Mental Health Teams Increasingly Dispatched to Answer 911 Calls

When the owner of a busy Florida warehouse phoned the Orange County Sheriff’s Office to complain about a homeless trespasser with a history of illegally entering the building, the officers didn’t show up alone. This time, they brought a mental health professional along.

The responding sheriff’s deputy “really did not want to arrest her, but the person was not supposed to be there and was refusing to leave,” Sgt. Bruce Vail said. The clinician convinced the woman to voluntarily enter a mental health facility, and no arrest was made.

The incident is one of more than 380 that two deputy-clinician teams have defused since the sheriff’s office launched its Behavioral Response Unit in January. The unit pairs a deputy with a mental health professional, who follow another deputy to calls that potentially involve someone with a mental illness, post-traumatic stress disorder or is under the influence of drugs.

Vail said arresting mentally ill suspects for crimes like trespassing, public intoxication or possession of drug paraphernalia kept “the ball … rolling and rolling” when they missed court dates or continually repeated the offense. “It’s not doing any good,” he said. “We needed to figure out a way to do better.”

Vail’s department is among a growing handful of law enforcement agencies around the country to add clinical social workers and mental health professionals to their teams in response to post-George Floyd public pressure to limit police confrontations with non-violent, mentally ill citizens who become the focus of calls to 911.

Police in New York City, Denver, Minneapolis, San Francisco, Los Angeles, Orlando, Raleigh, North Carolina, and elsewhere have taught 911 operators to determine whether an emergency might involve someone with a mental health issue—and to dispatch clinicians instead of or in addition to police officers.

Denver’s Support Team Assistance Response group, or STAR, for example, couples a paramedic with a mental health clinician and responded to 748 calls in the first six months after it launched in June 2020. None of those cases ended with an arrest.

The initial $1.4 million funding for the program did not come out of the police department budget, which is about $230 million. Denver allocated $1 million to expand the program in 2021 due to early data, which shows that “25% less personnel time is required when STAR responds,” according to the city.

After New York City, the largest city with this kind of program, started its Behavioral Health Emergency Assistance Response Division—B-HEARD—pilot in June, 911 dispatchers took approximately 18 mental health calls per day for the first month. Spectrum News reported that about 25% of all mental health 911 calls were routed to B-HEARD that first month, and people accepted help 95% of the time, up from 82% when police responded. The city’s budget includes a $92 million expansion of the program, beginning in late fall.

Susan Herman, the director of the mayor’s office of ThriveNYC, which oversees the city’s mental health programs, called B-HEARD “the default response to 911 mental health crisis calls.”

A Model Approach

New York’s program and many others are modeled after the 32-year-old CAHOOTS model (Crisis Assistance Helping Out On the Streets) in Eugene, Oregon, where a community clinic dispatches nurses, paramedics, EMTs or crisis workers to approximately 24,000 non-violent cases a year referred to them by 911 because they involve suspects with mental or physical health problems.

The cost savings to the city are considerable, according to the CAHOOTS website. The program’s budget is about $2.1 million annually, compared with the $90 million combined annual police department budgets for Eugene and Springfield. In 2017, the CAHOOTS teams answered 17% of the Eugene Police Department’s calls, and the program saves Eugene about $8.5 million in public safety spending each year.

Like New York, Orlando dispatches mental health professionals instead of police officers when 911 dispatchers determine that the situation is non-violent and involves a mental health crisis. In a pilot program that will last through 2021, Orlando’s Community Response Team responded to 534 calls from March 1 to Sept. 1.

The program in Orlando, which is the county seat of Orange County, differs from the one run by the sheriff’s office there. The county uses a co-responder model, sending two deputies and one clinician to each mental health call. One deputy arrives ahead of the clinical team to determine if the situation involves weapons or another threat, and the second accompanies the clinician.

In Orlando’s alternative response model, a clinician and case manager answer the call instead of police.

Orlando Police Capt. Lovetta Quinn-Henry, who oversees the city’s program, said residents told the mayor in listening sessions that “they did not want police showing up to deal with incidents where their loved ones were in crisis mode. They wanted mental health professionals.”

Prior to the city’s pilot, Quinn-Henry said, police who answered mental health-involved calls had three options: arrest or jail the suspects; take them to a mental health facility for a 72-hour evaluation under the state’s Baker Act; or leave them where they were.

“More often than not,” Quinn-Henry said, “they left them in place. … We realized mental health [professionals] could meet their needs without law enforcement being involved.” She said clinicians can handle “the vast majority” of those calls without police assistance.

Orlando Mayor Buddy Dyer agreed. “In the wake of George Floyd, we spent a considerable amount of time evaluating our police department policies and practices,” he said. “In light of that, we determined that there were calls that could be responded to not necessarily with people with badges and guns.”

He added: “It’s simply a recognition that there are better ways to respond to a certain type of call than sending a police officer.”

Dyer called the Orlando pilot “a great success” and said he expects the city, which paid for the program with general funds, to expand the service. The city, he said, did not divert funds already allocated to the police. And he said the city “should continue to ramp it up in terms of the number of responders and adding additional types of calls” once the pilot ends.

And he said callers to 911 have started requesting the Community Response Team, which not only responds to calls but follows up with callers and their families with community resources, instead of police.

Both Orlando and Orange County teams check in with those involved in mental health calls. Vail said his unit has checked in on at least 1,000 people referred by regular deputies when neither of the county’s clinician teams was available.

“We follow up,” he said. “We provide resources. We check on them.”