hours 
4,344 hours

20. MCRRT Supervision
MCRRT team is based in the police station in office with Police Sergeant
COAST Manager →Senior MHW
Team attends daily huddle/report at COAST office for 15 minutes
Each team submits a log to supervisors at end of shift
LHIN Lead – ensures all MCRRTs in the region remain consistent
Regular meetings held within each police service and Regional Meetings held quarterly

21. Barrett Centre For Crisis Support MCRRT/SNP Crisis Bed
10 bed centre for individuals experiencing a mental health crisis
24/7 crisis line, face-to- face counselling and 3 – 5 day stay
Proceeds of Crime funds one bed for MCRRT/SNP to access

22. Mobile Crisis Rapid Response Team Benefits and Efficacy
Coordinated response to people in crisis
Redirect PICs away from criminal justice system to appropriate community resources
Significant reduction in use of the Emergency Department

23. Questions and Comments
A/Sgt. Steve Holmes, Community Response Unit, Hamilton Police Service
Sarah Burtenshaw, Senior Mental Health Worker – MCRRT
Deb McGrath, Manager – COAST Hamilton
Terry McGurk, MCRRT LHIN 4 Lead
Sgt. Dave Tutte
Regional Community Mobilization Bureau, Halton Regional Police Service