RELUCTANT WARRIORS: POLICE AS PAWNS IN THE WAR ON DRUGS, HOMELESSNESS, AND
MENTAL HEALTH

By

Ted De Jager

Bachelor of Engineering (Civil), Royal Military College of Canada, 1987

MAJOR PAPER SUBMITTED IN PARTIAL
FULFILLMENT OF
THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS (CRIMINAL JUSTICE)
In the
School of Criminology and Criminal Justice

© Ted De Jager 2021
UNIVERSITY OF THE FRASER VALLEY
Winter 2021
All rights reserved. This work may not be
reproduced in whole or in part, by photocopy
or other means, without permission of the author.

Approval
Name: Theodore De Jager
Degree: Master of Arts (Criminal Justice) Degree
Title: Reluctant Warriors: Police as Pawns in the War on Addiction, Mental Health and
Homelessness

Examining Committee
Dr. Zina Lee
Graduate Program Committee Chair
Director, School of Criminology and Criminal Justice

Dr. Amanda McCormick
Senior Supervisor
Associate Professor, School of Criminology and Criminal Justice

Dr. Irwin Cohen
Second Supervisor
Associate Professor, School of Criminology and Criminal Justice

Dr. Laura Huey
External Examiner
Professor, University of Western Ontario

April 26, 2021
Date Defended/Approved: ______________________________________________

i

Abstract
Police agencies throughout Canada have been increasingly relied upon to respond to
complex social issues, such as addictions, mental health, and homelessness, despite these
concerns falling outside the traditional realm of criminal activity and public safety (Department
of Justice Canada, 2018). Although police have a role in resolving these societal issues, this
study posits that they should not be the primary agency when dealing with vulnerable
populations. This study examines the causal factors that create stigmatisation toward
vulnerable populations, particularly at the local government and community level, that has
manifested into a criminal justice, rather than a health and wellbeing approach, to address
community concerns. To examine these issues, calls for service data from the Royal Canadian
Mounted Police in British Columbia were analyzed, followed by semi-structured qualitative
interviews with 14 professionals working in the areas of criminal justice, health, and advocacy.
Several related themes emerged from this analysis, including the need for: increased
collaboration between police, social services, and health agencies; the reduction of barriers to
implementing collaboration, the reduction of stigmatisation towards vulnerable populations; a
re-assessment of the role of police toward vulnerable populations; increased investment into
supports; and decriminalisation of illicit drugs providing that significant investment and policies
are in place. The data and interviews indicate that police have become the default in
responding to certain social concerns, causing them to become reluctant warriors against those
suffering from mental health and addictions due to outdated policies that stigmatize and
marginalize the very people they seek to protect.

ii

Acknowledgements
Participants
Thank you to all the participants who took so much time to share their experiences and
recommendations to improve the lives and wellbeing of our vulnerable populations. Your
passion to help those less fortunate shone through in our interviews. You encouraged me to
continue to work towards justice for the disadvantaged.
Dr. A. McCormick
Thank you for your guidance throughout this program and specifically for this major paper.
Your attention to detail and enthusiasm for the subject matter kept me digging deeper into the
causes and solutions of this topic. Your encouragement and support to go big and expand on
the research was invaluable. Thank you as well for your support while I navigated my way into
this program, it took time, but it was worth it.
Dr. I. Cohen
Your patience and thoroughness allowed me to examine the subject matter in a much broader
manner than I thought possible. Thank you for the power of four small words: “Basis for this
claim!” You showed me the importance of detailed research and opened me up to so many
perspectives that guided this work and fuelled an appetite for learning.
Ms. T. Haarhoff
Thank you for all the work you did in preparing the data for this major paper. The thoroughness
of your charts and tables allowed me to clearly express the pressures experienced by police and
identified areas for change. Your busy schedule did not get in the way of getting this
information to me, and for that I am very thankful.
My Classmates
I am so happy that we met in person before the pandemic sent us to “Zoom School.” Despite
our broad ranging background and experiences, I am blessed to have made new friends that I
know I can count on. Thank you for tolerating my long rants and protestations on the state of
our society and its approach to the vulnerable.
Family and Friends
My family and friends have been so very supportive during these last two years. Your support
as I transitioned from job to job and finally into retirement gave me the encouragement to keep
going. Thank you for letting me practice my lectures and presentations on you, and for your
sage comments in furthering my education.
My Wife, Dionne
What can I say about my lovely wife Dionne? You are my rock and guide in all that I do. It has
been a long couple of years with many changes that we always weathered together. Thank you
for allowing me to hibernate in my academic den while you took on so many challenges that
swirled around us. And I thought I was the protector.
iii

Dedication
This body of work is dedicated to my older brother Peter, who found himself a member
of the vulnerable population referred to in this major paper following a serious brain injury in
his teenaged years. I am grateful for an extended and caring family that guided him through
many difficult years, especially our sister who finally managed to find him continuing support in
a care facility. Without the care of family and dedicated support workers, I fear Peter would
have been just another statistic in an ongoing battle against addictions, mental health, and
homelessness. I am saddened that help did not come to him sooner, but encouraged that
change is possible.

“How wonderful it is that nobody need wait a single moment before starting to improve the
world” - Anne Frank
iv

Table of Contents
Abstract .......................................................................................................................................... ii
Acknowledgements ...................................................................................................................... iii
List of Tables ............................................................................................................................... vii
List of Figures ............................................................................................................................. viii
Chapter 1: Introduction ............................................................................................................... 1
Chapter 2: Literature Review ...................................................................................................... 4
Police and Social Disorder ................................................................................................................... 4
Changing Nature of Police Response .................................................................................................. 5
Police Officers and Social Triage ........................................................................................................ 7
The Social Disorder Dilemma ............................................................................................................ 10
Increasing Acknowledgement of Social Concerns .......................................................................... 10
Why Police Became the Front-line .................................................................................................. 13
The Role of Police in Modern Society ............................................................................................. 17
Criminalisation of Addictions, Mental Health, and Homelessness ................................................. 20
De-Institutionalisation, Stigmatisation, and Trauma ....................................................................... 22
The Nexus to Homelessness ............................................................................................................ 24
Health Approaches to Social Disorder: What is Working? ............................................................ 25
Vulnerable Community Outreach .................................................................................................... 28
Cross Sectoral Collaboration ........................................................................................................... 32
Decriminalisation ............................................................................................................................. 35
Harm Reduction to Medicalisation .................................................................................................. 40
Alternatives to Sentencing ............................................................................................................... 42
Changing Perspectives ....................................................................................................................... 45

Chapter 3: Methodology............................................................................................................. 48
Research Question .............................................................................................................................. 48
Objectives ............................................................................................................................................ 48
Sample Size and Composition............................................................................................................ 49
Research Design .................................................................................................................................. 49
Ethics Approval and Risks ................................................................................................................. 51

Chapter 4: Findings .................................................................................................................... 54
Statistical Analysis .............................................................................................................................. 54
Qualitative Interview Results ............................................................................................................ 66
Perceptions of Effectiveness in Working with Vulnerable Populations ......................................... 67
Theme One: Cross Sectoral Cooperation ......................................................................................... 70
Theme Two: Barriers to Community Wellness................................................................................ 87
Theme Three: Redefining the Role of the Police.............................................................................. 95
Theme Four: Investment and Resources ........................................................................................ 105
Theme Five: Understanding Trauma and Reducing Stigma ........................................................ 115
Theme Six: Decriminalisation of Illicit Drugs ................................................................................ 126

Chapter 5: Discussion and Analysis ........................................................................................ 141
Statistical Analysis ............................................................................................................................ 141
Development of Themes ................................................................................................................... 142
Purveyors of Crime Reduction or Social Engineers? .................................................................... 144
Just Walk on By ................................................................................................................................ 145
Investment Requires Political Will and an End to Stigma ............................................................ 146
The 3 AM Question........................................................................................................................... 147
Collaboration Requires Investment ................................................................................................ 148
Decriminalisation .............................................................................................................................. 149

Chapter 6: Recommendations: Building Pathways to Care ................................................. 151
Recommendation 1: Cross Sectoral Cooperation .......................................................................... 151
Recommendation 2: Redefining the Role of the Police .................................................................. 152

v

Recommendation 3: Reduce Stigmatisation and Increase Understanding .................................. 153
Recommendation 4: Decriminalisation of Certain Illicit Drugs ................................................... 154

Chapter 7: Limitations ............................................................................................................. 155
Limited Sample Size ......................................................................................................................... 155
Limited Geographic Context ........................................................................................................... 156
Limited Perspective .......................................................................................................................... 157
Limited Transportability Assessment ............................................................................................. 157
Future Research................................................................................................................................ 157

Chapter 8: Conclusion .............................................................................................................. 159
Appendix A: Interview Guide.......................................................................................................... 161
Appendix B: Human Research Ethics Board Approval ................................................................ 166
Appendix C: Informed Consent Forms .......................................................................................... 167

References .................................................................................................................................. 171

vi

List of Tables
Table 1: Illicit Drug Toxicity Deaths by Health Authority. (BC Coroner Service, Feb. 11, 2021) 12
Table 2: Illicit Drug Toxicity Deaths by Place of Injury 2017-2020. (BC Coroner Service, Feb. 11,
2021) .......................................................................................................................................... 12
Table 3: Illicit Drug Toxicity Deaths by Place of Injury and Health Authority 2017-2020. ........ 13
Table 4: Top Drugs involved Among Illicit Drug Toxicity Deaths. (BC Coroner Service, 2021) 2021)
.................................................................................................................................................... 14
Table 5: Occurrences Cleared by Charge. (E Division RCMP, 2021) .......................................... 56
Table 6: Occurrences Cleared by Charge, by Type. (E Division RCMP, 2021) ............................ 57
Table 7: All Occurrences Cleared by Charge. (E Division RCMP, 2021) ..................................... 58
Table 8: Founded Occurrences as % of Total. (E Division RCMP, 2021 ..................................... 59
Table 9: Founded Violent Criminal Code Occurrences. (E Division RCMP, 2021) ..................... 61
Table 10: Top 20 Founded CDSA Occurrences. (E Division RCMP, 2021) .................................. 62
Table 11: Top 40 Founded Criminal Code Property Occurrences. (E Division RCMP, 2021) ..... 63
Table 12: Property/Violent/CDSA as % of Total Occurrences. (E Division RCMP, 2021) ........... 64
Table 13: Founded Non-Criminal Code as % of Total Occurrences. (E Division RCMP, 2021) .. 65
Table 14: Founded Non-Criminal Code Occurrences - Top 15 (E Division RCMP, 2021) ........... 65

vii

List of Figures
Figure 1: Gaining momentum: multi-sector CSWB in Ontario, Russell and Taylor (2015). ....... 33
Figure 2: Four filter approach to CSWB. BC Office of Crime Reduction and Gang Outreach
(2019). ...................................................................................................................................... 355

viii

Chapter 1: Introduction
In the mid 1930s, rumours of war abounded in Europe and modern society. Despite the
emerging threat of Hitler’s policies, appeasement was the flavour of the day, with a hope to
prevent war at all costs, despite the suffering of other countries under the Nazi regime.
Appeasement policies were predicated on outdated strategies and experiences of the previous
world war that led to the misplaced belief that static defences, such as the Maginot line, would
protect the interests of a peaceful Europe. The outdated policies did not work, and Europe was
cast into an extended war that at the outset seemed hopeless with no path to victory. Were the
allied nations to remain isolated from each other, that approach could very well have led to
defeat, but that was not the case. Guided by a collective will to achieve a common purpose, the
Allied Powers defeated the largest, most efficient war machine in modern history (Black, 2015).
Collaboration, investment, and innovation were the key elements of victory, yet those lessons
have not been fully embraced in a different type of war. The current war on drugs in North
America continues to utilise enforcement and criminal justice measures focussed on the wrong
enemy, as defined by the visible, vulnerable population, while at the same time failing to target
the root causes of addictions, mental health, and homelessness.
In early 2020, the Angus Reid Institute reported that confidence in police was waning.
The report was issued well before events that prompted certain groups, including various levels
of government, to raise concerns around systemic racism leading to calls of defunding police
agencies. The report stated that 48% of Canadians believed that crime had increased (Angus
Reid Institute, 2020), even though only 15% of respondents indicated they had actually been a
victim of crime during the reporting period. This indicated that perceptions of crime may be
1

higher than actual experienced crime. Similarly, growing public concerns with mental health
and the visible manifestation of addictions cause concern for local communities that affects
their citizens’ perceptions of safety. Contrary to this perception, the people suffering from
these afflictions tend to commit lower-level crimes, such as theft from auto, shoplifting,
mischief, and disturbances (Boyd & Kerr, 2016; Centre for Addiction and Mental Health, 2019;
Department of Justice Canada, 2018). Still, this perception leads to a reliance on police for
services that draw officers away from their primary duties of public safety and protection, in
particular the requirement to investigate criminal activity and apprehend those committing it.
Given that between 50% and 80% of police reported occurrences are non-criminal in nature, it
is apparent that police are being accessed for more issues than serious crimes, likely due to
these very expectations (Canadian Association of Chiefs of Police, 2015; Conor, 2019;
Vancouver Police, 2016).
Although police reported crime has decreased, the actual number of calls for service or
responses has increased or remained stable (Kramp, 2014). This is attributed to increased
response to non-criminal calls for service, such as for social disorder, mental health, and overall
community wellbeing (Canadian Association of Chiefs of Police, 2015; Kramp, 2014; Leuprecht,
2014). While police are actively involved in criminal matters, their larger call burden is on noncriminal matters, with over 60% to 80% of all calls for service falling outside the criminal realm
(Bhayani & Thompson, 2017; Canadian Association of Chiefs of Police, 2015).
This major paper examines the increasing burden on police agencies to respond to social
disorder, mental health incidents, and addictions, and provides recommendations for
increasing collaboration across the entire social system to address the root causes of these
2

afflictions. The current reliance on police to respond to these incidents is unsustainable and
arguably unconstitutional due to a tendency to criminalise these behaviours, as opposed to
using evidence-based methods to support those suffering from these disorders through
prevention, compassion, and medical treatment. Indeed, with over 85% of police budgets
allocated to salaries and benefits, leaving only 10% to 15% for operations (Conor, 2018;
Leuprecht, 2014; Statistics Canada, 2018), there is little room to defund police to address these
concerns. Collaboration across all sectors is required to reframe the conversation from
criminality to pathways of care with a view toward the subsequent reduction in the focus on
criminality to what should be seen as a health care issue.

3

Chapter 2: Literature Review
Police and Social Disorder
In major British Columbian (BC) cities, such as Surrey and Vancouver, police reported
calls for service as the result of chargeable offences are less than 40% of the police call load
(Bhayani &Thompson, 2017; Vancouver Police, 2013). This call distribution is also evident in
smaller communities, particularly those with significant social issues, such as homelessness and
addictions (District of Mission, 2017; Penticton, 2018). Regardless of whether the public
perceives crime as increasing or decreasing, it is becoming clear that a number of drivers of
crime that were typically found only in larger cities, such as homelessness, addictions, and
mental health concerns, can be found in smaller communities (Walmsley & Kading, 2019).
Police in smaller communities are often the only available resource to respond to concerns with
this vulnerable population and have considerably less resources to draw upon than police in
larger communities. For this reason, communities may be forced to turn to police to solve these
issues, rather than pursue a whole of government approach, including health approaches
(Livingstone, 2016).
Operating expenditures for policing in Canada exceeded $15 billion in fiscal years
2017/2018, and 2018/2019, which represented a steady rise over the previous 20 years (Conor,
2019). The rise in cost is due in part to increased salaries and operating expenditures, but also
due to increased accountability and disclosure requirements (Canadian Association of Chiefs of
Police, 2015; Leuprecht, 2014; Statistics Canada, 2018). Calls for service have also increased
over this period. Police in Canada responded to 12.8 million calls for service in fiscal year
2017/2018, which rose to 13.5 million calls for service in fiscal year 2018/2019, at least partly
4

due to public demand for increased police response to mental health and addictions concerns
(Conor, 2019). Concurrently, overall police strength in Canada has dropped, despite the growing
level of calls for service (Department of Justice Canada, 2018). Police budgets leave little room
to trim funding for non-operational responses.
Changing Nature of Police Response
Police responses in BC cities indicate an increase towards non-chargeable calls for
service, although earlier reports already estimated the call load for non-chargeable incidents to
be as high as 80% (Canadian Association of Chiefs of Police 2015; Malm et al., 2005; Statistics
Canada, 2021b). Using the above figure of 12.8 million calls for service in fiscal year 2017/2018
as a reference, this indicates up to 10.2 million calls for service that fall outside of the criminally
chargeable realm, with a significant portion of those calls consisting of mental health and social
disorder related incidents (Livingstone, 2016; Vancouver Police, 2013). While it may have been
necessary or desirable for police to attend many of these calls in the event the caller feared for
their safety or there was an appearance of high-risk behaviour, there is cause to determine if
other agencies are better suited to respond, particularly for mental health, addictions, and
social issues (Centre for Addictions and Mental Health, 2013).
Police agencies throughout Canada have come to recognise the requirement to deal
with people with mental health illness and addictions with respect and compassion, while, at
the same time, operating within their primary mandate of community safety (Toronto Police
Service, 2019; Vancouver Police Department, 2020a). Recommendations from police driven
reports have centred on a common theme of increased collaboration with health authorities,
including rapid assessment and treatment (Department of Justice Canada, 2018). Police
5

agencies appear to understand the scope of the issue and continue to advocate for an
increased focus on treatment and effective interventions (Canadian Association of Chiefs of
Police, 2020; Lamanna et al., 2015).
To build on their understanding of the need for collaboration, police organisations have
begun to address the role of trauma in vulnerable populations, including the root causes of
certain behaviours (Henry, 2019; Patterson et al., 2007). Traditional responses of arresting
vulnerable individuals and introducing them to the criminal justice system fail to recognise
trauma, be it due to adverse childhood experiences (ACEs), intergenerational transmission, or
the result of a compendium of adverse life experiences (Jones, 2020). Research indicates that
vulnerable populations, including offenders, often have a prior history of trauma dating to their
childhood (Bucerius, 2020; Daubney, 2021; Maté, 2018). Bucerius et al. (2020) conducted a
study in a remand centre and a provincial correctional facility in Western Canada where
sentences were less than two years. They interviewed 266 male and female incarcerated
individuals and determined that over 82% had been victims of crime or trauma, such as ACEs,
prior to their first arrest. The study determined that incarcerated offenders almost always have
a history of victimisation before criminality. Similarly, Bodkin et al. (2019) conducted a metaanalysis and determined half of the 41,000 federal prison inmates in Canada have experienced
ACEs, including sexual assault, neglect, and physical abuse (Bodkin et al., 2019). Increasing
awareness of ACEs in a policing context may help to inform the development of cross sectoral
responses that seek to prevent poor outcomes in later life, especially with a view toward
reducing criminality (Bateson et al., 2019). By effectively addressing issues early, the intent
should be to prevent involvement in the criminal justice system in the first place.
6

Police Officers and Social Triage
Police should be the option of last resort when it comes to dealing with social issues and
mental health, but often become the first response simply because there are no other agencies
available or capable of dealing with an emergent situation (Canadian Mental Health
Association, 2013; Centre for Addictions and Mental Health, 2019). Yet the very nature of police
response can lead to the criminalisation of mental health and addictions resulting in entry into
the criminal justice system by persons who would be better served by treatment and case
management as opposed to incarceration (Centre for Addictions and Mental Health, 2013;
Plecas et al., 2014). For instance, the opioid crisis is a public health emergency, but without
adequate treatment and support, it has created significant increases in policing costs due to
investigational time, response, court requirements, and offender processing when drug related
incidents prompt police as opposed to health responses (Mark et al., 2019). According to the
2012 Canadian Community Health Survey (Statistics Canada, 2013), approximately 20% of
police contacts involved an individual with a mental health or substance abuse disorder. This
was confirmed by a recent Vancouver Police Department Study (Vancouver Police Department,
2020b) that indicated that over a two-week period, 87% of detainees reported substance use
issues. Conversely, 40% of people who experienced mental health illnesses in Canada indicated
that they had been arrested by the police in their lifetime, and 30% indicated that police had
been involved in their pathway to care (Brink, et al., 2011).
Police also deal with a growing homeless population that has a higher rate of mental
health issues than the general population (Statistics Canada, 2013). People experiencing
homelessness are often the subject of complaints to police, either due to their behaviour or
7

societal preferences, even though the root causes of their behaviour often stem from mental
health concerns, addictions, or poverty (Wilson-Bates, 2008; Wood et al., 2016). The rate of
victimisation in these populations is also higher than the general population, both in terms of
ongoing victimisation and previous trauma, such as ACEs (Kerman, 2020; Vancouver Police
Department, 2020b). Police regularly interact with these and other marginalised individuals
who have been exposed to trauma, often in early childhood, such as sexual assault, familial
loss, violent crime, or poverty (Van Amerigen et al., 2008; Wood et al., 2016).
Much of what is considered criminality in communities is actually social disorder caused
by poverty, mental health, and addictions (McFee & Taylor, 2014; Patterson et al., 2007; Wood
et al., 2016). Over 21% of the Canadian population is estimated to have struggled with
addiction in their lifetime, most commonly alcohol addiction at 18% of the 21% (Canadian
Mental Health Association, 2019b; Statistics Canada, 2015). Over 10% of the Canadian
population are considered to have high risk addictions, especially with regard to the ongoing
opioid crisis (Canadian Mental Health Association, 2019b). ACEs are also prevalent in this
cohort, with over 66% of respondents indicating at least one form of abuse prior to the age of
18 years old (Maté, 2018; Statistics Canada, 2013). These negative experiences can lead to
future interaction with the criminal justice system, especially when compounded by lack of
housing, community support, poverty, and access to resources (Mental Health Commission of
Canada, 2020).
Most substance abuse concerns are the result of early childhood trauma or event-based
trauma beyond the control of the individual (Maté, 2018). This should lead to the creation of a
clear vison for addressing mental health and addiction concerns early, through treatment and
8

support, as opposed to reactive methods involving the police as the first level of response.
Instead, up to 40% of people with mental illness indicate they have been arrested or
apprehended by the police at some point in their life and 30% of those who suffer from mental
health illness have had police involved in their pathway of care (Brink et al., 2011; Mental
Health Commission of Canada, 2020; Livingstone, 2016). There is a significant cost to this
misallocation of effective response that may be reduced through more effective collaboration
amongst responsible agencies (Malm et al., 2005).
Public safety policies should rely on crime prevention policies that are evidence
informed, as opposed to perception based (Welsh & Farrington, 2012). Homelessness and
addictions are examples where the moral imperative to eliminate drug use may be secondary to
evidence that supports the use of medical intervention instead of punitive measures
(Baillargeon et al., 2009). For instance, needle distribution policies can be viewed negatively
when the unsubstantiated fear of contracting disease from a needle poke outweighs the fact
that there is little evidence of that ever happening, except in the case of immediate contact,
and usually by emergency personnel. Despite evidence that current distribution policies prevent
disease transmission and reduce health care costs (Buxton et al., 2008), the evidence alone
does not seem to be enough. Even so, evidence does need to be tempered against societal
values and understanding when developing policy (Welsh & Farrington, 2012). There is a need
for evidentiary facts in policy making, even if the policy has as its end goal an appeasement of
public opinion (Zane & Welsh, 2018).

9

The Social Disorder Dilemma
Increasing Acknowledgement of Social Concerns
Public opinion, stigma, and lack of understanding may result in increased calls for
service dealing with social chronic behaviours, mental health, and addictions in BC
communities. This highlights the need to develop a more collaborative approach to public
safety, including the use of evidentiary strategies. At times, these behaviours manifest as
criminal offences, such as causing a disturbance or mischief, but they tend to be on the lower
end of criminality and directly attributed to social issues (Bhayani & Thompson, 2017; Mission,
2017). These concerns were already deemed health and social issues so the notion that police
agencies could resolve them independently was misaligned with effective practice (BC Ministry
of Mental Health and Addictions, 2019).
Research indicates that the cost to society in terms of addictions and ineffective mental
health strategies is immense (Canadian Centre on Substance Abuse and Addiction, 2018;
Leuprecht, 2014). For instance, the cost to society of substance abuse in 2014 was estimated at
$38.4 billion (Canadian Centre on Substance Abuse and Addiction, 2018). The cost of mental
health treatment in Canada is estimated at $51 billion per year, but this is still insufficient to
meet the need (Centre for Addictions and Mental Health, 2019).
In April 2016, the BC provincial health officer declared a public health emergency under
the BC Public Health Act in response to a growing number of opioid-based overdose deaths
since the beginning of that year (Henry, 2019). The public health emergency allowed for the
increased disbursement of funds to assist in preventing overdose deaths, with a particular focus
on harm reduction measures, pathways to treatment and care, and engagement with persons
10

with lived experience (BC Ministry of Mental Health and Addictions, 2020). While these
approaches have been somewhat effective, especially in BC (Hyshka et al., 2017), the crisis
continues in BC and across Canada. Between January 2016 and June 2020, 17,602 people died
in Canada from apparent opioid toxicity deaths. BC is the de-facto epicentre of the crisis with
over 6,733 of those deaths occurring in the province between 2016 and the end of 2020 (BC
Coroner Service, 2021; Government of Canada, 2020a).
The stigma associated with overdose deaths tends to focus on street level vulnerable
populations; however, statistics indicate the problem is much broader (BC Coroner Service,
2021). Socio-economic factors do play a major role in the death rate, especially with regard to
unemployment and poverty (Statistics Canada, 2021c). However, in BC, one-third of opioid
overdoses occurred in employed populations, primarily in the construction industry, although
65% of those individuals indicated they had experienced unemployment in the five years prior
to their first overdose (Statistics Canada, 2021c). In total, 41% of those who experienced an
overdose were unemployed, but those were not necessarily street entrenched. Further
countering the notion that overdoses are associated to criminality is the fact that 60% of those
who have overdosed in the previous two years had no police contact in that timeframe
(Statistics Canada, 2021c).
Table 1 illustrates the alarming rate of drug toxicity deaths in BC over the past ten years. The
data indicate that the majority of deaths occurred in higher population areas; however,
factoring in population densities, it becomes apparent that the opioid crisis is not limited to
major cities and is in fact a provincial issue.

11

health and social support sectors, including early intervention, continuity of care, and a better
understanding of the complex nature of high-risk individuals found in vulnerable populations.
The summits further recommended the creation of a framework for cross sectoral
collaboration, continuity of care, coordinated crisis response protocols, reduction of
stigmatisation, and assistance with navigating a complex social support system (BC Justice
Summit, 2017). Although there has been some success in implementing recommendations from
the 2017 summit, effective responses have been slow to materialise, particularly at the
legislative level (BC Virtual Justice Summit, 2020).
What is striking with respect to the BC Justice Summit reports is the coordinated
understanding across the justice system for the need to improve access to health and support
approaches, as opposed to criminal justice system approaches for vulnerable populations. This
was borne out once again in the 2020 summit that focused on alternatives to incarceration and
a drawdown of the use of the justice system to address societal issues as a result of addiction,
mental health, and homelessness (BC Virtual Justice Summit, 2020). In other words, the wide
range of legal and justice professionals agreed that the justice system was the wrong approach
to these complex social issues, with little chance of effective change without cross sectoral
collaboration (BC Virtual Justice Summit, 2020).
There is a tendency to associate violence to mental health and substance abuse,
particularly controlled substances (Canadian Mental Health Association, 2013). Unfortunately,
vulnerable populations, such as street entrenched people, youth, and marginalised individuals
have a higher representation of mental health and substance abuse issues, in some cases,
compounded by dual diagnoses (Bucerius et al., 2021; Livingstone, 2016; Statistics Canada,
15

2012). This creates a tendency to criminalise these populations, which has the effect of pulling
police into these issues as the solution, rather than as a supporting agency to more effective
strategies delivered by others. Mental illness is in and of itself not predictive of violent
tendencies; however, persons with mental health issues may become violent (Boyd & Kerr,
2016; Canadian Mental Health Association, 2013). This violence is more a function of
community factors, such as a lack of treatment options, lack of housing, and increased exposure
to violence, rather than an inherent tendency towards violence on the part of the individual
(Centre for Addiction and Mental Health, 2013; Canadian Mental Health Association, 2013;
Vancouver Police Department 2020a).
In part, arrests of these individuals are due to police officers who do not recognise the
mental health issues involved or have no other option due to lack of treatment availability
(Canadian Mental Health Association, 2003: Coleman & Cotton, 2010). Once again, this
phenomenon of police as the first line of response to persons in mental health crisis or those
who suffer from substance abuse disorders is compounded by an increased prevalence of these
interactions (Livingstone, 2016). Livingston’s conclusions are similar to the experiences outlined
in the Vancouver Police Department’s 2013 report and those of the Toronto Police Service
(2019). He points out that numerous public inquiries and inquests have served to raise
awareness of the issue of increasing police response to mental health incidents. Livingston’s
conclusion is clear in that many police interactions may be unnecessary and avoidable with
more effective medicalised interventions (Livingston, 2016; Canadian Mental Health
Association, 2003).

16

The notion that police deal with people who are in a state of vulnerability, as opposed to
being intent on committing crime, is echoed across the country (Department of Justice Canada,
2018; Kramp, 2014). With such a high percentage of non-criminal calls, it is troubling, but not
unexpected, that police become triage agents for what should be considered health and social
issues (Canadian Mental Health Association, 2019a; Maté, 2018).
The Role of Police in Modern Society
In BC and in most areas of Canada, policing is conducted at three separate levels:
federal, provincial, and municipal (Conor, 2019). Although police resourcing at the municipal
level showed an increase over the past ten years, the same cannot be said of the provincial and
federal components (Conor, 2019). With the exception of communities with their own police
service, in particular larger municipalities, much of the policing in BC is conducted by the Royal
Canadian Mounted Police (RCMP). This is done through the Provincial Policing Service
Agreement (PPSA) for communities and areas under 5,000 population, or the Municipal Policing
Service Agreement (MPSA) for communities over 5,000 (BC PSSG, 2020). In Ontario and
Quebec, provincial police agencies operate in a similar manner for communities without their
own municipal police department. Independent police departments are governed by police
boards that set priorities and general strategies, leaving operations to the police service (BC
Ministry of Public Safety and Solicitor General, 2020). Similarly, RCMP detachments bound by
the PPSA or MPSA rely on performance planning to set priorities with their local, regional, and
provincial governments (BC Ministry of Public Safety and Solicitor General, 2020). Regardless of
the community or level of service, policing priorities are set by government, either directly or
through a police board in collaboration with the respective police service (BC Laws, 1998).
17

Despite the constitutional principle that police are independent of government once priorities
are set, police are often called to address the complex social issues of addiction, mental health,
and homelessness (Roach, 2017). However, their mandates as set by governments are generally
geared towards public safety and protection, which currently includes issues of social disorder
that contribute to negative perceptions of these vulnerable populations. Yet the responsibility
for social and health issues should instead lie with the respective governmental level
themselves, as opposed to their law enforcement agencies (Roach, 2018).
Overall, crime rates in Canada are trending down over the past ten years, particularly
with respect to violent crime (Statistics Canada, 2021b). Even though there are annual
fluctuations, the overall Crime Severity Index (CSI) indicated that police reported crime in 2019
was 9% lower than in 2009 but has been trending up for the past five years. The CSI measures
the volume and severity of police reported crime, excluding traffic, that, in 2019, totalled 2.2
million incidents (Statistics Canada, 2021b). The violent CSI was down 4% over the previous ten
years and the non-violent CSI was down 11% compared to 2009 (Statistics Canada, 2021b). This
brings forward an interesting question. If overall police reported crime is down, why are police
costs going up? The short answer is found in the increasing complexity of policing and the
criminal justice system as a whole that go well beyond actual calls for service (BC Virtual Justice
Summit, 2020; Canadian Association of Chiefs of Police, 2015; Department of Justice Canada,
2018; Leuprecht, 2014; Malm, 2005).
Regardless of the nature of the work being done, the time required to document
investigations and conduct proactive policing is not measured in crime statistics alone (Kramp,
2014). Even a minor investigation will take a significant portion of a police officer’s time when
18

factoring in travel time and increasing investigational steps (Canadian Association of Chiefs of
Police, 2015; Malm et al., 2005). Add to this the requirement for increased training, technical
competency on evolving equipment, and community expectations with respect to visibility and
it becomes clear that police are experiencing increased demands on their time. This is not
because crime is necessarily on the rise but calls for service and constraints on police officer
time continue to rise, even if these calls are not criminal in nature (Department of Justice
Canada, 2018; Kramp, 2014; Leuprecht, 2014).
Despite rising costs, police are stretched in different directions that can pull them away
from their primary mandate of public safety (Department of Justice Canada, 2018; Huey et al.,
2016). A significant portion of offenders are charged for relatively minor offences that stem
from a survival response due to addictions or mental health concerns (Canadian Association of
Chiefs of Police, 2020; Plecas et al., 2014; Vancouver Police, 2020b). It is apparent that an
inordinate effort is going into using the police and courts as the social triage element (Canadian
Association of Chiefs of Police, 2020; Huey et al., 2016). To consider police in particular as the
triage for mental health and addictions is a startling indictment of society’s ability to treat its
most vulnerable. It is difficult to determine the overall cost of the justice system across Canada
due to different provincial and territorial systems; however, estimates indicate that between
2014 and 2017, annual policing costs were approximately $14.7 billion, court services and
prosecutions cost $1.8 billion, corrections costs were $4.7 billion, and legal aid expenditures
were over $800 million (Moore et al., 2018). Considering that a significant portion of these
costs are directed at persons who require treatment as opposed to incarceration, it is apparent

19

that alternatives to the expensive realities of courts and incarceration are needed (Department
of Justice, 2018).
The financial costs listed above are exacerbated by the human toll. Loss in dignity,
productivity, impaired job performance, and long-term disability are less tangible measures
than police reported crime statistics but equally grave (Henry, 2019). Many of the people
involved in the justice system are also involved in the health and social systems. Costs across all
of these sectors could diminish if the criminal justice system was transformed to focus on
wellbeing and reintegration as opposed to punishment (Poleg & Sandlie, 2011; Maté, 2018).
Criminalisation of Addictions, Mental Health, and Homelessness
Crime reduction efforts and the approach to street level vulnerable populations are the
purview of individual municipalities, and lack the full coordinated approach across agencies, in
particular with respect to mental health and addictions (Maté, 2018). In the report of the BlueRibbon Panel for Crime Reduction, Plecas (2014) indicated that the majority of crime is
committed by a very small portion of the population. The report further indicated that by
focusing on prolific offenders, crime rates could be substantially reduced. Police agencies are
particularly well suited to this type of targeting; however, they are often hampered in effective
enforcement strategies by a need to respond to social issues, such as substance abuse and
mental health that should be outside their primary mandate as these are health issues (Henry,
2019). Police should spend more time focussing on prolific offenders; however, over 60% of
police reported occurrences are in response to non-chargeable occurrences. Many of these deal
with vulnerable populations and social disorder (Canadian Association of Chiefs of Police, 2015;
Coleman & Cotton, 2010; Department of Justice Canada, 2018; Roy et al, 2020). The report by
20

Plecas (2014) clearly endorsed inter-agency collaboration though initiatives, such as treatment
versus incarceration, for those with mental health and addictions issues, an increase in
accessibility to supports, and a whole of government approach to social issues.
Plecas (2014) recommended a shift in policing priorities toward a more complete focus
on crime reduction, whereby the most prolific offenders are targeted by the police. The report
further recommended alternatives to incarceration consistent with the community safety and
wellbeing (CSWB) approach currently underway in some communities in BC (BC Ministry of
Public Safety and Solicitor General, 2018). CSWB posits a whole of government approach as the
most effective way to deal with chronic social issues ranging from mental health and
homelessness to effective crime reduction techniques, as recommended by Plecas (2014). This
perspective was amplified in the Economics of Policing report from the Parliamentary Standing
Committee on Public Safety and National Security that included as one of its recommendations
the need to increase collaboration across all governmental sectors with a view towards
prevention before justice system involvement (Kramp, 2014).
Vulnerable populations, such as street entrenched people, youth, and marginalised
individuals, can become criminalised in a society that demonstrates a desire to minimise visible
deviant behaviours in the name of crime reduction or the perception thereof (Centre for
Addiction and Mental Health, October 2013, Maté, 2009, Morrisey et al., 2007; Roy et al, 2020).
The lack of effective responses and the criminalisation of social issues may result in
expectations from police and enforcement agencies that are actually outside of the Charter of
Rights and Freedoms and contrary to the goal of overall CSWB (Department of Justice Canada,
2018; Erickson et al., 1997; McFee & Taylor, 2014). These expectations lead to a culture of
21

forced legal action against a population that should be receiving treatment (Huey et al., 2016;
Vancouver Police, 2013; Wilson-Bates, 2008). By not receiving treatment and being seen as
deviant, the problems faced by vulnerable populations are compounded as police interaction
forces those needing help further into the shadows (Lamanna et al., 2015). Furthermore, there
is little evidence to support the notion that a criminal justice approach has had a significant
effect on reducing addictions, overdose deaths, or social disorder in Canadian communities
(Canadian Association of Chiefs of Police, 2020; Henry, 2019). Canadian drug policy continues to
be caught between a tough on crime enforcement perspective and the need to address
complex addiction illnesses though a public health approach (Erickson et al., 1997; Fischer et al.,
2016).
De-Institutionalisation, Stigmatisation, and Trauma
Much of the current police response to mental health and addictions stems from the deinstitutionalisation of people suffering from mental health illnesses (Bond et al., 2001). This
resulted from the policy decision to close psychiatric facilities in favour of community-based
treatments (Brodwin, 2011). This decision was due to economic, pharmacological, legal, and
humanitarian concerns. The process began as early as the 1950s in the United States with a
similar timeframe in Canada (Bond et al., 2001, van der Kolk, 2014). In BC, the most notable
instance was the closure of Riverview Hospital that began by downsizing in the 1980s to its final
shut down in 2012. At issue was the reality that community-based resources were insufficient
to treat the growing demand of mental health occurrences, especially when co-diagnosed with
addictions (Livingstone, 2016; Markowitz, 2006). An increased reliance on pharmacological care
reinforced the notion that community treatment could fill the void, even though evidence
22

would suggest previous patients did not have sufficient access to continuous care that exposed
them to increased criminal justice responses due to their untreated behaviours (Baillargeon et
al., 2009; Livingstone, 2016; van der Kolk, 2014).
The behaviours of persons suffering from mental health illnesses can be manifested as
deviant to societal norms, even though the visible manifestation is the result of inadequate
treatment (Kramp, 2014). This generates a level of stigma against these populations, especially
when concurrent to visible substance abuse (Crapanzano, 2014). Despite evidence that much of
the vulnerable population in BC is incapable of sustained care without support, this cohort is
often vilified in public discourse and in the media (Government of Canada, 2020; Walmsley &
Kading, 2019). The perception that the homeless population contributes significantly to crime is
not established in crime reports. Although some prolific or chronic offenders may be homeless,
there is little evidence to support the notion that homelessness itself directly equates to
criminality. Vulnerable populations are stigmatised by a justice system that is quick to respond
to the criminalisation of addictions and mental health behaviours due to a lack of cross sectoral
response (Department of Justice Canada, 2018).
Research indicates that the cost, both financial and human, of current social issues, such
as overdose deaths, is immense in terms of response and societal effects (Henry, 2019). Over
6,000 British Columbians have died from drug toxicity deaths since the BC opioid overdose
public health emergency was declared in 2016 (BC Coroner Service, 2021), yet progress on
harm reduction efforts, decriminalisation, and the development of treatment remains slow
(Henry, 2019).

23

The Nexus to Homelessness
The correlation between addictions, mental health, and homelessness is well
established (Bonkiewicz et al., 2014; Corrigan et al., 2009; Kramp, 2014; Lamanna et al., 2015).
In a 2018 homeless count sponsored by BC Housing, 58% of respondents indicated they had
one or more health conditions that created barriers to housing with the majority of those
conditions listed as mental health and addictions related (BC Housing, 2018). While drug
possession is a criminal offence, the actual use is established as a health issue (Henry, 2019)
that often includes concurrent disorders, such as mental health concerns (Bucerius et al., 2021).
Although it can be argued that many criminals are suffering from mental health and addictions
issues, providing stabilisation and housing, as opposed to incarceration, should produce better
long-term outcomes for reducing crime, especially when the cost of medical support,
corrections, and law enforcement exceeds the cost of supplying supports and infrastructure,
such as supportive housing (BC Virtual Justice Summit, 2020; Patterson et al., 2007). Regardless
of the causes of homelessness, it is a cause for concern in many communities. Frustrated with
the perceived inability to solve the problem and facing community backlash, several
communities have opted for increased enforcement, even though the evidence exists that
housing is a better solution, both morally and economically (Patterson et al., 2007; Penticton,
2018). Further, smaller communities in BC are now facing similar issues to large cities and often
turn to enforcement through bylaws to move homeless and vulnerable people to other areas of
the community (Walmsley & Kading, 2019). This does nothing to address the root causes of
homelessness and further victimises an already marginalised population (Penticton, 2019;
Maple Ridge, November 2019).
24

Housing concerns in BC are not new. In the 1980s, the discussion around homelessness
in BC usually focused on the Downtown East Side of Vancouver (BC Housing, 2019a). Since then,
the street entrenched population has continued to grow, as have concerns over open drug use
and increasing perceptions of lawlessness (Roy et al., 2020). The Housing First model endorsed
across Canada is geared to provide independent living for any category of homeless or lowincome individuals with an intent to provide rapid housing options. These options range from
drop-in centres and shelters to permanent living options (Canham et al., 2019). The ultimate
goal is to stabilise individuals either for continuing treatment or re-integration to end the cycle
of homelessness. The BC Housing Action Plan (2019b) is largely based on the tenets of Housing
First, which was an ideology first used in the United States and expanded into much of
Canadian housing philosophy (Turner, 2019). Essentially, Housing First implies that those
experiencing homelessness cannot progress towards treatment and independence without first
being provided with a stabilised environment. As such, focussing on the rapid movement of
homeless people through various levels of housing is deemed the most cost-effective manner
to reduce homelessness in any given community (Turner, 2019).
Health Approaches to Social Disorder: What is Working?
Although there is a recognition of the need for increased support for those suffering
from addictions and mental health, police agencies have been dealing with the issue for some
time (Canadian Mental Health Association, 2003). Faced with an increasing demand, police
agencies in Canada have developed strategies to support vulnerable populations, often in
collaboration with advocacy groups and health agencies (Fahim et al., 2016; Koziarski et al.,
2021; LeFebvre et al., 2018; Toronto Police Service, 2019, Vancouver Police Department, 2016,
25

2020b). Although these strategies may be initially developed by police, the most effective
manner is though collaboration and a whole of government approach (McFee & Taylor, 2014).
A significant component of the Toronto and Vancouver approach is to break down the barriers
of stigma and focus on accountability and learning. The need for continuous learning with
respect to mental health and addiction was emphasised by Coleman and Cotton (2010) in their
report to the Mental Health Commission of Canada. They recognised the increasing number of
police interactions with persons with mental illness, and accurately assessed the need for police
to be responsive to vulnerable populations, and to be prepared for these interactions through
the whole range of police calls for service. Although Coleman and Cotton (2010) advocated for
a specific training model, their assertion was that police can best deal with mental health
interactions through client centred policies, as opposed to enforcement options. Their report
was published ten years ago, and police have continued to develop training to address this
critical area, such as co-responder models and outreach (Vancouver Police 2020b). Police still
need to be prepared to use force to prevent serious injury to themselves or their clients;
however, the need to quickly resolve a mental health incident should be secondary to the
wellness of the individual, especially when there is no criminality apparent (Wood et al., 2016).
Although it is well established that a significant proportion of vulnerable populations
engage in social disorder or low level criminality have been exposed to ACEs and other forms of
trauma, police often remain the first responders to initial crisis (Elklit, 2002; Huey et al., 2016).
This is attributed, in part, to the lack of available appropriate resources, such as mental health
professionals and hospital facilities (Huey et al., 2016; Leuprecht, 2014). Although there are
increased demands for police training with respect to de-escalation and interaction with
26

vulnerable populations, their primary duties toward public safety can be at odds with providing
effective care and connection to treatment (Huey et al., 2016). Calls for service to the police
often fill the gap to deal with crisis situations when it would be more appropriate to allocate
prevention and treatment resources to prevent the crisis in the first place (Kramp, 2014; Plecas
et al., 2014; Wood et al., 2016).
Most mental health related incidents are resolved informally; however, police simply
cannot walk away from someone who is a danger to themselves or others (Bonkiewicz et al.,
2014). Without dedicated, on-shift mental health professionals, police are forced to either
place the person in custody or bring them to a medical facility, taking them away from their
primary duties as they wait for assistance. Crisis intervention teams, such as Assertive
Community Treatment (Lamanna et al., 2015), and police and mental health partnerships, such
as Surrey RCMP’s Car 67 program (Fraser Health, 2020), are effective ways to increase
immediate assessment and care, including rapid referral to appropriate treatment. Crisis
Intervention Teams (CIT) are an evidence-based policing practice that, if implemented properly
with trained police officers and medical professionals, are able to reduce negative interactions
with those suffering from mental illness and increase pathways to care (Fahim et al., 2016;
Watson & Fulambarker, 2012; Watson et al., 2017). They are preferable to police only
interactions with those in mental health crisis, particularly those who are not in a violent state
(Bonkiewicz et al., 2014); however, they are reactive to incidents, as opposed to being outreach
centric.

27

Vulnerable Community Outreach
The concept of Assertive Community Treatment (ACT) programs began over 40 years
ago in Madison, Wisconsin and has since spread throughout countries in North America,
Europe, and Australia (ACT-BC, 2021; Bond et al., 2001). There is a significant body of evidence
to support the effectiveness of ACT in reaching vulnerable populations to meet their mandates
of providing community mental health treatment (Aubry et al., 2016; ACT-BC, 2021; Bond et al.,
2001; Daubney et al., 2021; Lefebvre et al., 2018). The primary outcomes of ACT are reductions
in psychiatric hospitalization and mental health occurrences, with a commensurate increase in
vulnerable population stabilisation through housing and direct access to health services (Bond
et al., 2001; Phillips et al., 2001). These outcomes are also measured by decreased police calls
for service and an overall reduction in continuing treatment costs (Lehman et al., 1998).
From an outreach perspective, ACT teams create cross sectoral collaboration, including
health professionals, social services, and other service providers that are focussed on the
stabilisation of vulnerable communities (Bond et al., 2001). People with complex mental illness
and addictions are particularly well served by the in-community approach of ACT, reducing their
exposure to the negative outcomes of a street-entrenched lifestyle through a wraparound
approach (Aubry et al., 2016; ACT-BC, 2021; Vancouver Police Department, 2020a; Watson et
al., 2017). The programs provide ongoing and continuous services, such as medication
administration and monitoring, assistance with housing, and counselling (Bond et al., 2001;
Norris, 2020). The services provided by ACT often extend to 24-hour operations to meet the
specific needs of clients that include multiple contacts per week, access to food and shelter,
access to medical care, and rehabilitation (ACT-BC, 2021). Perhaps the greatest benefit is the
28

ongoing care that allows clients to build on successes with the support of a safety net of
consistent service providers. ACT units typically manage a small caseload of the most at-risk
individuals to provide ongoing support and eventual stabilisation to housing and supports
(Bond et al., 2001).
With over 20 ACT programs active in BC, the benefits are apparent to many
communities (ACT-BC, 2021; Pope & Harris, 2014). The success of the program with respect to
collaboration with police agencies is demonstrated by three collaborative programs involving
police, among others. The Vancouver Police Department fielded the Assertive Outreach Team
in March 2014 based on ACT principles to stabilise high risk individuals and transition them to
continuing care. The team emphasises the need for collaboration between police, psychiatric
professionals, and case workers to support clients suffering from complex and often concurrent
disorders. The team assists between 20 to 40 clients at any given time and helps them navigate
the social support structures in the city (Vancouver Police Department, 2021a). Concurrent with
their outreach work, one member of the police department works closely with the five ACT
programs in the city, serving 289 clients (Vancouver Police Department, 2021b). Police are able
to locate individuals, assist in connecting them to supports, and provide support to ACT units in
the field (Vancouver Police Department, 2020a). The result of the VPD approach was a
significant reduction in crime among the active clients. This included a 53% decrease in the
number of negative police contacts, a 49% decrease in clients committing violent crime, a 62%
decrease in mental health apprehensions, and a 49% decrease in criminal justice system
involvement in 2020. From a medical perspective, the results were similar with a 61% decrease
in emergency department visits and a 74% decrease in mental health bed days among the
29

identified clients, over a one-year period ending August 2020 (Vancouver Police Department,
2021b).
Similar to the Vancouver Police Department approach, the Surrey RCMP developed the
Surrey Outreach Team in 2017 that expanded to the Police Mental Health Outreach Team in
2019 (Surrey RCMP, 2021). The genesis of the team was a growing tent city and social concerns
in the downtown core of the city. The team consists of police, bylaw officers, mental health
professionals, housing contacts, community partners, and social services similar to the
Vancouver programs. The aim was the same; to actively reach out to vulnerable populations to
provide wraparound support (Surrey RCMP, 2021). In 2018, the team produced a collaborative
solution to the homelessness issues in the city core by obtaining temporary housing for almost
all of the immediate street entrenched population, while concurrently providing outreach and
treatment options (Collins, 2019). The team continues to provide outreach to vulnerable people
in Surrey, through a continuing partnership with Fraser Health and BC Housing (Surrey RCMP,
2021). What is encouraging about these police connected programs is the recognition of the
need for cross sectoral collaboration to provide a suite of solutions to complex social issues, as
opposed to one size fits all.
Although research indicates that police in Canada are increasingly responding to calls
associated to mental health illnesses and social disorder (BC RCMP, 2021; Statistics Canada,
2015), ACT teams often operate without the assistance of police. The police can assist the ACT
team in locating individuals and providing protection if required. Police databases also provide
valuable information on individual challenges in the community that can be shared with proper
privacy impact assessments. Given current pressures to examine police budgets, there is scope
30

to examine civilian-led, medical approaches that do not require direct police intervention.
Police collaboration with ACT and outreach teams demonstrate positive results with respect to
community wellbeing; however, in some circumstances, police presence at calls for service
dealing with vulnerable populations may have an intimidating or coercive effect (Norris, 2020).
This leads to the potential for using dedicated, non-police resources, such as the Support Team
Assisted Response (STAR) program in Denver, Colorado (Sachs, 2021). The team is similar to the
co-responder model used by the Vancouver Police Department (Car 87) and the Surrey RCMP
(Car 67) that pair a police officer with a psychiatric professional. In the case of STAR, the police
officer is replaced by a paramedic. In over 740 incidents, no arrests were required. The direct
focus of the STAR concept was to remove the criminal justice response to mental health
concerns in the community and was fully endorsed by the city’s Chief of Police who is seeking
to expand the program (Sachs, 2021).
Although it is deemed a civilian-led approach, the team often works collaboratively with
police, who are usually in a support role, even to the point of calling the STAR team when they
realised their approach would be more suitable. Most of the calls dealt with by the STAR
program were focussed on social or clearly mental health related calls which were deemed low
risk to the responders. The net effect of the program was a reduction in police calls for service
and an increase in service to the affected vulnerable population. This type of approach, which
does not seek to replace existing systems, such as ACT, indicates a positive step forward to full
community response to wellbeing (Sachs, 2021).
It is important to consider; however, that the removal of police from these types of
efforts is not always practical. For instance, in Vancouver, police reported that they responded
31

to 13,592 calls for service in 2019 where mental health was a contributing factor, with 84% of
these calls requiring police attendance. One-quarter of the calls were received from health care
professionals who needed police assistance (Vancouver Police Department, 2020b). Simply
removing police from the response continuum may not be as effective or practical as
encouraging cross sectoral cooperation and collaboration towards community wellbeing.
Cross Sectoral Collaboration
An example of effective cross sectoral collaboration at the local level was found in the
Situation Table model that gained traction in Prince Albert Saskatchewan (McFee & Taylor,
2014). Faced with an increasing crime rate, elevated CSI rating, and an increase in calls for
service, police identified the need to create an alternative to the traditional reactive response
to the social issues in Prince Albert. Many of the police calls for service were based on social
issues, such as addictions and mental health, to a point that their volume exceeded traditional
criminal code caseloads (McFee & Taylor, 2014). Factors such as a high youth mortality rate,
higher than average infectious disease rates associated to drug use, poor education rates,
inadequate housing, and changing demographics clearly identified a problem well out of the
scope of the police to deal with. Through discussion and engagement, partners in law
enforcement, social services, health, community support, and housing came together to create
what is viewed as the first situation table or “Hub” in Canada (Kramp, 2044; Nilson, 2016).
Despite police being actors in many of these issues, a whole of community approach was
identified to produce meaningful outcomes towards CSWB (Kramp, 2014; McPhee & Taylor,
2014).

32

hub model already endorsed by Saskatchewan to the implementation of a CSWB Framework
(Ontario Ministry of Community Safety and Correctional Services, 2018). As a result, situation
tables, or hubs, were developed across the province. Moving vulnerable persons towards
wellness is a key component of the recommendations for health-centred approaches, such as
decriminalisation (Henry, 2029). To this end, preventing involvement in the criminal justice
system can be supported through collaborative efforts, such as community mobilisation. Failing
prevention, cross-sectoral collaboration, in terms of restorative justice and reintegration, will
have better outcomes than a rush towards incarceration (Plecas et al, 2014; Ploeg & Sandie,
2011; Vancouver Police, 2020).
The establishment of Situation Tables often falls to police agencies to implement. This
was certainly the case in Prince Albert (McPhee & Taylor, 2014) and was consistent in other BC
communities, such as Mission, Penticton, Kelowna, and Williams Lake (Mission, 2017;
Penticton, 2018). This is not necessarily counterproductive to CSWB implementation; it simply
requires a commitment on behalf of the police to engage fully with their community, which is a
commitment that should be at the core of any service delivery model. Although police may
initiate the discussion, it is important that they are not seen to take charge or to have solely
crime fighting motives at the table to ensure collaboration of all table participants (Bhayani &
Thompson, 2017).
At the core of the Situation Table model is the need to intervene quickly. When a
situation is identified, participants at the table work quickly to assist those who are at imminent
risk of harm, victimisation, or criminality (Ontario MCSCS, 2017; McFee & Taylor, 2014;
Penticton 2018). The Situation Table model uses a four-filter approach to assess acutely
34

survival based criminal and drug offences, has had little success in changing criminal or social
behaviours (Hayle, 2019; Manitoba Ministry of Justice, 2018; Ploeg & Sandlie, 2011).
The failure to address the root causes of criminality and social disorder has led, in part,
to a failing war on drugs indicating the need for a cross sectoral approach to lower the incidents
of criminality associated to addictions and mental health (Canadian Association of Chiefs of
Police, 2020; Jesseman & Payer, 2018). Although decriminalisation should have the effect of
reducing survival-based criminality while increasing community wellbeing, there is a need for
caution before rushing headlong into this approach without the necessary resources in place
(Jesseman, & Payer, 2018; Moore et al., 2018). The Portugal experience, which will be discussed
below, gained success through a whole of government system of cooperation and collaboration
(Canadian Association of Chiefs of Police, 2020; European Monitoring Centre for Drugs and
Drug Addiction, 2019; Henry, 2019). Simply refusing to prosecute possession of illicit drugs
while allowing criminal trafficking networks to prosper will likely produce a negative outcry
from the public, since the illicit drug market will continue to flourish. For decriminalisation to
work, a fully integrated system of collaboration between criminal justice agencies, health, and
social services is required to support appropriate pathways of care (Bansback et al., 2018;
Banjerjee & Wright, 2020; Canadian Association of Chiefs of Police, 2020; Jesseman & Payer,
2018; Vancouver Police, 2020a). The outcomes of decriminalisation are not necessarily
budgetary but could be measured in terms of community wellbeing and a reduction in the
effects of crime (Canadian Association of Chiefs of Police, 2020). This approach is supported by
the UN General Assembly Special Session (2016) and the UN Office on Drugs and Crime that

36

advocate not only for a focus on demand reduction, but also a commitment towards a health
and human rights-based approach (Henry, 2019; United Nations, 2018).
The concept of decriminalisation is perhaps best captured by the pioneering experience
in Portugal in 1999 (Canadian Association of Chiefs of Police, 2020; Hughes & Stevens, 2010).
Misunderstanding the concept of decriminalisation may lead society to believe that the policy
will create an increase in overall illicit drug use, as police remove their focus on street level drug
use (Canadian Association of Chiefs of Police, 2020). The experience in Portugal did not lead to
an increase in drug use, and there was a reduction in overcrowding in the criminal justice
system and overall drug related harms (Hughes & Stevens, 2010). In their study, Hughes and
Stevens (2010) posited that a criminal approach to drug use was actually detrimental to overall
public wellbeing. Political reluctance to decriminalise possession and use of personal amounts
of illicit drugs have led western countries to focus on enforcement, rather than root causes,
creating a system that is not sustainable (Hughes & Stevens, 2010). The use of criminal
sanctions in an attempt to treat addictions have repeatedly proven to be ineffective in
supporting vulnerable populations and reducing crime associated to addictions and mental
health (Canadian Association of Chiefs of Police, 2020; Jesseman & Payer, 2018). The 1999
Portuguese National Strategy for the Fight Against Drugs and the 2013 National Plan for the
Reduction of Addictive Behaviours and Dependencies linked legislative reform of criminal justice
approaches to a drug strategy that sought pathways to care for vulnerable populations
(European Monitoring Centre for Drugs and Drug Addiction, 2019). Pathways to care included a
more humane and compassionate legal framework, expanded prevention policies, and
expanded supports, such as housing, treatment, harm reduction, and reintegration approaches.
37

Supply reduction was a key goal and was achieved through the introduction of a medically
controlled, safe drug supply (Hughes & Stevens, 2010). However, implementation of a safe drug
supply in the Canadian context is complicated by provincial health regulations and perceptions
of decision makers that differ across the country (Canadian Association of People who Use
Drugs, 2019). This barrier was not present in Portugal, a country with a single health and justice
system, prompting a recommendation by Portuguese officials to learn from their experience, as
opposed to copying it (Canadian Association of Chiefs of Police, 2020).
From an enforcement perspective in Portugal, criminal possession offences previously
punishable by up to one year in jail were repealed in favour of administrative or public order
offences that could be treated through ongoing interaction between the offender and social
and health supports (European Monitoring Centre for Drugs and Drug Addiction, 2019; Hughes
& Stevens, 2010; Jesseman & Payer, 2018). Since the majority of drug offences in Portugal were
deemed to be possession related, a harm reduction and treatment approach was deemed the
most effective to reduce demand and subsequent harms. Despite fears that illicit drug use
would increase due to decriminalisation, research indicates that, from 2007 to 2017, the usage
of amphetamines, MDMA, and cocaine stimulants dropped significantly1 in the young adult
population, defined as those between 15 to 35 years of age. The only significant increase was in
the use of cannabis, which remains illegal in Portugal (European Monitoring Centre for Drugs
and Drug Addiction, 2019). Treatment was the primary focus of Portuguese drug policy, with
27,150 clients receiving care in 2017. The burden on the criminal justice system decreased

1

Reductions as a percentage of overall young adult population: Cocaine dropped from 1.3% to 0.3%,
MDMA from 0.9% to 0.2%, and Amphetamine from 0.4% to 0.0%.

38

through the use of medical and administrative approaches that did not use punitive measures
against illicit drug users (Hughes & Stevens, 2010). Seizures of illicit drugs by police increased,
as they allocated resources to targeting trafficking as opposed to simple possession.
Furthermore, there has been a reduction in opioid related deaths and infectious disease that
may be attributed to the expanded health and re-integration approach taken, but not
necessarily decriminalisation (Canadian Association of Chiefs of Police, 2020; Hughes & Stevens,
2010).
Closely linked to decriminalisation is the concept of a safe drug supply to lower the risk
of toxic drug deaths (Canadian Association of People who Use Drugs, 2019). Given the potential
toxicity of street level drugs, including cutting additives and fillers, an argument exists for the
provision of safe alternatives in support of harm reduction initiatives. The provision of
pharmaceutical grade opioids through a treatment program has the potential to greatly reduce
opioid related deaths (Bansback et al., 2018; Canadian Association of Chiefs of Police, 2020). A
safe drug supply is defined as a legally regulated system to replace the illegal supply. Although
it would be difficult to introduce a safe drug supply absent of established decriminalisation
options, there is significant research on the effectiveness of providing pharmaceutical grade
opiates and agonists (Banjerjee & Wright, 2020; Hughes & Stevens, 2010). This form of
treatment may be more effective than traditional programs, such as abstinence, for long-term
opioid or illicit drug users (Canadian Association of People who Use Drugs, 2020).
There have been several successful applications of this type of approach throughout
Canada. The 2020 Canadian Association of Chiefs of Police report on decriminalisation listed
three current examples. The Crosstown Clinic in Vancouver, BC uses a medical prescription
39

model to dispense pharmaceutical grade heroin or the agonist hydromorphone in an outpatient
setting. This approach provides an ongoing treatment pattern with consistent oversight of
registered patients. Similarly, the Managed Opioids program in Ottawa, Ontario provides a
residential approach to the Crosstown Clinic example. The third example is also in Vancouver,
where the Portland Hotel Society provides low barrier access to hydromorphone pills to 50
patients in a supervised setting. The results of these treatment programs have been positive in
terms of wellbeing, with a commensurate reduction in overdose deaths, street drug use, and
criminality (Bansback et al., 2018; Ivsins et al., 2021).
Harm Reduction to Medicalisation
There is significant research supporting the concept of safe drug supplies within the
auspices of harm reduction programs (Canadian Association of People who Use Drugs, 2019).
Harm reduction is intended to reduce the potential of death or infectious disease through the
provision of safe supplies, including condoms and lubricants, needles and syringes, and alcohol
swabs and sterile water, including distribution systems (Buxton et al., 2008). While this provides
a traditional understanding of the goals of harm reduction, strategies have evolved from the
simple distribution of supplies to the acceptance of supervised consumption sites and
treatment programs, such as injectable Opioid Agonist Treatment (iOAT) (Bansback et al.,
2018).
The concept of using pharmaceutical grade heroine, known as diacetylmorphine, or
agonists, such as hydromorphone, is supported by a growing body of evidence indicating its
effectiveness (Banjerjee & Wright, 2020; Bansback et al., 2018). Since it is difficult to maintain
oral maintenance treatments, such as methadone, iOAT is an effective alternative that
40

medicalises provision of drugs away from the street level supply. Although there are variations
in application, the general premise is that injectable pharmaceutical grade opiates or agonists
are the most effective manner to treat people with severe opioid use disorder (Banjerjee et al.,
2020; Bansback et al., 2018). Once such program was the Study to Assess Long-term Opioid
Maintenance Effectiveness (SALOME) to evaluate the use of hydromorphone as an effective
treatment option. The study was held in Vancouver, BC for six months and included over 200
participants with severe opioid use disorders (Banjerjee et al., 2020: Bansback et al., 2018). The
study determined that hydromorphone was more cost effective than diacetylmorphine, but
also identified significant economic and quality of life improvements for participants. In
particular, this type of therapy resulted in an apparent drop in criminality on the part of the
participants, both in terms of property and violent interactions, although specific results were
not available (Bansback et al., 2020).
The SALOME trial built on trials in Portugal that demonstrated similar effectiveness.
Banjerjee et al. (2020) compared SALOME to the Portugal trial and three others with similar
results, including long-term stability and a reduction in drug use. It was determined that the use
of injectable hydromorphone was more effective than the use of methadone in terms of
reducing criminality (Banjerjee et al., 2020, Bansback et al., 2018). The participants also
demonstrated increased retention in treatment; however, mortality rates remined the same.
Overall, the use of hydromorphone was demonstrated to be more cost effective than
diacetylmorphine and methadone treatments (Banjerjee et al., 2020, Bansback et al., 2018).
Although SALOME and similar trials proved the effectiveness of replacement therapies,
in particular injectable hydromorphone, there is still political resistance to widespread adoption
41

of the program (Bansback et al., 2018). Trials, such as SALOME, allow for participants to actively
engage in their treatment with daily interaction with medical professionals. The need to use
street level drugs and the corresponding support for the illegal drug trade is virtually eliminated
during the participation phase. The success of these programs can become a working
foundation for the implantation of evidence-based shifts in drug policy (Bansback et al., 2018).
Concurrent with the development of iOAT programs is the potential for increased use of
supervised consumption sites to reduce the potential for overdose deaths and infectious
disease transmission (Kilmer et al., 2018). Although supervised consumption sites may create
political and community concerns, such as the perception of enabling drug use and the
perception that drug use is a choice that should be stopped, they are effective in reducing the
harms associated to illicit drug supplies and present an open door for provision of safe supply
and treatment options (Hathaway & Tousaw, 2008; Wood et al., 2006). Despite the potential
controversy over supervised consumption sites, their place as part of a broader treatment
strategy is warranted, especially with regard to immediate harm reduction, concurrent to the
implementation of other strategies (Hathaway & Tousaw, 2008; Hayle, 2015; Kilmer et al.,
2018; Wood et al., 2006).
Alternatives to Sentencing
The discussion around reductions in criminality due to effective treatment options is
particularly relevant to sentencing. Most street entrenched illicit drug users, if displaying
criminality, do so on the lower scale of property crime (BC Justice Review Task Force, 2005).
People experiencing homelessness are significantly more likely to experience violence than
surrounding populations. In Vancouver, although the homeless population represents just 0.3%
42

of the population, the homeless are 19 times more likely to be victimised (Vancouver Police
Department, 2020b).
It is evident that short term incarceration, especially for minor criminal and drug
offences, is not effective (Department of Justice Canada, 2018). The majority of sentences in
Canada are imposed on repeat offenders, yet are less than two months in duration (Dandurand
& O’Hara, 2020; Malakieh, 2020). This does not provide adequate time to present treatment
alternatives or programming to address why a person is offending in the first place. Research in
other countries, such as Norway and the European context in general, has indicated that using
diversionary programs, as opposed to incarceration, have better long-term outcomes
(Jesseman, 2018; Ploeg & Sandlie, 2011). The tendency in Canada to impose short-term
sentences is not only expensive, it has little effect on the actual crime rate (Moore et al., 2018).
Since the majority of more serious crime is committed by a very small group of offenders
(Plecas et al., 2014), it would be more effective to focus on the histories of these offenders to
change their trajectories, rather than retribution and punishment. Fully funded restorative
justice programs as a primary response to first time offending or survival-based criminality may
have better long-term outcomes than a revolving door system (Canadian Association of Chiefs
of Police, 2020; Department of Justice, 2018; Ploege & Sandlie 2011).
The Cowper report of 2010 and the following Blue-Ribbon Panel on Crime Reduction
(Plecas et al., 2014) emphasised the known vulnerability in certain offender populations and
cited the need to place increased emphasis on restorative justice practices. The experience in
Norway speaks to the success of moving away from a punitive system based on retribution to a
system that is based on reintegration into society (Ploeg & Sandlie, 2011). Case specific courts,
43

such as Indigenous courts, drug courts, and community courts that see restorative justice as a
primary response are important aspects of a move towards wellbeing as opposed to traditional
denunciation, since they reduce contact with the criminal justice system through a focus on
problem resolution as opposed to punitive measures. In turn, this will reduce police contact
with vulnerable populations (BC Virtual Justice Summit, 2020; Canadian Mental Health
Association, 2003).
The relationship between illegal drug use and crime is well established (Department of
Justice Canada, 2018). The use of alternatives to the normal court process, such as drug
treatment courts, may allow for more health-based approaches to addiction and associated
mental health illnesses by providing supervised treatment to address some of the root causes
of offender behaviour, particularly survival-based offenders, with increased potential to
connect them to community supports. In 2018, there were 106 people referred to a drug
treatment court program in Canada, a relatively small number compared to those in the
traditional criminal justice system, which in fiscal year 2018/2019 was 309,664 (Department of
Justice Canada, 2019; Statistics Canada, 2021b).
The use of remand and pre-trial detention has risen steadily in Canada, outpacing the
actual incarcerated sentenced population (Statistics Canada, 2017). In most provinces, there is
a higher proportion of adults in remand than in sentenced custody, and, in some provinces,
such as Alberta, Ontario, and BC, that proportion is as high as 70% (Jones et al., 2019; Malakieh,
2020). The opposite is true for youth, since the principles of the Youth Criminal Justice Act
(2003) have resulted in a trend away from remand towards diversion, such as through
restorative justice in the first instance, with marked improvement in rates of recidivism for
44

youth (Malakieh, 2020). In contrast, the trend towards the increased use of remand for adults is
troubling in that remand seems to be more punitive than the actual court process (BC Virtual
Justice Summit, 2020). Conditions in pre-trial facilities can be considered maximum security
with few amenities and no treatment or rehabilitative programs (Statistics Canada, 2017). This
seriously disrupts the offender’s life, employment, and relationships, with little evidence of an
increase in public safety in the near term (Dandurand & O’Hara, 2020). Using restorative justice
as a primary means is cited as one method to reduce remand rates; however, electronic
monitoring is also effective (BC Virtual Justice Summit, 2020). Powered by modern technology,
it presents an opportunity to lower the rate of remand while, at the same time, placing
sufficient oversight on an offender, especially if they are undertaking diversionary programs
(Plecas et al., 2014).
Changing Perspectives
Although police are often on the front-line in dealing with people suffering from mental
health and addictions, there is increasing recognition that appropriate levels of care need to be
allocated to these issues (BC Justice Summit, 2017; Department of Justice Canada, 2018). In BC,
the Pathway to Hope: A roadmap for making mental health and addictions care better for
British Columbians (BC Ministry of Mental Health and Addictions, 2019) is an example of a shift
away from the criminalisation of these illnesses. It focuses on wellness promotion and
prevention, seamless and integrated care, equitable access to culturally safe and effective care,
and Indigenous health and wellness. The report indicates that mental health and addictions
have an impact of $6.6 billion annually on BC’s economy, yet mental health and addictions
treatment options pale in comparison to acute and traditional care modalities (Maté, 2018).
45

Furthermore, the barrier of stigma often prevents people from accessing proper support (BC
Ministry of Mental Health and Addictions, 2019; Canadian Mental Health Association, 2019;
Maté, 2018; Lancaster et al., 2015; Toronto Police Service, 2019). Stigma is enforced by a lack of
understanding of the scope of the problem, a lack of funding for treatment, and a tendency
towards criminalisation of the illnesses, particularly addictions (Maté, 2018).
Police attitudes to vulnerable populations have progressed to the point where they are
often leading the way in developing solutions and cross sectoral responses (McFee & Taylor,
2014; Vancouver Police Department, 2020b). The ongoing amendments to the BC Police Act
indicate a strong desire to address current policing issues from a community wellness lens, as
opposed to traditional enforcement only options. In his testimony before the Special
Committee on Reforming the Police Act, Assistant Deputy Minister and Director of Police
Services Wayne Rideout indicated the need to move towards a more collaborative approach to
public safety in terms of who should be providing supports and responses (Legislative Assembly
of BC, 2021). He articulated that police roles have expanded outside of their core duties due to
lack of a collaborative and coordinated cross-governmental approach to issues, such as mental
health and addictions. He emphasised the need for health care intervention in these issues,
such as expanded harm reduction initiatives and increased communication, and access to
information sharing between agencies, such as those found in the Situation Table model
(Legislative Assembly of BC, 2021). There was also a recognition of the need to mandate
cooperation between agencies to move towards a more proactive approach to these societal
issues to shift from police response towards more qualified partners (Legislative Assembly of
BC, 2021). While his comments were specific to policing, they were echoed in the recent BC
46

Virtual Justice Summit (2020) that also called for increased collaboration across sectors,
including medical responses to addictions and mental health, as well as alternatives to
sentencing for vulnerable populations.
The literature concerning police and justice system interaction with vulnerable
populations is in need of an examination into the effectiveness of current approaches to
addictions, mental health, and homelessness. Research indicates that new approaches to
support vulnerable populations, from addictions treatment to mental health support and
housing, are required to see a reduction in police calls for service as a result of public concern
over social issues. BC Justice Summits, BC Government initiatives to reform the Police Act, and
Government of Canada reviews on justice reforms set the stage to create innovative
approaches to social disorder that seek to move away from the criminalisation of vulnerable
populations. These approaches should move toward the restoration of dignity in the delivery of
community safety and wellbeing. This study was undertaken to identify the need for change
toward more collaborative and health-based policies strategies.

47

Chapter 3: Methodology
Research Question
Statistics indicate that the majority of police calls for service across Canada do not deal
with violent offences or even those considered chargeable with respect to the Criminal Code of
Canada (Canadian Association of Chiefs of Police, 2015; Department of Justice Canada, 2018).
Police are often the first response to complex social issues, including addictions, mental health,
and homelessness. As a result, criminal justice approaches have become the public’s and
government’s expectation to resolving these concerns contrary to research and developing
public policy that indicates these are health and social concerns that require a health or social
response. Given the need to allow police to focus on their primary duty of public safety, the
research for this major paper examined what leading experts in the fields of public safety,
public advocacy, and medical response suggested as policy alternatives towards overall CSWB.
When combined, public safety, public advocacy, and health responses can be described as
public wellbeing or a collaborative approach to social concerns. Policy alternatives represent
medical approaches, collaboration across public sectors, and criminal justice reforms, such as
alternatives to sentencing, decriminalisation of illicit drugs, and de-stigmatisation of vulnerable
populations.
Objectives
There is a significant body of research with respect to the lived experience of those
suffering from addictions and mental health illnesses, as well as those experiencing
homelessness. There are also significant statistical data available that demonstrate the
response patterns of police and public safety agencies. The intent of this research is to
48

synthesise those data with the views of service providers, not just first responders, but also
those of advocacy and medical practitioners. This study examines current police crime data as a
basis for the assertion that police are being overtasked with social, non-criminal matters. This
assertion forms the view that there are alternatives to police response as a primary agency
based on cross-sectoral collaboration and support to vulnerable populations. This has the
potential to decrease crime and increase wellbeing in communities. The alternatives suggested
will be based on the input of a cross section of service providers to recommend improvements
to current addiction, mental health, and homelessness policies.
Sample Size and Composition
The data for this research was obtained through qualitative interviews with 14
participants. Participants were identified as those with managerial or policy development
experience in the areas of policing, mental health, medical service delivery, and advocacy. To be
eligible, participants must have dealt extensively, either directly or through their managerial
function, with vulnerable populations experiencing addiction, mental health, or homelessness
concerns. Participants were identified from a range of experience including police chiefs, frontline police supervisors and specialists, medical professionals, advocacy professionals, and nongovernment agency service providers.
Research Design
This research followed a mixed methods approach consisting of a data analysis phase,
followed by semi-structured interviews designed to elicit the views of participants with respect
to addictions, mental health, homelessness, and general social concerns. The data analysis
focused on RCMP reported calls for service throughout the province of BC. Crime statistics from
49

the Vancouver Police Department were obtained through published reports. Data was also
obtained from publicly available sources, such as Statistics Canada, to compare policing trends
across Canada. These datasets were used to compare calls for service to levels of violent crime,
property crime, and social responses.
Participants were recruited using a snowball sampling technique. Snowball sampling is a
non-probability technique where research participants identify other participants for a study.
The identified participants were introduced to the researcher by the initial participant and
subsequently interviewed using the same questions to develop a consistent dataset. A
maximum of two participants per agency or direct business lines were recruited to allow for a
broad spectrum of views. Once participants were identified, they were asked at the end of the
interview for other participants who could offer insight into the research question. Four initial
participants at the police leadership level were identified by the researcher due to their public
views on these social concerns. Other identified participants included advocacy and medical
groups not directly linked to police agencies. Saturation was reached after 14 interviews with
participants indicating consistent approaches to developing policy alternatives. In other words,
there was strong agreement as to the root causes of the identified concerns and strong
agreement as to future policy alternatives. Although the sample size was smaller than the
originally anticipated 20 participants, it is a rich sample due to the diversity of participant
mandates from police to advocacy groups who were not necessarily in agreement with respect
to overall police operations and tactics.
The semi-structured interviews were held using Zoom videoconferencing from the
researcher’s personal computer, except in two cases where the researcher was in contact with
50

participants as part of their coincidental duties. All interviews were conducted in English. The
interviews were mainly qualitative in nature to elicit the views of participants with respect to
root causes and policy alternatives to current police responses and criminal justice approaches
to social concerns (Appendix A: Interview Guide). Four specific questions were asked of each
participant to compare their views on certain policy questions, such as the decriminalisation of
illicit drugs and the need to reduce stigmatisation of vulnerable populations. On average, the
interviews were 45 minutes in length and required very little prompting from the researcher as
the participants had very well developed views on the subject matter. Responses were
tabulated and compared participant mandates across five categories: police leadership, police
supervisors and specialists, advocacy participants, medical participants, and non-government
agency participants.
All interviews were audio recorded using a separate, secure device after obtaining
permission from the participant as part of their informed consent. Upon completion of the
interviews, a dataset was developed using Microsoft Excel to categorise responses into themes.
The transcribed portion of the dataset used an inductive approach to group frequently
repeated findings into themes that were then grouped to compare policy suggestions. This
dataset also included direct quotes from participants that were directly relevant to the policy
suggestion or current practice.
Ethics Approval and Risks
There was no remuneration for participants, as they were all interviewed with respect
to their current roles and responsibilities. Many of their responses and views were already
publicly expressed or directly attributable to their agency or area of expertise. As a result, this
51

research was considered low risk. All participants were advised that direct quotes would be
attributed to anonymized pseudonyms with consistent themes attributed to general
occupations or groups. Each participant was advised that it was possible that they could be
personally identified due to their already publicly known views on the research question. Each
participant indicated that this was not a concern, since nothing they stated was in conflict with
the mandate of their agency, current law, or their inherent desires to increase wellbeing in their
communities. Although anonymity was not guaranteed, confidentiality of the interviews was.
Ethical approval for this study was approved by the University of the Fraser Valley’s
Human Ethics Research Board (Appendix B: Certificate of Human Research Ethics Board
Approval). Participation in this study was voluntary and all participants were asked to provide
informed consent that included audio recording of the interview (Appendix C: Informed
Consent Forms). Although no participant withdrew from the study, they were all advised of that
option. To ensure the protection of participant’s information and identity, all data was secured
on a password protected drive on the researcher’s personal computer or on an encrypted
portable hard drive if required for use away from home. Throughout the study, no person other
than the researcher accessed raw information from the interviews.
RCMP statistical information was obtained through an RCMP approval process. No
RCMP or police data can be attributed to any individual, as it was obtained to indicate general
trends as opposed to activities in any specific community. Finally, all participants were advised
of the researcher’s current status as a senior police officer (Superintendent) in the RCMP, with
experience in police leadership dealing with the concerns raised in this research. They were

52

further advised that the researcher was retiring from policing in the immediate future. None of
the police participants were in the direct chain of command of the researcher.

53

Chapter 4: Findings
Statistical Analysis
Concurrent to the qualitative interview phase of this study, a statistical analysis of
current charge rates and calls for service was conducted. The following tables include RCMP
data from the entire province of BC. Although data from all municipal police forces in BC are
not included, in terms of chargeable call ratios to overall response, the trends are consistent.
This was confirmed in discussions with senior police officers in large municipalities in BC, as well
as an open-source statistical review of the number of criminal code offences, versus total calls
for service. For instance, in 2019, the Vancouver Police Department responded to 265,232 calls
for service, 56,780 of which were criminal offences, 1,459 were drug offences, and 1,493 were
criminal traffic, such as impaired operation of a motor vehicle (Vancouver Police Department,
2019). Similar to RCMP jurisdictions, this data indicates that 22.5% of the Vancouver Police
Department’s calls for service were Criminal Code related.
The following tables use RCMP data in BC as an indicator of charge ratios and overall
crime types. Given that the data represent detachments from as small as three police officers
to a detachment of over 850 police officers, there is a high level of confidence that these data
are representative of overall trends for the purposes of this study. The focus of this portion of
the study is the comparison between the number of Criminal Code and Controlled Drugs and
Substances Act (CDSA) occurrences police attend versus the overall number of occurrences.
Second, this comparison is also used to determine the number of Criminal Code and CDSA
charges that actually develop from these occurrences.

54

The volume of property crime is considerably higher than violent crime. The number of
violent crimes in this data set may appear lower than publicly available data, since each
occurrence is counted as one, regardless of the number of victims. The BC Ministry of Public
Safety and Solicitor General (2019) describes this difference as follows:

The number of violent crimes recorded is equal to the number of victims involved in a
violent incident. For example, when one person murders three people, three offences
are recorded. For all property crimes and other crimes, the total number of offences
recorded is equal to the number of distinct or separate incidents. For example, in an
incident where several vehicles parked in one block are spray-painted with paint from
the same spray can, only one incident of vandalism is reported.

The BC Ministry of Public Safety and Solicitor General (2019) defines clearance rates referred to
in this study as follows:

Crimes are cleared when police have sufficient evidence to identify the offender(s) and
prove the offender(s) committed the crime. Offences can be cleared in one of two ways:
cleared by charge or cleared otherwise:
Cleared by charge: When the police have identified at least one offender and
have sufficient evidence to prove the offender committed the crime, the police
prepare a Report to Crown Counsel (RCC) to recommend charges. Once an RCC is
forwarded to the local Crown Counsel office, the police consider the incident to
be cleared by charge, and this status is recorded in the UCR2 Survey.
Cleared otherwise: In some instances, police identify the offender(s) and have
enough evidence to support a charge, yet they do not recommend charges. Such
offences are reported in the UCR2 Survey as cleared otherwise; that is, the
offence is cleared by a method other than by recommending charges to Crown
counsel. Offences are cleared otherwise for a variety of reasons including: the
offender is under the age of 12; the offender has diplomatic immunity; the
offender is deceased; the offender has been sentenced for other similar crimes;
or police wish to divert the offender from the formal system.

55

19.4% of all occurrences in BC RCMP jurisdictions. This does not include Criminal Code offences
listed in the “Other” and “Traffic” Criminal Code categories.
Table 9 indicates that the most commonly reported violent crime was common assault,
defined as the least serious of the three types of assault4, followed by uttering threats,
harassing communications, and the more serious violent crimes of assault (Level 2 and 3),
robbery, and sexual assault. These serious occurrences require significant investigational time
and commitment.

4 A common assault occurs when an individual intentionally applies force or threatens to apply force to another person

without that person's consent. The seriousness of physical injury is what distinguishes this type of assault from more serious
assaults. Common assaults include pushing, slapping, punching, and face to face verbal threats (Statistics Canada, 2021). Assault
with a weapon or causing bodily harm (Level 2) involves carrying, using, or threatening to use a weapon against someone or
causing someone bodily harm. Aggravated assault (Level 3) involves wounding, maiming, disfiguring, or endangering the life of
someone (Statistics Canada, 2021).

60

Table 11: Top 40 Founded Criminal Code Property Occurrences. (E Division RCMP, 2021)

63

The majority of Criminal Code occurrences were for property crimes, although this
category had the lowest clearance by charge as compared to violent crime and other Criminal
Code. The most reported property crime occurrence was theft from automobile, followed by
mischief to property, theft under $5,000, mischief loss of enjoyment of property, and
shoplifting under $5,000. Fraud, break and enter, and theft over $5,000 rounded out the top 15
property offences reported.
Qualitative Interview Results
The data for this research was obtained through qualitative and quantitative interviews
with 14 participants. Participants were identified as those with managerial or policy
development experience in the areas of policing, mental health, medical service delivery, and
advocacy. Participants were identified from a range of experience including police chiefs, frontline police supervisors and specialists, medical professionals, advocacy professionals, and nongovernment agency service providers.
The interview guide was designed to garner participant perceptions of the role of police
in dealing with vulnerable populations, including comments on current drug policies. The
interviews were designed to be qualitative in nature to assess participant views. An important
question determined participants’ opinion on the effectiveness of their agency with respect to
its mandate for addictions, mental health, and homelessness. Participants were also asked for
their opinions with respect to certain policy alternatives concerning vulnerable populations and
Canadian drug policy, including their views on the four pillars approach of harm reduction,
education, treatment, and enforcement.

66

Perceptions of Effectiveness in Working with Vulnerable Populations
It was very evident in the interviews that all participants felt that meeting their agency’s
mandate on the issues of vulnerable populations, including addictions, mental health, and
homelessness, was too broad for any one agency or group to deal with. The four police
executives felt they were meeting their mandates in terms of CSWB, although they were very
clear that their mandate was to provide overall public safety, and as such none of these issues
were particularly a police role. They clarified that each of these issues should fall into the
mandates of other government agencies, with the police as a necessary support in each
category.
Interestingly, the three front-line officers who dealt specifically with vulnerable
populations stated they felt that police agencies were challenged in dealing with these issues.
Although they agreed with police executives that they needed to respond to these matters out
of a concern for public safety, they were disappointed that there was not more collaboration at
the front-line level between agencies. Front-line officers were very consistent in their desire to
see increased collaboration, as were the executives.
The four participants associated with advocacy and non-governmental support agencies
were also reluctant to consider the three concerns as direct to their mandates. Two agencies
did not deal specifically with mental health concerns but agreed with the police participants
that increased collaboration was necessary. Another participant felt that without full
collaboration, it was difficult to assess any agency against this mandate, since there was so
much multisectoral intersectionality in these issues. The fourth participant agreed and stated

67

their agency was not specifically involved with these groups but had a broader mandate to seek
improved policy options to support the rights and dignity of vulnerable populations.
Finally, the medical participants agreed that this question was too broad to answer each
aspect specifically. One participant only dealt with addictions treatment and felt that their
agency was highly effective, but it did not have a mandate with respect to homelessness and
mental health, other than they were often concurrent to addictions. The second participant
agreed with this; however, from a mental health perspective. The final medical participant felt
the approach to all three concerns was somewhat ineffective due to the lack of coordinated
vision to support vulnerable populations.
All participants were provided with a number of policy alternatives and asked to
comment on the extent to which they agreed or disagreed with the option. The policy
alternatives were: (1) decriminalisation or medicalisation of controlled drugs should take
precedence over enforcement in vulnerable populations; (2) reducing stigmatisation is a key
target for effective implementation of alternatives; (3) developing alternatives to police
responses, such as co-responder models, is an important component of building well-being
amongst vulnerable populations; and (4) developing alternatives to sentencing is an important
component of building well-being in vulnerable populations. All participants strongly agreed
with these policy alternatives and felt they were vital in moving forward with effective support
to vulnerable populations specifically, but also those in the general population suffering from
any of these concerns. It was interesting to note that regardless of agency mandate, all
participants agreed that current approaches to supporting vulnerable populations have gone

68

too far into criminalisation as opposed to treatment for what should be deemed health and
support issues.
All participants were asked for their opinions with respect to Canadian drug policy. The
policy questions were: (1) Canadian drug policy should move towards decriminalisation of
certain illegal drugs, particularly those at the street level; (2) harm reduction efforts, such as
safe consumption sites, are an important component of effective drug policy; and (3) treatment
should be available on demand. As with the previous question, there was strong agreement
across sectors that Canadian drug policy needed to move away from criminalisation of
behaviours associated to addictions and move towards a treatment approach. This question
generated much discussion that is incorporated into six themes in the next section. Participants
required little prompting to express their views on how to best support vulnerable populations.
Their views with respect to the failure of current approaches were evident from the outset, as
were their views that investment into solutions was urgently needed. The need for
communication and collaboration also became apparent, since all participants agreed that
issues around addictions, mental health, and homelessness were far too broad for any one
agency, especially if that agency was siloed into one aspect due to funding, legislation, or
general practice. It was also apparent that some of the themes are intrinsically linked due to
the complexity of the issues. Two specific themes that crossed over the others were the need
for cross sectoral cooperation and the need for significant investment into funding solutions to
addictions, mental health, and homelessness.

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Theme One: Cross Sectoral Cooperation
Participants were very clear that cross sectoral cooperation, collaboration, and
communication were urgently needed to address the issues around addictions, mental health,
and homelessness. This perception was not just about inter-agency cooperation, but also the
need to communicate the overall roles of the agencies to community partners to build
understanding about root causes of these issues. As covered more fully in Theme 5:
Understanding Trauma, Reducing Stigma, the lack of understanding of the root causes created a
tendency towards criminalisation and the use of the criminal justice system to address what the
public views as deviant behaviour. However, addictions, mental health, and homelessness were
clearly health concerns based on the views of the participants and supporting evidence.
“Blake” is a police executive in a large BC city. He was very clear that other levels of
government needed to be active participants in finding solutions to these issues. He stated:
Do we need other levels of government? Do we need other agencies to step up and
provide assistance and take some of that burden away from police? Yes, but it is
important to remember that with high levels of victimisation, and some people involved
in criminality, the police will still have a hand in those investigations. Regardless, it is not
like you are going to take all that away from the police. If you can do a good enough job
dealing with the upstream drivers, then hopefully you will have a good impact on the
prevention, so you will have fewer people becoming involved in criminality.

One of his counterparts, “Alex”, a police executive in another large BC city agreed:
We are somewhat struggling because we need other agencies to step up. We need [the
health authority] to commit to providing us resourcing if we want to make a change.
There is a lot of lip service, but not a lot of action, so I hope to have more, a better
approach to mental health that we are trying to start up, but I need [them] to step up.
So, we are actually looking to go more to a car 87 type approach like a Vancouver model
where we have you know, a mental health nurse and police officer.

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Upstream drivers were defined as the root causes of behaviours exhibited by the
vulnerable population. “Blake” was referring to the need to address these drivers before they
manifested in criminality and victimisation. To achieve this, other agencies are required at the
table, well before police intervention, in a broad reaching way. “Sidney”, who is an executive
with an advocacy group for vulnerable populations agreed. Her view echoed the assertion that
upstream drivers needed to be addressed for all people, regardless of their current situation.
This included the need to speak with people from affected groups, including those with lived
experience:
I think there is the issue where the board is saying that we want to serve the more
vulnerable, but actually they do not. They want to serve a portion of the vulnerable and
they want to hand pick. I am saying no, we are going to work collaboratively, but it does
not need to be just this sector. We intersect with people doing sex work, people that are
non-Caucasian, et cetera. We have to include the high representation of folks amongst
the homeless who are like 40% Indigenous people. So Indigenous people have to be
involved in the decision making. If we are living with addictions, those living with
addictions have to be part of the solutions and the harm reduction. It is like you want to
solve homelessness? Ask someone that is homeless. What do you need?
What became evident in the interviews was the identification of barriers to working in a
collaborative manner. Despite the desire of many sectors to work together, perceptions and
siloed approaches often proved stronger than available evidence. “Reilly” is a senior member of
an advocacy group that focusses on the rights of vulnerable populations. She identified that the
current system was almost set up to fail due to pre-established perceptions of what should
happen, lack of coordination, and the inability of vulnerable populations to succeed in a
criminal justice-based approach:
This adversarial system, right, the law? The court system? It is not really designed to
build collaboration. It is like I have my side, you have your side, and now we are going to
fight and see who can make a better argument that does not serve vulnerable people at
all. They do not have access to that system. They do not even use that type of language
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or vocabulary. So now we are just talking about you up here and you are still struggling
down there.
Medical professionals concurred that the current system was rife with bureaucracy and difficult
to navigate for vulnerable populations. Even more troubling was the lack of broad support for
vulnerable people, even if there was a recognised need. “Jules” is an executive at a regional
hospital and stated:
So, when you think of BC housing, there's multiple departments. You have got
Community Living BC; you have got Ministry of Children and Family Development. Now
you have a Ministry of Mental Health and Substance Use, and those ministries do not
coordinate together. They all have levels of hierarchy and administration and now God
forbid add the new First Nations Health Authority. Unbelievable bureaucracy.
Much of the concern was due to the siloed approach in social support networks, even
though a certain amount of this was viewed as necessary. For instance, police have a direct
mandate to investigate criminal offences and the BC Ambulance Service is directly mandated to
provide emergency paramedical service in the field. This is understandable; however, the lack
of organisational or political will for each agency to collaborate outside of their specific
mandate seems to have perpetuated the notion that the agencies should operate
independently. “Jules” went on to say:
Our job is not to address social issues, but quite often we have no other people at the
table for us when social issues intersect with health issues. For example, the person who
happens to be homeless and now needs medical treatment but needs to be discharged
back to a homeless situation. There is no wrap around supports to do that. We are not a
housing agency under our provincial structures. Healthcare is not housing. That is BC
housing and other municipal or other provincial and municipal departments.
“Jules’” frustration was not borne out of a lack of willingness to help, but from the
inefficiencies in the ability to connect urgently with agencies that could or should help. The
hierarchy and bureaucracy were also identified by other participants; however, they qualified
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their concerns with the understanding that people in those ministries and agencies truly
wanted to help, but their mandates were either too broad, or not aligned with other agencies
who could support them. “Drew” is a police executive responsible for provincial policing who
faced similar concerns with his police peers and other participants:
My overall perspective is obviously we want to help people and get them out of that
path. But the reality that maybe what some really well-intentioned people in the
industry do not realise is we can’t just ignore that individual user and say why are you
wasting your time on that one person? They may have an addiction, but when they are
causing that much chaos in the community, we need to do something. We as a
community need to do something. Often it is left to the police because they are
committing crime, right?
While police and health officials have concerns with the current balkanized approach to
community safety and wellbeing, it was telling that their concerns were aligned with advocacy
groups and frontline workers. “Robin” has worked extensively with large police organisations to
increase their understanding of vulnerable populations, including the development of outreach
programs. She agreed that the current system did not have enough intersectionality on an
urgent basis. In her view, everything took too much time:
There is so much that is lacking. I think that is part of why there is no action and why we
sit around tables and we all nod our heads, but this is not working, and although we
should not be doing things this way, it is just so hard to see the next step. There are so
many to choose and so many competing interests, right? I mean, if you think about it,
how do you prioritise one group over another? It is not going to be politically smart to
prioritise people who are considered to be “lesser than” in our society. Our society is
not going to support politicians or others who come forward as champions of those
groups.
“Robin’s” perception was echoed in the experience of “Drew” who provided a compelling
example from a community where he was the Chief of Police at the time:
One day we did an exercise with a number of agencies, be it ministry, for profit, nonprofit and everyone else who were trying to help people, like low income housing,
homeless people. There were 13 separate agencies in [the town] that had housing on
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their mandate. Not talking to each other. All in 13 separate directions, because they are
chasing grant money, they are chasing their own objectives. Why work with you if you
are going to take some of my business away? It is like Burger King working with
McDonald's on a new a new, you know King Mac, right?
“Drew’s” counterpart, “Taylor” expressed similar concerns with the siloed approach to finding
solutions. He is also responsible for policing initiatives at the provincial level after being the
Chief of Police in a large BC city. He stated that many groups were interested in helping
vulnerable populations, especially with respect to something tangible like housing, but there
was not enough cooperation and understanding within the various roles:
And there's certain special interest groups that come in for valid reasons, but oftentimes
their involvement can exacerbate the situations that the police are trying to solve. For
example, we were very open about our plan to clean up the strip, by which we meant
find alternative housing. We were very open right from the start because we knew we
would be in potentially an uphill battle. So, we engaged with [various] groups, brought
them in and told them our plan well in advance. We explained these are the rules we
operate under. We are respecting someone's tent; it is their home. We are not just
barging in, but we are trying to create engagement. I think that approach was very
successful when it came time to actually transition from [the street] to housing.
Another illustrative example was provided by “Clarke” who is a physician involved in iOAT
programs in BC. In his case, the resistance came from within the health agencies themselves:
Well, I can tell you, 20 years ago, when the first [iOAT] study was raised, there were
medical professionals who were openly hostile to even asking the question whether
prescription heroin would be an option. Over the last five years, there is still sort of
quiet opposition, but with this, with the solid evidence, I think we are starting to see
growing allies. Not just among physicians, but amongst the other health professions as
well.
Most participants expressed the view that programs around addictions, mental health, and
homelessness were improving, but there was still a long way to go in terms of developing
effective cross sectoral approaches. “Clarke” went on to say:
I guess ideally moving them to the appropriate system is the way forward. So, if it is the
criminal justice system, and sometimes that is the appropriate approach, but if it is the
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diversion from the criminal justice system to care, and medical care in a sort of case
management team, then we should have those doors available to the police. Yeah, I
think we have had a couple of referrals, so people that the police have taken to our door
and introduced them as this is a place you might want to check out.
“Charlie” is a mental health professional who worked in hospital psychiatric units and in
private practice. He was concerned by the lack of understanding with respect to vulnerable
populations, especially with respect to root causes of behaviours and the ability to engage
other sectors in a collaborative manner:
Most of [my experience] has been related to the dual diagnosis of mental health and
addictions. In that context, I played a key role as the hospital liaison to community
resources, and managing and planning for marginalised individuals, particularly with
mental health concerns. In most cases those also involved addictions or pre-addiction
kind of behaviour. Truly, it is not my mandate, but there are very few, if any, points of
access to them that are effective.
The lack of connection to various supports has societal ramifications but could also lead to
more dire consequences than those already faced by a marginalised community. “Taylor” was
concerned not only with the lack of coordination, but the difficult position police were put in
when they became the first response to crisis medical situations:
They are either threatening self-harm or they become a threat of harm to others and
the police are responding. We have a considerable amount of de-escalation training that
our officers are provided but de-escalation does not always work. Ultimately, many of
our officers are put in a situation where they are going to have to use force to deal with
a mental health issue, either to protect themselves, to protect the individual that is
experiencing the crisis, or the public. It is tragic and oftentimes that ends in fatality or
significant injury.
The issue with reactive only approaches is that they often come too late. “Blake” expressed
similar concerns:
It is [co-responder] good for that type of call, but the ones that I am more interested in
are the calls like where we have got somebody that has been shot by police. We have
had already two officer involved shootings this year. Both, but one more so than the
other, had a huge mental health component to it. Police had to unfortunately shoot this
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person that was charging at them with a sword and going to kill a police officer. So that
will have to be investigated but let us back it up six months. How did that person get to
the point where they are naked, standing in the middle of [the street] covered in blood,
smashing up windows, running around with a sword completely out of their mind? Like
how does that person get to that point? So, [the mental health car] is going to do
nothing for you at that point.
The tragic consequences of poor collaboration were a primary concern; however, expectations
could also come into play when assessing the role of police in dealing with vulnerable
populations. Police leaders and front-line officers agreed that it was often difficult to balance
community expectations with the time it took to respond to so many occurrences, many of
which were either outside of their mandate or required collaboration to resolve. “Taylor” went
on to say:
It drains police resources that should be directed to other areas. The police do not
necessarily have all the training they need to deal with those areas and those issues, but
we are kind of left holding the bag. If there is an issue that a member of the public sees
or that is being experienced in an area, everybody knows the phone number. It is just
911 and they know someone is coming. Does not matter if that person is trained or if
they are engaged, somebody is coming, some representative, some third party is coming
that will then be left to try and deal with that issue, and the amount of time and
resource drain that creates is incredible.
“Avery” is a senior police officer who, at one time, worked under the command of
“Taylor” in the same large city. He was directly responsible for interacting with a growing
homeless population, many of whom suffered from the typical hallmarks of mental health and
addictions. He saw first-hand the effects of these afflictions and wondered why change was so
slow to come, despite the growing crisis:
I think that as we move forward, we need to start to address the underlying issues,
right? We need to start, and I think we do. When you look at a serious gang squad, they
are starting in schools and they are having these conversations with people. And I think
you know the school liaison officers are in the schools trying to establish those
relationships. So, I mean, I think we are working that way. But there needs to be more
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collaboration, 100% more collaboration within our own house and with the health
authorities.
Despite the consensus that collaboration was lacking, all participants recognised that
things were improving, albeit slower than they would like to see. Much of their explanation for
the slow pace of change dealt with political will and investment. As front-line workers, medical
professionals, and police officers, they identified the steps that needed to be taken to move
away from a punitive approach; however, in their view, this required large scale collaboration,
even to the level of legislation. “Skylar” is a director in an advocacy group that focusses on
supporting vulnerable populations, particularly marginalised women involved in the sex
industry. She expressed the need for increased outreach as a building block for change:
What are the responses needed for these people? What is actually happening? When it
comes to policing, and no housing, and gentrification, what is happening to them is
much more difficult to pinpoint. People living in this reality do not just have one
response. So, what does safety mean to you? I know we are unpacking this one thing at
a time. We can discuss all of those things too, but having mobile units and foot
outreach, community-based teams, [Emergency Medical Services] prepare for a
multitude of issues right now is really important to me, because I do not see any of
these issues going away any time soon. And, what is the police role in all of this?
“Skylar’s” concerns were echoed by “Reilly” who questioned why police had become such a
primary response to societal issues, as opposed to support:
In some ways, in some small ways, I empathise with police because I think they're the
only agency that's available 24/7.They're the only ones who can do certain things. You
are dealing with, like, the end of the line in terms of every other institution failing
people, but at the same time I do not see the political will from police, RCMP, municipal,
provincial, federal to actually distribute some of their massive budgets to communitybased safety initiatives.
Participants in this study agreed that the primary role for police was public safety, but
that this had shifted so far into responding to mental health, addictions, and homelessness

77

matters that it would take time to achieve any kind of redistribution of efforts. As “Skylar”
stated:
People say that if someone is screaming and yelling, we do not know if they have a
weapon, we do not know who to call [other than police]. And it is that pigeonholing and
social profiling of this entire community. Unpacking this is going to take a while, but I
think what the role [of police] is, it is responding to immediate safety and harm and
then assessing when they get on site to wherever they are with the person. I am
wondering if they had the resources to call the nurse or doctor to send them in? I do not
see a lot of people opposed to the initial assessment of safety in the area.
Defining how to deploy police resources in support of vulnerable populations was also
identified as a challenge. Although all participants agreed on the primary role of the police, they
recognised that the requirement to connect vulnerable people to services unfortunately often
defaulted to the police. “Jordan” is a front-line police officer in a large BC city who is tasked
with outreach to marginalised populations:
I think we have missed a whole bunch there. There are people who have probably been
in places like [rundown single room occupancy buildings] for I do not know, like 8 to 12
years and they are stuck. You got your house, you are done. You are off our radar. We
do not care about you…we all do it. We all drive the [police prisoner] wagon for a while
and then we get out on the street, right? So, there is that buy in, and I just I thought,
man, you know it would be nice if we connected because then we would have people in
that mid-range who still have a chance at, you know, making something out of their life
for being in a nicer place or a better place, a healthier place.
Once again, the question was one of who should respond, or in the case of 24-hour
response, who could respond in an appropriate manner. This often revolved around the ability
to arrive in a timely manner. “Skylar” spoke about the benefits of ACT teams, but pointed out
they were limited when time may be of the essence:
And ACT teams do not respond straight away. That is the thing, it sounds great, but they
do not have the resources to be a response team. We get participants who are working
on [a major road] saying, I think I am in trouble. I am scared. They have to go find them,
but they are not emergency response. So, they are on the phone with them.
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Participants agreed the solution relied on identifying who was responsible for specific aspects
of societal issues, but not in a siloed manner. Responsibility, in their view, did not mean any
particular agency was on its own, it was simply a recognition that certain agencies were better
suited to move towards an effective resolution to a problem, contingent on collaborative
support. As “Drew” stated from a police perspective:
Use what you can in your own community as a multisectoral effort because we do not
own mental health, we do not own homelessness. But we are a piece of the pie, right?
You have to contribute, but that can be the hammer and the hug if you will. The
hammer is we just charge, charge, charge and force our way out of that issue. Or the
hug where you try the wrap around approach. We try to get everybody to understand
that person and why they are in that state, and how can we try to help them.
Throughout the interviews, examples of successes were offered as the way forward in
building collaboration. Police participants often stated their initial willingness to cooperate with
other agencies was a key component of building a collaborative relationship. In other cases,
supporting agencies wanted to help, but they did not have a direct connection to specific
vulnerable populations. “Avery” again used an illustrative example of successful collaboration
with a large homeless population:
And then we looked at [the health agency], right? I mean, the biggest piece of the puzzle
here is addiction, mental health, and crisis. As a police officer I can deal with that and
we are incredibly good at dealing with, maybe deescalating, in the moment. But we do
not deal with the underlying issues whatsoever, so it was most important establishing a
relationship with them…so one of the things that we really needed to look at was
collaboration, because we had never done that. We had always worked in a silo. In fact,
I can say we had an almost acrimonious relationships with a lot of the social services
down there.

“Avery’s” counterpart “Jordan” had a similar example in another large city with a different
health authority on the importance of maintaining relationships and collaboration:

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It is not just treatment, it is not just getting you away from the substance, but it is what
next? Because what are you going to do? You are going to come right back down here
again. The ministry is paying for it while you are at one their facilities, but there needs to
be more like a planning and staged approach. So, detox needs to be planning for
recovery, and recovery, while you are in there, needs to be planning for your next steps
like your second stage housing. There are a lot of people down here who are ready to go
into something like that and can manage their housing by themselves and can do things
like that. Free up some of the sorrows.
As a recurring substantiation of the need for increased collaboration, “Blake” and “Avery”
offered approaches to working together across sectors. In “Blake’s” view:
Hey, we need way more of it. I think that we do need more coming in from the
healthcare stream, but I do not agree with this idea that police should be totally
eliminated from it because I think we add a lot of value to it, right? I do not think it
should be our main bailiwick, or that we have to take the lead on it, but I am happy to
be secondary on it. We need to be part of that conversation with health, and if they are
going to come in and take on more of a role, which I would love to see.
“Avery” worked with a health authority in a different city and echoed “Blake’s” approach,
especially in terms of gaining support from other social service organisations:
We started to really see that there were some holes in the way we were
conducting business, so it was always about re-evaluating what we are doing.
We committed to a course that we developed with [the health authority]. They
were phenomenal.
“Avery” went on to say:
The number one thing I needed to do it was actually just start to actually listen instead
of talking. So, I established kind of this core working group. I worked with a local society
which was our biggest social service provider down there. I went to them first and got
buy in from them. I went to this urban mission and got buy in right away from [them].
Then I looked at other faith-based organisations. We had some other faith-based groups
down there that were always feeding people, so we talked to them about establishing a
relationship.
Participants agreed that effective collaboration required a new approach to
destigmatising vulnerable populations. Most participants agreed that simply forcing someone
into treatment or insisting that they become “clean” was an outmoded approach to people who
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were actually suffering from a recognised illness. Many participants expressed their dismay at
the societal belief that addictions and mental health illnesses, particularly those manifesting as
homelessness, should be dealt with harshly since they were viewed as a choice, despite
evidence to the contrary. “Blake” provided an example of how compassion and understanding
of the actual illness could change the
trajectory of a person, either newly experiencing substance abuse, or with a lifelong history of
social
disorder:
If you are 55 years old and you have been using heroin for 35 years, there is a very low
likelihood you are ever going to get off heroin, like very low. That is the way you are
going to be for the rest of your life. And the healthcare professionals know that. The
doctors know that. They tell me that. So, for that person we have to do something
different than we do for the 18-year-old. That person needs to be on drugs the rest of
their life, so let us get them under a medical regime prescription. Whatever it is to help
them have a better path in life. The 18-year-old? Let us go full out to full on recovery
treatment. And you know this person, the 55-year-old, they never have to go into a
treatment bed. We just need to get them on a track where they come and see us, and
we get him on track. This person we need like acute intervention. And let us save this
18-year-old before they become the 55-year-old down the road or dead before that.
The perspective offered by “Blake” was shared by other participants. From an advocacy
perspective, “Robin” explained the futility of using the justice system to resolve social issues.
She stated it simply created a cycle of disorder as opposed to actually addressing the root
causes. While this may appear to work on a response basis, it did little by way of long-term
intervention:
It is a cycle; it just simply continues. Like the no go rule is one of the most ridiculous
rules that we would see for [vulnerable] people. Their dealers and their support services
are in a particular area, and then we say no, you cannot go in that area for the next year.
I guarantee that person is going to breach that order, so you are creating more things
with which to criminalise people. So that person is just going to try to avoid police more,
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which makes them more vulnerable in the community, and it does not address any of
the issues that the community is actually most concerned about.
Participants agreed that alienating vulnerable populations from their support systems
created additional problems over and above what justice approaches were trying to solve in the
first place. Police participants agreed that creating adversarial barriers to interacting with these
populations separated them from their primary mandate of public safety and further
exacerbated the community concern with crime. To address this dichotomy, “Avery” stated:
So, we actually did something very unique…. we brought all the homeless people into
one area and had a 24-hour police presence. The idea behind it was to assist these
people, fast tracking them into services if we can, and then also protecting them. What
we were seeing is these drug dealers would come down there and they would assault
these people. So, we actually went about finding all these other encampments and
inviting them to the [street]. And we did. We ended up having about 95 tents and a little
over 200 people living on the street [under our protection].
Using treatment approaches as opposed to a criminal justice approach was viewed by
participants as a recognition that illness could not be resolved through enforcement. While the
police executives interviewed stressed this repeatedly, evidence continued to build on the
front-line. Similar to “Blake’s” example, “Kennedy” saw the change in an otherwise incorrigible,
yet marginalised individual. At the time, “Kennedy” was working as a police mental health
liaison officer with an ACT team in a medium sized BC community:
He was prolific. He burned out an entire building, but when he was on medication, he
was fine. He was housed. He kept everything together. He did not bring anybody to his
house and the voices were not talking to him, but it comes down to that support. The
ACT team gave that support…We were able to kind of swing him back into the right
place and he stopped committing crime. But now, he is completely off the rails after he
lost his housing. He has got no goes to just about everywhere right now and he has just
completely all gone off the deep end and it is so hard to watch it. I do not think that
[police] have enough manpower to be able to fix that problem by themselves.
Community supports like the ACT team, as well as proper places, that at the moment
that they need to get clean, that place is available. I don't have to tell them that you will
be homeless for another month because I lost that person at that moment.
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“Kennedy” offered a good example of the effectiveness of co-responder models as a
means towards collaboration. The research indicated that ACT teams were more effective in a
proactive as opposed to reactive manner, with coordination between police, health, and social
services agencies viewed as a net gain. For instance, “Charlie” explained the value of being able
to deal with an emergent situation through a co-responder model, with each part working in
concert with the other:
I think they have to be brought together [to the scene], I mean having mental health
workers going out with officers, recognising the immediate situation. I mean obviously
the safety of the issue for both the public and the individual is often the first response.
The first level of assessment. Then what is the need of the individual at that point? I
think that is where there needs to be alternative ways of managing situations by
assessing the mental health risk and identifying alternative ways to move that person
into supportive services if that is necessary.
Co-responder models were effective, but they did not always need to be police led. As
the research indicated (Norris, 2019), the presence of police at a situation may have a
detrimental effect if not managed properly. “Skylar” stated that other agencies could be equally
effective if there was not an immediate need to address safety concerns. Similarly, “Reilly”
offered the importance of recognising the lived experience and trauma of marginalised
communities with a view to developing responses that were not “one size fits all”:
Yes, so for the co-responder model, I think the concern remains the involvement of
police and the delivery of what is clearly becoming mental health services. So why are
police attending those calls with someone else? And I think on top of that, it is very
dangerous to assume that the mental health system is safe in many ways. We know
there is a provincial enquiry that took place around anti-indigenous racism and
healthcare institutions, so that is a huge piece of it.
Despite “Reilly’s” cautionary advice, all participants recognised the need for increased
investment into collaborative approaches. Police executives were primarily concerned that
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there was not enough collaboration, often resulting in the need for police to take the lead.
Although co-responder models were effective, when used specifically within a social disorder
context, such as when they stem from a 9-1-1 call, they could become overly reactive. “Blake”
articulated this well:
You know it frustrates me when I see people toting a car 86 or 66 or whatever you want
to call it in your jurisdiction, like this is something leading edge. Partnership cars with
police and mental health nurses? We started doing that 1978. That is nothing new.
Doing it forever. The Americans are hilarious because, you know, they come out in 2020
after George Floyd. Oh look, now we are doing these partnership cars. It is important, it
does an important job, but it is reactive, so you are waiting until somebody is having an
episode, somebody is in crisis. Somebody calls 911, we need the cops, and we need
health professionals.
When asked about the way forward in addressing collaboration, all participants agreed
that communication between government agencies, support services, and the vulnerable
populations themselves was key. That last component was echoed throughout the interviews.
In the view of the participants, the urgency to address the social issues of addictions, mental
health, and homelessness often created the situation where solutions were proffered without
speaking to the very people who they intended to help. For instance, “Sidney’ expressed
concern with not respecting cultural needs when developing solutions:
It is unbelievable that we do not think about these things globally. They are all separate
siloed decisions. What about the First Nations courts, right? We want diversion, we
want restorative justice, and we want traditional cultural ways. There will be times
when incarceration is needed. There will be times when apprehension is needed. But we
need to build the capacity. In some areas of this country, First Nations reserves have
said they want to self-govern. They said we want our own child protection and the
[Federal] government in their wisdom said okay, here you go. They had no capacity, so
they fail because how can they take over?
There was consistent agreement in the need to build capacity and create investment.
This was brought out extensively in Theme 4 that discusses the need for significant investment
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and resources; however, collaboration does require a broad approach to providing service. As
stated by “Taylor”:
I think you need that continuum of service. You need to have the ability to react for
issues that are coming up right away, but I think you need the stakeholder engagement.
You say we are one cog in this wheel in terms of how we manage these problems. We
need a commitment to actually address the issues, not only just from an individual
agency or stakeholder point of view, but also in terms of backup, research, funding, and
commitment. What is our collective approach? Who owns what piece of the pie? How
can we information share? Work together to deal with these issues? I think that is the
best way to go about it.
Coordination of effort was a key point of agreement among the participants in this study.
Advocacy participants agreed that community partners needed to share information and work
together towards a common goal. While they may all have that intention, barriers, such as
funding, created situations where they needed to be protective of their own program. While
this is in part funding related, it is also a function of existing laws and policies. “Robin” pointed
out that existing legislation created barriers that could only be rectified with political will and
funding:
But yeah, we need a different solution, but we also need to look beyond simplistic
interactions to critically examine those laws that are in place. Fundamentally we need to
look at support, both financial and political support.
“Skylar” agreed with the need to move forward with solutions:
How much does it take to undo 50, 60 years of trauma for some people? …There are all
these recommendations in every single report that is almost based on advocating to
provincial and federal governments…If I see one more gender-based violence report
that has all the same regurgitation of the recommendations that were never met? That
is there too when you look at the mental health reports …but these recommendations
actually have not been met due to administration changes, due to shifts in policy, due to
pandemics. It is about is coming together and looking at the answers that are already
there.

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Participants stated that collaborative efforts needed to move beyond good intentions
and a desire to help into a concrete, government-led action plans. Participants in this study
recognised that good intentions alone cannot solve a very complex situation that requires
coordinated, multi-faceted approaches. “Charlie” came at this through a treatment lens:
There is no one size fits all that is right. Every region, every area probably needs to be
handled differently, although some of the principles are the same right? But yeah,
everybody needs something that uniquely fits who they are and what they are dealing
with. How much of their issue is mental health versus addiction, and all of those things
even plays a role in deciding what a person needs. I think of greater coordination of
services too. Communication between key players and parties, but I think that has
always been an issue…I understand there's other things that are high priority too, but
somehow, we have been very short sighted in letting these things continue to slide.
Participants agree that building collaboration took time, but the seriousness of the situation
required an urgency in the development of effective partnerships. “Blake’s” experience as a
police executive highlighted the need to move forward with urgency:
Yeah, so I think a lot of people have good intentions. I think a lot of the discussion that
has been happening over the last year in particular resulted in a police focus. I think
health in many cases was a silent partner, but the way that we have dealt with it here in
[this city] is that our relationship with [the health authority] right now is outstanding. It
was not always that way. We have built those relationships over time and we have a
program which is regular meetings between police executives, the police board, health
executives, and [the] health board. So, you know I was getting tired of going to these
meetings where you have got some manager, or some director, meeting with an
inspector and then they talk about these things, and nothing ever happens, and it gets
stalled in the chain. We need the chair of the board there and we are going to sit down,
and we are going to give some presentations and we are going to make decisions right
in that room before we go…we talk about these things and we get the decision makers
there and then. Yes, it is improved.
Participants agreed, regardless of their background, that siloed approaches needed to
be set aside in favour of solutions that examined the overall wellbeing of the individual and the
community. They agreed that current approaches needed to develop beyond individual

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mandates to one where doors of support were opened, regardless of which agency initiates the
discussion. As “Jules” aptly stated:
If I was king for a day, I would make a proclamation that nobody will die in the province
of BC alone, or with addiction, without us actually being there wherever they are at to
support them. If we were to have done [what was done for COVID response] with
mental health, we would be saving lives. It does not mean we are not saving lives now,
but we are not saving enough.

Theme Two: Barriers to Community Wellness
The need for collaboration was emphasised by all participants, so the question was why
is it not more prevalent in communities? When asked this question, participants pointed out
the need for funding and increased resources. Secondary to funding, societal expectations and
a lack of political will were reported as significant barriers to building community wellbeing,
particularly in vulnerable populations. Concurrent to this issue was the sheer amount of work
that needed to be done, which was expressed by most participants. “Sidney” summed up the
overall sentiment for this theme by stating:
We all know what has to be done, so why are we not doing it?
Most participants agreed with that statement, answering the question as a function of
workload. Police executives were clear that an inordinate amount of time was spent on noncriminal and non-chargeable calls for service, which was backed up by police reported crime
data, as presented in Tables 5 through 14. Although they recognised that call volumes are not
necessarily indicative of overall workload, they stated that every call for service for social issues
took up police time that could be otherwise allocated to more serious community safety issues.
They stated that criminal offences took longer to investigate, even when they did not lead to
charges. In the view of police leaders and front-line officers, their time should give priority to
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criminal and chargeable offences, as opposed to social issues, even if they were less time
consuming. “Alex” described part of the issue as follows:
We arrest [him] every single day for SIPP (State of Intoxication in Public Place) and we
are begging the health authority to help us. We are getting nothing, so you know, he is
going to die in jail, and we are going to bear the responsibility. It frustrates me to no end
that there is no accountability. It is left to the police to manage someone who is truly in
a health crisis, until you only punch somebody on the street and then we have to go. So
yeah, I think health as a support services needs to be held accountable
Other police leaders expressed similar frustrations with the distribution of workload. “Blake”
stated:
More and more time is spent on issues that are non-criminal. You know that percentage
will vary from 25%, 30%, or 40% depending on the agency or bona fide Criminal Code
offences. The rest is social issues we are dealing with or things that will have a nexus to
social issues. The percentage of calls that we deal with that have a nexus to mental
health and addictions is high. There is also a high number of people that are from
vulnerable populations that are much more likely to be victimised, I think.
Many of the issues with workload were expressed as resulting from societal expectations.
Police leaders felt beholden to the current system, since there was no one else to do the work
in the first instance. “Taylor” put it this way:
We cannot avoid coming. You know, if someone picks up the phone and calls 911, we
are coming. We are obligated to attend and then once we are there, to disengage if it is
not a police matter is very challenging, right? If there is an apprehension in the middle
of a call, we cannot leave that individual alone until a doctor actually signs off on them,
right? So that could mean waiting six hours at the hospital to get that person either
signed in or apprehended medically, or just turn around and released through the
revolving door. It creates, and I am just saying this in a general sense, potentially a
reluctance among police officers to apprehend or to deal with the critical issue of
mental health because it is going to take up half their shift or even longer, and by and
large, once they do go down that process, that individual is not treated but released.
Why am I bothering to deal with this crisis?

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“Drew” expressed the concerns from the front-line officer’s view as well, indicating that
workload often prevented effective response, even though mental health should not be a
primary police response:
Do I have three hours to deescalate you, or do I have to do this in three minutes? That is
a barrier to doing an effective job, and that I am sure that does happen, knowing the
demands that are out there. So, the barrier is lack of time to effectively deal with some
of these situations as well. Even if there is not an emergency going on, knowing that I
have to get back to the office and do this report to Crown because I arrested someone
earlier in the shift.
The frustration was not just on the part of police, but by medical professionals as well,
who thought there was a link missing in the system between health approaches and
accountability for responding. As “Jules” stated in his hospital executive role:
Our mandate is not with social issues, our mandate is health and quite often many
people confuse health with social issues. I will give you an example. At times you know,
municipal leaders do not understand how the health care system can actually turn
people away from the emergency department who have terrible social issues. While we
have social support for them like social workers, if there is not a bona fide medical, or
emergent or urgent medical issue, particularly around hospitals, we cannot hold people
against their will, and I think that is a real big misunderstanding.
The concept of missing linkages was echoed by “Blake” who expressed the need to develop the
political and agency will necessary to assist those in need, while building collaboration on the
front-line:
It can happen if you get the right decision makers in the room, but the big barrier is
going to be money, so a lot of these programs could be even better than what it is now
if we had more police involved and more health involved. People say, well, why do you
need the police? Okay, you could try and do it without the police. The reality is that a lot
of these cases, these mental health professionals are not going to go into these
situations without the police. They actually like having us. We were in plainclothes and
we put officers in there that are not like grunts. We put officers in there that are very
thoughtful and talk to people. You cannot tell which one is the cop, which one is the
psych nurse, and they just talk to people, and you know, schmooze them and have
respectful conversations with them. And it works great, just like anybody in society.
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Although workload was expressed as a significant barrier, the lack of funding to break
out of siloed approaches was considered problematic by most participants. This was
compounded by a lack of understanding of budgetary delegations to the police and the time it
took for investments to come to fruition. “Blake” went on to say:
I know everybody keeps talking about defund the police. Take the money from the
police is not about taking money away from the police, it is about we all agree that we
need more money in this area. Over time, if you have enough of an impact that you are
affecting those upstream drivers of crime and we need fewer police then so be it. But
right now, you cannot, in the current system, hold the money from police and think you
are going to put it over there. Maybe not a full generational change, but close to it. Like
you probably have a full decade, at least, till you are going to see real results here. But
you need an infusion of money on the health side is where you need it. That to me is the
biggest barrier right now.
Taking money from the police and putting it towards social issues was mentioned by
several participants. Police leaders and front-line officers believed this approach was only
applicable after significant investment in social and health supports to lessen the upstream
drivers mentioned by “Blake”. “Alex” agreed by stating that the issue was compounded by the
availability of response. He was amenable to effective distribution of funding; however, he
stated in the current system, the only response was by emergency services:
So, you know, I think we have done ourselves, no not we, the community a disservice by
some of the rhetoric that has gone on about, you know, not trusting the police and the
police present evil. Every police officer I know truly cares about trying to find, and help,
and support individuals. So, because we are 365, 24-7 we will often be that first
connection for an individual.
How those connections are manifested was a recurrent issue for all participants. They all stated
it was difficult for a marginalised person to access supports without coming through a
government agency, particularly the police. Although this will be covered further in Theme 4:
Investment and Resources, it is important to note that lack of funding has created a significant
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barrier to effective support. “Clarke” has had experience dealing with various governmental
levels:
Funding, yes, the barrier is provincial. Health Canada has changed the regulations to
allow expansion [of iOAT]. That was ten years ago, but the barrier now is at the
provincial level of funding.
The whole discussion around the lack of collaborative support for addictions was best
summarised by “Clarke’s” views of the Four Pillars approach to addictions that seeks to address
harm reduction, enforcement, prevention, and treatment:
The pillars are not adequately funded. So, there is not a four-pillar approach. It is a fourpillar idea that has not quite been realised.
“Jules” went further in expressing the need for increased examination of funding allocations at
the provincial level:
You know what? Do I think there's money in the system? Oh yeah, we have a $2 billion
budget. There is money in the system, but the layers of bureaucracy are always there.
We are in healthcare; we are extremely risk averse. We do not want to look bad, and we
want to look good, so this plays out that nobody at times can make a decision, even
though they know better.
As mentioned in Theme 1, collaboration across sectors was often hindered by
competing interests. In particular, police leaders found it difficult to navigate various agency
mandates in terms of connecting vulnerable people to supports. “Drew” provided an example
for a medium sized BC city:
I can tell you I have found that in [the city], there were two competing factions within
the health industry. There was the health authority that was all about harm reduction,
and there was a group of private individual businesses that constructed a facility outside
of town. It was all about abstinence, none of this harm reduction stuff. We fed a lot of
people into the abstinence path, but also had to manage the health authority’s harm
reduction path, right?

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“Jules” agreed that competing interests were troubling and went further to describe it as
bureaucratising addictions and mental health to protect specific agency agendas:
We bureaucratise addiction. This is a very strong word, but I am going to use it. We
bureaucratise addiction and mental health to a level that is incomparable to other areas
in healthcare. So, for example, we have a special ministry and I have to tell you, when I
heard about our new Ministry of Mental Health years ago, I said oh no, oh no, another
layer of bureaucracy. Bureaucracy. They are the most bureaucratic system.
“Jules’’” concern over treating addictions and mental health in a different manner than other
health care issues was significant. It spoke to other concerns raised by participants in terms of
access to supports and a frustrating siloed approach to carrying out individual agency
mandates. Many participants expressed this frustration, but also recognised that there were
solutions. For instance, “Avery” recognised that there were issues with the separate mandates
and worked to build collaboration:
Obviously, as we progressed, we started to see major flaws and I guess the way we were
doing business it was not great. But now we are working with the social services in the
area, and it was great that we were actually trying to bridge a lot of these gaps that we
have had forever. We started to see, to realise our own members themselves need
advanced training too. The biggest barrier is when you, as a policing agency, believe you
only have one little job, and you are not going to work with other people. So,
collaboration became probably the number one reason that this worked.
While “Avery” saw barriers removed by recognising that front-line workers could
collaborate at their level, police executives agreed on the need for more high-level
collaboration, both in terms of decision making and legislation. When asked about this aspect,
“Blake” articulated the need for high level steering groups to ensure individual agency
mandates do not interfere with each other:
Stop talking about this as an issue where we have homelessness issue, or a mental
health issue, and addiction issue, and we got a committee for this and a committee for
that and a committee for this…It is about community safety and well-being. It is about
dealing with people in crisis, whatever it is, but they are going to have more than one
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thing going on. They are going to have a lot of different things. Often all three
[addiction, mental health, and homelessness], and I often throw in poverty. Throw in,
you know, they were abused as a kid. There's childhood trauma and they have got
criminal issues as well. You need definitely a holistic approach to these things, right? Do
not pigeonhole it. And even in [the health authority] they admit it. And I remember
early on in these discussions five or six years ago. You would meet with the addictions
doctor and then you would meet with the psychiatrist and they would both give their
own view of the world. This guy [doctor] was trying to pull money from this woman
[psychiatrist] and this, like vice versa, they were tugging on the same dollar.
One of the critical barriers resulting from the lack of a high-level approach to directing policy
and collaboration was the issue around information sharing. Police and medical executives
agreed that working together was often hampered by a lack of understanding of privacy
legislation. In their view, the wellbeing of an individual or a group superseded legislative
restraints on sharing information. As “Blake” explained:
Partnership and then sharing the data, the information, because it is so intrinsically
linked. Its huge, but so there are barriers of the data sharing, but they can be overcome.
There's information sharing agreements that have passed the scrutiny of information
and privacy commissioners, and they have given their blessing.
“Taylor” agreed:
We have the [Situation Table] which is a team approach. You know if you can work
through the privacy impact assessments and the information sharing, that I think assists
in the broader collective approach to deal with the issues. So, I think they did that very
well in terms of working through those agreements, and also building the relationships
among the different agencies, so that you would have comfort in sharing that
information and get a great job on that.
Police executives agreed that the lack of direction with respect to a collaborative, cross
sectoral approach was a significant barrier that could be overcome through high level
coordination. The concern over information sharing was an example that had been addressed
in their view by BC privacy commissioners. The issue was not just between government
agencies, but also in the advocacy and support realm. As “Sidney” suggested earlier in this
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paper, “everyone knows what needs to be done”. She further stated it was frustrating to have a
lack of clear, coordinated direction towards working collaboratively:
I am really struggling with the direction the board is going. There is some people in your
team that, you know, do not buy your philosophy right…and so our board, I think, is
taking a more operational approach because I press send on a grant to help with the
exploited and trafficked girls, but that is not sexy. They want to serve Caucasian women
with black eyes and their arm in a sling. In a pink dress and holding the hand of a child
with a teddy bear.
Perceptions of the community were also cited as barriers to a lack of coordinated vision
for cross sectoral approaches. A good example of this was presented by “Robin” who expressed
the apparent need for retribution in today’s society as opposed to a health centred wellbeing
approach. She felt this was especially difficult for police who often bear the brunt of society’s
desire to eliminate what are viewed as deviant behaviours:
I think that the law itself is deeply problematic. I think it is set up this really polarised
kind of perceptions on things. I think we have criminalised activities without logical
reason behind criminalising them. Instead, we got a fairly moralistic kind of perspective,
and we have done it from this perspective of retribution, and these ideas that policing
and criminalising people can stop social problems. There is no actual science behind any
of that, so I think that the law itself, as the structural frame in which police are forced to
work, is one of the really big issues here. I also think there is a really important
economics factor. You know if we are having trouble providing resources to people who
need those resources, then people are going to turn to illicit means to meet their needs.
Participants in the advocacy group felt the law and perceptions created significant barriers to
allowing vulnerable populations to exit from addictions and mental health concerns, either due
to the actual law or supporting policy: “Skylar” stated:
There are so many restrictions and red tape where sometimes it felt exploited even if
the intention was not. My managers and supervisors were amazing. So were the social
planners at work, but it was really hard when the community has very hard lines on
what had to happen and it is all compromised, right?

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It was felt that the perceptions of the community drove political response to these social issues,
to the point that they did not receive adequate funding. Without the political will to address
the issues head on, “Robin” felt the lack of clear goals made it difficult to move forward:
There is something that the law plays a really important role here in creating barriers to
people, but I think part of the other problem here is we do not really know what our
goal is. Is our goal peaceful society? I do not know if we all agree that is our goal, you
know that would be lovely if we all agree on that. I do not think we are there. I think
people keep throwing the word justice around without really thinking about what
justice really means to different people.
“Reilly” agreed that without concerted effort and will on the part of government, progress will
continue to be slow:
A huge barrier in meeting our mandate is lack of government will. Even at our most
effective, we are still subject to the barriers imposed by law and policy. I think it is very
clear around, for example, drug policy and substances. We have been advocating for
decriminalisation from the federal government and I think that we are an effective
advocate. Our agency is able to really have a strong voice, but if there is no political will?
Perhaps the best explanation of barriers was provided by “Robin”, who stated:
Man, that is where that political, ideological, social aspect of it comes in. Ultimately, this
is politics. Your politicians are not going to stand up and say something they do not feel
there is support for. Law and order agendas win votes. Hence the system continuing to
be the way it is.
Theme Three: Redefining the Role of the Police
Throughout the participant interviews, the definition of the role of the police in
addressing the concerns of vulnerable populations was a clear focus. Police executives in
particular felt the criminal justice system has been used to ill effect in attempt to address
complex social issues best addressed though coordinated pathways to care. Their views were
echoed by the other participant groups, all of whom agreed that police have a role in
addressing these issues; however, that should be more in a support capacity, except when
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criminality is present or public safety is at risk. This theme did not touch on the notion of
defunding the police but examined the role of properly funding partner agencies. In the view of
the participants, if that meant an eventual stabilisation or decrease in police funding as a result
of decreased calls for service, that could be a good long-term result.
Simply reallocating funding from the police in favour of social supports without properly
funding those supports was not recognised as an effective strategy. Police executives and
frontline officers were quick to point out that they would appreciate being used less for social
issues so that they could concentrate on higher level criminal matters. Advocacy participants
agreed. “Skylar” put it this way:
I worry sometimes about the way it is going. Did you want no police? Let me understand
this. When you ask a lot of people who do not understand the defund the police
movement; what exactly do you mean, that society is well enough and well behaved
enough? And that we have the capacity to police ourselves? Because that has never
happened, and it never will. I think having those conversations even within my
organisation have had some people who are bit too adamant about this. They need to
understand in their own personal world what they would need and stop “othering” the
people we serve as if they need something different, because their safety is the same.

“Skylar’s” views were indicative of the views of other participants. “Blake’s” experience allowed
him to see changes in the approaches to vulnerable populations that are starting to see
progress in de-criminalising behaviours by addressing root causes of social issues:
If you look strictly at what the role of police is, it is the things about preserving life and
property, crime prevention, public safety, law enforcement, all the traditional kind of
roles. But over the years, what I have seen during my career is that more and more
emphasis has been placed on dealing with those upstream drivers that do impact public
safety or do impact crime, people in crisis.
“Blake” explained that a significant portion of police time was allocated to dealing with social
drivers or what he called upstream drivers of behaviours. Other police executives agreed that
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these upstream drivers needed more focus from a collaborative lens, not just by using police
response capacities. Much of this was attributed to the deinstitutionalisation of vulnerable
people without the necessary community supports:
We did over-incarcerate or over-institutionalise people with mental health issues. There
will always be people that should be institutionalised that are, you know, just a danger
to society, like highly violent that you cannot control. But there was more people,
probably, in that setting than needed to be. So, the idea of getting them out in the
community, and making sure their medication [was used], making sure they were
getting supports, mental health professionals meeting with them, all that was good in
theory but didn't happen in reality…over the 90’s we really saw the number of
interactions we were having with people increase dramatically.
“Alex” had a similar experience in his policing career and, in his executive role, expressed his
frustrations with the reliance on police to deal with social issues as opposed to the agencies
that are better suited:
I would like to find some better approaches for social disorder in regard to how do we
better work with our courts and our justice system with the people who are committing
the [low level crime]? We are getting no response. Or the theft from autos who will
commit crimes ten times a day to support an addiction. We are not fixing it. So, for me it
comes down to the accountability and that is one thing I have been advocating for. We
will do everything we can to help you, but at one point when you are not taking that
help, there has to be a level of accountability. We rely on external agencies or the
criminal justice system to provide that accountability and I would argue, for the minor
crimes like that, they do not.
“Blake” expressed the same frustrations in that police were viewed as the easy route to deal
with concerns that were better suited to other agencies:
So, nobody was prepared to deal with it [mental health]. The health system was
overwhelmed with that, so consequently we get calls when those people, in some cases,
commit crime, or if they become suicidal, or they are yelling or screaming in the street,
or having an episode, or people just are not sure what to do. We have somebody in our
business who will not leave. There is somebody strange walking down the street. I am
not sure what they are up to. You get all these suspicious person or suspicious
circumstance type calls, you name it. Just so many things that will come across the radar
of police that we respond to…and that burden becomes very heavy on police, not just
here but in Canada.
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The expectation that police will respond to issues clearly related to addictions or mental
health has, in the view of police leaders, become mainstream. Since there are insufficient
supports for vulnerable populations, “Taylor” argued that police had no choice but to respond,
even if they are not fully equipped or the appropriate agency:
Like I said before, it is very difficult to disengage, and at some point, particularly with
mental health, if you can't secure a voluntary apprehension…if you can't deescalate the
situation and secure a voluntary apprehension, there is going to be a physical
confrontation at some point…. It can escalate incredibly quickly, right? By virtue of the
nature of all the gear that we carry now for protecting everybody, whether it is carbines,
or Tasers, or firearms, or batons, or pepper spray, they are going to be used at some
point if the threat level escalates. That is the training, that is the response; and that
really presents the challenge. So, the more focus we can have on de-escalation, and
avoiding unless absolutely necessary, any use of force, I think the better off we are in
dealing with those situations.
Police leaders recognised that they had a role with respect to dealing with persons
suffering from addictions and those with mental health concerns since other agencies were not
equipped or did not have the capacity to intervene. Instead of police-only responses, “Drew”
explained that partnerships and structural change were needed to share the load with the most
appropriate agency:
Because as I said, we always have that space for police when you are dealing with these
people, like this sector, these vulnerable people. So, to have someone dedicated to
doing that is important, but not just one person on a [police] watch, that will easily get
consumed and cannot keep up. If you have a huge chunk and I just made up those
numbers 75/25, maybe it is 50/50, maybe it is 90/10, I do not know, but whatever that
complement is that can address that community’s issues because some are worse than
others. So, I think those alternatives in terms of significant structural change to how the
government approaches the vulnerable people needs to occur, and the structure of how
policing is delivered needs to follow that investment.
The experience on the front-line is reflective of the concerns of police leaders. Previous
direction to enforce all manner of offences has given way to seeking collaboration and support,
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although the change has been slow to materialize across sectors. “Avery” has seen the change
firsthand:
I have seen everything. I have gone from an enforcement background where it was
enforcing every single little thing. You know, the more people you take to cells, the
better, but I saw how that failed. How pitiful that was of a strategy. Obviously, I did that.
I spent about five years just on [the street] dealing with the drug dealers, dealing with
people that were addicted, dealing with the social services down there. There was no
ability, and no time to collaborate. It just was not even in the cards at that time. It was
enforcement, enforcement, enforcement. It was about stats and it was about putting
people in jail. That is what management wanted from us. That is what they thought
would bring down the complaints in the area, and that is what we did.
Although police have steadily changed their approach from enforcement-only strategies to
collaborative effort, it remains a difficult task. Police are not particularly well suited to be
everything for everyone in the community. “Robin” explained the difficulty faced by police in
trying to protect vulnerable populations while enforcing societal expectations:
I cannot imagine just how difficult it is for police in that role because you are given both
the protection and prosecution mandate. This is one of my issues that I always brought
up in the context of the sex industry. You are given both. You are supposed to somehow
both protect but also prosecute. You just cannot do both. So, for some people, as soon
as you move more into that prosecution side, you will never again be able to protect
that person.
“Reilly” also suggested that perceptions play a large role in what society considers as significant
crime or social issues. She further explained that police need to be part of the conversation to
identify the important issues and approaches:
To some degree police contribute to the moral panic that is out there…We live in
communities that are on balance, quite safe. Violent crime rates have dropped. But
people’s bikes get stolen and like, that is a huge thing. People take cycling very seriously,
but the level of the kind of outrage that the police would generate off of these things,
which are property crimes, and I am not saying it's fun to get your things stolen, but we
have to be able to nuance this. So, we have the police kind of talking about stolen bikes,
and fake guns, and people sitting underneath awnings, that become the focus… I am not
saying I want a world where people are getting hurt, but I also think we have to be able
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to understand that a bike being stolen is different than a predatory serial killer in our
community…but I see the police really feeding in to, like a bit of mania.
“Reilly’s” observations are relevant to police perceptions. Police executives stated they
wanted to change their focus to more serious calls for service with a view towards increasing
wellbeing for everyone, including vulnerable populations. “Blake” was encouraged by an
increasing understanding of root causes by police and health professionals:
We are public safety and law enforcement experts. So, we want to work with you guys
[health industry]. And if you are telling us that this is a good conduit to save people’s
lives and make a difference, then fine. We agreed to the Health Canada exemption
because they needed our sign off back in 2003… so our officers actually will direct
people, like if they see somebody shooting up in a laneway, they will direct them. ‘Hey
man, use the supervised consumption site down the road, there's nurses there and they
will make sure you don't overdose and get you help.’ They direct a lot of people there.
When it first started 17 years ago it was hard for us because of that generation of police
up to that point.
Police participants stated they believed they should be targeting the criminal element of the
drug trade, as opposed to the victims thereof; in this case, the marginalised people they were
trying to protect. “Avery” was quite clear on the approach his team adopted in his large urban
jurisdiction:
You are bringing in fentanyl into my community? Absolutely, I think we should throw
the book at you, right? But for somebody that is using, I mean, come on. Let us just
come up with a better strategy for how we are going to get that person healthy again. It
is not about throwing them in jail, I can tell you that much. It was all about
concentrating on who is dealing, but I started really looking at it from a broader
perspective. Dealing with that population and just hammering them and having this
myopic, microscopic, myopic kind of view of dealing with it, just dealing with it as a
police officer and not looking at the broader picture. So, I rewrote the entire thing, and I
came up with a team that would actually be out there to assist.
Police participants, especially executives, understood the futility of targeting at the wrong level.
“Drew” felt police efforts should focus on interdicting high-level traffickers, while realising that
the issue will continue without a different approach:
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We find whenever you disrupt drug groups, it feels good because we are stopping the
distribution of that drug, but what it also does is create marketspace, right? Then often
conflict for that marketspace, because there is always somebody to come in behind to
fill that marketplace. That is why the war on drugs can never be won, because there is
always somebody to come in behind when you disrupt and dismantle. I am not saying
we cannot do it or should not do it, but that's our conundrum.
From a medical perspective, the trauma that causes many in the vulnerable population
to fall into addictions was viewed as exploited by traffickers. Medical professionals
acknowledged the police’s role in interdicting illicit supply in addition to treatment. “Charlie”
put it this way:
I think the police really need to be focusing on enforcement and getting to individuals
and groups that are running the drugs into the area. They are the people creating the
power structure that keeps people under their thumb. So, I think that enforcement
element is important. I think they need to be supportive of redirecting people that are
the users, if you want to put it that way, into treatment. I know there is perhaps a fine
line sometimes there, but yeah, generally I think the focus needs to be on the dealers
and dealing with these rings and so forth.
From a mental health perspective, participants agreed that collaboration needed to
increase to refocus police from the primary role of mental health response. Again, they
emphasised that police need not be fully removed, but placed in a support role. Much of this
stemmed from an inability to share information in a timely manner to eliminate redundancy of
action. As “Blake” pointed out:
We have got all these people that do not need to be institutionalised, but we are having
a lot of calls for service for them, so we set up a program where we track them through
PRIME5. So, we look at these people and we have an early warning system where we
pull the data out of RMS6 and we put a note on CAD7 and we say okay, here is the
people that we are dealing with on a regular basis, like high incidents of police
involvement. Let us get an information sharing agreement going with health, because
health is dealing with these same people every time, we are picking somebody up and
Police Records and Information Environment – The police dispatch and report generation system in BC.
Records Management System – Directly linked to PRIME.
7
Computer Aided Dispatch – Directly linked to PRIME.
5
6

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for whatever reason we take him hospital. They know these people on a first name
basis. We got an information sharing agreement that went through the Privacy
Commissioner and everything. We can view health records and they [health] can view
police records for public safety purposes under the Police Act. We meet every single day
in this program.
The development of partnerships was viewed as key to success in moving people out of a street
entrenched lifestyle and into support. “Blake” and “Alex” emphasised the importance of
dedicated police positions that can work with vulnerable populations and outreach teams.
“Blake” stated:
There is a lot more that can be done to support, but we do have people dedicated. One
constable right now is a full-time homeless outreach coordinator. But then you are
going to get into this argument, why are the police even in that space? Why are you
there? Why aren't they out catching bank robbers? But we have come to realise that our
officers are dealing with people living in alcoves, in doorways and parks, and those
people need a path sometimes. That officer is very good at getting the path to housing,
and that sort of thing.
Alex agreed with the need for outreach:
So, the street outreach response team is working with our homeless community,
working with our partners, to get people into pathways of care and getting them
connected. We have a project, kind of like bar watch, where businesses can sign up for
this program and then they give us the authority under the Trespass Act to remove
people from their alcoves and doorways. It was a huge problem of people defecating,
using alcoves as their home, and causing issues. So now our police officers will go by the
businesses and not just kick them away and tell them you got to move on but identify
the person. Then they are connecting with someone from our street outreach response
team who will then connect them to care and support.
Participants recognised that the role of police with respect to public safety was not just
about the community, but the need to support outreach workers as well. They stated it was
difficult to separate the role of police from the role of these programs because they were so
intrinsically linked. They advised that the vulnerable populations were often victimised and the
areas they lived in could be unsafe without police support. “Taylor” stated:
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Persons that were struggling with addictions, not just drug addictions, but you know
multiple issues, mental health issues and homelessness at that point in time. We had
upwards of 200 campers that brought all kinds of social disorder. It was our highest
concentrated area for property crimes, violent crime, physical assaults, robberies. You
know, drug trafficking, sex trade, assault on sex trade workers, you name it. It sucked in
a considerable amount of police resources, not just from the enforcement perspective
to deal with and respond to all the criminal complaints that came out of it, but to
protect the area.
“Alex” agreed with the need for police in certain situations but was also supportive of agencies
responding on their own if there was no indication of the danger referred to by “Taylor”:
And for those calls where we do not think there is a danger to the public or the
individual, they [outreach] can attend. Even just a month ago I heard a call of an elderly
male walking down the road who was wearing a hospital gown and appeared to be
mentally unstable. Well, I will argue we do not need to send police officers in
bulletproof vests and a gun to that call, and I would have loved to have been able to
send him into health care with no police officer.
“Alex’s” observations presented the need for new approaches to dealing with social
disorder and police response. Participants agreed that these approaches needed to focus on
increased outreach in terms of training and partnership that allowed police to support other
agencies. “Taylor” explained that programs needed to be developed that removed police from
primary response:
But at its core, it is not a crime issue, but it can bleed into a public safety issue. I look at
it more of a health and social issue that the police, through the absence of engagement
of other agencies and bodies, are left to deal with or kind of clean up. I think when that
happens then police start to assume roles that go far beyond their regular role in law
enforcement.
Frontline police officers were willing to engage in the collaborative effort to move police back
toward their primary duties, while working towards collaborative solutions. “Jordan” was
engaged with vulnerable populations every day:
When I first started it was because of the missing women background. Coming
downtown I needed to be sort of part of the community. You need to be in the
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community. A lot of their stuff is court related. But the work that I do is different, you
know? My approach is different because I am allowed to do that. When I first started
realising that I was really blurring the lines here, but I am police first. I told my boss that
I guaranteed two things. I am not going to do anything to get myself fired, and I'm not
going to do anything to embarrass the department. For the rest you give me a full tank
of gas. There is just so much more that we can do.
Similarly, “Avery” emphasised the need to engage directly with the population with compassion
and understanding:
Understanding the empathy that you really need to start to work with these individuals
is kind of where were we went. It was strange because you got this, I want to call it a
motley crew of young officers that just kind of came to me. You know, I had a few
volunteers. They were excited, they wanted to go out there and do that work. But then I
had a whole bunch that just did not want to be there. You know they first came in; they
were like, what are we doing? We are going to hammer these guys and put them in jail,
and I am going to go find every warrant. What we actually needed to do was to work in
established relationships with our partners and we cannot be looking like we are over
heavy handed. So, there was a huge education component that had to be every single
time I had a new person come to the unit. We had to educate them that this is not
about hammering somebody.
“Avery’s” compassionate and understanding approach was echoed by advocacy participants
who emphasised the need to understand why vulnerable populations found themselves in their
circumstance at the root level. Developing trauma informed responses was a key
recommendation from “Robin”:
You know people were in desperate circumstances who are now in more desperate
circumstances, but I think at the same time you have these incredible politics [defund
the police] that rose last summer…. what does it look like for police to reallocate
resources, what can we realistically expect police to do? Where have we gone too far in
kind of turning police officers into social workers? So, I think it has been an interesting
journey for me from working from the trauma of the community at the time to working
with police, trying to heal some of those pieces and try to make some of those pieces
better…it was the first time that we saw police departments coming to the table and
saying we need to do things differently. What we have been doing is not working, so
even if it was not full agreement, but there were segments of agreement and there was
a common desire.

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Theme Four: Investment and Resources
The need for further investment and resources was identified by all participants as key
to providing support for vulnerable populations, not just in terms of addictions and mental
health treatment, but for overall wellbeing. There was consensus among the participants that
under-resourcing, deinstitutionalisation, and lack of in-community supports has led to the
current homelessness crisis and stigmatisation of vulnerable populations.
Participants felt that several sectors required significant substantive investment, not
simply a reallocation of funding from one sector to the other. While this may be possible in the
long-term, most participants, particularly police, feared that reallocation of funding without
addressing the upstream behavioural drivers would cause a negative impact to public safety
and wellbeing.
Police executives feared that response-based workload would still remain in their mandate if
other agencies were incapable of providing around the clock service. Their fears appeared to be
well founded based on the downloading of services over the past several decades from
institutionalised settings to community-based services. At issue was the belief that these
community-based services did not have the resources or capacity to address the complex needs
of the vulnerable populations, so this was left to emergency services to deal with. “Blake”
explained it as follows:
They are victims. There has been a huge downloading over the years onto police who
were dealing with it more and more. It started probably with the de-institutionalisation
back in the late 80s, early 90s. It was not just a [city], or BC, or even a Canadian thing. It
was the whole western world. It was sort of the philosophy at that time of day, deinstitutionalising people, which makes sense if you have the right supports in place.
They think, probably, in the Western world we did over-incarcerate or over
institutionalise people that had mental health issues.
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Advocacy participants expressed concern with society’s lack of understanding of the
root causes of additions and mental health that created an acceptance of criminal justice
approaches. “Skylar” stated:
You are painting everybody with the same brush. When [a vulnerable person] says I am
having a mental breakdown or anything like that, they do not need to see units come
with guns, but there is no one else to call, and maybe at least somebody will keep me
safe. They say to me, yeah, I am traumatised by it…This is the thing that I have been on
the phone with them when I was in housing, and it's not their fault, it’s the resources.
“Reilly” expressed the concern that the criminal justice system was not only the wrong system
to deal with social disorder, but that this issue went deeper into the very structure of our
justice system:
Not just human rights codes, but a real recognition that we are often having to
shoehorn deeply complex social, economic, intergenerational issues into the very
narrow framework of legitimacy of a court. We are forcing people through a process
that can at best be ineffectual, at worst can further traumatise them. So now we are
looking at tools like communications, shifting public narratives through media, police,
and also just trying to focus our work on the most impacted communities.
“Reilly’s” concerns were echoed by “Sidney” who saw a revolving door approach, centred on
the criminal justice system instead of root causes and actual trauma. In this example, she was
describing intimate partner violence and the propensity to separate children from struggling
parents:
And if it's criminal or child protection related, some of them are just so sad. And you
know, [a woman] fought back but…. they have been charged. Then with the child
protection, all of their children have been apprehended, but what are the ages? Zero to
five, 6 to 12, and 8 to 13? I mean, in just a very small sector, 14 children have been
apprehended. First Nations children like that, so 14 lives have been just torn apart
anyway, so there is a lot of work that needs to be done in building capacity in our
services.

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Considering that a large proportion of vulnerable populations have struggles with ACEs
and other trauma, “Robin” expressed the need for more resources in that sector that created
the conditions for better success in adulthood:
As an alternative, how about we do not cause the problems in the first place. If you
think about our childcare systems, you will think that the support for families exists,
particularly those of lower socio-economics. One of the hugest, most important risk
factors for youth is whether they have ever been in care. If you have been in care with
the government, then that means you are like 10 times more likely to actually be
victimised, have addiction, and end up homeless. That is the government care. That is
on us, right? That is on us.
“Skylar” agreed:
But what if somebody could actually respond with the skill and medical expertise? But I
know there is a lack of that response because even if they expressed it, where do we put
him? Where do we take him? What do we take on? So, you cannot just look at just the
police without separately looking at the systems that need so much done…. mental
health treatment is absolutely crime prevention. It straight up makes sense, and it is not
new, it is just the system again.
From a medical perspective, “Clarke” and “Charlie” saw the lack of resources as
particularly troubling when trying to treat addicted people. In their view, the overuse of the
criminal justice system was borne out in the lack of access to other supports. Clarke explained:
And when people started at our clinic, 80% had unstable housing within the last two
years. 80% had no primary care provider or a formal connection with the health care
system and most of the 80% had been in jail for at least a month. So, they have better
connection with the criminal justice system than they do with the health care system,
right?
“Charlie’ described the lack of resources as a failure in the system. He stated that there were
insufficient access points, so people found themselves on the street with nowhere to go:
Those numbers began to grow over the years, and I would see more and more mentally
ill people, people that needed treatment. But the system was failing them in just
pushing them out. And these promised services were not there, they were not. There
was no safety net, and gradually those people were turning to street drugs as well to
manage. They did not want their loud noises in their head, and they did not want the
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drugs that mental health was giving them so they would start using other drugs. We
started to see more momentum grow with that and I think that was a huge shift.
“Clarke” expanded on the issue by addressing the need for additional services, including
collaboration at all points in the system, and within his mandate, opioid agonist treatment:
So, we need to provide comprehensive care and comprehensive services, and I guess
why I'm telling you that? Because the system does not, does not, meet people where
they are at and provide those services that are required. At this point that is something
we aspire to, but we are not quite there as a clinic, or as a health authority yet. We see a
clientele who have not been engaged prior to having access to the program that we
offer. That includes substance use, and unmet needs, and in general, health and mental
health. All those, all those domains improve when people have access to this service.
The need for medical and social support was amplified by “Alex”, who, as a police leader, was
concerned with the number of resources his department had to expend in this sector:
I am frustrated that I actually have four police officers fully engaged, and that is actually
small, between homelessness and addictions. I really think that is more of a health
authority issue. Health should be taking the lead on that, so I am frustrated when I
phone, you know, the CEO of [the health authority] and plead for resourcing for people
to take a lead, I just do not get the response that I would hope for. Unfortunately, I think
with the police, that we are part of the problem, right? Like, we solve problems, we get
the job done and unfortunately that is why we end up managing it in regard to social
disorder.
A common concern expressed by participants was the lack of alternatives to police
attendance. “Skylar’s’ experience was that emergency services were left as the only response to
complex issues due to the narrow framework of emergent and non-emergent call response,
thus creating redundancy:
At 3:00 o'clock in the morning who are you calling? And this is a thing when it comes to
resources. One thing we have thought about is 911. There's non-emergency and there’s
emergency [call centres] right now in Vancouver and then you usually have to wait
before you are asked if you want fire, police, or ambulance. Often, you expect the
paramedics to come, but then you have the police behind you, and fire. It is
understanding who needs to be responding.

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“Blake” experienced similar frustration but stated they were starting to see increased
collaboration, which was good in his view, but not sufficient in terms of the actual resources
needed:
And it is really sort of highlighting the fact that there are all these gaps in the system
which started more conversations happening here in the city. It is a lot better now. It is
not perfect, but we have a lot of things now that we did not have before. We have got
mobile overdose outreach teams where we have got social workers and [health
authority] people. Nurses are out on the street and they can get people moved into
different treatment options. We got it in our jail now. Some people come in and the jail
actually does a really good job of triaging people. We've got doctors and nurses that
work there full time. There are always at least two nurses on duty, and we have a doctor
that comes in every day.
Police executives agreed that while investment is needed, there was good work being
done at the local level to set parameters for increased funding and to encourage collaboration.
For instance, there was increased understanding by health authorities of the need to allow
hospitals to support vulnerable populations, regardless of how they enter the system. From the
front-line officer’s perspective, without this type of increased collaboration, the lack of
resources was not only frustrating, but heartbreaking as they sought to bring supports to
vulnerable people. “Kennedy” pointed out the human toll:
It is, I mean, it is sad because a lot of the people that come up to the car and they are
like, hey, I am ready. I need to get clean now. I have to literally tell them okay, let us
make a phone call, and you will be on a wait list for a month for you to get to
[treatment]. Even then it is only one week for heroin, fentanyl, cocaine addictions, and
meth, and then two weeks for alcohol. That is not fair. You are going to kick a person
that's two weeks clean and sober back onto the street? You are 100% going to put that
person in that same situation. They are going to die.
“Charlie” summed up the unintended consequence of deinstitutionalisation from not
putting the necessary infrastructure into the community in the first place. His concern was that
without proper support, too many people have fallen though the systemic cracks:
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You will pay a price down the road. That is great, and it is all well and good to
decentralise places. The government at that time had decided to quickly move from a
centralised approach of providing centralised care for the most severely mentally ill,
vulnerable individuals, and instead they were going to decentralise the money and put it
into the local communities. There was a promise that all of the money would be in the
local community to support the individuals that needed at the most. I would be sitting
up in my office and I began to look out my window and see walking through the parking
lot somebody that obviously should have been in a mental health boarding home. I
could see that they were psychotic, untreated, no support, no outreach there to help
them. Obviously, the system had already failed.
The trend towards deinstitutionalisation without effective community supports was seen by
police executives as a significant driver in their current workload. Just as “Charlie” articulated,
police leaders felt the closure of institutions, such as Riverview in BC, led to a marked surge in
vulnerable people in the community without adequate support. While they recognised the
need to be part of supporting those populations, they were unanimously concerned that police
responses created potential dangers of escalation, including use of force, to a population that
would be better supported through medical or event co-responder intervention. They referred
to the current approach as a “band-aid” solution to the required investment that should include
increased medical and treatment support, especially in smaller communities. Emphasis on deescalation, improved access to pathways of care, and increased overall training were all viewed
as important steps towards community wellbeing. Their unanimous concern was that although
they viewed the situation as improving, there was still not enough access to treatment and
support, such as housing or social assistance. “Jordan” agreed with the earlier comments by
“Kennedy” that without ongoing and dedicated support, people trying to recover would just
regress:
Let’s stop along the way so you can heal. You do not just go back out on the street. A lot
of people end up going to detox. They leave after four or five days and then they just
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come back on the street. It is just like that is their break, right? Just kind of taking their
January dry month but taking it in three days and then just going right back again.
The needs of the vulnerable populations were expressed by advocacy and medical
participants as very complex. They agreed that stigmatisation led to a view that certain people
were “lesser than” the rest of the population and, as such, government was less willing to
support them. “Robin” expressed the need to place more emphasis on root causes:
People really, really, really need to remember some of the causes of addiction, and that
we are very often dealing with trauma, and addiction as a response to trauma. It is a
way for people to escape trauma, and then it often leads to more trauma, which they
then need to escape the secondary trauma. So, I think that the only way that you
honestly have people moving forward, who are already dealing with really hardcore
addictions, is to treat. So, it cannot just be that we are going to provide you with that
service, it has to also be housing that has to also be such intensive support. That is going
to be much more expensive.
“Charlie” agreed:
It is the same attitude, I think. It is the same pervasive attitude. We know it is there, but
we do not want to do anything about it and do not want to put the money. And now we
are throwing money, perhaps at it, and it has become a tsunami. There is a huge
correlation between mental health and addiction. I think the research shows that quite
clearly. Homelessness becomes a sort of an outgrowth of it. As the person’s lifestyle and
capabilities deteriorate, they lose. They go through a series of losses and lose the
support networks they have.
This observation was echoed by police executives who were concerned by the haphazard
approach to dealing with homeless populations who usually fall into vulnerable categories.
They felt that a criminal justice approach involving police as enforcers was misguided and
dangerous, even though it has been used to dismantle unsightly camps. “Blake” considered the
approach of moving people around without investing in long term supports as futile:
Over 90% of those people had mental health issues and over 90% were addicted. You
may have a few people in there that are one or the other, but almost everybody is both.
So, you have taken 170 people that are living in a park in the [downtown] and have now
moved them over to a [different park] or put them in a building. Then we have
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politicians celebrating it because we have given them a roof over the head. That is great.
That is perfect, but you have done about 1/3 of what you need to do…They are still
going to be anti-social. They are unable in many cases to function in society. They are
still committing crime to support their habits. There is still going to be wandering the
streets accosting people, breaking into cars. Where is the plan for all that right? There is
none. What is that pathway to care? What is the plan? Yeah, very good question that
that seems to be asked a lot, but that answer is not forthcoming.
Advocacy participants supported the police assertion that there were not enough
support plans in place, which were exacerbated by ineffective policies. “Reilly” previously
pointed out that current laws were actually detrimental to supporting some vulnerable
populations and expanded on that observation:
We also have some key events in the law around rights of people to shelter in public
parks. The recognition that displacing them is an inequitable solution, that it
disproportionately harms indigenous people, and people with disabilities. In some ways
those are wins right there. But then we also see on the flipside, the reaction that
happens in municipalities because that is where a lot of bylaws are actually enforced. It
really feels like whack a mole and I think that courts cannot really address that, and also
going through litigation is such an expensive, resource intensive process. Those
resources, both from our agency, but also from government, could be better utilised
actually just providing the things people need.
Participants agreed there were positive steps being made, but the need for an overall
plan was urgently required, one which was not compartmentalised by government, but
involved all sectors working together. They all agreed that preventative measures, as opposed
to the current reactive structure, were needed not just to reduce police calls for service, but to
prevent repeated medical calls for people who should have substantive support. There were
examples of effective support in large cities that involved investment and collaboration
between police and health, but also other social support services. “Blake” talked about
community outreach partnerships, such as ACT and assertive outreach, as opposed to reactive
only models:
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There is a cohort of about 400 people in the city that we deal with. We have reduced
police calls for service with that cohort by over 50%, and hospital visits by over 60%. You
think policing is expensive, healthcare is even more expensive, so it does work. The
proactive side. I just really want to get people away from this car 87 or 67, whatever you
call it. It is great, but it is not the answer, it is the proactive side. You got to go to
upstream and help people get on a better track.
Police executives also spoke about the apparent decreases in 2020 of crime types
typically associated to vulnerable populations due to the supports they received during the
COVID-19 pandemic. They reasoned that housing a large portion of the vulnerable population
and giving them increased funding reduced the incentive to commit crime. Even if increased
funding from the Canada Emergency Response Benefit (CERB) was used to support addiction
needs, it had the benefit of reducing crime. “Alex” stated:

We started tracking when CERB came in, what our property crime levels were, and we
saw for that five months, as CERB was in place, our property crime levels for that entire
five months actually went down. So, I think CERB was an unbelievably amazing social
experiment, because it actually showed that when individuals received additional
funding and things, there was a significant reduction in property crime. Now there are
other things in play of course. More people were at home so less break ins, but we do
need to study that and learn from that.
A continuum of support was emphasised by all participants. They felt that simply
treating one aspect of need fell short of the overall support required to address the complex
interconnection between addictions, mental health, poverty, and homelessness, especially as it
related to trauma. All participants agreed that housing was essential to stabilise vulnerable
populations as a precursor to further effective supports. The discussions often centered around
access points to care, regardless of which agency was primary. “Jules” expressed the need for
increased connection between the medical and social support sectors:
Many times, there is no housing available, so we have to discharge to their
preadmission situation. Sometimes it is a hotel. Sometimes we can link them to BC
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housing or other housing, but it is a large wait list. It is not like people in acute care or
needing medical get preferential treatment…There are times where we have to have
people who happen to be homeless come into our outpatient clinic, which is a whole
other issue to actually get the treatment they need.
Participants considered where the funding could come from. While they agreed there needed
to be substantive funding put in place, they also realised that collaboration could create the
conditions to allow reallocation of funding or simply better efficiency. “Jules” put it this way:
So, I am going to tell you something that's fairly provocative. We are not underfunded.
We have misaligned our resources in ways that do not serve the citizens that need the
services the most. I do not believe, and I am going into 30 years of my health care
career, I do not believe we are underfunded. I think we have so many triplicate and
quadruplicate layers and layers in our system.
Overall, participants agreed that funding and political will were the main drivers for
successful outcomes. They submitted that effective solutions in providing pathways to care
would be expensive, but felt that, even in the near term, the overall cost would be reduced,
especially with regard to police response and emergency medical interventions. Effective
collaborations that were underway were also recommended for immediate support. For
instance, the iOAT programs in Vancouver only reached a fraction of the people who could
benefit from that treatment program. According to “Clarke”:
For the small number of people that are here, yeah, we are doing great. But for the
people that are out in the street and do not have access to the services that are needed,
it is a public health disaster.
Participants agreed that part of the issue was a lack of political will, complicated by a
bureaucracy that was lethargic in its approach to vulnerable populations. As “Robin” stated:
Society is not going to support politicians or others who come forward as champions of
those groups. So, we have a really fundamental problem here, and that is even if you
have people sitting around the room with power to make these choices, you have
rejection from communities. You would need to approach things from so many different
directions at exactly the same time. There is an educational piece here that is so vitally
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important. There is a whole re jigging of a criminal justice system. It is not just police,
and it drives me nuts when I see these conversations stop at police services. We forget
that actually they are just the front of the system, and the system is huge….so just
deciding okay we are going to reallocate some of the policing funding, or we are not
going to hire more police, or we are going to put money towards partnership with social
workers. Okay, cool, but what about when somebody is affecting crime? And who is
who is assisting that person through the process?
“Charlie” agreed:
I think up to the present time there has been a collective lack of will by policymakers
and not an absence or ignorance of the problems. We are not lacking a lot of knowledge
or understanding or even statistics. So today there are a number of really useful services
available, both by government funding and by non-profit sector funding, but their
funding and their ability to stay afloat is so tenuous because of budget changes, they are
the first organisations and services that get cut. As a result, the continuity of care is lost,
which is critical in managing people with mental health or addictive problems… It comes
down to finances and political will and unfortunately that boils down to what will get me
re-elected.
Theme Five: Understanding Trauma and Reducing Stigma
Participants in this study were very concerned about the lack of resources dedicated to
vulnerable populations that they felt was due to the stigma associated to these groups. They
were unanimous in their view that vulnerable populations, especially those experiencing
homelessness, were more likely to be criminalised by the community than they were to be seen
as needing support. Societal attitudes, fueled by Canadian drug policy and moral panic, were
viewed not only as barriers to effective reform and support, but as stigmatising principles
preventing that support that was manifested in the lack of political will and funding. As “Clarke”
put it:
Well, the fact that it's not funded is stigma. So, it sounds like a catch 22. The stigma is at
the funding level. The stigma is at the cabinet level in the province.
A lack of understanding of the trauma experienced by vulnerable populations was also
viewed by all participants, regardless of background, as a barrier to reducing stigma. All
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participants felt that increased education was required for BC and Canadian communities in
general to understand what caused people to move into a vulnerable state. Much of this was
attributed to deinstitutionalisation that brought the hidden magnitude of the problem to the
forefront. As “Charlie” observed:
And the system began to breakdown at that level and that dates back to the mid 90s.
Over that period of time, the number of homeless and mentally ill grew exponentially.
There was no safety net. They had been promised the money, but it was not put back
into the community to create boarding homes and create mental health outreach teams
that would go into the community and find these people and work with them. They just
weren't there, so we ended up with people fending for themselves. Oftentimes the
police would be down in the parking lot dealing with a mentally ill individual, who
probably could have been managed, and treated, and lived a much more functional life,
but now they were getting connected into the criminal justice system…I could see the
trend of what was happening and that's continued on. And now of course with the drug
issues as well.
Participants felt that stigmatisation caused society to be more comfortable with using criminal
justice approaches since they felt vulnerable people were responsible for the majority of social
disorder in their communities. Participants attributed this to a lack of understanding of what
vulnerable populations were experiencing. In many cases, participants believed these
populations were looked down upon, as opposed to being considered as candidates for
support. Robin put it succinctly:
The same person can also be seen as a victim on one corner of the street, right? And
then they walk to the other corner and are perceived as an offender. That comes out
when we think about who a deserving victim is and who is not a deserving victim… It is
very strange, but we do have these ideas behind us about deserving and they play out in
really specific political socio-economic ways. So, these are all way bigger than any
individual police officer or even individual police department. And they make it virtually
impossible, and they create these tremendous barriers because we can never actually
get on the same page in the first place.
“Skylar” agreed that community perceptions actively contribute to stigma, due to a lack of
understanding of trauma:
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A lot of people are really willing to do that, you know, say you just got to pull your boots
up or pull your bootstraps up, right? Or I'll give people money if they're going to change
their life. I will fund something like that if they're going to turn their life around and
become taxpayers, but if they are not, I am not interested…. If it hits anybody
mainstream, or if it threatens certain people’s lives, the money will be spent...
Other participants from the advocacy sector felt the issue centred around unfair policies
and practices that put people in a no-win situation. They cited the court system as particularly
prone to further victimising or traumatising vulnerable peoples, as well as the health system
that was not easily accessible. They agreed that the lack of government support and
downloading exacerbated the lack of accessibility. For instance, they cited the propensity of
various governmental levels to consider complex issues, like crime, housing, or addictions as
singular problems when they should be viewed as interconnected. In particular, municipalities
were cited as not wanting to be seen as soft on crime, which caused them to implement
policies that were marginalising to the most vulnerable people. “Reilly” felt that this led to
increased stigmatisation:
There is a huge issue around stigma and what constitutes a vulnerable population.
People are made vulnerable by poor policy, by lack of access to resources, due to
stigmatising beliefs, and prejudice around the activities they do in their life. I'm not
really sure if the courts are able to address that…the Mental Health Act also contains a
lot of provisions where people lose their autonomy when they're certified, so it's not
necessarily something that keeps people safe. It's just not. It's another different type of
control.
Further blurring the line between criminality and victimisation was the public view that
these populations committed the majority of crime, despite evidence to the contrary. Police
executives and front-line officers agreed that was not the reality and that more serious crime
was committed by relatively few prolific offenders. They refuted claims that vulnerable
populations were crime drivers stating that the majority of crime committed by vulnerable
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populations was on the lower end of the scale, particularly nuisance or minor property crime.
On the other hand, vulnerable populations were highly victimised by predators who took
advantage of them. These observations were backed up by statistics, but “Blake” also
attributed societal perceptions to a type of stigma:
People focus on people that may be addicted or mentally ill. That they are bad people,
or they are committing crime. And yes, that does happen and there is that whole life
cycle of addiction with committing petty crime to support your addiction and that goes
round and round, breaking into cars and stuff. But the other thing we have done quite a
bit of research on is the victimisation patterns of people that are suffering from mental
health and addiction issues. You are 15 times more likely to be the victim of a crime if
you are suffering from mental health issues. 23 times more likely to be the victim of
violent crime, and 19 times more likely to be the victim of crime if you are homeless.
Police executives agreed that this type of stigmatisation was challenging in creating approaches
to support these populations and to generate collaborative efforts. They were troubled that the
lack of resources and funding delegated to these issues continued to force agencies to work in
siloes that only served to exacerbate the stigmatisation of the population by increasing the
complexity of their access to care. “Blake” expressed concern that first access to care was often
generated through an introduction to the criminal justice system, as opposed to addressing the
health and poverty issues of the person in the first instance. “Drew” agreed that the propensity
to criminalise first and support after was problematic:
The mayor there is very concerned about the homelessness issue and wants them
eliminated from the downtown core. He says they are homelessness issues, but he
knows that chances are there are some other issues involved with that homeless
person. There are some addictions potentially on board with that person. Some mental
illness potentially, or other issues that are unknown. You know, trauma in their lives. But
generally, it’s just that “Get them off the street” request.
“Drew” expanded on this desire to address the unsightliness of homelessness as opposed to the
root cause:
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They're just aesthetically not pleasing, and we get calls because they're unsightly.
Mayors and city managers want them out because they're not aesthetically pleasing but
they are not really committing any crime.
The desire to only address specific symptoms can actually contribute to stigmatisation by
creating a type of circuit breaker approach to vulnerable populations. Instead of addressing
root causes, communities often default to enforcement since it appears easier and more
expedient. In “Taylor’s” experience:
If they want assistance, you know they are going to call for the police. It may be
presented as a criminal related call, but in reality, it's not…it is trying to find that balance
of the homelessness issue, but also creating some structure around society’s
expectations on victimisation, crime, drug use and the like. Sometimes, unfortunately,
those homeless camps are subject to being victimised by drug traffickers and the like
because they know that there is a very significant client base.
The importance of outreach and building relationships with vulnerable populations was
seen by police participants and advocacy groups as a key component of reducing stigmatisation.
They argued that treating these populations with dignity and respect would go further in
building community wellness than enforcement and stigmatisation. “Avery” had first had
experience with the trauma experienced by homeless individuals, and cited approaches that
started to restore dignity and wellness:
We had people living in tents and they freeze to the ground. They literally freeze to the
ground. You know there was one washroom for 200 people, and it was an outhouse. It
was disgusting. How is that Canadian?...you need to be a little bit gentle and deal with
people that are dealing with some of the most difficult situations that any human being
can be going through. Poverty, extreme poverty, extreme addiction, not knowing where
you are going to get your next meal, like these types of things…. and then if you spend a
little bit of time with somebody, yeah, they might call you a pig, but after about three
weeks and you are talking to him every day, and they actually have a big smile on their
face when you come up to talk to them. They realise you are not there to put them in
jail. You are just there to make sure they are safe.

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There was consensus among all participants that root causes stemming from trauma,
ACEs, and marginalisation contributed to stigma around vulnerable populations. They
articulated the need to understand individual circumstances and develop approaches that did
not demand a certain level of success to enter a program, but more of a “meet them where
they are” approach. “Sidney” stated:
We have to understand that there are different lenses. There is a cultural lens. There is a
gendered lens that we have to bring to it, and we have to provide opportunities for all
people.
In this regard, police executives agreed that a one size fits all approach would not be effective.
They agreed with advocacy participants that the individual circumstances of a vulnerable
person needed to be taken into account in everything from restorative justice to court and
sentencing. Acknowledging the history of the individual was viewed as vital to developing
supports for that individual. While this approach once again emphasised the need for additional
resources, it also focused on the restoration of dignity. “Alex” further explained:
So, I would like to see a preventative approach where we are able to identify those that
we know are very susceptible because of trauma and provide them more supports to
not go down that pathway in the first place.
The recognition by police executives for the need to understand individual circumstance would
appear to have been transmitted well to the front-line. “Kennedy” emphasised not only the
need to meet people where they are, but also the need for education for the police and public:
The biggest thing that I noticed with them specifically is they've had some sort of
trauma that they don't want to talk about. Especially with mental health patients…. I
wouldn't judge them. The other thing I would do is I usually remind them hey, I know
what happened to you and I know you told me that and I appreciate that. I’m just
looking out for you and making sure you are okay.

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“Jordan” took the same approach. She explained that the trauma experienced by vulnerable
populations was not only significant, but ongoing, often due to court or societal expectations.
“Jordan” stated:
I was really immersed with a lot of vulnerable women down here. Mental health issues,
women who are trying to get their kids back and don't even have housing. They just
keep getting snapped back to that family unit [homeless community] that they just long
for.
The experience of front-line officers and advocacy professionals was often frustrating.
Participants articulated the need for increased supports, but also for increased understanding.
Along with police executives, advocacy, and medical professionals, they recognised that many
in the vulnerable population have little choice in where they have found themselves. “Sidney”
put it this way:
Those living with addiction need to be part of the conversation. You talk about stigma,
right? Oh my gosh, I mean all druggies are criminals and you know you've heard that
and it's like actually no, there's a lot that are using inside, in silence, using in their homes
that are working, employed or parenting. When people feel like they are valued and
they matter, then we can work with their trauma and we can work with their addictions.
Police executives recognised the need for increased understanding and have seen positive
changes in the past several decades. Although it was slow to materialize, collaborative
approaches allowed for increased information sharing and outreach to vulnerable populations.
Still, participants advocated for increased contact with street entrenched persons to build a
rapport and relationship. In their view, building rapport was more effective than straight
enforcement, especially when trying to introduce people to supports. Rapport was also
essential in reducing negative and even violent interactions between police and vulnerable
populations. “Kennedy” recounted one such incident:

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We were at a file with the ACT team to give an injection to a guy and I was in
plainclothes…. a guy grabbed the back end of my gun and I was just trying to wiggle my
way out of it. The other homeless guys started beating on this guy because he was
touching me. Like he wasn't allowed. I'm one of theirs. That was a huge moment for me.
I realised, okay now I'm part of the pack and I was accepted. It was that respect that
started removing the barrier.
Similarly, “Jordan” realised that police could be actively supporting vulnerable populations with
compassion while still maintaining their role as a police officer. In this particular case, she was
working with an advocacy group and simply talking to the clients and building rapport. She
recounted one particular incident that spread throughout the groups as a sign that she could be
trusted:
Girls come in and they ask who are you? I'll tell them I’m police, and that's what you just
want. You're just there…So it was like just go down to where the masses are and see if
there's anybody we missed or anybody that wants to commit. A girl came through the
front doors and just kind of slammed the doors and she said there's this effin guy out
here, parked outside here who won't leave me alone. I thought well I can do something
about that. So, I go downstairs, and the car is there, and the guy is there and sure
enough the guy was wanted…. and then there's a tow truck, and then this guy is gone in
the police wagon. So, I came back in and the girl was there, and she looked at me and
she says who the F are you and I said, well, this is who I am. So, from there I think it was
more of a word-of-mouth thing that happened, and I started to get more people kind of
chit chat and then chit chatting and then it just kind of worked.
Police executives agreed that developing and maintaining a connection to vulnerable
communities was a critical component of effecting change. To that end, they felt that
community involvement and planning were important parts of effective collaboration. They
viewed outreach and connection as effective means to connect with vulnerable populations
from a policing standpoint, but also with a view to connecting them to services and support.
They emphasised the importance of community acceptance. Regardless of the approach, the
community needed to be a part of programming efforts. Without support from the community,
it was likely that stigmatisation would continue. As “Alex” stated:
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But we can't forget our community in this conversation. I think our community is turning
and they're getting, frankly, pissed off because of the degradation of the
neighborhoods. I think what we're trying to do is stop stigmatisation, but it's actually
getting worse in a way because people are so frustrated with the crime, like with the
shopliftings and those survival type crimes.
Inasmuch as efforts to prevent stigmatisation were important, participants felt that
outreach programs needed to be expanded. Part of the reason for stigmatisation was the lack
of understanding of the root causes. Outreach was seen to bridge that gap to the vulnerable
population and the communities they were in. “Charlie” described it as follows:
The ongoing stigma of mental health persists in spite of education and so forth. They are
disenfranchised from any form of power and hence they do not have a voice. Individuals
and businesses with money behind them, and lobbying groups and so forth have a
voice. Typically, people with mental health issues, and people with addictive issues do
not have a significant voice compared to those that could make a difference, especially
policy makers. There has to be a commitment to it as a high priority. I mean, we are only
as strong as our weakest among us, and so if we are ignoring the weak or just paying lip
service to it, then we are really doing a disservice to the rest of society.
Most participants agreed that it was important to meet vulnerable populations where
they were in their lives. For instance, the notion that treatment can only be achieved through
abstinence was rejected in favour of a broad spectrum of supports from abstinence to iOAT
with integration into assisted living and fully supportive housing. Participants agreed that there
was no one size fits all approach to these social issues; however, they recognised that many
communities still believed that the road to support must start with a commitment to “get
clean”. Participants felt that different approaches designed to meet people where they were at
would be the most effective, since everyone has come to where they were by a different path.
“Blake” put it this way:
We are willing to try these different things, and I do not think there is one size fits all
solution. And the other thing I will say about that is that if you have 10 people that are
addicted, all 10 people have a different story. They have 10 different treatment plans.
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From a medical perspective, “Jules agrees”
Yes, you always have to meet people where they are at. Everybody's going to be
different. So, your wrap around health services has to be able to meet people where
they are at. Stigma keeps people from getting what they need when they need it,
wherever they're at. We have to understand, this is not a knowledge gap, this is
addiction.
Participants agreed that the need for new approaches outweighed society’s moralistic views of
drug addiction and social disorder. They stated that these new approaches included
medicalised drug treatments that went beyond abstinence. As “Clarke” put it:
Well, it should just be providing care, and providing evidence-based care. Get over
yourselves.
According to participants, communities and support agencies had the opportunity to
realise immediate changes by taking an evidence-based approach. Outreach programs were
important, but they gained their success through the human element. Participants felt that if
they could affect individuals where they were, they could cascade that into meaningful, broad
spectrum change. “Blake” provided a personal example of the importance of meeting people
where they were and accepting that there were multiple means to measure positive change.
While this was a unique situation, he felt it exemplified the successes that could be achieved by
removing stigma and taking action:
We all knew [him] back when I was on the street years ago. They said, oh, you know, he
really wants to meet with you [in your current position]. So, we went and saw him, and I
met with him. I sat down with him for an hour and we were chatting, and you could tell
he still had severe mental health issues, but he was clean. He was in a nice room. He
was joking around with staff that lived there. He was on his medication. He was seeing
workers and he was getting his life back on track as much as he ever will. He never will
be somebody that would fully be a functioning person in society, but he had become a
bit of a leader in his group. He thanked us for getting him into this program. He died
unfortunately of medical issues that he had going on inside his body after 30 years on
the street of neglecting his body. I still have that thing that he gave me, but he was the
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example. This is somebody that I thought was so far gone, like one of the most bizarre
people you'd ever deal with. It was humane and he was functioning really well.
Medical and advocacy participants agreed that evidence-based approaches and investment
were key approaches to reducing stigma. Both groups felt that despite the evidence of success,
such as the example offered by “Blake”, it was unfortunate that bylaws and elements of the
criminal justice system were still being used to target vulnerable populations, even though that
approach was ineffective. “Jules” stated:
You know, we also have this dichotomy between our charter rights, which say that we
cannot impose treatment on other people... People have a right to not take their pills
until they hurt somebody, right? It is a dichotomy, right? We live in a free country that
cannot impose treatment on other people. That is the crisis of living a democracy. And
then there is the other side of the democracy that says we should just lock people up.
“Robin” agreed with “Jules” that all too often stigma drove decision making and policy by using
criminal justice approaches that would appear to be more economical, but actually cost more in
the long run than effective housing and support:
And you can even see the science behind it, right? You can actually see the studies that
show that it is cheaper. It is cheaper to give someone money and house them than it is
to manage everything that goes on with homelessness, right? It is economically smarter
and a smarter move socially, except maybe in this one context, if your morality includes
retributive justice.
Participants felt that moral standards, as opposed to evidence, caused some of the
decision-making processes to default toward the criminal justice system. According to “Skylar”
and other advocates, the stigma associated to this was the result of the view that vulnerable
populations were considered “lesser than” tax paying citizens:
There is a stigma. There is still feeling that many of the people we serve are disposable,
and they're not. Its changing from society’s view but it's also more so “what is our
responsibility to do so”?

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Police participants agreed. They stated that they saw the suffering of vulnerable populations
firsthand and were frustrated by the systemic intolerance towards them. Police participants at
all levels stated that they were looking toward government to set policies aimed at support
rather than enforcement. “Avery” summed up the feelings of the police and other participants:
If I didn't have the solid family structure that I did growing up, I could very likely have
been out there in the same boat. It is about swallowing your own ego and realising
anyone can be one of these people. That makes you humble. Eventually I started to
realise we are going about this so wrong, like so wrong. I would be lying to you if I if I
told you that I didn't have some guilt about, you know, how we did this in my early
career.
Theme Six: Decriminalisation of Illicit Drugs
Although all six themes in this study are intrinsically linked, the desire to investigate and
implement improved treatment and care plans was the thread that most often linked all six
themes. In particular, participants felt that decriminalisation of illicit drugs, leading to effective
treatment systems, such as iOAT, was the way forward. Regardless of their background, all
participants believed the current criminal justice approach towards vulnerable populations was
not only ineffective, but morally wrong.
Decriminalisation was supported, especially by police executives, all of whom supported
the Canadian Association of Chiefs of Police (2020) report recommending the same. However,
they did include a major caveat stating that decriminalisation should not be just about refusing
to charge someone for possession, but it should be a key building block for a full spectrum of
supports and infrastructure. Medical participants agreed that simply refusing to charge
vulnerable people may feel good in the short term, but it did nothing to address the root causes
of their suffering and would do little to change societal impacts without intensive support.

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“Blake” stated that police would always have a role in criminally prosecuting certain individuals,
but the approach taken by police in BC was changing to pathways of care:
Possession for the purposes of trafficking, we will still do that, but we are not focusing
on possession. We just find it honestly a complete waste of time. There will be
exceptions where somebody has been repeatedly asked not to use in a school ground,
or in a park, or in front of kids, then there may be cases where we will take an
alternative approach. There could be cases where you're dealing with somebody that's a
chronic offender. Somebody on parole, something like that. So, we would take a
different view, but generally speaking, people get a bit of a pass on drug possession
here and they have for many years because we have not seen any good benefits from
the criminal justice system coming out of charging people with possession. We think
that there are better paths that are more suited for those people to help them, right?
“Taylor” and “Alex” agreed that police have resisted charging people for simple possession for a
long time, citing the futility of the process. “Taylor” stated:
Not to speak for crown counsel, but they are not prosecuting simple possession offenses
for a variety of reasons, not the least of which it does not seem to be effective in
deterring that behaviour. It clogs up our court system substantially. I think this is
welcome from our perspective. We certainly could not deal with the volume of dealing
with individuals for simple possession.
“Alex” agreed with the ineffectiveness of charging people who were suffering from a medical
issue:
We will not arrest unless there are extenuating circumstances, but that has actually
been put in a policy by the [Public Prosecution Service of Canada] now. With their new
policy, and it has always been made clear that we want to find different approaches…. I
think I have seen a couple of times where we disrupted prices slightly but that was very
short term. We as police leaders have to stop being naive that were ever stopping the
supply. We need to come at this from a different angle and that is what I think the safe
supply angle is.
Advocacy participants agreed that new approaches were required but cautioned against
maintaining an “or else” mentality with respect to using the criminal justice system, except
when required for serious matters. They called for a more well-rounded approach that did not

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use enforcement to force cooperation with treatment but stopped short of suggesting full
legalisation. “Robin” put it very clearly:
I would not be willing to take anything off the table at this point, but I can tell you that
for the most part, legalisation so closely resembles criminalisation that it can often
produce the same results…but there needs to remain a criminalised element, that if you
do not follow the legal route, you will be criminalised. You are not going to get rid of
that criminal aspect to things, so in that regard they almost have come together. With
decriminalisation, as well as medicalisation, you have to almost treat it more like
business where there are other forms of regulation and not just criminal forms of
regulation… we need to find alternatives because I think that it is so easy to use the
blunt force of criminal law to try to address social issues, but all it does is exacerbate.
“Reilly” emphasised the importance of multiple access points to a treatment system, and
thought it would be self-defeating and contrary to the goals of decriminalisation if police were
the primary access, which would have the effect of continuing traumatisation in vulnerable
populations:
They [Canadian Association of Chiefs of Police] endorsed decriminalisation, but I did not
hear anything about how we can free up these public resources so that they can actually
go to drug user groups who can in turn serve their peers. It actually means will have
more policing, because now they will be doing the referrals, which is frankly, ridiculous.
If you talk to anyone who uses drugs, the last person they want to talk to is a police
officer.
Participants felt that current Canadian drug policy was focused on the wrong target by
an over response to perceived criminality, as opposed to targeting higher level traffickers and
violent predators. Again, they felt that treatment and support, with a view to addressing root
causes, should be the approach to vulnerable populations, rather than enforcement. “Jules”
spoke of the need for more collaboration and resources, citing governmental response to the
COVID-19 pandemic as an example of how well this could work if there was political will:
We are losing more people to overdoses than we are to COVID. We're having the
grimmest months on record. The level of coordination interprovincially with COVID has
been exceptional, but the level of coordination with addictions has not. That is why our
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children are continuing to die, because it's unpopular to save marginalised, addicted
people. These are stigmatised people. I think of the Dionne Warwick song Walk on By.
It's a disposable population. I've seen these people lose their children. These are these
are young people that are getting killed by fentanyl.
Police executives agreed with “Jules’” frustration and felt that they bore the brunt of ineffective
policies that criminalised vulnerable people, despite their experience that the current system
was broken. “Drew” stated:
It is naïve to expect that hammering the heck out of the users, so somehow there is now
no market to sell to, will cause the suppliers and the traffickers to go away because
nobody wants to use it. We have already charged the heck out of all the users and it
does not work. That is not practical. So again, there is balance, but it should be
weighted, obviously on the dealers and the suppliers, right?
“Blake” agreed and advocated for treatment and pathways of care for addicted people, while
targeting those that took advantage of them:
So, from a business side it makes sense for these drug dealers to use it and then the
other side of it is that they are killing people because as you know they mix it up and it's
not evenly distributed, and you get hotspots and people are dying.
On the front-line, “Kennedy” has seen the influx of Fentanyl and tainted drugs firsthand.
She stated that the current system did little to address why people were addicted and became
homeless. She was supportive of decriminalisation. She provided the same caveat as police
leaders in saying that infrastructure and support had to be in place first, as well as the
acknowledgement that these types of drugs were so dangerous that legalisation might be a
step too far:
It is a little harder to watch some of this. One of our big buyers right now is a [school]
teacher. I just cannot wrap my mind around it. I cannot even disclose this to the school
until I get charge approval that [they are] buying fentanyl and touching kids… I definitely
do not think we are dealing with it the proper way.

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“Avery” also saw the ineffectiveness of using the criminal justice system to address obvious
medical issues. He experienced the slow turn of the system and its detrimental effect on
wellness:
It is another roadblock to their recovery as well because what ends up happening is
now, they build up all these convictions. Next thing you know they cannot get a job…so
it is a real barrier to recovery when we do that, when we really chicken shit these guys
with all those types of things. I do not think it is that the appropriate way to go.
Even using drug courts as an alternative to traditional sentencing was questioned by
front-line officers. While they agreed with their executives that a multi-faceted approach was
required, they saw firsthand the trauma experienced by vulnerable populations and understood
how difficult it was to move away from their addictions without adequate supports. “Jordan”
was supportive of decriminalisation but offered the following caution:
They often accept drug court over immediate jail, but they just cannot do it, it is just too
hard. It is just too much. Maybe there are baby steps into getting through drug court.
Maybe just do not go slam and right into your sentencing. I mean, it is great the
supports and the programming that they have in there, but I do not even think I know
one person who has actually made it right through drug court without, you know,
getting yanked back or something.
Alternatives to the current enforcement and sentencing approaches were supported by
all participants; however, advocacy participants were concerned that entry into proposed
support systems was still very police centric. Just as “Jordan” indicated, “Reilly” and “Sidney”
were concerned that using the police as a primary access point still traumatised and
marginalised vulnerable populations by viewing their behaviour as deviant to the point of police
involvement. Similar to “Blake’s” view that there needed to be more discussion about upstream
drivers and prevention, “Reilly” cautioned against a decriminalisation approach that relied on
extensive police involvement as opposed to medical and advocacy support:
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When I hear alternatives to sentencing, I am still thinking that is like diversion at the
court level, and it sounds like people are still interacting with police. At that level of
interaction, an officer is choosing to use their discretion…If these are not criminal issues,
why are they being subject to police interaction? You know it is kind of like this carrot
and stick where you are told if you are going to go this [drug court] route you are going
to plead guilty. That is how you get to this. That is how you get access to all this support,
which is already like really problematic, because you might still want some of those
things. You just need to plead guilty. Not a big deal, oh, but if you mess up, you are
going back to jail and you are serving your whole sentence.
“Sidney” was also concerned by the carrot and stick approach to gaining support that seemed
to be offered as an alternative to jail:
Harm reduction and treatment are needed but we know it is not there. But what we do
though, is we have this criterion that to get in you have to be clean and sober. You and I
both know that when you have arrested someone, they may want to go to treatment
right now. Put me in treatment right now, but in an hour, they are going to be FU, I am
not going to treatment, right? So, when we have their undivided attention and their will
to do it, we need to actually be able to get them there.
Participants advocated for more research into effective approaches in other countries.
The “Portugal” model, as discussed above, was repeatedly cited as an example of effective
policy. “Robin” felt that without such innovative approaches, the Canadian system would
continue to repeat its focus on criminalisation:
I think that you do see some interesting things happening in other countries who are
starting to think maybe we should think about alternatives. I wish we would think about
alternatives because I think that generally speaking again, we are setting up a system for
failure. We are setting up individual officers for brutally unsafe situations and I think we
are contributing to issues of corruption. I hope that we are coming into an area where
we are starting to think things through a little more carefully. I do not believe there is
enough political will to make those changes yet.
“Jules” agreed with “Robin” about the lack of political will. He cited progress in other countries
and was concerned by the lack of political or societal will to follow proven practices:
It is going back many, many years, but I am very well versed on European practices. We
have a long way to go. So, for example in in the early 90s when we went to Europe you
could not find a bus or train station of any kind without sharps and needle exchanges.
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They just were very liberal. So, I think from a Canadian, North American perspective,
Canada is leading the way …. but when you compare it to more of the progressive
European countries, we have got a long way to go.
Participants agreed that the need for a decriminalised approach to addiction and
substance abuse was the way forward in building wellbeing in vulnerable populations. Advocacy
participants viewed this not only as a policy decision but a basic human right. Their assertions
were backed up by evidence offered by the medical participants in this study, as well as by
police participants who have seen positive changes in otherwise difficult clients. “Skylar”
studied programmes in other countries:
What is that one quote? Something about the test of society is how it treats its most
vulnerable? That is true, you know, and you see models in Europe that literally take
[addicted] people who are like that. It's not so much forced, but there is concern for
their own rights. I think a lot of people will never know what it would be like to suddenly
lose everything, fall into addition, fall into depression, which is a very underrated mental
health issue. It can cripple you and suddenly everything changes.
Medical participants have seen effective treatment programs in Canada and are frustrated by
what they perceive as a lack of political will to move forward with wider use of these programs.
“Clarke” explained that there was still a great deal of criminality and stigma around illicit drug
use that was driven, in part, by a continuing “War on Drugs” attitude:
I mean, the fact that our clinic is providing prescription heroin, and it's been doing so for
nearly ten years is a sign of success. If we were doing this to the south of us, we could
be arrested and put in jail, so Canada is further ahead than our neighbours to the south.
I don't like the word harm reduction. To me, it's just care.
“Clarke” went on to cite statistics and evidence of the effectiveness of iOAT and other such
programmes that provided treatment beyond abstinence and looked at ways to effectively
stabilise those suffering from addictions as part of an overall strategy:
Providing prescription heroin to this population is clinically cost effective. Looking at our
data, between 70 and 80% are retained in care, including housing and treatment. We
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need to find more ways of getting care like this to folks…this is from our studies and
other studies, but [this treatment] also reduces mortality and it reduces crime. Both
property crime and violent crime.
While participants were hopeful that new programs could be put into place that would
address root causes and trauma, they were concerned that the urgency was being under
appreciated. “Skylar” has seen the urgent need for change in her city:
But it is turned. Fentanyl has turned this community where the community members
say I do not even recognise my peers. That they are literally walking dead. It is a hard
thing to reconcile.
As “Charlie” put it:
I think the treatment element of it needs to be emphasised, especially for those that
cannot take part in treatment for various reasons because of mental health issues or
just because of how disenfranchised they are from society and their ability to function in
society…. we do need to look at more treatment rather than criminalising or charging
people and pushing them through a system that will probably enhance the issue, the
problems.
Participants were asked for their views on the four pillars approach of enforcement,
prevention, treatment, and harm reduction. While their views on this program varied slightly,
they all agreed that it was good in principle, but not in implementation. At issue was the
inability to effectively implement each component in an effective manner. Participants felt that
enforcement and harm reduction seemed to be the mainstays of the program with unequal and
limited representation and collaboration between sectors. As “Blake” put it:
I am big fan of the four pillars, but you know, it has been like a dog running around on
two legs for many years because there has been a huge gap.
“Alex” agreed:
But the four pillars is a bomb. Valuable approach, but I think sometimes we put too
much emphasis in one or two pillars, and we have not maybe done enough in the other
pillars.
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Advocacy participants were also supportive of the concept but were disappointed by the results
to date. Their viewpoints linked back to the need for more resources and an understanding of
the trauma faced in vulnerable populations. In “Robin’s” experience:
I don't think it was ever fully implemented so it is hard to evaluate it because it has
never actually happened. I think there is a lot of good ideas behind having a more
holistic approach to all of this, but I think that again it is the reality of politics, the reality
of allocation and support, the relative training, the reality of who has the capacity to do
any of this stuff. We never properly implemented anything relating to it, we just kind of
said we would, and put a couple of things together, which is never the intention behind
that approach.
Police participants agreed. “Drew” stated his concern with the four-pillar approach was a lack
of balance and resources:
Everything is about balancing right? It is the same thing with abstinence or harm
reduction. Not even thinking about trying to help them long term, but just give them all
the needles and all the drugs in the world. Yeah, they are not going to get hep C, and
they are not going to get disease potentially through a needle, but they are going to
completely wreck their bodies, and they are going to die anyway, right? So, balance that
off with harm reduction until we can get them into treatment, maybe some abstinence.
If not abstinence, then I mean stabilising them and giving them some other comfort
might get them along that path.
When asked for their views on developing effective policies around the treatment and
support of vulnerable populations, police participants were quick to suggest the need for
prevention. As “Blake” put it, there was a need to address upstream drivers before
communities had to deal with downstream behaviours. All participants agreed with the need to
address preventative measures and support, especially before behaviours manifested
themselves in perceptions of violent or deviant behaviour. As a front-line officer, “Avery”, and
“Blake” as an executive addressed the need to prevent vulnerable people from entering the
criminal justice system. “Avery” stated:

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When you are dealing with somebody who is addicted, who is dealing with the disease,
you cannot expect to drop him off at [treatment] and in six months they show up and
they are all healthy and looking good, right? The disease itself is continuous, it will
progress.
“Blake” agreed with the current inability to continually support people, even if they were in the
system:
If you walked into hospital and he had a heart attack or broken leg, they would know
how to fix it, but if you show up addicted to drugs, they will say okay, see you later and
send you back out the door. We will have a spot open in a couple of weeks. But in two
weeks you know your window is gone right? I cannot send them back out for two more
weeks. We need to do it now.
Similar to “Avery’s” concern, “Jordan” emphasised the need for continuing care, including the
assurance that people coming out of treatment would be set up for success:
When you finish detox and say you go through the recovery, then what? you come back
to your same SRO [accommodation] down here. Except now you're the sober one for
however long before your neighbours down the hall decide it's party time again and you
are triggered…
Despite evidence to support increased access to treatment and stabilisation,
participants were concerned that current approaches were too lethargic to make a broad
impact on the wellbeing of vulnerable populations. All participants felt that decriminalisation of
illicit drugs, including the implementation of a safe drug supply, would lead to a reduction in
the criminal distribution of harmful drugs, such as Fentanyl, and other toxic drugs. They agreed
that a significant investment in infrastructure would be required to ensure the system worked,
including housing, treatment facilities, and a broad spectrum of community supports. Medical
participants felt that treatment options did not need to be confined to a clinical setting, but
could be implemented into supportive housing systems, especially with medical professionals
embedded in the facilities. In particular, police emphasised the need for proper infrastructure
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prior to implementing decriminalisation policies fearing that simply ignoring possession would
keep vulnerable populations under the control of predatory drug dealers without addressing
the root causes of their vulnerability. “Alex” warned against this issue by citing examples
currently underway in BC:
And we are the most lenient province in Canada with drug use, and it is because we
have not built the infrastructure. There are politicians who naively think we just
announce that we are going to decrim drugs in our city because that is the right thing to
do, and everything will be better.
Other police executives agreed. “Blake” stated:
We need to take people that are addicted to drugs and we need to move them into a
healthcare pathway, as opposed to criminal justice system pathway which does nothing.
But we also need to be able to provide health supports for them in the first place. It is
not as simple as people say. People say just decrim everything and everything will be
fine. I say to the mayor and other people they know it is not that simple. I will argue we
have de facto decriminalisation in [this city] for 10 years, but people are still dying from
a poison drug supply. People are still getting it from illicit sources and organised crime.
They are still breaking into cars and breaking into your house so that they can afford to
buy their drugs. So just decrimming it tomorrow, does nothing. You actually have to
have a plan, like a pathway to get them into health.
“Alex” stated he was very familiar with the Portugal model. He stated that while it is a
good program to create a basis for Canadian response, it was important to build
decriminalisation programs that were specific to the Canadian context. For instance, he
cautioned that Portugal has one health system, while, in BC, there are five separate health
authorities:
So, my argument was to build a system, like a Portugal, who said do not copy us, but
learn from us. We need to build a made in Canada approach that will help people…but I
am just frustrated that the rhetoric has sort of taken a life of its own, and everyone is so
quick to just say just decriminalise, without the infrastructure in place first.
The main concern presented by all participants with simply saying that the police would
decriminalise without establishing the necessary infrastructure was the issue of supply.
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Although all participants urged the necessity of a safe drug supply, they did not have enough
research to advise how it would operate, especially if the illicit supply was not curbed first or
left to wither away due to lack of demand. “Alex” continued with his experience:
It makes no sense. So, we say okay, we have a place where you can actually go once you
buy your poison on the street, which we know is highly toxic, highly dangerous, and
there is a good chance it is going to kill you if bring it into this place [supervised
consumption site]. We are going to let it kill you, then we are going to revive you, kick
you out again, go buy more drugs and repeat.
From a medical perspective, “Clarke” agreed with “Alex”. In his view, and in the view of
advocacy participants, pushing forward with harm reduction initiatives and decriminalisation,
while allowing the illicit, toxic drug supply to continue would set up people for failure, even if
there were effective treatments:
Because knowing what we know now about medicalising or providing pharmaceutical
options, I do not think we should have supervised injection sites without offering a
pharmaceutical alternative to the street supply. Standalone supervised injection sites
are no longer adequate. When they go hand in hand. When we provide decriminalised
or legal heroin, but it is in a medicalised context. If it was just decriminalised and people
still had to rely on the illicit market or the street market, you would not see the benefit.
There needs to be a medicalised or legal access as well.
Participants agreed that a vital component of any move towards decriminalisation was
the need for treatment. Harkening back to earlier comments on meeting people where they
were, participants urged for treatment on demand in multiple formats, including
decentralisation, housing supports, and medical clinics. Although all participants were
supportive of this concept, and the commensurate programs of developing safe drug supplies
as a form of stabilisation and treatment, they were frustrated with the slow pace of
implementation. “Jordan” stated that the lack of availability was the biggest issue with
supporting those who needed immediate detox or support:
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For sure, it's like on demand, right? I've heard it for years; I know we need to have it, but
we don't have it. It’s luck of the draw, you can phone, and they'll give you a date like
maybe 9 days.
As stated earlier by “Sidney,” the expectations put on vulnerable people as a condition of them
receiving treatment were unreasonable. “Reilly” agreed that these expectations did not set
people up for success:
That is like the type of really conditional support that relies on a deeply disenfranchised
community that has very limited ability to assert their rights. On one hand, we want to
divert people from the prison system, but we are going to send them through drug court
before they are going to go to treatment centres or recovery houses. If they relapse,
admit to, or are found to have been using illicit substances they are going to jail. It is
totally at odds with the bio-medical understanding of substance use.
“Skylar” saw the dysfunction in the system firsthand. Similar to the concerns expressed by
“Reilly”, “Sidney”, and “Jordan”, her view was that setting expectations for people to be sober
before going into treatment to become sober set the bar too high:
But there are waiting lists and when we talk about low barrier, and high barrier
programs you have to be clean. You are on the street, all your friends are using drugs,
and you almost committed suicide the night before because you just cannot take it
anymore. Then you got to jones out there and you have to withdraw? You got to detox
but it is full …that window of opportunity somebody has is gone when they are turned
down. I mean, you have lost it for a long time, for many, forever, right?
The manner in which a decriminalisation policy might be implemented was a concern for all
participants. “Reilly” explained that the lack of political will and societal acceptance would take
significant education to change:
Canadian drug policy is stuck. It is overly conservative and cautious. It assumes that
medicalisation will keep people safe and alive but lacks a sufficient critique of the
medical model. I think that Canadian drug policy needs to really be handed over to
peers and people who use substances to actually direct it without being fettered by
prohibition, but also with the gatekeeping of clinicians.

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This view spoke to the need for accountability and understanding of what works. An evidencebased approach, using information from those with lived experience, coupled with medical
success was deemed the most appropriate path forward. Unfortunately, participants felt that
much of Canadian drug treatment policy was centred on a very narrow view of what
constituted effective treatment. Similar to “Reilly’s” view, “Alex” agreed from a policing
perspective that there needed to be more support for the medical viewpoints of what works:
I certainly want doctors or clinicians to be part of this discussion. A drug dealer tries to
make a user use more drugs, but in a health approach, you try to make people stabilise
their drug use and eventually, hopefully, moderate their drug use.
Medical participants agreed that treatment and stabilisation efforts needed to move
away from the singular focus on drug use to a full spectrum approach that recognised the very
complex nature of addictions and mental health. Once again, this led back to the need for
significant investment to ensure infrastructure was in place prior to a decriminalised approach.
Police executives, while supportive, were adamant. “Alex” stated:
What we are doing right now is we are putting the cart before the horse. We have not
built the infrastructure. We have not built the system or the program, so we are not
helping individuals …my argument was build a system first, like a Portugal model.
“Drew” went further to discuss the negative views of decriminalisation on the part of certain
sectors in society that could only be shifted with education and the knowledge that effective
supports were in place:
Supporting harm reduction is important, but it has to be done right. It has to have
proper resources attached to it.
“Blake” agreed that effective implementation of decriminalisation needed a concurrent push
for understanding:
A lot of this, I will tell you, is in the eye of the beholder, right? In Eastern Canada, there
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is still a more of a law enforcement, old school kind of attitude about enforcement. You
broke the law and its sort of an American attitude as well. If that person is possessing
drugs, then we need to arrest, we need to send them to the courts, and into jail, and
that is going to fix the problem.
Finally, police executives stated that pathways to care would not work for all vulnerable
people and that, at times, a criminal justice process would be needed. This was supported by
other participants who stated that there could not be a one size fits all approach to effective
policy implementation. Participants were keen to express the need for multiple approaches
carried out by agencies working in collaboration with one another.

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Chapter 5: Discussion and Analysis
This study examined current responses to addictions, homelessness, and mental health
through a literature review of current approaches, an analysis of police reported crime data
provided by the BC RCMP, and 14 interviews with professionals in the fields of law
enforcement, advocacy, and medical services.
Statistical Analysis
While serious crimes, such as aggravated assault, robbery, sexual assault, and serious or
serial property crimes consume a great deal of police effort, what became clear in the research
was that police spend an inordinate amount of time responding to occurrences that are not
criminal in nature. The literature review and analysis of police data demonstrated that over
60% of police occurrences are non-chargeable (Canadian Association of Chiefs of Police, 2015;
Department of Justice Canada, 2018; Huey et al., 2016). The majority of these occurrences
resulted from day-to-day operations of policing involving assistance to the public and other
agencies; however, this number is stark in that it shows that a significant portion of police work
did not deal with their primary mandate of interdicting criminal behavior. When they are
dealing with incidents of a criminal nature, the statistics demonstrated that a substantial
portion of police activity is consumed during the response and investigation of property crimes,
the majority of which are for less serious property crimes, such as theft from motor vehicle,
that typically involved low value thefts, according to police participants. Following theft from
motor vehicle were mischief under $5000, theft under $5000, mischief-loss of enjoyment of
property, and shoplifting under $5000; all of which are on the lower end of severity when
compared to violent crime or societal perceptions of the harms of social disorder. According to
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police participants, theft from motor vehicle and shoplifting were often associated to
vulnerable populations, many of whom were engaged in survival-based crimes to support their
addictions or their poverty conditions. This determination was confirmed in discussions with
police executives, advocacy, and medical professionals who understood the root causes behind
survival-based crimes. To summarise, most of the police calls for service do not involve calls of a
criminal nature and when they do, they are often driven by low-level property related offences,
many of which are associated with vulnerable populations who are experiencing addictions,
homelessness, or mental health issues. In turn, this drives a demand for response to these
issues from the public that relies too much on police response and not enough on a CSWB
approach borne out of collaboration and investment. Police have become the de facto response
agency to matters concerning vulnerable populations because of the lack of effective policies
and infrastructure to support them through a continuity of services.
Development of Themes
The interviews specifically pointed to the need for increased investment and
collaboration across sectors. All participants agreed that matters of addiction, mental health,
and homelessness were often outside of their particular agency mandate, even though they
responded to these issues on a regular basis. This was especially true for police participants. For
instance, addiction is not a police mandate, but should fall to the medical system since it is
considered a health issue. Despite this, police are often left to deal with the consequences of
addiction, specifically when it comes to vulnerable people. The data was consistent with past
literature in indicating that dealing with vulnerable populations required multiple agencies
working together in a more collaborative fashion.
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All participants agreed that policy alternatives concerning decriminalisation of illicit
drugs, reduction of stigmatisation, and the development of alternatives to criminal justice
responses were necessary steps to assist people suffering from mental health, addictions, and
homelessness. There was also unanimous agreement that Canadian drug policy should continue
with harm reduction initiatives leading to decriminalisation of certain illicit drugs, particularly at
the street level. However, the discussions that arose out of this question included the need for
a safe drug supply and treatment on demand. Still, all participants agreed that treatment
should take precedence over enforcement when dealing with vulnerable populations, with the
caveat that people needed to be met where they were at in their particular circumstance.
Participants cautioned that there was no one size fits all solution to complex social
concerns. They stated that a full spectrum of supports ranging from housing to social assistance
was required. In the case of drug addictions, multiple treatment options, such as iAOT, were
deemed necessary, especially when concurrent disorders were present. Participants agreed
that police responses, such as enforcement, were still required to deal with people who were
benefiting from the misery of vulnerable populations, as well as people whose behaviours
presented no alternative other than initial police response. Shifting to more collaborative
models where police provide a supporting, rather than primary, role, would enable police to
focus their resources on more appropriate enforcement targets, such as traffickers of illicit
drugs, such as fentanyl.
Throughout the interviews six themes became apparent. There was agreement
throughout the interviews on the need for collaboration across sectors. This led to a second
theme that discussed the barriers to achieve collaboration and the role of police within
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cooperative efforts. This led to a discussion about funding and resources as a key component of
moving forward with assistance to vulnerable populations. Closely related to the reasons
behind the existence of barriers to collaboration was the theme of stigmatisation. Several
participants felt that barriers, especially due to stigma were caused by a societal view that
vulnerable populations were “less than” the general population. In part, this was because they
were viewed as authors of their own demise. As a result, these populations suffered further
due to limited access to supports. The final theme focussed on alternatives, such as treatment
on demand and decriminalisation. Since the focus of these interviews was to determine the
policing role in bringing support to communities in general, and vulnerable populations in
particular, much of the discussion centred on what police could do to increase CSWB while
working in collaboration with various partners.
Purveyors of Crime Reduction or Social Engineers?
Participants felt that many efforts geared towards solving social issues were directed at
law enforcement and criminal justice responses, rather than addressing root causes in the first
place. Participants often expressed frustration at the lethargic pace of change when considering
alternatives to a criminal justice approach, especially considering there were high levels of
agreement across sectors of that need. Evidence showed the majority of crime was committed
by a very small percentage of society and, in particular, by prolific offenders (Cohen et al., 2014;
Plecas et al., 2014). According to the research, the majority of that crime was on the lower end
of the spectrum, including low level property crime driven by survival activities due to addiction
and mental health (Department of Justice, 2018). Advocacy participants agreed with police

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executives that it made no sense that armed police officers were at the frontline of dealing with
vulnerable populations.
Participants discussed alternatives, such as using a medicalised approach to mental
health, whereby, in certain circumstances, police would not be required. While police
executives agreed with this approach, they cautioned that, in many cases, police response was
predicated by the service agencies themselves. Although the literature revealed that criminality
was not necessarily associated to vulnerable populations, except perhaps in terms of overvictimisation, the perception that these populations were crime drivers often supported the
politicalized notion that police should be involved from the outset. However, the research,
supported by participant views, suggested that medical approaches that addressed root causes,
such as ACEs, generational trauma, poverty, and mental health, would have a more positive
long-term effect.
Just Walk on By
Stigma and a view of vulnerable populations as being “less than” others were cited by
participants as a leading cause of lack of supports. Participants across the spectrum agreed that
stigmatisation, as well as silent approaches at the government level, prevented effective
collaboration and, therefore, effective support to these populations. Despite this attitude,
medical participants cited examples where collective will towards a common goal and purpose
achieved significant results. The most notable example of this was a discussion about COVID-19,
as compared to the approach taken towards addictions, mental health, and homelessness in
general. Participants felt that the approach towards mental health and addictions does not
appear to lack funding inasmuch as it is a lack of coordination of effort. They cited the response
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to COVID-19 as effective collaboration throughout medical, social, and law enforcement
systems in Canada. Conversely, approaches to addictions and mental health showed
stigmatisation either by considering the people suffering from them as a lower-level priority
than the rest of population or by the view that pathways of care were not politically expedient.
Investment Requires Political Will and an End to Stigma
The recent exchange between the BC Minister of Housing and the Mayor of Penticton
articulated the view that vulnerable populations can be seen as “less than” quite well (Fries,
2021). At one level, the provincial government was attempting to provide housing for homeless
people, albeit in an approach somewhat siloed from full wrap around supports, including
medical systems and mental health treatment. On the other hand, the city of Penticton was
concerned with the perception of an over-burden of homelessness and the commensurate
social disorder. The political battle of wills exemplified the lack of understanding of the root
causes of how these people came to be homeless and does little to create long-term solutions.
The mayor’s statement, shown below, demonstrated the lack of political will to address root
causes by classifying the behaviour of vulnerable populations as “not normal”:
“Maybe they could get rid of their addictions and mental health issues and make them
somewhat normal.”
It is unlikely that society's definition of normal can ever be achieved by people who do not have
access to treatment and care or the dignity of the acceptance of their trauma. Regardless, the
Charter of Rights and Freedoms enshrines the right of individuals to live free of discrimination,
which cannot be curtailed simply because people do not appear normal to those in power.
Participants in the study agreed that tackling stigma was a key component of moving
forward with alternatives. They also agreed that to increase collaboration, stigmatisation, and
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barriers presented by a lack of political will need to be removed in favour of medically effective
approaches to deal with these social concerns. However, tough on crime approaches to deal
with social disorder are often more politically expedient with the general population, even
though social concerns, such as addictions and mental health, should be addressed through
medical support and intervention.
The 3 AM Question
Most participants considered the problem of who responded to social concerns when all
of the agencies have gone home. The general population has grown overly comfortable with
calling 9-1-1 to address unsightly issues or what may be viewed as socially deviant behaviours.
With mental health, for example, police are often the first responders. Sending armed police
officers to what should be considered medical or social issues makes little sense, but currently,
there are few alternatives. It was acknowledged by all participants that to create an approach
where police were not the sole responders, significant investment and infrastructure would be
required.
The 3:00 AM question then becomes one of who will do the work outside of normal
business hours? The effectiveness of co-responder models, such as those where police and
mental health professionals are partnered in one car, was discussed at length by all
participants. These types of partnerships were viewed as a good example of collaboration,
although police cautioned that they are reactive in nature and often failed to address the
upstream drivers of what caused the occurrence in the first instance. All participants agreed
that addressing root causes and preventing socially deviant behaviours was the correct
approach, which, once again, led to the need for significant investment. As an example of
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expanded support, the use of assertive community treatment and assertive outreach teams
was discussed. These types of proactive approaches allow police, medical, and social services to
work in partnership to address root causes in advance of crisis. The literature and participant
interviews made it very clear that more work was required in expanding these types of
assertive outreach programs, not just in major centres, but in rural areas of the province as well
(Walmsley & Kading, 2019).
Collaboration Requires Investment
During most interviews, there was limited discussion on the defund the police
movement. Participants agreed that taking money from one agency to support another agency
was the wrong approach in the short-term. They called for substantial and substantive
investment into each of the agencies responsible for supporting vulnerable populations and
communities in general. A significant portion of this discussion centred around the availability
and the likelihood that other agencies would be able to respond in a similar fashion to
emergency services, which was considered cost prohibitive.
As discussed above, Situation Tables are an example of effective collaboration that allow
police, social service, medical, housing, and community support agencies to work in
collaboration to address issues concerning acutely elevated risk in the community. By working
together to support people at risk, participants in Situation Tables can prevent crisis and
connect vulnerable populations to the supports they require. While Situation Tables are a good
example of collaboration at the frontline level, it begs the question why such cooperation does
not occur at higher levels? For instance, the current review of the British Columbia Police Act

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presents an opportunity to codify responsibilities and opportunities for that type of
collaboration.
Participants agreed that barriers, such as privacy and individual agency mandates,
should not trump wellbeing and the safety of individuals. They cited privacy concerns as one of
the main barriers to effective collaboration, even though the legal aspects of information
sharing in the name of saving lives and creating wellbeing have already been resolved. Again,
the Situation Table model is an example of effective information sharing across agencies and
maintaining an individual’s dignity. Participants argued that if privacy sharing and collaboration
worked at the front-line level, increased support, infrastructure, and resourcing should be
legislated to enable this support throughout all levels of government.
Decriminalisation
Participants in this study cited multiple examples of effective collaboration leading to
pathways to care for vulnerable populations that removed stigma and criminal justice
approaches in favour of support. The need for housing was a recurring element, but so too was
the need to have supports available to meet people where they were. Participants felt that
decriminalisation and treatment should be primary responses to current social concerns, while
recognising police responsibility to interdict illegal drug operations, predators, and organised
crime. The motivation behind moving to a decriminalisation strategy for illicit drugs was not
simply about reducing police occurrences and court burden, even though those may be positive
outcomes. Instead, decriminalisation policies were envisioned as building on community safety
and wellbeing for all citizens, including vulnerable populations. Participants agreed that
decriminalisation was an important step forward to build on existing harm reduction strategies
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through expanded outreach, treatment, and stabilisation through housing. Police executives
cautioned that for decriminalisation policies to work, significant infrastructure was required
prior to the implementation of the policy. The Portugal initiative relied on just such an
investment and full collaboration across sectors prior to implementation (Canadian Association
of Chiefs of Police, 2020; European Monitoring Centre for Drugs and Drug Addiction, 2019).
The requirement to meet people where they were in their respective journeys was
articulated by medical and advocacy participants with respect to decriminalisation policies built
on treatment. Again, they emphasised that there was no one size fits all approach, further
supporting the police view that significant investment was required prior to implementation.
Simply expecting decriminalisation policies to reduce harm in communities without follow on
supports would, in the view of participants, further stigmatise an already vulnerable community
by forcing them to maintain relationships with illicit drug dealers and organised crime. Instead,
a safe drug supply should be available in a medicalised and prescribed manner to eliminate the
illegal market. Once again, this suggested the need for significant infrastructure and resourcing
at the medical level to allow for medicalised interventions, such as iOAT, prescription
medications, and abstinence treatment programs on demand. Once in a supportive system,
multiple alternatives for dispensing medication could be made available ranging from
outpatient iAOT to coded dispensing systems in supportive housing facilities.

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Chapter 6: Recommendations: Building Pathways to Care
The interviews indicated multiple opportunities to build pathways to care, such as
supportive housing and medicalised approaches to addictions and mental health. The views of
participants were supported by the research and cannot be overstated in terms of the need for
collaboration across sectors and significant infrastructure investment. This study presents the
opportunity to investigate the most effective pathways to care, to move away from a criminal
justice approach to one where vulnerable populations are treated with compassion and
understanding with a view to resolving the conditions that led them to where they were. The
following recommendations are built from participant suggestions and the review of effective
strategies found in the literature review:
Recommendation 1: Cross Sectoral Cooperation
Legislation and policies should be strengthened to create collaboration across sectors.
Collaboration should include front-line initiatives, such as Situation Tables, assertive treatment
and outreach programs, treatment on demand, and alternatives to short-term incarceration.
Changes to policies and legislation should include a clear definition of agency roles and
responsibilities, both in terms of their unique mandates and how they interact with each other.
Multiple access points are required to allow those needing support to connect to resources,
regardless of how they come into the system. Policy discussions should centre on evidencebased initiatives, such as iAOT, to move away from punitive measures toward a health and
social support approach. Police should be able to refer vulnerable individuals to a broad
spectrum of support ranging from increased restorative justice approaches to entry into
treatment and supportive housing. Concurrently, support agencies should be able to work in
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collaboration with police for protection and to maintain accountability of individuals who are
not readily accepting of support.
This level of collaboration will require significant investment in terms of physical
resources, such as housing and treatment facilities, as well as substantial funding to supportive
programs. Alignment between agencies and supports utilising evidenced-based approaches
should be considered to reduce duplication of effort and to properly allocate existing budgets.
Data and information sharing should form an integral part of the approach towards effective
collaboration, while respecting confidentiality and private information.
Recommendation 2: Redefining the Role of the Police
Criminal justice policies should be representative of the community as a whole, not a
specific and identifiable component thereof. In this case, efforts to use enforcement to control
the social and health issues associated to addictions, mental health, and homelessness should
be eschewed in favour of evidence-based interventions, such as medicalised approaches to
drug use, outreach support, and access to services. Given the current workload of police, over
60% of which is consumed by non-chargeable occurrences, efforts should be made to reallocate police resources to more serious criminal matters, including drug importation and
trafficking, serious violent crimes, crime reduction through prolific offender management, and
crimes of exploitation, such as human trafficking and financial integrity. Police should remain a
part of collaborative efforts to support vulnerable populations by supporting other agencies to
meet their needs before exposure to the criminal justice system. Each community should
conduct needs assessments specific to their situation with guiding policy and legislation from
the provincial and federal level. When developed, needs assessments could be implemented
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through funding and support from provincial agencies to facilitate program success. Provincial
and federal policies should be evidence-based and guided by approaches that are proven to be
effective, such as Situation Tables, supportive housing, and medicalised support to vulnerable
populations.
Recommendation 3: Reduce Stigmatisation and Increase Understanding
The removal of barriers to collaboration should begin with an understanding of root
causes of addiction, mental health, and homelessness. The intent should be to reduce the
negative effects of stigmatisation against vulnerable populations to allow for holistic
approaches to overall community safety and wellbeing. Similar to the first recommendation,
policy development should focus on providing evidence-based research to governmental
decision makers to create understanding within their communities, as opposed to vilification.
Dated notions that vulnerable populations are somehow the authors of their own misfortune
should be removed in favour of actual understanding of why these populations exist, what can
be done to reduce their suffering, and evidence-based approaches to restore their dignity.
Holistic approaches respecting the dignity of the individual should be geared to people’s
specific needs and the overall community in general. This should include training programs for
police and community leaders that create an understanding of root causes. Wherever possible,
when the behaviour of vulnerable individuals does not present a threat to public safety,
alternative approaches, such as medical intervention, social outreach, and stabilisation through
housing should be priority responses before defaulting to the use of police and the criminal
justice system. Prevention of upstream drivers to negative behaviours should take precedence
over reactive enforcement. This can be made possible through increased investment into co153

responder models, peer support and experience, ACT teams, outreach programs, and early
intervention programs to prevent vulnerable population interaction with the justice system as
the default approach, when it should be the last resort.
Recommendation 4: Decriminalisation of Certain Illicit Drugs
Participants felt that decriminalisation and treatment should be primary responses to
current social concerns, while recognising the police’s responsibility to interdict illegal drug
operations and organised crime. The motivation behind moving to a decriminalisation strategy
for illicit drugs was not simply about reducing police occurrences and court burden, even
though those may be positive outcomes, but decriminalisation policies should focus on building
CSWB for all citizens, including vulnerable populations. Police executives cautioned that for
decriminalisation policies to work, significant infrastructure was required prior to the
implementation of the policy. Before undertaking legislative change to implement
decriminalisation, infrastructure should be funded and established to create multiple access
points to treatment, extended and coordinated outreach programs that may or may not involve
police participation, housing stabilisation, criminal justice diversion systems, and human
resourcing to operate a broad spectrum of care. The Portugal model is often cited as an
example of this broad spectrum approach since they were able to mobilise infrastructure and
cross sectoral response to their program. Police participants supported this model, but pointed
out that the Portuguese officials themselves recommended that a Canadian approach should
learn from, not copy Portugal. They cautioned against simply importing and adopting their
model due to the differences in social and governmental systems.

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Chapter 7: Limitations
This study analyzed police involvement with vulnerable populations through a literature
review, data analysis, and interviews with various professionals involved with these
populations. These interviews yielded valuable perspective in the application of the literature
and data to real life situations. Regardless, several limitations to this study should be recognised
to provide context for further research into the concerns faced by vulnerable populations:
Limited Sample Size
In total, 14 individuals were interviewed during this study, all of whom had significant
experience in policing, advocacy, and medical approaches to mental health, addictions, and
homelessness. Despite the relatively small sample size, the experience of the participants was
evident in terms of the understanding of root causes, current policies and approaches, and the
overall societal concern with respect to this population. For instance, police participants
consisted of senior officers with dedicated front-line experience with these concerns, as well as
executives who had actively participated in the crafting of legislation and policy at the
provincial and national level. Advocacy and medical participants had also published guiding
documents to describe evidence-based approaches to develop effective policies to support
vulnerable populations. The snowball sample methodology relied on references from initial
participants to others who likely shared similar views. Nonetheless, the findings in this study
were substantiated by the cross sectoral agreement of the participants. All participants were
quick to articulate the need for increased collaboration, investment, and support for vulnerable
populations to the point that the themes were not only apparent, but consistently similar in
their viewpoints, regardless of background.
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Further research can build on these experiences by expanding the participant base to
another advocacy and medical professionals, as well as interviews with people with lived
experience to bolster the qualitative nature of the research. Furthermore, interviewing other
police agencies, beyond large centres, would shed light on concerns specific to those
communities for a more complete understanding of societal issues.
Limited Geographic Context
Although participants had experience dealing with at all levels of government policy
development, most were from the Lower Mainland of BC. The data set used in this study was
specific to the BC RCMP with limited consideration of municipal police force data. Despite the
single data set, there is confidence on the basis of the literature review and interviews that the
BC RCMP data set is representative of overall policing and crime trends in BC and Canada.
Similarly, while participants in this study had limited direct experience working other
jurisdictions outside of BC, their professional experience and interaction with other agencies in
Canada allowed for a fulsome understanding of issues in other communities throughout the
country. Still, future research could be enhanced by focusing on specific communities outside of
major population centers to develop a broader perspective of societal issues in rural areas,
smaller towns, and different provinces. Notably, a significant portion of the literature
referenced studies and experiences from outside of Canada. Future research would be useful to
determine specific Canadian context with respect to the number of mental health and
addictions occurrences, including outcomes of Canadian specific approaches to these issues.

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Limited Perspective
Although this study relied on interviews from a broad range of participant experience, it
was focused on police interactions with vulnerable populations. This study determined that
police responses to dealing with societal concerns are over-represented when compared to
other agencies. While this is reflective of police concerns, there is scope for further research
with respect to the concerns of other agencies in the health and social support sectors. The
broad spectrum of participant experience coupled with the literature review lends confidence
that there is significant desire for increased collaboration across sectors; however, this would
be enhanced by specific viewpoints from those sectors.
Limited Transportability Assessment
This study is very specific to concerns in large BC communities and the overall BC
context. Care should be taken before assigning recommendations to other jurisdictions that
may be further along in developing and implementing evidence-based approaches or are
experiencing different types of social issues. The recommendations in this study focus on the
acceptance of significant investment in support of vulnerable populations that will require
governmental support at all levels, depending on the community or province.
Future Research
This study indicated that there was a desire to increase cross sectoral collaboration
among police, social service, medical, and support agencies in BC in support of vulnerable
populations. The motivations for that collaboration varied from agency to agency. In some
cases, the motivation may be a reduction in police workload to allow for reallocation of
resources to more serious crimes. In other cases, the motivation could be to increase overall
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community wellbeing and support to vulnerable populations. Decriminalisation of illicit drugs
was also an overarching theme in this study that was supported by all participants provided
that substantial infrastructure and supports were in place prior to implementation. All of the
motivations and approaches bear consideration for future research, especially within the
Canadian context of police and criminal justice response to mental health as a result of
deinstitutionalisation. There was limited research available to specifically identify why
deinstitutionalisation has led to the current homeless crisis in many BC communities. As
indicated by the participants, there was an understanding that supports were difficult to access,
but the reasons behind this require more investigation. Furthermore, police and criminal justice
data collection should be re-envisioned to consider a better understanding of specific upstream
drivers of mental health behaviours, including specific data with respect to mental health calls
for service beyond simple classification.

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Chapter 8: Conclusion
Are police reluctant warriors in the battle against addictions, mental health illness, and
homelessness? The results of this major paper indicated that they were indeed reluctant, not
due to a lack of compassion or willingness to help, but because, in their view, criminal justice
approaches to these concerns remain ineffective at resolving them. Police spend the majority of
their response time dealing with non-chargeable occurrences, many of which involve
vulnerable populations. Police, advocacy, and medical participants in this study expressed their
frustration in the slow pace of change in developing effective solutions that focussed on
meaningful support and interventions, based on the restoration of dignity and wellbeing in
vulnerable populations.
Societal demands to eliminate the spectre of homelessness and behaviours deemed to
be socially deviant have forced police agencies to fight a war that targets the wrong enemy. The
current focus on vulnerable populations must be changed to target the root causes of those
afflictions. Adverse experiences in childhood, physical and mental trauma, intergenerational
trauma, poverty, poor access to supports, and stigmatisation all contribute to the degradation
of people who should be supported, not vilified. Using police agencies to enforce politically
expedient polices, as opposed to those designed to create overall wellbeing, place those
agencies in a constant struggle between protecting the rights and freedoms of all citizens
versus those of the vulnerable population.
Collaborative efforts, bolstered by significant financial investment, are required to allow
police to focus on their primary mandate of public safety and wellbeing. Just as World War II
was won through the collective will of the Allied Powers to a common goal of peace, so too will
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the war on addictions, mental health, and homelessness be won through collaboration,
investment, and collective will.

160

Appendix A: Interview Guide

Reluctant Warriors: Changing Police Perceptions in the War on Drugs, Homelessness, and
Social Disorder
Interview Guide

1. What is your current position and how long have you been in this role?
2. What are your primary duties in your current position?
3. Could you describe your experience in dealing with marginalised or vulnerable
populations with respect to:
a. Addictions
b. Mental health
c. Homelessness
d. Social disorder
4. Do you work directly with persons suffering from these issues or are you in more of a
supervisor or policy development role?
5. What is your agency’s mandate with respect to these social issues?
6. Do you believe that your organisation’s mandate is aligned to the agency’s actual
practice?
7. In your opinion, to what extent do you feel your agency has been effective or ineffective
in meeting its mandate on the following social issues, using the scale of very ineffective,
somewhat ineffective, somewhat effective, or very effective with respect to vulnerable
populations including:
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a. Addictions
b. Mental health
c. Homelessness
d. Social disorder
8. WHY have you rated your agency the way you have?
9. In your experience, what do you believe are the major barriers to achieving your
agency’s mandate with respect to supporting:
a. Addictions
b. Mental health
c. Homelessness
d. Social disorder
10. If you feel that there is a need to develop alternatives to your agency’s current practice,
what, if any, do you think are the major barriers to producing effective policy
alternatives to the current response to addictions, mental health, and homelessness ?
11. To what extent do you agree or disagree with the following policy alternatives:
a. Decriminalisation or medicalisation of controlled drugs should take
precedence over enforcement in vulnerable populations?
b. Reducing stigmatisation is a key target for effective implementation of
alternatives?
c. Developing alternatives to police responses, such as co-responder
models, is an important component of building well-being amongst
vulnerable populations?
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d. Developing alternatives to sentencing is an important component of
building well-being in vulnerable populations? WHY?
12. What other alternatives would you recommend?

General open-ended questions:
1. What is your view of the role of the police with respect to being first responders in
matters of addiction, mental health, homelessness, and social disorder?
a. Why do you feel this way?
b. What should police do differently, if anything?
c. Who else should be involved?
2. What are your overall views on Canadian drug policy?
3. What are your views on harm reduction measures? Treatment programs?
4. Where do you think police should focus their efforts with respect to illegal drugs? For
instance, should they be seeking support for drug users while at the same time targeting
importers and traffickers?
a. How should resources be deployed?
b. Who should be the targets of enforcement?
5. How should the police divide or allocate their efforts on drug dealers and criminal
behaviour as opposed to street level possession?
6. In your opinion, how strongly do you agree or disagree with the following (use the scale
of strongly agree, agree, neither agree nor disagree, disagree, strongly disagree)?
a. Canadian drug policy should move towards decriminalisation of certain illegal
drugs, particularly those at the street level? Why?
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b. Harm reduction efforts, such as safe consumption sites, are an important
component of effective drug policy? Why?
c. Treatment should be available on demand? What types?
7. In your opinion, how strongly do you agree or disagree that the four pillars approach of
harm reduction, treatment, enforcement, and education has been effective, starting
with:
a. Harm reduction
b. Treatment
c. Enforcement
d. Education
e. Are each of these pillars still relevant or are there other approaches that can be
more effective?
8. In your experience, are tough-on-crime approaches beneficial or harmful to someone
experiencing a substance addiction?
9. In your experience, are harm reduction approaches beneficial or harmful to someone
experiencing a substance addiction?
10. What would an ideal approach to mental health, homelessness, drug use, and addiction
be?
11. In your opinion, what is the way forward to developing effective policy to support those
suffering from addictions, homelessness, mental health, and social issues?

That concludes our interview. Is there anything else that you would like to share with me about
these vulnerable populations?
164

Thank you for your time today.

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criminal justice approach to these issues. An important part of the interview will be your
perceptions around stigmatisation of vulnerable populations and alternatives to support these
populations outside of the criminal justice system. The interview, which is anticipated to take
approximately 30 to 45 minutes of your time, will be audio recorded with your consent. If you
do not wish to be audio recorded, the interviewer will take detailed notes during the interview,
which you will be able to review upon request.
Interviews will be conducted using ZOOM, due to current COVID requirements. The recording
function on ZOOM will not be used.
If you feel there are other people within your organisation or contacts who could provide
additional context, they may express their interest to participate in this study by emailing me
directly at
Potential Benefits
This project is designed to analyse current data with respect to social issues, such as
homelessness, addictions, and mental health, particularly with respect to police responses and
stigmatisation. Any information that you can share on these topics will provide further insight
into these complex issues will help to inform the final recommendations made in the major
paper.
Potential Harms, Risks, or Discomforts to Participants
There are no anticipated harms or discomforts associated with your participation in this
research. Your personal views as a professional in your field are important to provide context to
existing data. Any information that you feel could put you in a negative light, either with your
agency or the public you serve, will be discussed during the interview to ensure your wishes are
respected. You will be informed of the context of your statements, prior to the completion of
the project. Your views will not be presented in a negative light, given that the interview is
meant to gather your expertise with respect to alternatives to using the criminal justice system
to address social issues.
Confidentiality
All information obtained during these interviews will remain confidential. Any information used
in the major paper will be shared with you in advance to ensure an accurate summary of your
information, and that it conforms to your expressed views. Information that you feel does not
accurately reflect your views will be removed. Data for this project, including the audio
recordings or the detailed notes taken during the interview, will be de-identified and
subsequently destroyed by June 1, 2021. Data will be securely stored on an encrypted drive and
on a personal computer. Your name will not be used in the major paper. Transcripts will be
shredded and data stored on electronic devices will be securely deleted. Given the sampling
method, it is possible that your identity may be ascertained by referring the research to
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Consent Form
By signing below, I agree to participate in this study, titled Reluctant Warriors: Changing Police
Perceptions in the War on Drugs, Homelessness, and Social Disorder.
I have read the information presented in the letter of informed consent for the study being
conducted by Ted De Jager at the University of the Fraser Valley. I have had the opportunity to
ask questions about my involvement in this study and to receive any additional details.
I understand that I have the right to withdraw from the study at any time before March 30,
2021, and that confidentiality and/or anonymity of all results will be preserved. If I have any
questions about the study, I should contact Ted De Jager at

If I have any concerns regarding my rights or welfare as a participant in this research study, I
can contact the UFV Ethics Officer at 604-557-4011 or Research.Ethics@ufv.ca.
I consent to being audio recorded during this interview and have initialled this line to indicate
my consent. The record function on ZOOM will not be used. If I do not wish to be audio
recorded, I may be able to continue in the study by reviewing the notes of the researcher, Ted
De Jager. Initial of participant_________
Name (please print) ____________________________________________________________

Signature ____________________________________________________________________

Date ________________________________________________________________________

Once signed, you will receive a copy of this consent form.

170

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