The Victoria Integrated Community Outreach Team (VICOT) team provides intensive support to 65 individuals living with persistent mental illness who face multiple barriers to independent living including substance abuse. These individuals were targeted for team support because of their elevated emergency services usage, including emergency health care and police involvement. VICOT was formed to address complex issues by providing clients with access to a team of service providers including nursing staff, outreach workers, social workers, a probation officer, a police officer and a Ministry of Social Development (MSD) assistance worker.Integral to the work done by probation is the Victoria Integrated Court (VIC) system that works for VICOT and ACT clients by ensuring that all interested parties are working toward a common goal, rather than taking a simply punitive approach.
Focused Enforcement Team
The level of involvement has been cooperative.
This initiative has been in place since 2007.
Within the Victoria / South Vancouver Island region, there is a population subset that presents with severe mental health and addiction disorders, cognitive impairment, low impulse control and overall high needs. These disorders often lead to addiction issues and homelessness. These individuals generally respond favourably to acute institutional support, however, once returned to community care they often degrade to the point where they frequently come into contact with the police and emergency health services. These individuals are often arrested for their chaotic behaviour, with incarceration and/or probation as a result. The economic benefit of providing them with supports is the drastic reduction in psychiatric acute care bed days and the reduction in police/emergency service calls for service.
Funding was primarily provided by the Vancouver Island Health Authority, and contributing agencies (probation, police) provide staff at no cost.
Since December 2006, the Ministry of Social Development (MSD), Vancouver Island Health Authority (VIHA), Victoria Police Department (VPD), Community Corrections Division (Ministry of Justice) and other stakeholders have met in order to discuss target group service provision, the need for integration of our services, and the need to work toward establishing a common service delivery model and program goals.In July 2007, partners agreed to proceed toward the preparation of a program and a services delivery trial. Resources are focused on a small group of the most challenging individuals who would fall within the partners organizations' client group in the downtown Victoria core. This program was designed to provide an opportunity to test our service approach, include an assessment component combined with frequent steering committee input and review. This process and the project outcomes guided partners in the development of a long-term integration proposal for the downtown core.In October 2007, in response to the Mayor’s Task Force on Breaking the Cycle of Mental Illness, Addictions and Homelessness, the Vancouver Island Health Authority agreed to fund the development of four new teams tasked with serving hard-to-house people with mental disorders and addictions. VICOT was determined to be the first of these teams and permanent funding was made available for five staff, office space and supplies with the understanding that the other partner organizations would each contribute appropriate staffing.
Based on the collected statistics from the four areas of data collection (health indicators, police statistics, probation statistics, and MSD and housing statistics), it is evident that the VICOT model is contributing positively to the improved health and well-being of clients. Further, the case scenarios provide a snapshot of client successes that illustrate the positive role VICOT plays in the lives of clients who face multiple barriers to housing. As a result of being supported by VICOT, clients are involved with fewer police interactions, they remain successfully housed for longer, their use of emergency care facilities (including acute care beds and psychiatric acute care beds) is decreased, their medication compliance improves (resulting in improved physical and mental well-being), they have increased opportunities to engage with social activities and groups and have increased opportunities to engage in productive work that builds skills, abilities and confidence. Perhaps the most important indicator that clients are seeing improvement in their lives is that they have increased capacity to build and maintain healthy relationships with others.
VPD statistics show a decrease of 67.15 calls per month in 2011 for VICOT clients, or 805.8 over the course of the year. This translates to roughly one less call per client per month. While some clients showed rather dramatic decreases in the number of police calls, others remained the same or increased. All told, 55 VICOT clients showed a decrease in police calls, with an average decrease of 1.4 calls per month (16.8 calls per year). Those clients who showed an increase in calls averaged at 0.47 more calls per month (5.6 calls per year).There are several factors that explain why the majority of clients experience decreased interactions with police after becoming involved with VICOT. These factors include: attaining appropriate housing, engagement with substance abuse treatment or recovery programs, increased awareness of harm reduction strategies, better access to the health supports required (including mental health supports), improved medication compliance, and improved overall stability as a result of having regular contact with nursing staff, social workers and outreach workers who help clients manage and avoid crises.