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Lessons learned

I became the first mental health officer for my police department in New Westminster, B.C., in 2013. It was an exciting and daunting proposition. While larger urban cities had co-responder units of police officers paired with mental health clinicians, such liaisons were less prevalent at the time. I remember sitting at the desk of a recently retired community officer, with no portable police laptop, no vehicle and feeling like all eyes were on me to somehow magically fix all the mental health calls we were dealing with. There was certainly no shortage of work, as our agency experiences a high volume of mental health crisis calls. These often involve suicidal persons or those with paranoid delusions who report they are being followed, tracked or threatened. At the time I had no formal training for this role, and was fresh out of a stint on our emergency response team, where there were a number of other tactical tools at our disposal to be able to resolve calls safely.

Thankfully, in the years that followed, I received tremendous guidance and mentoring from community partners, psychiatrists and fellow police officers — many of whom were also just starting out in dedicated mental health policing roles.

On the policing side, several of us banded together and eventually created a province-wide group of 20-30 officers who shared challenges, successes and best practices with one another. That, coupled with strong support from my department to attend a number of conferences, trainings and to obtain a master’s degree in counselling psychology, really helped me develop in the role.

Now, after seven years in the position — and having watched our unit expand to a second full-time officer — I have also seen a lot of new faces taking on these roles within other agencies. At present, there is still no local formal training program for new mental health officers. As such, I want to share a few lessons learned during my time in the role.

Step 1. Find your Focus

When in doubt focus on high system users. A recent U.S. national study involving 4,200 participants identified that 80 per cent of patrol officers report addressing chronic callers or high system users as their top challenge.¹

Step 2. Figure out position logistics

If available, opt for an unmarked car with secure transport while wearing plain clothes or a soft hybrid uniform (cargo pants and a polo shirt). The uniform can carry a stigma with both system users and mental health professionals. Some version of a softer or plain clothes setup is helpful to integrate more easily into a community team.
Operate during daytime hours as that matches up with the schedules of most community partners who you will need to work with. Also, ensure you have a memorandum of understanding (MOU) with your community mental health partners. Engage your supervisors and senior managers to assist in this process as with any other legal or systemic processes.

Step 3. Networking

Participate in face-to-face coffees, drop-ins and attend multi-agency network meetings (sometimes called hubs) as well as forums, situation tables, etc. You will learn a lot from your community partners and the issues at hand, their various roles and how they can assist with solving problems moving forward.

Step 4. Learn the mental health language

You will be amazed at what you can learn just from observing your local mental health clinicians and psychiatrists. Try to get additional training in mental health signs and symptoms, crisis communication, as well as violence and suicide risk assessment. This is not so you can start diagnosing people, but rather to improve your comprehension of assessments and of the options for diagnosis and treatment within the mental health system. Even without formal training, spending some time researching issues before meeting with community partners (i.e. different disorders, treatments, etc.) can be very helpful.

Step 5. Track, identify and prioritize

I know, at least initially, it may be hard to focus on the administrative aspect of the role, especially when you are receiving a multitude of requests from community partners, and you may feel pressure to be visible on the streets so your patrol officers see you responding to calls. While these parts of the role are important, it’s equally important to get some administrative systems up and running as soon as possible.

As far as documentation, many mental health officers opt to operate offline in limited access databases. Many use Microsoft Excel to track files and subjects, and then link them to Microsoft Word documents/PDFs with key contacts, subject background and “next steps” that can be taken on the file.

Keeping documentation offline in word documents can help protect confidential health care information, which is very important to maintaining key stakeholder partnerships. If there are relevant updates to patrol officers, you may want to create a Canadian Police Information System (CPIC) Special Interest to Police (SIP) entry, linking to a file with additional information for patrol. Some officers also use the same strategy with address hazards.

Step 6. Understand the different courses of action and why you are doing what you are doing

It is more professional if you can articulate what you are doing with files and why you are doing it.

1. “Assess and evaluate.” This is a big part of it. Gather information and review the subject’s police history. Talk to the responding officers, witnesses, family, neighbours and health care providers. Get to know the subjects’ baseline characteristics, so you know when something is different and of concern.
2. NFAR (no further action required). You may feel pressure to do something on every file you receive. However, if you’re comfortable that it’s a one-off, or that there are no red flags with the person being left at home, you may choose to take no action. This approach can save valuable time and doesn’t provoke the subject with unwanted follow-up.
3. Monitor/ watch and wait. This involves waiting to see if the particular name starts coming up more often prior to taking further action. It requires discipline to monitor regularly, and it is important to ensure this does not become a default position as little behavioural change is achieved through this measure.
4. Refer to a third party to monitor or follow up, which will typically be your community mental health agency. This can mean updating an existing worker with police contacts involving their client, or creating a new referral. Your partner agency will appreciate you getting better about filtering relevant and actionable referrals for them, rather than just taking the blanket approach of ‘everyone needs help and a worker.’
5. Outreach or subject interview. Go out and speaking with the subject, with or without a mental health team clinician. It’s ideal to have a community mental health partner, if you have access, attend and provide their opinion and/or assessment. Going to the person’s residence can also give you additional information on how they are living. Once you are there, you can decide to apprehend under the mental health act and take them to the hospital, or potentially refer them back to a community partner. These visits also offer the opportunity to warn the individual regarding some type of unacceptable or criminal behaviour. They also contribute to the development of rapport with a person. This can be helpful later on when you may need to influence and change different subject behaviours.
6. Utilize diversion strategies, including the “lighting rod/re-direct” methods. This is where you can place a flag or special interest to police entry on your police database for dispatch or patrol to contact you if there is a call generated and you take over the file. It can also mean having an agreement with the subject, where they call you instead of the report desk and discuss their police concerns with you.
7. Consider criminal charges or peace bonds. Policing has become far more socially minded and often the choice is made to hospitalize someone rather than criminalize, which is really progressive for the most part. But it’s also important to try and understand the root and motivations for different behaviours. Sometimes it’s important to lay charges to manage high-risk or violent behaviours.

8. Co-ordinate a multi-agency approach.

In some cases, despite various interventions a client may continue to be in crisis. Rather than be frustrated about why some part of the mental health system is failing a person, set up a meeting with the necessary stakeholders. It’s typically not one person’s job to set these up, so be the initiator. Once you have a group of representatives in the same room, you’ll be amazed at the knowledge people have and the solutions the group can come up with.

Step 7. Master the art of the soft sell

As you already learned in general duties, convincing paranoid or delusional people that what they are experiencing isn’t real is a losing battle. People who are unable to accept that they suffer from mental illness are often more easily able to accept that they need help managing the stress of their situation or help getting some sleep. Focus on that, or talk about the physical symptoms they may be experiencing such as, racing heartbeat, rapid or shallow breathing, or any pain or known medical conditions. Use those a bridge into getting them connected to services. Help them see that any action you are suggesting is mutually beneficial as well.

Step 8. It’s okay to strategically spend some time talking to clients

A chronically delusional subject once told me, “You’re the first person that’s ever listened to me.” Making someone feel like a person worth listening to can end up being more powerful than some medications. Building rapport and getting in front of crisis points can go a long way in saving a reactive response down the road. If you have a little down time, pick up the phone or drop by one of your high system users and say hello, it can be quite effective when you need that relationship later to influence certain outcomes.

Step 9. Celebrate the wins and take breaks

Many officers find themselves in small units, handed numerous files for which others don’t fully understand the risk, the complexity, or the level of systematic barriers. That, coupled with ongoing frustrations from patrol officers for the number of calls they are taking or hospital wait times, can take its toll. It’s important not to own these systemic failures as that can easily lead to burnout.

Remember there’s no perfect system out there, and some cases will be exceptionally complex and at times unfixable for a variety of reasons. Do the best you can, know you are making a difference in improving the efficiency of police response, and, perhaps even more importantly, providing a helpful service to a vulnerable person.
There will always be another case, another crisis, and it’s important to remember to take breaks. Celebrate the small victories and remember to connect regularly with other officers in similar positions.

Good luck in your role, as it may just end up being one of the most challenging and rewarding work you ever do. Please feel free to reach out if you have any questions: awlodyka@nwpolice.org.

End note

1. Lexipol. Law Enforcement Response to People in Crisis. (2019). Retrieved from: info.lexipol.com/mental-illness-report .

Art Wlodyka, M.A., RCC, is a New Westminster Police Department police officer and mental health clinician. He has worked in law enforcement for the past 13 years, holding roles in the patrol division, on the emergency response team, and as a hostage and crisis negotiator. He was also the founding member of a Police Mental Health Unit in 2013. Since that time, he has assisted hundreds of individuals in crisis, and in 2014 was awarded a Chief’s Constable’s Commendation. In 2017, he was further named by CAMH as one of 150 Canadians making a difference in the field of mental health. He is a certified workplace Psychological Health Advisor and a Critical Incident Stress Management Team leader. He holds a Master of Arts degree in Counselling Psychology from the University of British Columbia.