Vancouver’s city council will consider this week whether to give $2.8 million to Vancouver Coastal Health to increase staffing for mental health crisis teams this year.
The cost to run the proposed program will rise to $7.9 million a year starting in 2024 — all shouldered by the city.
City staff have worked with Vancouver Coastal Health to put together a proposal after the ABC party, which has a majority on council, ran on an election campaign promise to hire 100 more police officers and 100 mental health nurses to reduce crime and violence.
While campaigning, Mayor Ken Sim described that promise as an expansion of the Car 87/88 program, which pairs a police officer with a mental health worker.
The plan significantly tweaks that promise, proposing to create 32 positions to form a de-escalation team that does not involve police, as well as 10 more workers to expand the Car 87/88 program and two positions to increase staffing for the Assertive Outreach Team program, which also sometimes involves police.
After years of senior levels of governments downloading costs to municipalities, critics of the plan say the city should not be paying millions to a provincially funded health authority with a budget of $4.8 billion.
They’re also raising concerns about the involvement of police officers in mental health calls.
Councillors have been told by multiple mental health experts that embedding police in mental health teams “can lead to escalation, trauma, injury and fatality.”
During a council meeting on Nov. 15, Jonathan Morris, CEO of the Canadian Mental Health Association BC, and Stacy Ashton, executive director of the BC Crisis Centre, urged council to consider other crisis response models that don’t involve police.
Lisa Dominato, an ABC city councillor, said she’s been meeting with the CMHA and learning about non-police response models, like the Peer Assisted Care Team in North Vancouver and Toronto’s Community Crisis Service. She said she supports VCH’s proposal to create a non-police response team.
“I was really pleased to see such a strong focus on having those teams, and the sheer number of [full-time employees] that will be dedicated to that,” Dominato said.
Dominato said the city spending money on what is normally a provincial responsibility is needed because of the urgency of the problem.
In November, the province announced funding to expand the Peer Assisted Care Team model to 12 more B.C. communities.
But the non-police de-escalation teams that VCH is proposing will not be the same as North Vancouver’s PACT program, the health authority told The Tyee.
“Car 87/88 and the Assertive Outreach Team help individuals in the most acute situations, followed by moderate (non-police) de-escalation teams, which supports those people who are approaching crisis,” Jeremy Deutsch, a public affairs staffer for the health authority, wrote in an email to The Tyee.
The Peer-Assisted Care Teams “respond to people at the lower end of the acuity spectrum,” Deutsch said.
OneCity Coun. Christine Boyle said she’s been told in information sessions between VCH and councillors that the non-police teams would focus on Vancouver’s inner city neighbourhoods. Vancouver does not yet have a PACT program.
The latest development shows ABC is backtracking on its campaign promise to hire 100 nurses and 100 police officers, she said.
“What’s clear from Vancouver Coastal Health’s proposal is that their 100-nurses, 100-police campaign slogan had no depth to it,” she said.
Boyle said she was glad to see VCH come to council with a proposal that included non-police response teams, but she still has a lot of questions about the plan.
“If I’m walking down the street and I see someone in obvious distress — say they’re yelling and flailing, they’re not violent or a risk but they’re clearly unwell — under this new service, who do you call?” Boyle said.
“Because what we heard from Stacey Ashton was that right now, even if Car 87 shows up, they bring someone to the hospital, there aren’t those supports, the person is not being admitted under the Mental Health Act and they’re ended up back out again.”
During a press conference on Feb. 5 to announce the plan, Dr. Patricia Daly, the chief health officer for VCH, said she had asked “our psychiatrists who provide medical leadership to Car 87/88 and the assertive outreach teams what message they wanted me to give today.”
“They responded that these important programs would not be possible without the partnership of Vancouver Police.”
Daly said it would not be possible to deploy health-care workers to high-risk incidents without police partners.
Tyson Singh Kelsall, a social worker who works for Vancouver Coastal Health, said that is not his experience as a frontline worker in the Downtown Eastside, and said he was dismayed by Daly’s comments.
“I've consulted with other frontline workers and they agree that it's not safe. The police don't help us in our work, they actually escalate violence,” Singh Kelsall said.
“This is basically an expansion of the relationship between VCH and VPD. I worry what that means for a team that’s supposedly non-carceral, when it's within this broader framework that does have relationships with police.”
Singh Kelsall said a mobile crisis team could be a positive step, if it was community-based and community-led. He said the money being budgeted for this expansion would have been better spent on community services like more public bathrooms accessible to unhoused or precariously housed people and community drop-in centres.
Boyle and Green Coun. Pete Fry said they continue to be concerned about how ABC plans to pay for the extra police and health-care staffing.
Budget deliberations will start in March. In their report on the new mental health funding city staff have said that the money needs to either come from a tax increase or shifting spending from other programs.
“I expect that they're going to want to reduce taxes because that's what they committed to in their campaign, but they've also committed to a lot of pretty expensive initiatives to do with policing and this entrance into the provincial realm of health care,” Fry said.