Episode Transcript
Elizabeth: Welcome to “Advancing justice,” a podcast that explores the interface between human rights, poverty, racism, and the criminal justice system. My name is Elizabeth McIsaac, president of Maytree. We’re a Toronto-based organization exploring solutions to poverty in Canada using a human rights-based approach.
Joining me today to discuss community alternatives to policing is a Akwatu Khenti. He’s an Assistant Professor with the Dalla Lana School of Public Health at the University of Toronto. Akwatu is also a member of the editorial board of the “Advancing justice” series.
He has over 25 years of experience in government and community settings. Akwatu formerly served as Assistant Deputy Minister for Ontario’s Anti-Racism Directorate, Cabinet Office, and Director of Transformative Global Health at the Centre for Addiction and Mental Health.
Welcome, Akwatu, and thank you for joining me on the “Advancing justice” podcast. I’d like to start our conversation today by situating the question of policing within the themes that we’ve been exploring in this series. So when it comes to the question of policing, how do you see the intersection of human rights, race, poverty, homelessness, and the criminal justice system?
Akwatu: I think the intersections happen in fatal encounters. But it also happens in DWB, WWB – “driving while Black,” “walking while Black” – where you have these huge disparities in fatal encounters: Indigenous people in particular, four per cent of the population, 16 per cent of the fatal encounters; Black people, three per cent of the population, and almost nine per cent of the fatal encounters.
And those rates also apply to “driving while Black,” “walking while Black,” and it’s in Toronto, it’s Montreal, it’s Halifax. It’s even in places where the population of Black people is small – so PEI, Newfoundland, Saskatchewan, Manitoba.
What’s also important is that mental health and substance abuse issues are involved in the majority of these situations, particularly the ones that lead to fatalities.
Often, “driving while Black” or “walking while Black” leads to arrest and detention for issues that nobody would have anticipated. They didn’t have insurance, had some cannabis under the car seat, things like that, that you had to actually be looking around to find it. And next thing you know, the person’s on a pathway to criminalization.
I also think in terms of these situations that policing depends on skillsets that are not really appropriate or necessarily relevant for mental health issues or substance abuse issues. Because policing is about authority, establishing control, whereas we know that mental health crisis is about listening, trying to reason with the person, de-escalating, respecting autonomy and decision-making, so that the outcome is satisfactory to all, as opposed to satisfactory to the one who’s charged with establishing law and order.
The police themselves say, “We can’t solve all the social problems of the country and it’s unrealistic to expect us to do so.” And I actually agree with them on that. But I also say, “Why is it so much easier to pull the trigger when the person on the receiving end is Indigenous or Black?” That’s also a problem that needs to be addressed.
That’s one component of the answer. The other part of the answer is the research that shows that people who are homeless have 42 interactions with the police a year compared to people who are not homeless, which is about four.
So ten times the interactions just by virtue of not having a home. In a city like Toronto, with 9,000 homeless on average, that’s like 360,000 interactions with the police. More than ten per cent of police interactions taken up by people who are not involved in any criminal activity, because homelessness is not a crime, it’s a socioeconomic reality, a problem that remains to be solved. And what amplifies the racialized risk, of course, is that Black people are disproportionately represented amongst the homeless, three to four times the rate of the population, and Indigenous people even more so, actually I would almost say obscenely so, 30 times the rate in the population.
Elizabeth: So the situation that you’ve described, particularly “Black while walking,” “Black while driving,” it has just become so stark in the public view and has led to movements around defund the police. I think the spirit behind that is some of what you talked about, that police aren’t necessarily the best positioned to do certain things.
Some in the community, and some advocacy groups, have called on governments to develop emergency systems of response to mental health, addictions, and homelessness, and to take this outside of the police purview, to take this outside of something that immediately feeds into the criminal justice system.
In the piece that you wrote for us, you talked about a model, called CAHOOTS from Eugene, Oregon. Can you tell us a bit about this model?
Akwatu: The White Bird Clinic came up with the idea. It comes from the idea, or the inspiration for the term – “in cahoots with the police.” It comes with the irony of the involvement with the police in order to solve a problem that the police actually amplify.
The reality is we have to work with our law enforcement officers. We don’t want to create a problem to solve a problem. We want to solve a problem with a solution, not with another problem.
It’s less expensive than a police model. It involves two-person teams: one for crisis intervention, psychiatric emergencies, de-escalation, counseling; another one for the medical emergency management when such issues emerge. Like, for instance, somebody is cutting themselves, you need somebody to deal with that, as well as talk to them because the crisis is both psychiatric and medical.
What’s important also is the mission. Their mission was to address substance abuse and mental health, and homelessness, and to arrive at problem solving.
The other thing I like about the CAHOOTS model is that it reduces stigma around mental health in a real way. You don’t need a doctor in an emergency vehicle to come to the house to deal with a minor medical emergency. You’ve got emergency medical teams, a nurse, or an EMT support worker.
Similarly with mental health, you don’t need a police officer. Having a police officer respond to mental health issues, someone in psychiatric crisis, adds stigma. So when you send people who are dressed casually, look like the person in crisis, it’s a different vibe and a different message about how to manage these things and how these things can be managed.
That’s another reason I like the model, especially given the issues that we have about trust, or lack of trust. The model really allows for trust-building, particularly because it recognizes the role of human contact, empathy, compassion, and de-escalation.
Elizabeth: So those are all critical principles. Does it work?
Is it effective? Can you tell us more about what we know with the evidence?
Akwatu: The record indicates that CAHOOTS has effectively managed conflicts and wellness checks. Less than one per cent of the calls in fact have required the CAHOOTS folks, the two-person teams, to call the police in because the individual was violent and out of control and they couldn’t handle it.
Instead of have people in uniform establishing authority, looking to control the situation, just having people who look like you ask you: “What’s going on? What help do you really need? What can we do?” has its different messaging around what safety actually means and what your relationship actually means.
Because the people who are doing it don’t have baggage. And if you’re homeless, you have baggage because, as I said, 42 contacts a year for no reason just because you’re homeless doesn’t incentivize you to call the police in the first place. In fact, you’re more than likely to be reluctant and respond positively to the messages of de-escalation.
Elizabeth: Even I would imagine that the physical representation of a uniform would be a trigger for many people.
Akwatu: And that’s what a uniform does. We wear uniforms to convey authority, establish control, message out: “We’re in charge.” It’s a power thing.
Elizabeth: This is about taking that right out of the equation. It’s about relationship. So often, it’s how it gets implemented. Are there lessons to be learned about implementation here?
Akwatu: Yeah, there’s a lot of lessons to be learned. It’s about walking the talk. At the point of contact or the frontline, so to speak, it’s really a different collaborative venture. It’s not a hierarchical experience or interaction in the way that it would be – because that’s what police are trained to do. They’re trained to establish control, take charge, reduce this “quote, unquote” safety threat.
The collaborative output or outcome is a reflection of the collaboration that’s required at the back end. In order to work, it needs to be a true collaboration between community, police, fire, EMT, emergency housing and other social supports.
The model says: interfere within a crisis, control, reduce the crisis, but begin to look for long-term solutions immediately.
What does the individual really need?
A lot of times, it’s just a home. And once you establish a home, the road to recovery begins. But a lot of times, it’s more than the home. They need counseling, contact. A lot of times people may be socially distanced already, and that social distance translates into mental health problems, into depression, into anxiety, in some cases even into the psychosis. And so collaboration is required in the relationship-building between the people intervening in the emergency.
What I like about the CAHOOTS model is that collaboration isn’t just at the end. It’s in the development of the initiative from the back end to the front end. So you’re walking the talk with community. You’re building trust with the community because they are gaining confidence that if they call 9 1 1 for this situation, people they know and practices that they themselves have had a hand in crafting will be the results. And no one will be dead as a result. No one will be further stigmatized as a result.
It will be handled with sensitivity and care; and really with an understanding of mental illness that this person will be stable one day if you work with him or her.
Elizabeth: Has it spread? When you see something successful like this, the question is, so who else has taken this and run with it? And are they seeing the same success or was it just unique to what they were able to do in the first site?
Akwatu: It’s had similar types of success. I was reviewing a couple of places where the program was set up. Sometimes, you have different issues because it’s different management styles. And in some cases, they don’t have the same amount of resources. But I haven’t read any negative reviews of the program.
In terms of sort of warnings, I guess, the program must be trauma-informed. That’s key.
The survivor is at the centre. The person in crisis has to be. When we talk about client-centred, that’s what client-centred means.
The other issue is, it has to be civilian management or community management. Because otherwise, if it’s perceived as being too close to the police, it’s hard to gain the confidence and trust of marginalized members of the community, who wonder, will they be snitched upon, will they end up with more likelihood of being arrested for things they did or didn’t do than would otherwise be the case?
So community management is a key piece, and sometimes it hasn’t happened in the way that it’s required. And so the perception of the project has been tainted. So that’s very important, that hands-off civilian management piece, very important for community perception.
Thirdly, the connection to the resources in the community are critical.
You could actually use people in the community in the delivery of the program, the delivery of the service. Having the housing, having the counseling, having whatever the needs are that people have for schooling, for rent, for immediate financial relief, whatever it is, in place before you actually start sending people out is very important.
And, finally, training is very important. Empathy-building, understanding how to read situations, how to identify what’s the problem here, and be intuitive, that doesn’t [snaps finger] happen like that. Long-standing training programs, hundreds of hours of field training, supporting the individuals adds to the proficiency of the program.
Elizabeth: From what you’re saying, it’s really where you see fidelity to the principles and the elements of what works, then you see success. Where you have the wraparound services built in, thought through the relationships, then you begin to see the results that the model can offer.
You and I are in Toronto and we’re in a city that has had too many of these crisis moments of people’s lives that have been lost because of the wrong response to a particular moment in someone’s life.
That’s tragic every time it happens and there’s many more that we’re likely not aware of that maybe not resulted in a fatality but certainly damaging to individuals and families and communities. I understand that there’s a series of pilots that are going to be starting in the next year, perhaps similar to the CAHOOTS model. What are you hoping for in our city?
Akwatu: I’m hoping for a demonstration of how cost-effective, as well as how effective generally in terms of recovery, the program is. And I’m hoping that tons of data will be collected and there’ll be sufficient analysis of the data to demonstrate really the power of health interventions .
So I’d like to see data. I’d like to see different types of models so that we can actually compare, not just the cost-effectiveness of different models, but the associated recovery rates of the different models.
And then we get to see what the results are from the different approaches. We may end up merging the two and creating a new model, the Toronto model, which brings together different set of resources to tackle some of these problems.
The most innovation is in the long-term advocacy around homelessness. Not only do we find these individuals a home, but we use each individual incident to sort of advocate for real-time solutions now that we can see the immediacy of the need and translate into a reality show for everybody, including our decision-makers to be constantly reminded that it’s not going away. And actually the pressure is on them to do what their power allows them to do.
And I also want to see in the analysis, by comparison with the status quo, the reduction in criminalization, arrests, the sort of escalation from minor offenses to serious offenses.
I would like to see this program contribute and demonstrate that long-term problems can be solved, that the long-term homeless problem can be solved because communities will be empowered in the problem-solving, in the construction of the crisis management, as well as the evaluation of the crisis management.
And the communication of the progress that they have observed, what are the people who recover as well as the costs that’s saved for the system. The cost in terms of arrest reduction, incarceration reduction, and just the cost of issuing all those thousands of tickets that will never be paid.
I’d also like to see growing awareness of social problems and the possibilities of solving these problems. Because oftentimes people see the problems and think they cannot be stopped because they seem so huge. But I actually believe, and historical records should back me on this, that when people get a sense of empowerment and begin to see small gains, that also paves the way for bigger gains. Because they then become more confident and enthusiastic about going harder and longer upstream where problems have to be solved.
I’m looking for unique sets of skills and training in the teams, the Toronto model, which I hope will involve the usual stuff, de-escalation, harm reduction, restorative justice, but also uniquely to Toronto, cultural components of Indigenous health leaders, African elders, getting everybody involved in finding a solution to this homeless problem, but also to the crises that unfold on a day-to-day basis.
Elizabeth: I think that’s a final word of hope. I think I hear hope in your voice.
Akwatu: James Baldwin said in response to an interviewer who was asking him why so cynical and pessimistic? He said, Cynical and pessimistic? This is the author, James Baldwin, he said, I’m an optimist. And the reason I’m an optimist, I know where Black people have come from. I look back and I have to look back five, 10 years ago. And what I see, really, is that is remarkable in terms of how far we’ve come. It’s just that we have so far to go. And I sort of learned from that approach that, yes, we’ve come a long way, but we still have a long way to go.
Elizabeth: Well, let’s push for that Toronto model that you talked about. Thank you so much, Akwatu.
Akwatu: My pleasure. Thank you so much.
Elizabeth: Thank you for listening to this episode of our podcast, “Advancing justice,” with Akwatu Khenti. To hear all episodes in this series, please subscribe to this podcast on Apple Podcasts, Google Podcasts, Spotify, or Stitcher. You can find the full transcript of this conversation, Akwatu’s article, links to resources, and other contributions to our series on the Maytree website at www.maytree.com.
