It was the kind of 911 call the Ottawa Paramedic Service responds to multiple times a day, a person in mental distress in need of help. But this call ended differently than it would have in the past.
Soon after arriving on the scene, paramedics called the service’s new mental wellbeing response team, which includes a specially trained paramedic partnered with a mental health worker. They took over care of the patient, conducted a mental health examination, safety assessment and registered the person for follow-up care the next day.
Project lead Logan Martin said that the team, which has been in place since March, is already making a difference.
The new team is designed to provide more appropriate care in the community for emergency calls that are non-violent and non-criminal, where mental health and substance use are the contributing factors. That includes crisis intervention and referrals to community organizations, as well as next-day follow-up by The Ottawa Hospital’s mobile crisis team, in some cases.
Before the team was in place, paramedics would be limited to providing immediate medical assessment and treatment. Often people in distress would end up in the hospital, where they would face a long wait and likely not get the specific care they need.
Beyond providing a more appropriate, and effective, response to those with mental health needs, the program frees up paramedics to respond to other calls, officials say.
In this case, that proved to be a lifesaver.
After transferring the case to the mental wellbeing team, the paramedics were able to answer a nearby 911 call for a person who had gone into cardiac arrest. Because they were so close, they successfully treated the patient in time to make a full recovery.
Martin calls it an example of a “win-win-win” — for the mental health patient, who received appropriate care, for the cardiac patient, who received rapid life-saving care, and for the paramedics, who had the satisfaction of knowing two patients had good outcomes.
“The beauty of the program is we are providing the appropriate care to the individual in their home or wherever they may be,” said paramedic Chief Pierre Poirier.
Since the program began, he said, two-thirds of mental health calls have been redirected away from emergency.
Typical types of calls that the team might respond to are people with acute anxiety or having a depressive episode. In the past that has included university students away from their families and failing to cope, said Poirier. He also said the paramedic service has received calls from recent immigrants experiencing anxiety and isolation and uncertain how to navigate the system to get help.
“We have individuals calling 911 when they don’t have any other place to turn to get help.”
The 2016 death of 37-year-old Somali-Canadian Abdirahman Abdi following a violent arrest outside his Hintonburg apartment, became the focus of calls for changes in the way police respond to mental health calls.
Part of the Ottawa Police Service’s response to Abdi’s death is the development of a new mental health strategy.
Poirier said the paramedic program will not respond to the same issues as the police strategy — the Ottawa Paramedic Service Mental Health Wellbeing Response Team answers only non-violent and non-criminal mental health calls. But the program has similar goals, making sure people in mental health crises get access to appropriate care, including help navigating the system for longer-term support and better results.
It operates under a new provincial Ministry of Health “treat and refer” model of care, which means patients experiencing mental illness or substance abuse can receive care in the community.
The program also aims to remove any stigma related to substance abuse and mental illness. Among other things, the team arrives in an unmarked vehicle and members wear khaki pants and a golf shirt.
“What triggered this was asking ‘Can we do better? How can we provide the care that they need?’ “ Poirier said.
The Ottawa Hospital’s mobile crisis team works with the paramedic response team.
Shannon Turcotte, a registered nurse who is the clinical manager of the mobile crisis team at The Ottawa Hospital said the partnership will help provide high-quality mental health care and “improve the overall patient experience.”
The Ottawa Paramedic Service based its program, in part, on successful programs in other communities.
In Eugene, Oregon, the CAHOOTS (Crisis Assistance Helping Out On the Streets) mental health crisis intervention program handling lower-risk emergency calls has been operating since 1989. Ottawa is among cities around the world that have been inspired by the concept.
After the George Floyd protests in 2020, several hundred cities in the U.S. requested information from CAHOOTS about the program, The Atlantic reported.
Mayor Jim Watson said the program “is a great example of what can be achieved by listening closely to our community’s needs and engaging collaboratively with health care partners.”