Mental Health Crisis Response Applied Training and Education Program

The MHCR features:

• An evidence-based curriculum that has been created through multiple years of scientific research and development, as well as testing and validation. Study results to date have clearly demonstrated improved outcomes in police officers’ de-escalation skills, confidence, empathy, and reduced bias toward people with mental health and substance use problems upon program completion.
• A comprehensive training and education package that is easily accessible through a hybrid model consisting of a foundational online curriculum, active scenario-based learning in classroom contexts and assessment scenarios. This format brings together optimal forms of scenario-based training and adult learning through applied, observational, and group problem-solving methods.
• A design model based on iterative user testing across Ontario police services. All training scenarios are fully immersive, based on actual encounters between police and individuals experiencing a mental health crisis. These scenarios are designed to prepare officers for what they will actually encounter in the field.

The program is guided by the DePICT™ model, a built-in and validated assessment tool that measures de-escalation competencies specific to policing and highlights targeted skills integral to working with people in crisis. Trainers assess and evaluate trainees through a comparative analysis of pre- and post-scenario training competencies while providing a guide for targeted debriefing to support formative learning, reinforce de-escalation techniques, and identify specific areas to focus on for continued skills development.

The MHCR evolved through a community co-design framework. This approach is characterized by a working relationship between professionals and citizens, where each party plays a pivotal role in informing best practices to improve the quality of life for people and communities (Slay & Stephens, 2013). Collaboration cannot be understated with respect to mental health and substance use crises, given that these particular concerns exceed the capacity of any singular discipline and are community-based issues.

As such, the MHCR was created by a trans-disciplinary team of over 40 individuals including:

• persons with lived experience
• mental health professionals, including clinicians, nurses, mobile crisis response team members, and forensic psychologists
• researchers, academics, students and simulation experts
• Indigenous cultural safety and anti-discrimination experts
• defensive tactics and use of force trainers, and members of the Ministry of the Solicitor General’s ETT Community of Practice

Consequently, the program focuses on the relational policing approach, which emphasizes a genuine and personalized response.

Relational policing is:

• humanized
• person-centred
• procedural justice
• empathy
• trauma-informed
• mental health and crisis awareness
• cultural safety

The MHCR is a homegrown curriculum that is culturally, geographically, and jurisdictionally relevant to the needs of Ontario citizens and police officers. The program offers a rigorous response and demonstrates a commitment to addressing the recommendations made in the Ontario Ombudsman’s (2016) report “A Matter of Life and Death: Investigation into the Direction Provided by the Ministry of the Solicitor General to Ontario’s Police Services for De-escalation of Conflict Situations.”

This domestic approach to crisis de-escalation is particularly important given the unique landscape of policing and mental health in Canada. As a community-designed curriculum, the MHCR reflects local training priorities, protocols, vocabulary, and province-wide stakeholder investment. It emphasizes relational policing, an award winning framework centred on officers offering a genuine and personalized response to people in crisis, conveying empathy and concern for wellbeing, and taking the necessary time to cultivate a connection and build trust while managing safety risks.

A hallmark of this approach is encouraging the person in crisis to collaborate on ways to peacefully resolve the situation together with the officer. Relational policing is multifaceted in its approach and includes humanized, person-centred, procedurally just, empathetic, informed, and culturally safe modes of engagement (Lavoie et al., 2022).

Prior to engaging in applied, scenario-based learning, officers move through four online modules that offer foundational knowledge in de-escalation and mental health crisis response.

Module One: Mental Illness and Mental Health Crisis

Focuses on understanding the current context of mental health calls made to police services, the nature of mental illness and mental health crisis, how to identify them and common misconceptions.

Module Two: De-escalation and Relational Policing

Focuses on approaches, tools, and techniques that can help de-escalate and safely resolve mental health crisis situations. De-escalation and non-escalation techniques are introduced.

Module Three: The Context of Modern Policing

Examines societal attitudes toward people with mental illness, and how beliefs, attitudes, and bias can impact interactions.

Module Four: A Focus on Race

Focuses on interactions between police and racialized persons in mental health crisis. Explores how citizens’ attitudes and beliefs about police can affect an encounter and how bias can impact risk assessment.

Designed to replace lecture-based learning on mental health crisis response, this 90-minute problem-based scenario training engages observational, group problem-solving and applied learning methods. Trainees move from being observers of the scenario to participants, engaging in stop, rewind, and playback techniques that provide repeated opportunities to test approaches and try alternative crisis resolution strategies.

Trainees engage in competency-based rehearsal learning while guided by integrated, in-scenario video feedback from subject matter experts, ranging from people with lived experience of mental illness and clinicians to police trainers.

Trainers assess officers’ skills acquisition in a 10-minute scenario followed by a five-minute debrief using the validated, observer-rater DePICT™ evaluation framework. This assessment tool captures 14 distinct competencies and each item is scored on a four-point scale. The post-scenario debriefs ensure they serve as a formative learning exercise and an opportunity to identify specific competencies needing improvement and further practice.

The trainee must achieve a score of “Satisfactory” in 11 of the 14 DePICT™ competencies. If this minimum standard is not met, the trainee is required to repeat the scenario focusing on the debrief feedback and the competencies requiring attention.