Police violence is a public health crisis, so why aren't there health-based solutions?

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Image: Mitchel Raphael

Doctors across Canada are joining in the fight to defund the police, and attempting to revise how medical professionals interact with police, and reviewing which areas could be improved. This comes to a head after months of protests across North America calling for Black liberation and dismantling anti-Black racism. 

"People don't know how intertwined medicine is with policing but especially mental health, it's the number one thing," said Semir Bulle, a second-year medical student at the University of Toronto who has recently started rotations at a local city hospital, and is one of the core members behind Doctors for Defunding the Police. He has teamed up with medical professionals across the country to petition local governments to defund the police and reallocate funding to community programs. 

Cities across Canada are facing calls and protests to cut police budgets and to reinvest that money into community and social programs. So far, Edmonton, Alberta, has passed a motion to cut the police budget by $11 million over the next two years. Meanwhile, Toronto has dismissed motions to reduce the police budget, and has instead invested more money into reform strategies such as body cameras. 

"If anyone is watching [Toronto Mayor] John Tory, clearly we're starting to see people like him don't belong in society. They should not be leading us when they don't understand what's going on," said Bulle, who also added that police have become our answer to all of society's challenges even the ones that need a health-based approach like mental health and addiction. 

"When you have a hammer, everything looks like a nail, and having police try to solve every issue in society; mental health problems, drug addiction, everything that goes on in our community," he said, "We think that if we did a proper cost-benefit analysis and looked at where each dollar went, we can have a better society."

Along with calls to reduce the police budget, Doctors for Defunding the Police is also advocating for the city to invest in health-based solutions for crime prevention.

Sané Dube, a Toronto-based health policy expert who works with Alliance for Healthier Communities, points to solutions tested in B.C. where during the COVID-19 pandemic the government was mailing prescription opioids to address the challenges for folks suffering from addiction and who were isolated at home. This initiative was designed to keep a decline in overdoses by decriminalizing drug use and making their overall health a number one priority. 

"That is very much taking a health-based approach to something that is a health issue, because addiction is a health issue," she said. 

In 2018, Ontario's human rights commissioner found that Black Toronto residents were 20 times more likely to die at the hands of police than their white counterparts. Since police structures are contributing to the mortality of Black Canadians, organizers and experts are calling police violence a public health crisis. 

"What we want to see is funding of programs that are able provide health care to Black communities that is culturally safe," said Dube, who added that the medical field also has to address the lack of anti-bias and anti-racist training in medical schools. 

Maurice Michelin is a nurse practitioner who runs a clinic in the west end of Toronto. Many of his clients are raised in public housing. Andrew Loku was one of his patients, who was killed by police in 2015. In his years of working with Loku, Michelin knew him to be gentle and soft-spoken. 

"Sometimes he would speak so softly it was almost hard to hear him," Michelin said. "[His death] was a reminder to me about trauma in communities and how that ripples through the community."

Michelin says that officers not trained in de-escalation or working with folks in crisis can have a devastating impact. He recalls visiting a patient who lived in the same building as Loku, and was in crisis after his death. Police were called as part of a routine to prepare the patient to be checked into the hospital, but aggressively handled the situation. Michelin had to ask them to rethink their body language and tone before intervening.

"It was a reminder that the effects of the story don't end with the individual whose life was taken. It manifests as decreasing mental health for individuals," he said.

The incident changed the way Michelin approached policing when helping Black folks experiencing mental health distress. He's grown more hesitant to call police for intervention, and redirected his efforts to enhance patient-physician relationships instead. 

"That's one of the problems with mental health crises: the person who's experiencing it may not identify it as a problem until other people provide some feedback and say 'oh maybe this is a problem,'" he said. 

Michelin has one patient he's been seeing for 10 years. They were referred to his practice through court diversion after an altercation with police. He has since been diagnosed with schizophrenia and eventually stopped attending psychiatric sessions. He's not mandated to take medication, since his episodes are triggered by stressful situations where he's provoked. 

He visits Michelin every two to three months, and his clinic monitors him, prescribes medication and refers him urgently when needed. It's because of this relationship that this patient was able to get help, leaving less room for police intervention. 

"That's not necessarily a scalable solution, but it's important for the health-care system to have ways of connecting with the people that they serve. In the same way the police should represent, should look like the community that it serves, and teachers should look like the students that they're teaching," he said.

Improving the relationship between physicians and patients would take large efforts across many different systems—including the health sector. Dube says this involves the medical field addressing its own anti-Black racism, and how professionals can better improve communities through health-based solutions. 

"When we have health responses, we actually see better outcomes, we actually see people getting help that they need as versus ending up in systems where they are again, criminalized or behind bars and not getting the care that they need," she said.

Lidia Abraha is a freelance journalist based in Toronto, whose work has appeared in VICE Canada, NOW Magazine, The Canadian Press and Exclaim! She is the recipient of rabble.ca's 2020 Jack Layton Journalism for Change Fellowship. Her work at rabble focuses on some of the issues most urgently affecting racialized and marginalized communities, notably racism in the criminal justice and policing system.

Image: Mitchel Raphael

 
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