Responding to people in crisis: a policy analysis of the Hamilton Mobile Crisis Rapid Response Team (MCRRT) model

This paper examines how and why the Mobile Crisis Rapid Response Team (MCRRT) model was developed and adopted in Hamilton, Canada. Using a qualitative case study design involving document analysis and comprehensive semi-structured interviews with MCRRT leaders, we applied frameworks that explain government agenda setting and policy choices to organise the preliminary data, and then refined the data to identify themes and generate an in-depth analysis. Attention to the issue was driven by what key stakeholders viewed as a compelling problem: frequency of contact between police and people in crisis (PIC), volume of PIC admitted to emergency departments, and the corresponding high costs and suboptimal care received by PIC. The only policy alternative considered was the MCRRT, which was further substantiated by absence of political desire to consider alternatives to the status quo. This analysis offers a snapshot of the factors that can be useful in proposing new initiatives that expand on the boundaries of existing programs. Decision makers can strategically align their proposals within existing government directives in ways that incrementally build on existing structures and processes. The findings provide a useful reference for aligning ideas within the context of structural interests to implement a program.