When someone is in mental health crisis, the response they receive can mean the difference between stabilization and escalation, between connection to care and incarceration, between life and death. Across Canada, communities are experimenting with mobile crisis response teams that send mental health professionals—sometimes alongside or instead of police—to respond to psychiatric emergencies. These models represent a fundamental rethinking of who should respond when people are in crisis and how those responses should be structured.
The Problem with Police-First Response
Traditionally, 911 calls involving mental health crises have been dispatched to police officers. This approach has significant limitations. Police are trained primarily for enforcement, not therapeutic intervention. Their presence—uniforms, weapons, vehicles—can escalate distress rather than calm it. Officers may lack training to recognize psychiatric symptoms or de-escalate effectively. And the tools available to police—arrest, force, detention—are poorly suited to helping someone in psychological crisis.
The consequences have been tragic. People in mental health crisis have been injured or killed during police encounters. Others have been arrested and funneled into criminal justice systems rather than healthcare. The criminalization of mental illness fills jails and prisons with people whose primary need is treatment, not punishment. Even when encounters end without violence, the experience of police intervention during a vulnerable moment can be traumatizing and can discourage future help-seeking.
These problems fall disproportionately on marginalized communities. Black, Indigenous, and racialized people face elevated risks during police encounters generally, and mental health crises are no exception. People who are homeless, who use substances, or who have previous justice involvement may be particularly likely to experience harmful police responses.
Alternative Models
Co-Response Teams
Co-response models pair police officers with mental health professionals—nurses, social workers, or crisis counselors—who respond together to mental health calls. The mental health professional can assess the situation, provide therapeutic intervention, and connect the person to appropriate services. Police provide security and can intervene if safety concerns arise.
Co-response teams have operated in various Canadian cities for years. They represent an improvement over police-only response, bringing clinical expertise to crisis situations. However, critics note that police presence may still escalate some situations and that co-response does not fundamentally change who leads the response.
Civilian-Led Response
Some jurisdictions are piloting civilian-only crisis response, dispatching mental health professionals without police for calls assessed as not involving weapons or imminent violence. These teams typically include crisis counselors, social workers, and sometimes peer support workers with lived experience of mental health challenges.
The CAHOOTS program in Eugene, Oregon—operating for over 30 years—is often cited as a model. It responds to a substantial portion of the city's 911 calls, rarely requiring police backup. Canadian adaptations are emerging in cities including Toronto, Vancouver, and Edmonton, though implementation and scope vary.
Civilian-led response shifts the fundamental paradigm from enforcement to care. It may be particularly appropriate for people who distrust or fear police, who may refuse police assistance, or whose crises involve primarily psychological distress rather than violence or criminality.
Dispatch and Triage
Effective alternative response requires effective dispatch. Call-takers must assess situations to determine appropriate response—police, co-response, civilian team, or ambulance. This requires training, protocols, and sometimes real-time consultation with mental health professionals. Getting triage wrong can have serious consequences in either direction: sending unarmed responders to dangerous situations or sending police to situations that would be better handled clinically.
Implementation Considerations
Scope and Availability
Alternative response programs often operate with limited hours, staffing, and geographic coverage. A program available only during business hours cannot respond to overnight crises. A team covering a large city cannot reach calls in time if there are only a few responders. Expanding scope requires substantial investment in personnel, training, and infrastructure.
Clinical Workforce
Mobile crisis response requires mental health professionals willing to work in community settings, respond to emergencies, and accept the unpredictability of crisis work. This workforce overlaps with broader shortages in mental health services. Recruiting, training, and retaining crisis responders is an ongoing challenge.
Integration with Services
Crisis response is only the first step. People in crisis often need ongoing services—psychiatric care, counseling, housing, substance use treatment, income support. If crisis teams cannot connect people to appropriate follow-up, the same individuals cycle through repeated crises. Effective crisis response requires integration with the broader mental health and social service system.
Liability and Safety
Sending civilians to crisis situations raises questions about safety and liability. What happens if a situation escalates? What backup is available? How are responders protected? Programs must develop protocols for dangerous situations, ensure responder safety, and address liability concerns without letting these concerns prevent effective alternative response.
Police Role and Culture
Shifting calls from police to alternative responders changes police workload and may meet resistance from police organizations or unions. At the same time, many officers welcome relief from mental health calls they feel ill-equipped to handle. Successfully implementing alternative response requires engagement with police organizations and attention to how the change affects policing culture and practice.
Measuring Success
How should alternative response be evaluated? Potential metrics include: proportion of crisis calls diverted from police; use of force in crisis encounters; injuries to people in crisis or responders; arrests and criminal charges; emergency department visits and hospitalizations; connection to follow-up services; repeat crisis calls; and satisfaction among people served, responders, and community members.
Robust evaluation requires data collection systems that may not exist and comparison conditions that are difficult to construct. Early results from various programs are promising, but comprehensive evidence on effectiveness remains limited.
Broader Context
Mobile crisis response is one component of a broader spectrum of mental health crisis services. Upstream prevention, accessible ongoing treatment, crisis lines, peer support, and residential crisis stabilization all play roles. Mobile response cannot substitute for a functional mental health system—it can only provide better response when crises occur.
The movement toward alternative crisis response also connects to broader debates about policing, public safety, and community wellbeing. For some advocates, crisis response reform is part of defunding or abolishing police. For others, it is simply about matching responses to needs. These different framings affect political dynamics and implementation approaches.
Questions for Further Discussion
- What types of crisis calls should be diverted from police, and how should that determination be made?
- How can civilian crisis response be scaled while maintaining quality and safety?
- What is the appropriate balance between co-response models (with police) and civilian-only response?
- How should crisis response be integrated with ongoing mental health and social services?
- What role should people with lived experience of mental health challenges play in crisis response?