SURREY, B.C. -- Deaths and injuries involving police during so-called wellness checks coupled with recent protests against police brutality are generating scrutiny over how officers respond to people struggling with mental health challenges.

Police departments in Halifax, Toronto, Hamilton, Calgary, Edmonton, Vancouver and Kelowna are among those that have partnered with local health-care providers to create mobile response units that pair officers with mental health professionals.

They tout these specially trained units as a more effective way of handling calls related to mental health, while advocates say chronic underfunding of mental health services has thrust police into a role for which they're ill-equipped.

"There aren't good supports for mental health to begin with, so people end up in distress and their only resort is to call the police it seems, or to call 911," said Margaret Eaton, CEO of the Canadian Mental Health Association.

Officers have a high degree of discretion when it comes to using force and their presence during wellness checks is rooted in stigma and fear that people with mental illnesses are dangerous, Eaton said in an interview on Thursday.

Meenakshi Mannoe, a campaigner with Pivot Legal Society, said police intervention in mental health crises too often leads to people being funnelled into the criminal justice system.

The Vancouver-based organization works with communities affected by poverty and social exclusion, with a focus on police accountability, drug policy, homelessness and sex workers' rights.

"We see it in the statistics of who's incarcerated, whether it is Indigenous people who have survived intergenerational trauma, or people with mental health issues who were acting in ways that were criminalized," said Mannoe, who is also a registered social worker.

"Yet we continue to invest in the most crisis-oriented, escalating approach, which is law enforcement, when we could be investing in foundational institutions that actually prevent crisis."

In Surrey, B.C., RCMP officers say they're doing things differently. The detachment has been working with nurses specializing in mental health for 20 years through its Car 67 program, born from a partnership with the Fraser Health Authority.

The car operates from 1 p.m. to 1 a.m., when police say the volume of calls related to mental health tends to be higher.

Surrey RCMP officers attended more than 7,600 calls related to the Mental Health Act last year, and Car 67 handled just under 900 of them.

Car 67 may be dispatched directly or called in by other front-line officers, explained Tina Baker, a nurse who's worked with the mobile unit for the last decade.

Either way, police assess the situation first to make sure it's safe for Baker or another nurse to attend.

When she is called, Baker checks the person's health records, which police cannot do. That provides a baseline understanding of what the person may be grappling with and what treatment they've already had, she said.

Whether a person is getting help can influence if they are taken into custody under the Mental Health Act, said Baker.

If they have support in the community, "we can liaise with them as opposed to going to the hospital," she added.

Apprehending under the act can be traumatizing and confusing, said Baker, especially since it involves handcuffs. When she's on duty with Car 67, Baker said she works with the officer she's paired with to de-escalate the situation.

"A lot of people can be quite calm and then the minute you change their environment, whether it be into the police car or into the hospital setting, then they can become agitated. So, we have a role to keep everybody safe until we know that client is going to be OK."

Cpl. Scotty Schumann, who leads the Surrey detachment's mental health outreach team, said police are probably taking people to the hospital more often than necessary when a nurse isn't present.

The outreach team receives specialized training from the Fraser Health Authority, which team member Const. Maciej Roszkowski said builds compassion and offers insight into the root causes of people's behaviour.

"I always picture what if this was my family member in distress," he added.

Roszkowski is among a group of officers specially selected based on their interest in working with vulnerable people, said Insp. Wendy Mehat, who oversees the outreach team.

"Our policing strategy is not based on arresting and handcuffing our way out of situations. It's developing bonds, negotiating with our clients and getting them the support and referrals and help that they need," she said.

At Pivot Legal Society, Mannoe said specialized police training is not a substitute for preventative measures and crisis services that are led by people who have experienced mental health challenges, or in other cases homelessness or substance use.

People and communities who tend to be criminalized don't associate the police with safety, she noted, and external accountability can be limited when it comes to police officers' own conduct while responding to mental health crises.

"The police attendance at these wellness checks can, in fact, escalate situations and put people at real risk. For people who are using substances or experiencing homelessness or who are racialized, that risk is compounded by systemic racism and bias."

Mannoe points to a program in Oregon called Cahoots, which stands for crisis assistance helping out on the streets, as a good example of a community-based program that works. It's dispatched through the local emergency communications centre but doesn't necessarily involve police.

Wellness stems from dignified access to health care and basic needs, "not a uniformed officer banging on your door," she said.

This report by The Canadian Press was first published June 28, 2020.