When you dial 911, a domino effect occurs: You’re connected with a telecommunicator who assesses your problem, pings your location, and dispatches the appropriate emergency response teams to your location (the EMS, fire department, or—yes—the police). This uniform procedure ignores the complexity of what it means to be in crisis, specifically when it comes to mental and emotional health. That’s why several cities throughout the United States have implemented programs for mental health emergency services.
At the end of last year, New York City announced a pilot program that dispatches mental-health experts rather than police officers in response to 911 calls involving mental-health emergencies. First Lady of New York City Chirlane McCray, the leader of the initiative, said there are 170,000 such calls to 911 each year—an average of one call every three minutes. Generally regarded as one of the safest major city in the United States, New York’s five boroughs are home to an estimated 8.4 million people. In June 2021, the program took effect in parts of Manhattan’s “high need” Harlem neighborhood.
Several months after its inception, new data suggests the initiative is working. Information compiled in July 2021 indicates the Behavioral Health Emergency Assistance Response Division, or “B-HEARD” program, in Harlem has already responded to at least 110 mental health emergencies in the past month. Rather than sending cops, three-person teams of social workers and mental health professionals respond to calls where there is no threat of violence. New York City’s data indicates that in 95 percent of those cases, the individual in distress accepted the team’s help.
“This is the first time in our history that health professionals will be the default responders to mental health emergencies, an approach that is more compassionate and effective for better long term outcomes,” McCray said at an event announcing the program in November 2020.
“The vast majority of cases you’re talking about you have an opportunity for a peaceful outcome with a health-centered approach, and that’s what we are focusing on here,” said New York City Mayor Bill de Blasio at the press conference.
In July 2020, Portland, Oregon, announced a program called “Portland Street Response” that will send mental health professionals instead of police officers in certain 911 responses. The new strategy is partially modeled after the Crisis Assistance Helping Out on the Streets (“CAHOOTS”) program in Eugene, Oregon, which sends a team of one medic (either a nurse or an EMT) and a crisis worker in response to a variety of situations including suicide prevention, grief and loss, housing crises, and substance abuse issues. In other words, a suicide attempt won’t be approached the same way as, say, an armed robbery or a homicide—a clear win for justice when you consider that only about 1 percent all calls for 911 services end up dealing with violent crimes.
In November 2019, when the Portland City Council voted to accept the Portland Street Response, Commissioner Chloe Eudaly said that the plan was designed in large part to help the homeless population and others who wind up being treated as criminals even though they’re not. “Being homeless is not a crime, having a mental illness is not a crime, and addiction is not a crime,” said Eudaly. Making 911 responses more nuanced also has an even wider-reaching impact for racial justice.
As San Francisco followed suit with similar police reform policies, Mayor London Breed acknowledged that decreasing the time police spend face to face with the community would naturally decrease police violence overall. “San Francisco has made progress reforming our police department, but we know that we still have significant work to do,” she told the Los Angeles Times. “We know that a lack of equity in our society overall leads to a lot of the problems that police are being asked to solve.” (Breed has also moved forward with a policy to ban the use of military-grade weapons in interactions with unarmed civilians, audit hiring, and promotional exams by the San Francisco Police Department and the San Francisco Sheriff’s Department, and introduce bias testing into these same settings.)
Perhaps most importantly, New York, Portland, San Francisco’s policies have sparked a conversation about the fact the crises that spark a 911 call rarely line up with police expertise. A 2015 internal review of the Los Angeles Police Department found that 37 percent of police shootings in 2014 involved suspects with known signs of mental illness. Meanwhile, Crisis Intervention Team (CIT) training—the police curriculum that aims to reduce the risk of serious injury or death during interactions between those with mental health struggles and police officers—has shown promise, but hasn’t yet been widely adopted by police departments nationwide.
Really, the conversation around what a more fastidious emergency response system should look like has just begun. As other American cities follow in New York, Eugene, Portland, and San Francisco’s footsteps, we may start to see emergency services equipped to handle situations peacefully, ensuring that loss of human life doesn’t become the collateral damage of “justice.”
Published July 16, 2020; updated July 23, 2020.
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