Who Should Respond to a Mental Health Crisis?

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The Question at the Core

When someone is in crisis, the phone call is often simple — help is needed. But the answer to who actually shows up is anything but simple. Police? Paramedics? Social workers? Peer teams? The debate cuts to the heart of how society defines both safety and care.

The Current Default

  • Police first: In most of Canada, 911 routes mental health calls to police by default.
  • EMS and hospitals: Often brought in once a situation escalates or requires medical attention.
  • Patchwork pilots: Some provinces and cities are testing alternatives — but access is inconsistent.

The Case for Police

  • Safety concerns: Responders argue police are necessary when there’s potential violence.
  • Legal authority: Police can enact involuntary holds under provincial laws.
  • 24/7 availability: Unlike most health or social services, police are always on call.

The Case Against Police

  • Escalation risk: Uniforms, weapons, and compliance tactics can heighten distress.
  • Deadly outcomes: Several Canadians in mental health crises have died during police interventions.
  • Stigma and mistrust: Communities often see police presence as criminalization, not care.

Alternative Models Emerging

  • Health-led crisis teams: Social workers, nurses, and peer supporters as first response.
  • Co-response models: Police attend only if safety risks are clearly present.
  • Peer navigators: People with lived experience supporting crisis stabilization.
  • 988 crisis lines: Offering national phone-based triage with potential links to non-police response.

Canadian Context

  • Toronto & Winnipeg pilots: Mobile crisis units with health professionals and peers are showing promise.
  • Indigenous-led responses: Some communities are building culturally grounded, police-free crisis care.
  • Policy momentum: National and provincial task forces are reviewing crisis response frameworks, but change is uneven.

The Challenges

  • Funding and staffing: Health-first teams require stable investment, not short-term pilots.
  • Jurisdictional patchwork: Provinces, municipalities, and federal agencies don’t align on responsibilities.
  • Public perception: Many Canadians are still conditioned to see police as the first and only option.
  • Equity gaps: Rural and remote areas lack alternatives entirely.

The Opportunities

  • Reframing safety: Treat mental health crises as public health issues, not public order problems.
  • Integration: Build systems where health, housing, and justice communicate instead of passing people between them.
  • Scaling up pilots: Turn small community successes into national standards.
  • Building trust: Responders trained in trauma-informed and culturally safe practices reduce fear and stigma.

The Bigger Picture

Who responds to crisis is ultimately a reflection of our values. If we keep defaulting to police, we send the message that crisis is a threat to be controlled. If we choose health- and community-led models, we affirm that crisis is a human moment to be supported.

The Question

If mental health is health, then why do we still send police before paramedics? Which leaves us to ask:
how can Canada redesign crisis response so the right people — with the right training — are the ones who show up?