Evaluating Mobile Crisis Intervention Teams in Toronto

Update, November 2015:
The TCLHIN and MCIT Steering Committee recently engaged researchers at CRICH to complete a mixed-methods outcome evaluation
to examine client experiences and outcomes in crisis interactions with MCIT and Primary Response Unit police teams (PRUs) and explore MCIT’s role in Toronto’s crisis response system. Additional information can be foundhere.   

In Toronto, police officers are often called to respond to mental health crises. To begin to address this issue, Toronto hospitals and Toronto Police Services developed ‘Mobile Crisis Intervention Teams’ (MCITs), each of which has one psychiatric nurse and one police officer with specialized training. There are currently six MCITs working out of hospitals in Toronto.

MCITs are generally dispatched at the request of ‘primary response units’ (PRUs) – regular police officers who are already on the scene. In some cases, community agencies, health care providers or family members will call 911 and request an MCIT. (MCITs are almost always preceded or accompanied by PRUs, and only respond to non-violent situations.)

Currently, the Toronto Central Local Health Integration Network is working with hospitals and Toronto Police Services to improve and expand the MCIT program. To inform this process, the MCIT steering committee engaged researchers from the Centre for Research on Inner City Health (CRICH) to conduct an evaluation. The final report includes a number of specific program recommendations, and can be downloaded here.

CRICH found that MCITs are helping to keep care in the community by preventing unnecessary admissions to the Emergency Department and interactions with the justice system. We also found that a range of stakeholders experience MCITs in a positive way.

People responded to by MCITs shared largely positive comments regarding nurses and police officers on the teams. Themes included:

Listening and respect. People considered interactions to be positive when they felt listened to, respected and cared about.

Choice. It was very important to people to have choices instead of being told what to do.

Referrals. The importance of choice extended to the services people were referred to – hospitals, supportive housing, etc.

Clarity. People did not always know what the MCIT was, why they had been called or the scope of their authority.

Criminalization. People at times felt uncomfortable with encounters with PRUs and MCITs. This included experiences like being visited by uniformed officers; put in handcuffs and/or put in the back of a police car – often in front of family members and/or neighbours.

These findings are consistent with the literature related to best practices in mental health care, and deeply important to the future of the MCIT program and the crisis response system in our city.

At the same time, it should be noted that researchers were not able to speak to a large sample of people who had interactions with MCITs. The report highlights the need for thoughtful planning, data collection and reporting and further evaluation to support the development of a comprehensive crisis response system for people who might experience mental health crises in the community.