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Mental-health cases flood capital region's police

The woman on the phone said she had killed three people and had a loaded gun, which she would use to shoot the police once they arrived on her property. It was March 2 about 6:30 p.m.

The woman on the phone said she had killed three people and had a loaded gun, which she would use to shoot the police once they arrived on her property.

It was March 2 about 6:30 p.m. and her rural residence was shrouded in darkness as four Sooke RCMP officers surrounded the home, hiding in the bushes. The woman, standing in a back shed, was calling out: “Come on, I know you’re out there. I’m going to shoot you.” She was clutching what looked like a handgun.

The officers were armed with their sidearms, Tasers and pepper spray, but the most crucial tool for dealing with the woman in mental distress was the information gathered just before heading onto the property.

Mounties knew from their database that they had dealt with the woman before for mental-health-related calls. They also called her husband, who works out of town, who told them the woman had talked about suicide by cop but he also told them she had no firearms in the home, but did have a pellet gun.

So Cpl. Andrew Baylis said when he saw the woman point the gun into the trees and discharge it, the telltale pop of a pellet gun reassured him that it was safe to quietly approach the door of the shed and restrain her, taking the pellet gun away. Officers took the woman to the hospital for help.

It’s a dramatic example of the complexities of dealing with people with mental illness, whose first point of contact when they’re in distress is often the police. How police officers deal with that person could be the difference between life and death.

There has been a shocking increase in mental-health-related calls to police in Greater Victoria over the last five years, which has departments scrambling to find a solution.

Victoria police have seen a 356 per cent increase in “disturbed person” calls over the last five years, from 226 calls in 2008 to 1,031 calls in 2013. The biggest spike was between 2009 and 2010, when such calls more than doubled from 314 to 674 calls.

Victoria police Chief Frank Elsner called the numbers “alarming.”

“More and more people are presenting with mental-health issues, and their first point of contact is with the police,” Elsner said. “Is that the most appropriate place of contact? My view is absolutely not. Often we don’t have resources, we don’t have any training nor are we the appropriate agency to deal with people who have a health issue, be it a mental one but it’s a health issue not a criminal issue.”

He said some nights “the vast majority, if not all, the officers” are tied up with mental-health calls.

“Rightly so, governments have moved away from institutionalizing people with mental illness to a community approach,” Elsner said. “The problem has been it’s been drastically underfunded for years. So I think what we’re seeing now is the result of that drastic underfunding.”

The spike in Mental Health Act cases has also been felt by psychiatric wards across the province, which simply do not have enough beds to house people.

On Jan. 27, two VicPD officers were assaulted after a 24-year-old man became distraught and physically combative outside the Victoria courthouse. The severely mentally ill man was diagnosed with bipolar disorder but was kept in an isolation cell, shackled and chained around the waist, in the Vancouver Island Regional Correctional Centre because no beds were available at the Forensic Psychiatric Hospital in Port Coquitlam.

People arrested under the Mental Health Act are often bounced among police cells, hospitals, overcrowded drop-in centres and then right back to the streets, a rotating door with few long-term solutions.

Police cells, Elsner said, can be a harsh environment for people with mental-health issues.

“The only thing we’re doing is housing that individual for a short period of time; for lack of a better word, they’re on a time out. Nothing positive happens for that individual.”

After the Tasering death of Polish immigrant Robert Dziekanski at the Vancouver International Airport in 2007, the Braidwood Commission recommended improved training for police in dealing with mental-health crises.

All police in B.C. have to complete an online training course called “crisis intervention and de-escalation” that helps police identify signs of a mental-health disorder.

Police across Greater Victoria can call the Integrated Mobile Crisis Response Team for help if they believe someone presents a risk of harm to themselves or others. The team consists of social workers, nurses, child and youth workers and two police officers who work around the clock to respond to mental-health emergencies.

IMCRT is also seeing a spike in calls from police across Greater Victoria requesting help on mental-health cases. In 2008, the team received 613 calls from police. That jumped to 985 calls in 2013.

Rev. Al Tysick, former executive director of Our Place drop-in centre who runs the Dandelion Society, a non-profit organization that focuses on the hardest to house, said he sees firsthand the challenges cops face on the street when dealing with people in mental distress.

Officers are “so damn busy putting out fires” that there’s not always a uniform or consistent approach, Tysick said.

“Some police are so good, some will listen and others will throw you in a paddy wagon and take you to the station. But it’s easy for me to say: ‘I think they should be more trained, more sensitive.’ It is a very difficult situation they’re in. It is in an environment of chaos when they’re dealing with this stuff.”

Sooke RCMP’s former Staff Sgt. Steve Wright, who is now the officer in charge of operations at West Shore RCMP, raised the alarm about a spike in mental-health calls after several suicides and suicide attempts last year, including the case of a 16-year-old girl who killed herself in December.

“Our mental-health calls are up dramatically over the last few years,” Wright said before he left his position with Sooke RCMP in March.

He said it’s particularly difficult for smaller communities where there are fewer specialized resources and officers might have to spend hours out of their jurisdiction when driving a person in distress to the hospital.

In 2008, Sooke RCMP responded to 83 mental-health-related calls and by 2013, that number shot up to 140.

The small community was shocked by the horrific killing of Sarah Nickerson, who was dismembered on Jan. 8, 2012, by her son, 21-year-old Alex Conte. Conte, who was known to have violent tendencies, was found to be psychotic a few days before he killed his mother but was given only a prescription to address the problem on his own, his lawyer said in January 2013, after Conte was found not criminally responsible because of a mental disorder.

Sooke RCMP did a curfew check the night before the killing and found no signs Conte was about to have a breakdown.

Baylis, the officer who subdued the erratic woman in Sooke, said mental-health calls are the most challenging for any police officer.

“People are in a state that’s not a normal state to be in,” Baylis said. “A lot of mental-health calls that we go to also involve alcohol or drugs, and that adds another layer to it that gets to be very dangerous very quickly.”

Saanich police dealt with 375 disturbed-person calls in 2008, which shot up to 532 calls in 2013. Saanich police spokesman Sgt. Steve Eassie pointed out that might not be a full picture of the mental-health-related calls, as many incidents might come in as weapons calls, assaults, uttering threats or car crashes but also involve someone with a mental illness.

On Jan. 19, a 29-year-old Saanich man suffering a mental breakdown sparked a frantic, 10-hour search by several police departments as he drove his car erratically up and down the south Island, smashing into a taxi in Victoria, fleeing from officers, hanging off signs and yelling at cars on the Malahat until causing a head-on crash on the Pat Bay Highway that injured two people.

The 29-year-old underwent a psychiatric evaluation and his case was being reviewed by B.C.’s Mental Health Review Board, to determine if he’s not criminally responsible because of a mental disorder. His case was transferred to the Ontario review board because the man was accepted into a master’s program at the University of Toronto.

Oak Bay police say mental-health calls have almost doubled from 43 calls in 2008 to 80 calls in 2013. Staff Sgt. Andrew Brinton, who took over as Oak Bay police chief in April, said police officers across the country are dealing with mental health crises on a regular basis.

“I can say in my 32 years of service, that really if you boil a lot of the situations down to the root cause, you’re going to find mental illness and you’re going to find addiction. To me, we can bandage it or we can get to the core response to it,” he said, which includes involving health and social workers in the response.

When Cordelia was taken on as a client with the Victoria Integrated Community Outreach Team, she was at her lowest point in a life scarred by drug addiction, mental illness and severe health problems.

“I was so suicidal when you guys first met me. I didn’t see any purpose,” she said to her outreach worker, Trudy Chyzowski, who also leads the VICOT team. Chyzowski allowed the Times Colonist to accompany her on one of her client visits one day in April.

“I was taking prescription drugs. I was just swallowing them. Just to numb myself out ... or die,” said Cordelia, who did not give her last name to protect her identity.

Cordelia is in a much better place now and doesn’t spend a lot of time looking back. The 56-year-old grandmother lives in a cozy bachelor suite in Ross Place retirement home, a world away from the drug-infested Traveller’s Inn room in Rock Bay she used to live in.

“It was bad news there, it was really rough down there. It was drugs and alcohol and people dying. People running around, police officers and dogs.”

Cordelia’s new home is decorated with plants and family photos of her two daughters and her grandchildren. She sits in a chair beside her bed, wearing a pink plaid scarf and flower-printed pants. Her voice is raspy, suggesting years of smoking, and the bags under her eyes make her look older than her 56 years.

More comforting than her new home are the regular visits from VICOT workers, who have accompanied her on trips to Vancouver, helped her with her finances and prevented her from slipping back into her addiction.

“They make me feel at home. I don’t know what I’d do without them,” she said. “They’re part of my world.”

VICOT is a team that joins a police officer, nurses, mental health workers and social workers to provide co-ordinated services to the most vulnerable people living with serious mental disorders. It is one of the four Assertive Community Outreach Teams that Island Health operates in Greater Victoria, and its 65 clients include people who are hard to house, are struggling with addiction or have a history with police.

The other ACT teams work with people with mental psychiatric disorders living in the community.

New clients are taken on by the team that has capacity at the time. Teams serve between 65 and 80 clients, depending on complexity of care required, and frequency of service to the client, according to Island Health. Visits can range from twice daily to twice weekly.

Victoria police Const. Debbie Justice has been assigned to the team for two and a half years. Justice typically goes along on calls when there could be a risk to staff, such as if a person is having a psychotic episode or if someone is apprehended under the Mental Health Act. There are certainly times where she has to arrest someone if they’re breaching their probation or if the person is a threat to themselves or others, but for the most part “I try and maintain the therapeutic relationship with the clients,” she said.

She has a wry sense of humour and that’s often the tactic she uses when trying to build rapport with clients, many of whom have a history of clashes with the police.

Justice’s job is to try to break down those barriers, to eliminate the us-versus-them mentality that the street community has with law enforcement.

“Clients have come to depend on the police officer in a very positive way,” Chyzowski said.

Justice tells a story that underscores how a police officer’s approach toward someone with mental illness can build a level of trust.

One night, two residents of Seven Oaks, a mental health facility in Saanich, left the grounds without permission after curfew. Staff called police with a description. A Victoria police officer found the pair and explained why he had to take them back.

One of the patients said to the officer: “You’re super chill, bro. Next time I escape, I want you to drive me back,” Justice recalls. “[The officer] wasn’t treating them like they were mentally ill; he treated them like human beings.”

Saanich and Victoria police also each have an officer seconded to the Integrated Mental Health Crisis Team, which responds to emergency calls when a person is experiencing a mental breakdown and poses a threat to themselves or others.

Victoria police Chief Frank Elsner said investing in the integrated mental health teams is money well spent.

“With these teams that are in the community, they have regular followup with these individuals. They can ensure they remain on their medication and they get the help, counselling and all the other resources that they need. It’s not in a bubble; these people also need other services.”

At VICOT’s morning team meeting one day in April, Justice, social workers and nurses sit in a boardroom and go down a list of their clients, delegating who will visit whom. One client desperately needs to be taken to detox, another needs to get her photo ID. Some staff volunteer to help clean a client’s home but are warned to be careful of needles. Staff also discuss how to deal with a client who has been extremely verbally abusive. Another social worker will take some clients on a hike up Mount Tolmie for their weekly fitness outing.

The most important factor in stabilizing a life of chaos is routine, and that’s why outreach workers try to visit their clients on a daily basis, even if it’s a 10-minute chat in the doorway.

“We have the time to build a relationship and get to know some of the life stories that come with it,” Chyzowski said.

That’s not to say the visits always go smoothly. During one visit at a women’s shelter in Esquimalt that morning, a client is erratic and delusional, swearing and accusing shelter staff of going into her room and stealing her things. She begs the social worker to find her another place to live, and the worker spends several minutes trying to calm her down and promises to visit again soon.

Building on VICOT’s success and dealing with growing caseloads, the health authority has used $500,000 to create a new intensive case management team that will focus on people who are homeless and struggling with addiction, which can often lead to mental-health issues.

“We spent more than a year talking with some of the non-profit partners, the city and the police. We identified a population that is different from the folks served by ACT,” said Kelly Reid, Island Health’s director of mental health and addiction services.

Operating since February, the team has 58 clients and is comprised of staff from AIDS Vancouver Island, First Nations representatives, outreach workers who work with women in the sex trade, nurses and psychiatric social workers.

“They will be supporting a population who are also engaged with police on a regular basis,” Reid said, adding the hope is that “encounters with police will go down, trips to the emergency department will go down, length of stays in hospitals will go down.”

A few years ago, Mark Ewart would have fit the bill for the type of client the intensive case management team is trying to help. Deeply addicted, he was a drug dealer with hundreds of run-ins with the police. He can’t count the number of times he has almost died, including getting run over by a car in a drug deal gone wrong, violent attacks and overdoses. He was diagnosed with HIV and couldn’t get the medication he needed in jail.

“All kinds of bad things happened to me out there. I was lucky to survive this far,” said the 50-year-old, who has been a VICOT client for the past two years.

When Ewart got out of jail, he finally set his mind toward working with his probation officer to clean himself up. That probation officer, a woman named Sharon Bristow, who was working with VICOT at the time, “became my best friend,” Ewart said. She helped him get his driver’s licence, gave him rides to appointments and helped him get into a treatment centre.

Ewart, sober for two years now, has turned his focus to painting, the passion that once found him studying fine art at Emily Carr University in Vancouver before his addiction threw that all away.

Ewart painted one of the panels of the Lady Justice mural on Chatham Street near Capital Iron. The mosaic mural was painted by clients of the Victoria Community Court as well as donors.

Every time he walks by it, Ewart said he feels proud to have a second chance.

“If it wasn’t for [the VICOT team] I wouldn’t have a chance to get clean,” he said. “Now I know I have people I can count on and they’re there for me all the time. They’re like everything to me.”

kderosa@timescolonist.com

ACT team effect

ACT teams have helped reduce hospital visits for clients.

Island Health analyzed the hospital visits of 262 ACT team clients who were provided services for a year or more since 2008. In the year before they were a client they averaged 70 days in hospital, detox or high-level mental health facilities. After a year or more of receiving ACT services, they averaged 22 days in these health care facilities, the health authority said.

Each ACT team costs about $1.2 million a year to run.

Island Health has had to steadily increase its budget to meet the growing demand for mental health and addiction services, jumping from $91.7 million in 2008/09 to $112 million in 2013/14.