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A new model for responding to mental health crises

Success by the North Shore Peer Assisted Care Team has spurred the creation of 12 similar groups across B.C.
“I had a counsellor from time to time, but it is hard to connect with someone when you’re traumatized and they pretend you are fixed," said Nooshin Gallehdari.

Fleeing war and instability in Iran in 1995, Nooshin Gallehdari landed in Vancouver a teenage refugee, alone. She had no friends or  family in Canada. There was no one waiting with a “welcome home” sign or  warm coat.

Gallehdari faced the challenges of learning English, finding a job and making community in Vancouver on her own. 

Within months she found herself thinking about suicide. Over the next few years she experienced homelessness and  being arrested by police again and again as she tried to get by. 

“I struggled for a long time to help  myself,” she said in an interview with The Tyee. “I had a counsellor from time to time, but it is hard to connect with someone when you’re traumatized and they pretend you are fixed.”

Nearly 30 years later, Gallehdari is a peer support worker for a North Shore civilian mental  health team that is becoming the model for a new type of crisis response  across B.C.

In its first year operating, the North Shore Peer Assisted Care Team, or PACT, has responded to more than 750 calls and texts from people in  need of mental health or substance use support. Teams are set to launch  soon in New Westminster and Victoria.

Eby’s expansion announcement

On Sunday (Nov. 20), Premier David Eby announced the province would create 12 new PACTs across B.C., two of which would be First Nations-led, as part of his flagship Safer Communities Action  Plan.

“These peer-assisted teams intervene when  people are in mental health crises in our streets, freeing up police to  focus on crime instead of social services,” Eby said from Queen  Elizabeth Park.

The program, run by the Canadian Mental  Health Association in B.C., pairs a peer support worker who has living  experience of mental health issues with a trained mental health  professional to attend to people in distress. The teams can help by  de-escalating the situation, connecting the caller to resources or  simply offering a listening ear.

And they already show promising signs of  diverting people in crisis from the emergency room and reducing the  involvement of police in mental health calls.

Gallehdari says she is now the person who would have meant everything to have when she was struggling.

“It would have stopped me from being  homeless, from attempting suicide and from getting involved with the  police,” she said. “And from facing that very vulnerable situation  without someone who understands.”

Gallehdari eventually found more stability  by connecting with the Iranian community in North Vancouver for support  and beginning to work in the service industry. Before joining PACT, she  spent 15 years volunteering to help women and 2SLGBTQ+ refugees and  newcomers find work. 

“It was healing to help others like me,” Gallehdari said.

Sunday’s announcement shows there is  political will to build civilian-led health responses that help keep  people well and in their communities, said Jonathan Morris, CEO of CMHA BC.

Police are not well-trained in mental  health crisis response, and many people in mental distress have been  injured or killed by police responses, particularly disabled, Black,  Indigenous and other racialized people.

And as more and more people  are unable to access stretched preventative supports, the number of  people admitted to hospital involuntarily for mental health treatment  has more than doubled since 2007.

“We need a sufficient and well-integrated  mental health and crisis care system, to support a shift away from  police being the default responder,” said Morris, noting that police  will continue to play a role until such a system exists. 

“There’s a sense of hope for meaningful change right now.”

Shaely Ritchey, a registered nurse who  advised the creation of the forthcoming PACT in Victoria, says  peer-support from people who have lived experience is a transformative  response to mental health calls.

When you are contemplating suicide or  self-harm, it is very difficult to speak to someone who hasn’t been in  that same place, they explained. If police are present, that can be  intimidating and make it difficult for the person to relax or feel safe.  

Ritchey has dealt with suicidal thoughts  and mental health crises in the past, but even calls to well-resourced  crisis lines have been damaging when they didn’t feel heard or  understood.

“The comfort and non-judgement from peers is so sacred and so needed,” they said.

The North Shore PACT operates from 6 p.m.  to midnight Thursday to Sunday, with 10 staff and one clinical  supervisor. Morris hopes funding and staff will be secured soon so the  PACT can operate 24-7.

Teams offer support by phone, text or in  person in English and Farsi. The team has seen demand for their services  grow markedly, particularly among Farsi-speakers as conflict and human  rights violations in Iran have escalated. 

“It shows we are creating a bridge between the organization and the community, and people are trusting us,” said Gallehdari.

Culturally safe, trauma-informed care is  hugely important, she added, especially when individuals may face stigma  or shame for asking for help. Non-police responses also reduce concerns  about losing employment, relationships or housing if someone is  apprehended or arrested.

‘Not about fixing people’

The teams in Victoria and New Westminster have taken their time to ensure their launch is as smooth as possible,  Ritchey said. But the work can’t end at a single PACT or even 12.

“If PACT exists but the only option for  care is to bring people to hospital, then people are still ending up in  traumatic environments,” said Ritchey. “We need to be trying to support  people as much as possible to stay in the community and to protect their  autonomy.”

It is challenging to keep up with the  demand for support, says Gallehdari. As the weather cools there are  fewer and fewer places open late to meet people who don’t wish to speak  at home. Sometimes there is simply no other resource she can refer  someone to, and she and her colleagues have their own health to attend  to as well.

Yet she finds comfort in the simple things that can make a world of difference, like helping someone without a  phone make a call to a shelter or offering them a gift card to the  grocery store.

“It’s not about fixing people, it’s about  connecting them to resources to take them out of that vulnerability so  they can make choices for themselves and grow into their own strengths,”  said Gallehdari. “That is what gives me joy.”