Toronto mobile crisis intervention team program evaluation final report

Law enforcement agencies frequently receive and respond to calls about crises of emotionally disturbed persons (EDPs) in the community. However, police face an increasing number of difficulties in responding to crisis calls due to challenges such as a perceived lack of training and referral expertise. The MCIT Program was put in place in Toronto to address some of these challenges.

Piloted in 2013, the co-response model incorporates nurses with mental health training as part of specially trained police response teams. As the program is set to expand in Toronto, researchers at the Centre for Research on Inner City Health evaluated the implementation of the program. The evaluation report provides valuable insights into stakeholder perceptions of the processes involved in implementing the program and of resulting program procedures.

EENet’s Tatyana Krimus developed a Research Report Round-up of the evaluation report.

Read it below or access the PDF.

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Report title and link: Toronto Mobile Crisis Intervention Team (MCIT) Program Evaluation Final Report
Authors: Maritt Kirst, Renira Narrandes, Kate Francombe Pridham, Janani Yogalingam, Flora Matheson and Vicky Stergiopoulos, Centre for Research on Inner City Health, St. Michael’s Hospital
Date of report: 2014
Location: Toronto, Ontario

What this report is about

This evaluation report provides an overview of:
  • Findings from Toronto’s Mobile Crisis Intervention Team (MCIT) Program implementation evaluation;
  • Facilitators and challenges of the program’s implementation; and,
  • Stakeholder feedback and suggestions for improvement.

The MCIT Program 

Law enforcement agencies frequently receive and respond to calls about crises of emotionally disturbed persons (EDPs) in the community. However, police face an increasing number of difficulties in responding to crisis calls due to challenges such as a perceived lack of training and referral expertise. The MCIT Program was put in place in Toronto to address some of these challenges. 
Piloted in 2013, the co-response model incorporates nurses with mental health training as part of specially trained police response teams. As the program is set to expand in Toronto, researchers at the Centre for Research on Inner City Health evaluated the implementation of the program rather than the program itself. The evaluation report provides valuable insights into stakeholder perceptions of the processes involved in implementing the program and of resulting program procedures.    

Summary of Program Implementation Evaluation Findings

Overall, staff, police, community agencies, health system partners and consumers, said that the MCIT Program provided an effective response to individuals in the community experiencing a mental health crisis. Although there were some challenges and recommendations for future improvements, the program was widely seen as meeting its goals, including preventing unnecessary hospitalization and criminalization. 
This report makes the case for further evaluation to support the expansion of the MCIT Program into a comprehensive crisis response system in Ontario. Acknowledging that effective implementation is key to scaling-up of interventions and achieving desired program outcomes, this evaluation narrowed in on implementation and identified key challenges and facilitators for effectively turning plans into action.

Facilitators to program implementation

  • Effective partnerships exist between police and health systems, between MCITs and emergency departments, and MCITs and community agencies.
  • MCITs are committed to their roles and believe they perform an important role in the community through the MCIT Program.
  • Staff, police, community agencies, health system partners and consumers viewed MCIT as knowledgeable in engaging with persons in crisis and in transferring individuals to appropriate community services.
  • Program participants cited the valuable skill and expertise of the MCIT nurse in responding to persons in crisis as well as follow-up procedures to prevent crisis recurrence.

Challenges to program implementation

  • Lack of awareness of the program’s mandate within police services among hospital partners and in the community as well as a lack of support for the program in some police divisions. 
  • Stakeholder confusion over the respective roles and responsibilities of mental health nurses and police officers.
  • Differing views on the usefulness of current MCIT practices, including handcuffing, transporting individuals in marked or unmarked cars, and bulletproof vests worn by mental health nurses. 
  • Need for consistent training, dispatch, and staffing processes in program implementation to achieve maximum effectiveness. 

Key recommendations for MCIT Program implementation

  • Clarify team roles, responsibilities and procedures, and standardize operating protocols. 
  • Increase external and internal feedback opportunities, such as involvement of frontline staff and community members in decision making and/or the creation of a community advisory committee or connection to an existing committee.
  • Prioritize MCITs upon hospital arrival so they are available to respond to other calls.
  • Strengthen partner relationships between MCITs, emergency departments, and community agencies and promote the program and its aims in the community. 

How this report can be used

This report highlights a number of program strengths to be built upon and challenges to be addressed to improve the MCIT Program. This evaluation should be of use to anyone looking to implement a program in addition to policymakers, providers of mental health and related services, as well as people with lived experience and their families.
Type of study: Qualitative
Key words: Mental health, implementation, Emotionally Disturbed Persons, partnership, people with lived experience (PWLE), hospitalization, criminalization  
Contact person: Organization: Centre for Research on Inner City Health, St. Michael’s Hospital, Toronto, Ontario
Language of report: English