By Michael Theilmann
 

Background
 

Starting in the 1940s in Canada, the United Kingdom and the United States, there was a historic move away from housing people with serious mental illnesses in institutions. This was brought about by two principal factors: media exposure of appalling conditions in some institutions; and the introduction in the 1950s of the first effective antipsychotic drugs, such as chlorpromazine and reserpine.
 

The mantra for treating people with serious mental illnesses became ‘care in the community’ using the new family of wonder drugs, and treatment and programs funded by the savings generated by closing psychiatric institutions
 

The subsequent wave of deinstitutionalization over the ensuing decades was enormous. In the US in 1955, there were 559,000 people with serious mental illnesses in psychiatric institutions. By 2015, there were approximately 35,000 (Surviving Schizophrenia, 7th Edition, Fuller Torrey, p. 381). In Canada, according to a report by the Canadian Institute for Health Information, there were 50,000 psychiatric beds in 1960. By 2019, that number had fallen to 7,000.
 

For several reasons, deinstitutionalization was a disaster. To cite just two factors: money meant for community mental health support was siphoned off for other government priorities; and many former psychiatric patients lacking advocates or family support and unresponsive to the new drugs, ended up on the street where they had to fend for themselves.
 

The net result was a huge spike in homeless numbers with a corresponding impact on the criminal justice system—that is, the police, courts and prison system. Lacking safe housing, treatment, and support programs, many individuals with severe mental illnesses, through no fault of their own, fell afoul of the law.
 

This situation has worsened in recent years, exacerbated by shortfalls in virtually every key area: number of psychiatrists and psychiatric nurses, psychiatric beds, supportive housing, treatment and therapy programs, and lack of funding throughout. Another aggravating factor is overall population growth in Canada with a concomitant increase in the number of people with severe mental illnesses.
 

Police and People with Serious Mental Illness
 

Police services in every major city in Canada have, by force of circumstance, become front-line workers for people with serious mental illnesses, many of whom are homeless and living on the streets. Their interaction takes place on a daily basis usually in one of these categories: responding to reports of a disturbance, wellness checks, executing warrants under provincial mental health acts, or investigating serious crimes, such as murder.
 

In many cases, the police are dealing with the same person on a repeat basis. An individual in psychosis is picked up, taken to hospital, stabilized and then released—until the next time. For example, in September 2024, Brendan McBride, a man with a history of severe mental health issues, was charged with second-degree murder of an elderly man in downtown Vancouver, plus aggravated assault for cutting off the hand of another individual. Subsequent investigation revealed McBride had over 60 previous interactions with police in various BC municipalities (Vancouver Sun, September 6, 2024).
 

Police response to this ‘new’ role has changed over time, driven in part by tragic incidents where either a person with severe mental illness or a police officer was injured or killed. Some examples include the following:
 

• The 2008 case of Vince Li who killed and beheaded a man on a Greyhound bus in Manitoba and was found not responsible due to mental illness. At the time, he was suffering from untreated schizophrenia.

• The shooting of 18-year-old Sammy Yatim by a Toronto Police constable in July 2013

• The death in detention of 30-year-old Soleiman Faqiri at the hands of Ontario correctional officers, in December 2016. Faqiri suffered from schizoaffective disorder.

• The death of Abdirahman Abdi, a 37-year-old Somali-Canadian man in 2016, after a violent arrest by two Ottawa police officers. Abdi was described as “struggling with his mental health”.

• The 2022 death in Vancouver of a female RCMP constable at the hands of 37-year-old Jongwon Ham, once an Emmy-award winning filmmaker. At the time of the attack, Ham was homeless and suspected to be suffering from serious mental illness.

• The Tasering of 19-yer-old Abdullah Darwich, a man suffering from autism, by Peel Regional Police in November 2022.

• The killing of Surete de Quebec police officer Sergeant Maureen Breau on March 27, 2023, in Louiseville, Quebec, by a man with severe mental illness.

• In June 2024, a Toronto court found 35-year old Tenzin Norbu not guilty of first-degree murder due to mental illness. Tenzin was misdiagnosed with depression when, in fact, he was schizophrenic. He set fire to a complete stranger on a TTC bus in 2022.

• CBC coverage in 2024 of the case of 74-year-old, ex-nurse and Ontario resident, Barbara Cleary, who suffers from bipolar disorder and has been repeatedly jailed and hospitalized since 2018.

• The stabbing to death of five young people at a Calgary house party in 2014 by Matthew deGrood, which still results in sensational news stories around the time of his annual review.
   

These types of cases have led many major police forces to institute training and form mental health and homelessness outreach teams.
 

A good example is Peel Regional Police Service where, under the leadership of Chief Nishan Duraiappah, the force partnered with the Canadian Mental Health Association (CMHA) in 2020 to form a Mobile Crisis Rapid Response Team of officers and mental health crisis workers to attend calls involving serious mental illness.
 

Another example is the Victoria, BC, Assertive Community Treatment Team (ACT)—a response group of mental health professionals where a decision was taken to include a police officer on the team.
 

While laudable, these are local initiatives and there is no comprehensive national picture of how police services are responding to the challenge of helping people with severe mental illnesses when they are in crisis. However, the fact that such people are still having negative interactions with the police specifically, and with the justice system in general, strongly suggests more work is needed in this area.
 

Research Proposal
 

• A national survey of major municipal police services in Canada to assess how they are responding to the challenge of crafting a humane and effective police response to individuals with severe mental illnesses who are in crisis. This assessment should look at what works (i.e., best models/practices), what does not work, cost and human resource implications, training required, potential changes to police policies and provincial legislation to facilitate a more effective response, and how best to ensure successful response models survive shifting budget priorities.

• Concurrent with the above, an analysis of what it is costing police services in Canada today to deal with people with severe mental illnesses. This analysis should look at what portion of police budgets are devoted to services in this area; the current human resource demands; how is service in this area impacting on other primary police duties such as major incident and organized crime investigations; has the demand for services in this area grown over time and, if yes, by how much; and what are the projections for future demand for police services in this area.