Police in British Columbia serve as a “de facto” arm the province’s mental-health-care system, for better or worse.

That’s the conclusion of a 43-page review by the B.C. Coroners Service that analyzed 127 deaths that occurred during or within 24 hours of a police interaction between 2013 and 2017.

“More than two-thirds or seven in 10 of these deaths involved a mental-health issue,” it reads. “Of the 127 deaths, 61 percent experienced challenges related to illicit drug use.”

Twenty-one deaths were the result of police use of force and 56 were by suicide.

“Persons with mental health and substance use concerns (MHSU) are increasingly interfacing with police agencies,” the document reads. “The high numbers of encounters for MHSU have, by default, made policing part of the mental health system in B.C. Persons in crisis are often unpredictable and police officers need more support when engaging with persons experiencing mental health issues.”

The report notes that Indigenous people were disproportionately affected by issues raised by the review.

“Indigenous persons in B.C. account for 6 percent of the population; in this review 20 percent of deaths were among Indigenous people,” it reads.

The report also states that the number of police encounters involving a mental-health component have increased in recent years, from 64,828 in 2015 to 74,827 in 2017. During that period, the number of apprehensions under the B.C. Mental Health Act also increased, from 13,592 in 2015 to 18,357 in 2017.

This is likely because of a combination of deinstitutionalization, a limited availability of mental-health services, and increases in the use of illicit substances, according to the analysis.

The B.C. Coroners Service included three recommendations in its report.

The first is that the province incorporate policing into its mental-health and addictions strategy. The second is for improved support for policing mental-health assessments and referral services. The third is for authorities to utilize subject behavior officer response data for the development of a mental-health training curriculum.

"Police in B.C. are responding to about 74,000 incidents annually involving mental health, and 18,000 of those fall under the Mental Health Act," said Michael Egilson, chair of the death review panel that drafted the report. "These are situations where police officers de-escalate crisis situations and assess, triage and transport persons for emergency care to health services or to cells.

"We need to drive home the point that the police have become part of the mental health system and that their role needs to be acknowledged, supported and incorporated into the larger provincial mental health and addictions strategy."

In 2015, the Georgia Straight conducted its own analysis of police-involved deaths in B.C. and, though it applied different criteria, found that a similarly high number of fatal interactions involved people who struggled with a mental-health challenge or an addictions issue.

That analysis was part of a six-part titled “Chasing a crisis: The challenge of caring for Vancouver’s severely mentally ill and addicted residents”.