Rapid Mobilization Table Data Report May 2014 to December 2017

Transcription

1 Rapid Mobilization Table Data Report May 2014 to December 2017

2 Table of Contents Background... 3 The Rapid Mobilization Table (RMT)... 4 Rapid Mobilization Table Data Overview... 6 Situations presented to the Rapid Mobilization Table... 7 Originating agencies Demographics Risks Categories and Factors Contributing to Acutely Elevated Risk Categories of risk Risk categories impacting individuals and families Risk categories by age group Risk categories by sex Risk factors Rapid Mobilization Table Collaborative Responses Partner agency involvement in RMT situations Special considerations that help guide RMT responses Situation resolution Appendix A Co-occurring Risk Factors Appendix B Co-Occurring Risk Factors by Sex Appendix C Co-Occurring Risk Factors by Age Groups Appendix D Data Dictionary Prepared by Elyse Lamontagne, Decision Support Specialist Canadian Mental Health Association Sudbury/Manitoulin March

3 Community Mobilization Sudbury Rapid Mobilization Table Data Report May 2014 to December 2017 Background Community Mobilization Sudbury (CMS) is a community partnership representing over 24 organizations from diverse sectors such as health, children s services, policing, education, mental health and addictions, housing and municipal services. We have come together around a common need and desire to build multi-sectoral and collaborative mechanisms for responding to situations of acutely elevated risk. The CMS threshold of acutely elevated risk refers to: a situation affecting an individual, family, group or place where there is high probability of imminent and significant harm to self or others, (e.g. offending or being victimized, lapsing on a treatment plan, experiencing an acute physical or mental health crisis, loss of housing). Circumstances and risk factors cut across multiple human service disciplines and have accumulated to the point where a crisis is imminent if appropriate supports are not put in place. Community Mobilization Sudbury is not a program or service delivery mechanism, but rather a way of utilizing and mobilizing existing systems and resources in a coordinated and collaborative way. The CMS model is often referred to as a Situation Table or Multi-sectoral Risk-based Intervention Initiative. It is based upon a well-established, evidence-informed, and evaluated model that originated in Scotland and has since been replicated in communities across Canada and the United States. In Ontario alone, over 50 similar initiatives are now operating or in development. It is recognized that the CMS model is an upstream investment of resources in the coordinated prevention of negative outcomes, rather than a response to harmful incidents once they have occurred. Community Mobilization Sudbury discussions and collaborations result in coordinated interventions to reduce acutely elevated risk. These early interventions have demonstrated their potential to reduce the need for more intensive and enforcement-based responses such as hospitalizations, arrests and apprehensions. 3

4 Community Mobilization Sudbury has three main goals: Individuals and families at acutely elevated risk are connected to timely and appropriate supports. Human service agencies have greater capacity to respond to situations of acutely elevated risk and prevent negative outcomes for individuals, families and communities. CMS partners and products influence positive change to improve the conditions that influence community safety and well-being. Community Mobilization Sudbury Partners Behavioural Supports Ontario Monarch Recovery Services Canadian Mental Health Association- North East Local Health Integration Sudbury/Manitoulin Network Centre de santé communautaire du Grand N Swakamok Native Friendship Centre Sudbury Children s Aid Society of the Districts of Rainbow District School Board Sudbury and Manitoulin City of Greater Sudbury Réseau Access Network Conseil scolaire catholique du Nouvel- Shkagamik-Kwe Health Centre Ontario Conseil scolaire publique du Grand Nord de Sudbury Action Centre for Youth l Ontario Greater Sudbury Paramedic Services Sudbury and Area Victim Services Greater Sudbury Police Services Sudbury Community Service Centre Health Sciences North John Howard Society of Sudbury Ministry of Children & Youth Services Youth Justice Services Sudbury Counselling Centre Sudbury Catholic District School Board TG Innerselves The Rapid Mobilization Table (RMT) Representatives from CMS partner agencies meet twice each week at the Rapid Mobilization Table (RMT). The RMT is a focussed, disciplined discussion where participants collaboratively identify situations of acutely elevated risk. Once a situation is identified, all necessary agency partners participate in a coordinated, joint response ensuring that those at risk are connected to appropriate, timely, effective and caring supports. 4

5 In order to ensure that privacy is appropriately maintained throughout RMT discussions, a four filter approach has been developed and endorsed by the Ministry of Community Safety and Correctional Services and the office of Ontario s Information and Privacy Commissioner. These filters establish the presence of acutely elevated risk, identify relevant risk factors related to the risk, identify the agencies required to mitigate the risk, and guide the coordinated, collaborative response. 5

6 Rapid Mobilization Table Data Overview At each Rapid Mobilization Table (RMT) meeting, deidentified data is captured to reflect the nature of RMT discussions. Variables collected include demographics, risk factors, agencies involved in response, and how each RMT situation is concluded. The report that follows provides a detailed report of RMT data collected between May 6, 2014 and December 22, The demographics and risk factors presented are not meant to be representative of the full nature and scope of risk in the City of Greater Sudbury. Rather, they represent situations that: a) meet the criteria of acutely elevated risk, and b) were identified by partners for presentation to the Rapid Mobilization Table. 6

7 Situations presented to the Rapid Mobilization Table A total of 409 situations were presented to the RMT between May 6, 2014 and December 22, Of those, 343 (84%) met the CMS threshold of acutely elevated risk and required a multi-agency response (see Table 1). Since the CMS launch in 2014, the percentage of situations that proceed to RMT response has increased from 71% in 2014 to 93% of those presented in This is likely due to increased partner understanding of the threshold of risk, familiarity with RMT process and mutual trust among partner agencies. It is important to note that even those situations that did not meet the CMS threshold of acutely elevated risk (66 of the 409 situations presented) benefited from presentation to the Rapid Mobilization Table. When situations do not proceed to response, partners are still invited to share suggestions regarding next steps and possible follow-up to assist the presenting agency. 7

8 Table 1 Situations presented to the Rapid Mobilization Table between May 2014 and December 2017 Situation required multiagency response Situation did not meet threshold of acutely elevated risk Overall n % n % n % n % n % 47 71% 98 84% 92 82% % % 19 29% 19 16% 20 18% 8 7% 66 16% The majority of situations of acutely elevated risk presented at the RMT involved individuals at risk, (78%, n=269). This is compared to 21% (n=72) of situations that involved families at risk. Although it appears that the percentage of individuals presented has increased in comparison to families, this was due to a change in data collection processes and is not a reflection of changes in the nature of risk over time. See Table 2. Of the 72 families at acutely elevated risk, 169 affected persons/family members were identified includes data from May 6, 2014 to December 19,

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10 Table 2 Type of Situations of Acutely Elevated Risk between May 2014 and December (n=47) 2015 (n=98) 2016 (n=92) 2017 (n=106) Overall (n=343) n % n % n % n % n % 2 Person 32 68% 67 68% 76 83% 94 89% % Family 14 30% 30 31% 16 17% 12 11% 72 21% Environmental n/a n/a 1 1% n/a n/a n/a n/a 1 0% Neighbourhood 1 2% n/a n/a n/a n/a n/a n/a 1 0% n/a: No presentations during that year Originating agencies Greater Sudbury Police Service introduced more than one-third (41%, n=167) of situations during the first 4 years. Situations are increasingly being presented by other partner agencies such as CMHA-S/M, SACY, HSN Mental Health & Addictions, CAS and the Rainbow District School Board. Table 3 summarizes the frequency with which partner agencies presented situations of acutely elevated risk to the RMT between May 2014 and December Rounding does not total 100 percent. 10

11 Table 3 Originating Agencies of Situations of Acutely Elevated Risk between May 2014 and December (n=66) 2015 (n=117) 2016 (n=112) 2017 (n=114) Overall (n=409) n % n % n % n % n % Collaborating partner agencies Greater Sudbury Police Service 34 52% 38 32% 50 45% 45 39% % Canadian Mental Health Association 3 5% 9 8% 7 6% 15 13% 34 8% Sudbury/Manitoulin Rainbow District School Board n/a n/a 10 9% 7 6% 9 8% 32 8% Children's Aid Society of the 5 8% 6 5% 9 8% 7 6% 27 7% Districts of Sudbury and Manitoulin Sudbury Paramedic Services 7 11% 2 2% 7 6% 9 8% 25 6% Health Sciences North Mental Health 5 8% 15 13% 3 3% 1 1% 24 6% & Addictions Sudbury Action Centre for Youth 1 2% 11 9% 4 4% n/a n/a 16 4% City of Greater Sudbury Social n/a n/a 2 2% 2 2% 8 7% 12 3% Services Sudbury Catholic Schools n/a n/a 2 2% 5 4% 4 4% 11 3% Sudbury Community Service Centre 1 2% 4 3% 1 1% 3 3% 9 2% NE LHIN Home and Community Care n/a n/a 2 2% 4 4% 1 1% 7 2% Homelessness Network 1 2% n/a n/a 1 1% 3 3% 5 1% North East Behavioural Supports n/a n/a 4 3% 1 1% n/a n/a 5 1% Ontario Réseau Access Network n/a n/a 1 1% 2 2% 2 2% 5 1% Conseil scolaire public du Grand n/a n/a 3 3% 1 1% n/a n/a 4 1% Nord de l'ontario Monarch Recovery Services 1 2% 3 3% n/a n/a n/a n/a 4 1% Conseil scolaire catholique du n/a n/a 1 1% 1 1% n/a n/a 2 0% Nouvel-Ontario John Howard Society of Sudbury n/a n/a 1 1% n/a n/a 1 1% 2 0% TG Innerselves n/a n/a 2 2% n/a n/a n/a n/a 2 0% Shkagamik-Kwe Health Centre n/a n/a n/a n/a n/a n/a 1 1% 1 0% Sudbury and Area Victim Services n/a n/a n/a n/a n/a n/a 1 1% 1 0% Ad hoc agencies Children's Community Network n/a n/a n/a n/a 1 1 n/a n/a 1 0% Greater Sudbury Housing n/a n/a 1 1% 5 4% n/a n/a 6 1% Corporation Northeast Cancer Centre n/a n/a n/a n/a n/a n/a n/a n/a 4 1% Sudbury & District Health Unit 2 3% n/a n/a n/a n/a n/a n/a 2 0% YMCA - Sudbury n/a n/a n/a n/a 1 1% n/a n/a 1 0% n/a: Agency did not present a situation during that year. 11

12 Demographics Age Of the situations that met the threshold of acutely elevated risk, 17% (n=59) involved children/youth under the age of 18. Of note, however, RMT data does not reflect situations that involve youth and the threat of violence. These situations are responded to using Greater Sudbury s Violence Threat Risk Assessment (VTRA) Protocol. Thirty-two percent (n=109) involved adults between the ages of 18 and 39 and 29% Table 4 Age of Individuals at Acutely Elevated Risk between May 2014 and December 2017 May 2014-December 2017 (n=343) n % 6-17 Years 59 17% Years 54 16% Years 14 4% Years 41 12% Years 63 18% 60+ Years 38 11% N/A 74 22% N/A: indicates families, neighbourhood or environment at risk (n=101) were adults over the age of 40. Between May 2014 to December 2017, youth between the ages of 12-17, adults and adults were the most frequently identified age groups at acutely elevated risk. See Table 4. Sex Less than half of situations (47%) involved a male individual as the primary RMT focus, compared to 31% of situations that involved a female individual the primary focus, (see Table 5). Seventy-five situations (22%) focused on a group, family or neighbourhood at risk. These are categorized as N/A for sex as there was no specific sex identified. Table 5 Sex of Individuals at Acutely Elevated Risk between May 2014 and December (n=47) 2015 (n=98) 2016 (n=92) 2017 (n=106) Overall (n=343) n % n % n % n % n % Female 11 23% 28 29% 28 30% 41 39% % Male 21 45% 39 40% 48 52% 52 49% % N/A 15 32% 31 32% 16 17% 12 11% 74 22% Unknown 0 0% 0 0% 0 0% 1 1% 1 ~0% n/a: indicates families, neighbourhood or environment at risk 12

13 Risks Categories and Factors Contributing to Acutely Elevated Risk Categories of risk There are 26 broad categories of risk captured from RMT situations of acutely elevated risk. Each includes multiple distinct risk factors. For example, under the category of criminal involvement, risk factors include: Arson Assault Drug trafficking Possession of weapons Possession of drugs Break and enter Damage to property Homicide Robbery Sexual assault Theft Threat Other Mental health was the most frequently identified risk category, identified in the majority of situations of acutely elevated risk, (84%, n=288). Other frequently identified risk categories include: antisocial/negative (53%, n=183), drugs (53%, n=182) and criminal involvement (52%, n=177). See Table 6 for an entire breakdown of all risk categories identified in situations of acutely elevated risk. 13

14 Table 6 Risk Categories Identified for Situations of Acutely Elevated Risks between May 2014 and December (n=47) 2015 (n=98) 2016 (n=92) 2017 (n=106) Overall (n=343) n % n % n % n % n % Mental health 31 66% 84 86% 78 85% 95 90% % Antisocial/negative 13 28% 50 51% 54 59% 66 62% % Drugs 22 47% 53 54% 45 49% 62 58% % Criminal involvement 31 66% 43 44% 57 62% 46 43% % Suicide 27 57% 52 53% 43 47% 41 39% % Alcohol 25 53% 33 34% 33 36% 48 45% % Physical health 15 32% 36 38% 35 38% 49 46% % Basic needs 7 15% 32 33% 38 41% 47 44% % Housing 16 34% 37 38% 30 33% 40 38% % Physical violence 19 40% 35 36% 31 34% 36 34% % Poverty n/a n/a 20 20% 23 25% 52 49% % Threat to public health 10 21% 28 29% 30 33% 28 26% 96 28% and safety Parenting 6 13% 37 38% 21 23% 25 24% 89 26% Negative peers 8 17% 27 28% 21 23% 31 29% 87 25% Crime victimization 11 23% 16 16% 20 22% 28 26% 74 22% Self-harm 7 15% 26 27% 15 16% 18 17% 66 19% Unemployment n/a n/a 11 11% 16 17% 34 32% 66 19% Emotional violence n/a n/a 12 12% 12 13% 36 34% 62 18% Missing school 9 19% 21 21% 17 18% 16 15% 63 18% Missing 9 19% 16 16% 9 10% 11 10% 45 13% Social environment n/a n/a 7 7% 7 8% 11 10% 26 8% Sexual violence n/a n/a n/a n/a n/a n/a n/a n/a 13 4% n/a: Values under 5 have been suppressed to protect privacy. Note: Not all risk categories presented due to small cell size. Risk categories impacting individuals and families The majority of situations involving individuals (86%, n=231) and families (79%, n=57) at acutely elevated risk included mental health as a risk factor. More than half of individuals at risk (56%, n=151) presented with antisocial/negative and fiftyseven percent of families (n=41) were affected by physical violence. Half of individuals (52%, n=140) and families (50%, n=36) were impacted by some form of criminal 14

15 involvement. Drugs (54%, n=145) and housing (49%, n=142) and were also common risk factors impacting individuals at risk. Parenting was identified in more than half of families at risk (56%, n=40). See Tables 7, 8 and 9. Table 7 Risk Categories for Situations of Acutely Elevated Risks Involving Families between May 2014 and December 2017 Overall (n=72) n % Mental health 57 79% Physical violence 41 57% Parenting 40 56% Criminal involvement 36 50% Drugs 36 50% Antisocial/negative 31 43% Suicide 30 42% Missing school 27 38% Alcohol 23 32% Physical health 12 31% Negative peers 18 25% Poverty 18 25% Emotional violence 17 24% Basic needs 16 22% Crime victimization 15 21% Missing 13 18% Threat to public health and safety 10 14% Self-harm 10 14% Housing 9 13% Unemployment 8 11% Note: Not all risk categories presented due to small cell size. Values under 5 have been suppressed to protect privacy. 15

16 Table 8 Risk Categories for Situations of Acutely Elevated Risks Involving Individuals between May 2014 and December 2017 Overall (n=269) n % Mental health % Antisocial/negative % Drugs % Criminal involvement % Suicide % Alcohol % Housing % Physical health % Basic needs % Threat to public health and safety 85 32% Poverty 82 30% Physical violence 79 29% Negative peers 68 25% Crime victimization 60 22% Unemployment 57 21% Self-harm 55 20% Emotional violence 45 17% Parenting 47 17% Missing school 36 13% Missing 31 12% Social environment 23 9% Sexual violence 11 4% Gangs 5 2% Note: Not all risk categories presented due to small cell size. Values under 5 have been suppressed to protect privacy. 16

17 Table 9 Risk Categories for Situations of Acutely Elevated Risk Involving Families and Individuals between May 2014 to December 2017 Rank Families (n=72) n % Individuals (n=269) n % 1 Mental health 57 79% Mental health % 2 Physical violence 41 57% Antisocial/negative % 3 Parenting 40 56% Drugs % 4 Criminal involvement 36 50% Criminal involvement % 5 Drugs 36 50% Suicide % 6 Antisocial/negative 31 43% Alcohol % 7 Suicide 30 42% Housing % 8 Missing school 27 38% Physical health % 9 Alcohol 23 32% Basic needs % 10 Physical health 12 31% Threat to public health and safety 85 32% 17

18 Risk categories by age group There is great variance in the risk categories presented by age group. For children/youth under 18, drugs were identified in the most situations (81%); compared to mental health among adults aged (90%) and mental health among adults over the age of 40 (90%). Physical health (62%) and basic needs (60%) were more prevalent risk categories for adults over the age of 40 whereas suicide risk - current or past - was more common for children/youth under 18 (59%) and adults 18 to 39 (73%). See Table 10 for a summary of the most frequently identified risk categories by age group. 18

19 Table 10 Risk Categories for Situations of Acutely Elevated Risk by Age Groups between May 2014 to December 2017 Rank Under 18 Years (n=59) n % Years (n=109) n % 40+ Years (n=101) n % 1 Drugs 47 80% Mental health 94 86% Mental health 90 89% 2 Mental health 47 80% Drugs 77 71% Physical health 65 64% 3 Suicide 38 64% Criminal involvement 69 63% Basic needs 62 61% 4 Antisocial/negative 35 59% Suicide 62 57% Antisocial/negative 57 56% 5 Missing school 33 56% Antisocial/negative 59 54% Alcohol 44 44% 6 Parenting 32 54% Housing 56 51% Housing 44 44% 7 Criminal involvement 31 53% Alcohol 45 41% Criminal involvement 40 40% 8 Negative peers 23 47% Physical health 42 39% Threat to public health 39 39% and safety 9 Alcohol 26 44% Poverty 42 39% Poverty 33 33% 10 Missing 21 36% Physical violence 40 37% Suicide 32 32% 19

20 Risk categories by sex The most frequently identified risk categories vary slightly by gender. Mental health was the most identified risk category for situations of acutely elevated risk involving both males (85%) and females (87%). However, suicide was identified in more than half of situations involving females at acutely elevated risk (58%) compared to only 43% of males. Antisocial negative, drugs and criminal involvement were also identified for more than half of females and males. See Table 11. Table 11 Risk Categories for Situations of Acutely Elevated Risk by Sex between May 2014 to December 2017 Rank Male (n=160) n % Female (n=108) n % 1 Mental health % Mental health 94 87% 2 Antisocial/negative 89 56% Suicide 63 58% 3 Drugs 83 52% Antisocial/negative 61 56% 4 Criminal involvement 83 52% Drugs 61 56% 5 Housing 73 46% Criminal involvement 56 52% 6 Alcohol 70 44% Physical health 48 44% 7 Basic needs 69 43% Alcohol 44 41% 8 Suicide 68 43% Housing 40 37% 9 Physical health 65 41% Basic needs 39 36% 10 Threat to public health and safety 58 36% Crime victimization, Negative peers, Physical violence 33 31% 20

21 Risk factors The CMS database tracks 102 distinct risk factors grouped by 26 risk categories, (e.g. criminal involvement, mental health, alcohol). An average of 8 risk factors were identified in each situation of acutely elevated risk (minimum of 2, maximum of 15). For a breakdown of the average and total risk factors by year see Figure 1. Between May 2014 and December 2017, the combined total of risk factors identified as part of RMT situation presentations was 2,842. Chart 1 illustrates the number of risk factors presented per RMT situation. Figure (n=47) Average of 7 risk factors Total of 324 risk factors 2015 (n=98) Average of 8 risk factors Total of 781 risk factors 2016 (n=92) Average of 8 risk factors Total of 746 risk factors 2017 (n=106) Average of 9 risk factors Total of 991 risk factors 21

22 Chart 1 Percentage of situations of acutely elevated risk by the number of risk factors identified 26% 70% 2014 (n=47) 4% 18% 64% 2015 (n=98) 17% 22% 53% 2016 (n=92) 25% Average of 8 risk factors per situation of acutely elevated risk 16% 46% 38% 2017 (n=106) 20% 56% 24% Overall (m=343) 1 to 5 risk factors 6 to 11 risk factors 11 to 15 risk factors From May 2014 to December 2017, the most frequently captured risk factors were person exhibiting antisocial/negative identified in 180 situations of acutely elevated risk and diagnosed mental health identified in 177 situations of acutely elevated risk. See Table 12. See Tables 13, 14 & 15 for a more detailed breakdown of the most frequently identified risk factors in situations of acutely elevated risk by year, sex and age groups. Appendix D contains a data dictionary for all risk factors contained in the database. Table 12 Most Frequently Identified Risk Factors for Situations of Acutely Elevated Risk between May 2014 to December 2017 Rank Risk factor n % 1 Person exhibiting antisocial/negative % 2 Diagnosed mental health problem % 3 Drug abuse by person % 4 Person doesn t have access to appropriate housing % 5 Suspected mental health problem % 6 Person unable to meet own basic needs % 7 Person living in less than adequate financial situation % 8 Person previous suicide risk 98 29% 9 Alcohol abuse by person 95 28% 10 Person s is a threat to public health and safety 96 28% 22

23 Table 13 Most Frequently Identified Risk Factors for Situations of Acutely Elevated Risk between May 2014 to December 2017, by Year Rank n % n % 1 Diagnosed mental health problem 17 36% Diagnosed mental health problem 58 59% Person doesn t have access to Person exhibiting % 49 50% appropriate housing antisocial/negative 3 Alcohol abuse by person 15 32% Drug abuse by person 39 40% Person doesn t have access to 4 Criminal Involvement assault 15 32% 33 34% appropriate housing 5 Criminal Involvement other & Person previous suicide risk 15 32% Person unable to meet own basic needs 31 32% Rank n % n % Person exhibiting Person exhibiting % 65 61% antisocial/negative antisocial/negative Diagnosed mental health % Poverty 52 49% problem 3 Criminal Involvement assault 32 35% Diagnosed mental health problem 50 47% 4 Drug abuse by person 30 33% Suspected mental health problem 49 46% 5 Person s is a threat to public health and safety 30 33% Drug abuse by person 45 42% 23

24 Table 14 Most Frequently Identified Risk Factors by Sex between May 2014 to December 2017 Rank Female (n=108) n % Male (n=180) n % 1 Person exhibiting antisocial/negative Person exhibiting antisocial/negative 59 54% 89 56% 2 Diagnosed mental health 55 51% Diagnosed mental health 87 54% 3 Drug abuse by person 44 41% Person doesn t have access to appropriate housing 68 43% 4 Suspected mental health 40 37% Drug abuse by person 62 39% 5 Previous suicide risk 40 37% Person unable to meet own basic needs 61 38% 6 Person doesn t have access to appropriate housing 37 34% Threat to public health and safety 58 36% 7 Person unable to meet own basic needs 33 31% Poverty 54 34% 8 Person associating with negative peers 33 31% Alcohol abuse by person 52 33% 9 Criminal involvement assault 31 29% Suspected mental health 49 31% 10 Alcohol abuse by person 30 28% Previous suicide risk 40 25% 24

25 Table 15 Most Frequently Identified Risk Factors by Age Groups between May 2014 to December 2017 Rank Under 18 (n=59) n % Years (n=109) n % 40+ (n=101) n % 1 Person exhibiting antisocial/negative 2 Missing school truancy 3 Drug abuse by person 35 59% Diagnosed mental health 63 58% Person exhibiting antisocial/negative 33 56% Drug abuse by person 61 56% Diagnosed mental health 30 51% Person exhibiting 58 53% Person unable to antisocial/negative meet own basic needs 4 Parent-child conflict 28 47% Person doesn t have access to appropriate housing 52 48% Person doesn t have access to appropriate housing 56 55% 54 53% 53 52% 42 42% 5 Person associating 27 46% Poverty 42 39% Alcohol abuse by 37 37% with negative peers person 6 Diagnosed mental 25 42% Criminal involvement 41 38% Suspected mental 35 35% health assault health 7 Previous suicide risk 23 39% Threat to public health 38 35% Physical health 34 34% and safety chronic disease 8 Suspected mental 21 36% Previous suicide risk 37 34% Poverty 33 33% health 9 Person has engaged in selfharm 19 32% Person unable to meet own basic needs 35 32% Physical health general health issue 28 28% 10 Current suicide risk 18 31% Suspected mental health 34 31% Physical health not following prescribed treatment 27 27% 25

26 Rapid Mobilization Table Collaborative Responses Lead and assisting agencies are identified as participants in each RMT response based on their mandate and capacity to respond to the risk factors present. All responding agencies contribute to the planning of the response based on their prior involvement or the perspective that they bring to understanding the situation. Their active role in the response is decided as part of Filter 3 and 4 planning. The lead agency is responsible for coordinating the response and reporting back at the next RMT meeting. Partner agency involvement in RMT situations An average of seven agencies were involved in responses. Between May 2014 and December 2017, Greater Sudbury Police Service presented the most number of situations to the RMT (41%, n=139). Agencies most frequently involved with RMT responses (lead or assisting) include Health Sciences North (82%, n=280), Greater Sudbury Police Service (78%, n=268), and CMHA Sudbury/Manitoulin (78%, n=268). Greater Sudbury Police Service (17%, n=59), CMHA Sudbury/Manitoulin (13%, n=43) and Children s Aid Society of Sudbury/Manitoulin (13%, n=43) were the most frequently identified lead agencies in RMT responses. Table 16 provides a summary of partner agency involvement in RMT situations; as originating, lead and/or assisting agency in RMT situations. 26

27 Table 16 Agency Involvement in Situations of Acutely Elevated Risk between May 2014 and December 2017 Originating Lead Assisting Overall involvement (n=343) n % n % n % n % Health Sciences North Mental Health & Addictions 22 6% 40 12% % % Canadian Mental Health Association Sudbury/Manitoulin 29 8% 43 13% % % Greater Sudbury Police Service % 59 17% % % Monarch Recovery Services 3 1% 19 6% % % City of Greater Sudbury Social Services 11 3% 13 4% % % Children s Aid Society of the Districts Sudbury and Manitoulin 22 6% 46 13% 89 26% % Sudbury Action Centre for Youth 15 4% 20 6% 86 25% % Homelessness Network 5 1% 10 3% 66 19% 76 22% Rainbow District School Board 23 7% 15 4% 56 16% 71 21% North East LHIN Home & Community Care 6 2% 12 4% 54 16% 66 19% N Swakamok Native Friendship Centre n/a n/a 7 2% 50 15% 57 17% Sudbury & Area Victim Services 1 0% 7 2% 48 14% 55 16% Sudbury Paramedic Services 21 6% 4 1% 46 13% 50 15% Shkagamik-Kwe Health Centre 1 0% 4 1% 40 12% 44 13% Sudbury Community Service Centre 7 2% 11 3% 31 9% 42 12% John Howard Society of Sudbury 2 1% 3 1% 38 11% 41 12% North East Behavioural Supports Ontario 4 1% 10 3% 31 9% 41 12% Réseau Access Network 5 1% 5 1% 23 7% 28 8% Sudbury Counselling Centre n/a n/a n/a n/a 28 8% 28 8% Adult Probation and Parole n/a n/a 1 0% 21 6% 22 6% Sudbury & District Health Unit 1 0% 1 0% 21 6% 22 6% Sudbury Catholic Schools 10 3% 1 0% 20 6% 21 6% Youth Probation n/a n/a 1 0% 20 6% 21 6% Children s Community Network 1 0% 1 0% 18 5% 19 6% 27

28 Table 16 Agency Involvement in Situations of Acutely Elevated Risk between May 2014 and December 2017 (continued) Greater Sudbury Housing Corporation 5 1% 1 0% 12 4% 13 4% NOAH s Space n/a n/a 1 0% 10 3% 11 3% Conseil scolaire catholique du Nouvel-Ontario 2 1% 1 0% 8 2% 9 3% TG Innerselves 2 1% 3 1% 5 2% 8 2% March of Dimes n/a n/a 1 0% 5 1% 6 2% Sudbury Fire Services n/a n/a 1 0% 5 1% 6 2% Northeast Cancer Centre 4 1% 1 0% 3 1% 4 1% Conseil scolaire public du Grand Nord de l Ontario 2 1% 1 0% 2 1% 3 1% n/a : Agency did not present or lead a response from May 2014 to December

29 Special considerations that help guide RMT responses As part of the de-identified information gathered in the CMS database, CMS tracks special considerations that may help to guide RMT responses. Table 17 illustrates the considerations that are currently captured as RMT study flags. Table 17 Most Frequently Identified Special Considerations that Help Guide Response for Situations of Acutely Elevated Risk between May 2014 and December 2017 n % Social Isolation 89 26% Risk of Losing Housing/Unsafe Living Conditions 76 22% Homelessness 68 20% Cultural Considerations 60 17% Domestic Violence 46 13% Youth Criminal Justice Act 41 12% Developmental Disability 32 9% Situation resolution Through the 343 situations of acutely elevated risk, 366 individuals were helped by RMT partner agency interventions. On average, situations remained open for 8 days (minimum of 2 days, maximum of 28 days). See Table 18. Factors influencing the amount of time that situations remained open include: 29

30 Trying to locate individuals (unknown incarceration, unknown housing) Coordinating participation from other non-cms partner agencies Leaving situations open to see if individuals will engage with appropriate connections to services Highly complex histories of being at risk including challenging relationships with many service providers. Table 19 illustrates the risk categories that were most frequently identified with the closure reasons Connected to services, Informed about services; not yet connected and Refused services/uncooperative. 30

31 Table 18 Closure Variables for Situations of Acutely Elevated Risk 2014 (n=47) 2015 (n=98) 2016 (n=92) 2017 (n=106) Overall (n=343) Average time between opening and closure 6 days 7 days 8 days 9 days 8 days # of individuals helped Connected to services 64% 57% 46% 50% 53% Informed about services; not yet connected 19% 20% 27% 20% 22% Refused services/uncooperative 6% 13% 9% 18% 13% Systemic issue 4% 6% 4% 1% 4% Other Unable to locate 4% 3% 4% 3% 5% Other Relocated 2% n/a n/a 1% 1% Other Deceased n/a n/a 1% n/a ~0% Through no action of the situation table n/a n/a 7% 8% 4% New information reveals that AER did not exist n/a n/a 2% n/a 1% n/a: Not reported during that year. 31

32 Table 19 Most Frequently Identified Risk Categories for Different Closure Reasons between May 2014 to December 2017 Rank Connected to services (n=181) n % Informed about services; not yet connected (n=75) n % Refused services/ uncooperative (n=43) n % 1 Mental health % Mental health 37 86% Mental health 37 86% 2 Suicide 92 51% Drugs 55 73% Antisocial/negative 29 67% 3 Drugs 87 48% Criminal involvement 47 63% Criminal involvement 22 51% 4 Antisocial/negative 85 47% Antisocial/negative 42 56% Housing 21 49% 5 Criminal involvement 77 43% Alcohol 40 53% Physical health 21 49% 6 Alcohol 70 39% Suicide 36 48% Basic needs 19 44% 7 Basic needs 65 36% Physical health 33 44% Drugs 19 44% 8 Physical health 63 35% Housing 30 40% Poverty 18 42% 9 Physical violence 60 33% Physical violence 29 39% Suicide 16 37% 10 Housing 55 30% Basic needs 26 35% Alcohol 14 33% 11 Parenting 54 30% Negative peers 24 32% Physical violence 14 33% 12 Poverty 52 29% Parenting 20 27% Unemployment 14 33% 13 Negative peers 45 25% Self-harm 20 27% Threat to public health 13 30% and safety 14 Threat to public health 45 25% Poverty 19 25% Negative peers 9 21% and safety 15 Crime victimization 43 24% Threat to public health and safety 19 25% Crime victimization 8 19% 32

33 Appendix A Co-occurring Risk Factors Most Frequently Identified Risk Factors Co-occuring with Person Exhibiting Antisocial/Negative Behaviour Diagnosed mental health 53% Suspected mental health 35% Antisocial/ negative (n=180) Drug abuse by person 38% Threat to public health and safety 38% 33

34 Most Frequently Identified Risk Factors Co-occuring with Diagnosed Mental Health Antisocial/ negative 54% Previous suicide risk 36% Diagnosed mental health (n=177) Drug abuse by person 38% Person doesn't have access to appropriate housing 36% 34

35 Most Frequently Identified Risk Factors Co-occuring with Drug Abuse by Person Antisocial/ negative 54% Person associating with negative peers 42% Drug abuse by person (n=126) Diagnosed mental health 54% Alcohol abuse by person 44% 35

36 Most Frequently Identified Risk Factors Co-occuring with Person doesn t Have Access to Appropriate Housing Diagnosed mental health 55% Poverty 45% Person doesn't have access to appropriate housing (n=115) Person unable to meet own basic needs 54% Person exhibiting antisocial/ negative 50% 36

37 Appendix B Co-Occurring Risk Factors by Sex Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for Females (1 of 3) Diagnosed mental health 51% Suspected mental health 39% Antisocial/ negative (n=59) Drug abuse by person 42% Person doesn't have access to appropriate housing 42% 37

38 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for Females (2 of 3) Antisocial/ negative 55% Mental health - not following prescribed treatment 40% Diagnosed mental health (n=55) Previous suicide risk 45% Drug abuse by person 44% 38

39 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for Females (3 of 3) Antisocial/ negative 57% Previous suicide risk 45% Drug abuse by person (n=44) Diagnosed mental health 55% Negative peers 55% 39

40 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for Males (1 of 3) Diagnosed mental health 54% Poverty 33% Antisocial/ negative (n=89) Threat to public health and safety 43% Drug abuse by person 36% 40

41 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for Males (2 of 3) Antisocial/ negative 55% Person unable to meet own basic needs 39% Diagnosed mental health (n=87) Person doesn't have access to appropriate housing 46% Person is a threat to public health and safety 41% 41

42 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for Males (3 of 3) Diagnosed mental health 59% Poverty 41% Person doesn't have access to appropriate housing (n=68) Person unable to meet own basic needs 57% Drug abuse by person 41% Antisocial/ negative 41% 42

43 Appendix C Co-Occurring Risk Factors by Age Groups Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those Under the Age of 18 (1 of 3) Missing school - truancy 51% Parent-child conflict 43% Antisocial/ negative (n=35) Drug abuse by person 46% Person associating with negative peers 46% 43

44 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those Under the Age of 18 (2 of 3) Drug abuse by person 58% Person associating with negative peers 54% Missing school - truancy (n=33) Parent-child conflict 58% Antisocial/ negative 54% 44

45 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those Under the Age of 18 (3 of 3) Missing school - truancy 63% Antisocial/ negative 53% Drug abuse by person (n=30) Person associating with negative peers 57% Parent-child conflict 57% 45

46 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those Years of Age (1 of 3) Antisocial/ negative 54% Criminal involvement - assault 40% Diagnosed mental health (n=63) Drug abuse by person 49% Person doesn't have access to appropriate housing 43% 46

47 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those Years of Age (2 of 3) Diagnosed mental health 59% Threat to public health and safety 41% Antisocial/ negative (n=58) Drug abuse by person 53% Criminal involvement - assault 41% Person doesn't have access to appropriate housing 48% 47

48 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those Years of Age (3 of 3) Person doesn't have access to appropriate housing 57% Alcohol abuse by person 44% Drug abuse by person (n=48) Antisocial/ negative 51% Diagnosed mental health 51% 48

49 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those over the Age of 40 (1 of 3) Diagnosed mental health 55% Person doesn't have access to appropriate housing 38% Antisocial/ negative (n=56) Threat to public health and safety 55% Person unable to meet own basic needs 45% 49

50 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those over the Age of 40 (2 of 3) Antisocial/ negative 57% Threat to public health and safety 44% Diagnosed mental health (n=54) Person unable to meet own basic needs 52% Person doesn't have access to appropriate housing 48% 50

51 Most Frequently Identified Risk Factors Co-occuring with Most Prevalent Risk Factors for those over the Age of 40 (3 of 3) Diagnosed mental health 53% Poverty 43% Person unable to meet own basic needs (n=53) Person doesn't have access to appropriate housing 49% Antisocial/ negative 47% 51

52 Appendix D Data Dictionary # Risk Factor Definition 1 Alcohol - alcohol abuse by person known to excessively consume alcohol; causing self-harm 2 Alcohol - alcohol abuse in home living at a residence where alcohol has been consumed excessively and often 3 Alcohol - alcohol use by person known to consume alcohol; no major harm caused 4 Alcohol - harm caused by alcohol abuse in home has suffered mental, physical or emotional harm or neglect due to alcohol abuse in the home 5 Alcohol - history of alcohol abuse in home excessive consumption of alcohol in the home has been a problem in the past 6 Antisocial/Negative Behaviour - antisocial/negative within the home resides where there is a lack of consideration for others, resulting in damage to other individuals or the community i.e. obnoxious, disruptive 7 Antisocial/Negative Behaviour - person exhibiting antisocial/negative is engaged in that lacks consideration of others, which leads to damages to other individuals or the community i.e. obnoxious/disruptive 8 Basic Needs - person being neglected by others basic physical, nutritional or medical needs are not being met 9 Basic Needs - person neglecting others' basic needs has failed to meet the physical, nutritional or medical needs of others under their care 10 Basic Needs - person unable to meet own basic needs cannot independently meet their own physical, nutritional or other needs 11 Basic Needs - person unwilling to have basic needs met person is unwilling to meet or receive support in receiving their own basic physical, nutritional or other needs met 12 Crime Victimization - arson has been reported to police to be the victim of arson 13 Crime Victimization - assault has been reported to police to be the victim of assault (i.e. hitting, stabbing, kicking, etc.) 14 Crime Victimization - break and enter has been reported to police to be the victim of break and enter (someone broke into their premises) 15 Crime Victimization - damage to property has been reported to police to be the victim of someone damaging their property 16 Crime Victimization - other has been reported to police to be the victim of other crime not mentioned above 17 Crime Victimization - robbery has been reported to police to be the victim of robbery (someone threatened/used violence against them to get something from them) 18 Crime Victimization - sexual assault has been reported to police to be the victim of sexual assault (i.e. touching, rape) 19 Crime Victimization - theft has been reported to police to be the victim of theft (someone stole from them) 20 Crime Victimization - threat has been reported to police to be the victim of someone uttering threats to them 21 Criminal Involvement - animal cruelty has been suspected, charged, arrested or convicted of animal cruelty 22 Criminal Involvement - arson has been suspected, charged, arrested or convicted of arson 23 Criminal Involvement - assault has been suspected, charged, arrested or convicted of assault 24 Criminal Involvement - break and enter has been suspected, charged, arrested or convicted of break and enter 25 Criminal Involvement - damage to property has been suspected, charged, arrested or convicted of damage to property 26 Criminal Involvement - drug trafficking has been suspected, charged, arrested or convicted of drug trafficking 27 Criminal Involvement - homicide has been suspected, charged, arrested or convicted of the unlawful death of a person 52

53 28 Criminal Involvement - other has been suspected, charged, arrested or convicted of other crimes 29 Criminal Involvement - possession of weapons has been suspected, charged, arrested or convicted of possession of weapons 30 Criminal Involvement - robbery has been suspected, charged, arrested or convicted of robbery (which is theft with violence or threat of violence) 31 Criminal Involvement - sexual assault has been suspected, charged, arrested or convicted of sexual assault 32 Criminal Involvement - theft has been suspected, charged, arrested or convicted of theft 33 Criminal Involvement - threat has been suspected, charged, arrested or convicted of uttering threats 34 Drugs - drug abuse by person known to excessively use illegal/prescription drugs; causing self-harm 35 Drugs - drug abuse in home living at a residence where illegal (or misused prescription drugs) have been consumed excessively and often 36 Drugs - drug use by person known to use illegal drugs (or misuse prescription drugs); no major harm caused 37 Drugs - harm caused by drug abuse in home has suffered mental, physical or emotional harm or neglect due to drug abuse in the home 38 Drugs - history of drug abuse in home excessive consumption of drugs in the home has been a problem in the past 39 Elderly Abuse - person perpetrator of elderly abuse has knowingly or unknowingly caused intentional or unintentional harm upon others because of their physical, mental or situational vulnerabilities associated with the aging process 40 Elderly Abuse - person victim of elderly abuse has knowingly or unknowingly suffered from intentional or unintentional harm because of their physical, mental or situational vulnerabilities associated with the aging process 41 Emotional Violence - emotional violence in the home resides with a person who exhibits controlling, name-calling, yelling, belittling, bullying, intentional ignoring, etc. 42 Emotional Violence - person affected by emotional violence has been affected by others falling victim to controlling, name-calling, yelling, belittling, bullying, intentional ignoring, etc. 43 Emotional Violence - person perpetrator of emotional violence has emotionally harmed others by controlling their, name-calling, yelling, belittling, bullying, intentionally ignoring them, etc. 44 Emotional Violence - person victim of emotional violence has been emotionally harmed by others who have controlled their, name-called, yelled, belittled, bullied, intentionally ignored them, etc. 45 Gambling - chronic gambling by person regular and/or excessive gambling; no harm caused 46 Gambling - chronic gambling causes harm to others regular and/or excessive gambling that causes harm to others 47 Gambling - chronic gambling causes harm to self regular and/or excessive gambling; resulting in self-harm 48 Gambling - person affected by the gambling of others is negatively affected by the gambling of others 49 Gangs - gang association social circle involves known or supported gang members but is not a gang member 50 Gangs - gang member is known to be a member of a gang 51 Gangs - threatened by gang has received a statement of intention to be injured or have pain inflicted by gang members 52 Gangs - victimized by gang has been attacked, injured, assaulted or harmed by a gang in the past 53 Housing - person doesn't have access to appropriate housing is living in inappropriate housing conditions or none at all (i.e. condemned building, street) 54 Housing - person transient but has access to appropriate housing has access to appropriate housing but is continuously moving around to different housing arrangements (i.e. couch surfing) 55 Mental Health - diagnosed mental health problem has a professionally diagnosed mental health problem 56 Mental Health - grief experiencing deep sorrow, sadness or distress caused by loss 53

54 57 Mental Health - mental health problem in the home residing in a residence where there are mental health problems 58 Mental Health - not following prescribed treatment not following treatment prescribed by a mental health professional; resulting in risk to self and/or others 59 Mental Health - self-reported mental health problem has reported to others to have a mental health problem(s) 60 Mental Health - suspected mental health problem suspected of having a mental health problem (no diagnosis) 61 Mental Health - witnessed traumatic event has witnessed an event that has caused them emotional or physical trauma 62 Missing - person has history of being reported to police as missing has a history of being reported to police as missing and in the past has been entered on CPIC as a missing person 63 Missing - person reported to police as missing has been reported to the police and entered in CPIC as a missing person 64 Missing - runaway with parents' knowledge or whereabouts has runaway from home with guardian s knowledge but guardian is indifferent 65 Missing - runaway without parents' knowledge or whereabouts has runaway and guardian has no knowledge of whereabouts 66 Missing School - chronic absenteeism has unexcused absences from school without parental knowledge, that exceed the commonly acceptable norm for school absenteeism 67 Missing School - truancy has unexcused absences from school without parental knowledge 68 Negative Peers - person associating with negative peers is associating with people who negatively affect their thoughts, actions or decisions 69 Negative Peers - person serving as a negative peer to others is having negative impact on the thoughts, actions or decision of others 70 Parenting - parent-child conflict ongoing disagreement and argument between guardian and child that affects the functionality of their relationship and communication between the two parties 71 Parenting - person not providing proper parenting is not providing a stable, nurturing home environment that includes positive role models and concern for the total development of the child 72 Parenting - person not receiving proper parenting is not receiving a stable, nurturing home environment that includes positive role models and concern for the total development of the child 73 Physical Health - chronic disease suffers from a disease that requires continuous treatment over a long period of time 74 Physical Health - general health issue has a general health issue which requires attention by a medical health professional 75 Physical Health - not following prescribed treatment not following treatment prescribed by a health professional; resulting in risk 76 Physical Health - nutritional deficit suffers from insufficient nutrition, causing harm to their health 77 Physical Health - physical disability suffers from a physical impairment 78 Physical Health - pregnant pregnant 79 Physical Health - terminal illness suffers from a disease that cannot be cured and that will soon result in death 80 Physical Violence - person affected by physical violence has been affected by others falling victim to physical violence (i.e. witnessing; having knowledge of) 81 Physical Violence - person perpetrator of physical violence has instigated or caused physical violence to another person (i.e. hitting, pushing) 82 Physical Violence - person victim of physical violence has experienced physical violence from another person (i.e. hitting, pushing) 83 Physical Violence - physical violence in the home lives with threatened or real physical violence in the home (i.e. between others) 84 Poverty - person living in less than adequate financial situation current financial situation makes meeting the day to day housing, clothing or nutritional needs, significantly difficult 85 Self-Harm - person has engaged in self-harm has engaged in the deliberate non-suicidal injuring of their own body 86 Self-Harm - person threatens self-harm has stated that they intend to cause non-suicidal injury to their own body 54

55 87 Sexual Violence - person affected by sexual violence has been affected by others falling victim to sexual harassment, humiliation, exploitation, touching or forced sexual acts (i.e. witnessing; having knowledge of) 88 Sexual Violence - person perpetrator of sexual violence has been the perpetrator of sexual harassment, humiliation, exploitation, touching or forced sexual acts 89 Sexual Violence - person victim of sexual violence has been the victim of sexual harassment, humiliation, exploitation, touching or forced sexual acts 90 Sexual Violence - sexual violence in the home resides in a home where sexual harassment, humiliation, exploitation, touching, or forced sexual acts occur 91 Social Environment - frequents negative locations is regularly present at locations known to potentially entice negative or increase the risks of an individual to be exposed to or directly involved in other social harms 92 Social Environment - negative neighbourhood lives in a neighbourhood that has the potential to entice negative or increase the risks of an individual to be exposed to or directly involved in other social harms 93 Suicide - affected by suicide has experienced loss due to suicide 94 Suicide - person current suicide risk currently at risk to take their own life 95 Suicide - person previous suicide risk has in the past, been at risk to take their own life 96 Supervision - person not properly supervised has not been provided with adequate supervision 97 Supervision - person not providing proper supervision has failed to provide adequate supervision to a dependant person (i.e. child, elder, disabled) 98 Threat to Public Health and Safety - person's is a threat to public health and safety is currently engaged in that represents danger to the health and safety of the community (i.e. unsafe property, intentionally spreading disease, putting others at risk) 99 Unemployment - caregivers chronically unemployed caregivers are persistently without paid work 100 Unemployment - caregivers temporarily unemployed caregivers are without paid work for the time being 101 Unemployment - person chronically unemployed persistently without paid work 102 Unemployment - person temporarily unemployed without paid work for the time being 55