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Pew survey finds 911 call centers lack proper training to deal with behavioral health crises

<i>Adobe Stock</i><br/>A Pew survey of 911 call centers around the US found few have staff with behavioral health crisis training.
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A Pew survey of 911 call centers around the US found few have staff with behavioral health crisis training.

By Eric Levenson, CNN

A Pew survey of 911 call centers around the US released Tuesday found few have staff with behavioral health crisis training, and most have only limited options in how they respond to crisis calls.

The survey illuminates the challenges for 911 call centers amid a closer examination of how cities respond to emergencies like mental health crises, drug overdoses or homelessness.

When people call 911 for an emergency, telecommunicators on the line are tasked with processing the caller’s information and deciding who to dispatch to the scene. Yet there is not a standard national protocol for how to handle emergency calls, and there are more than 5,000 separate call centers across the country, creating a disjointed system.

The survey, conducted by Pew in collaboration with the National Emergency Number Association, sought to learn how 911 call centers deal with behavioral crisis events.

To conduct the survey, Pew sent a questionnaire to 233 call centers across the country. They ultimately received 37 responses in 27 states, so the study cannot be considered nationally representative, the organization noted.

Still, it adds key insights into what resources 911 call centers have to deal with behavioral health crises. The responses indicate centers have limited training for dealing with such calls, limited options to dispatch specialized responses, and inconsistent data collection.

Of the 37 responding centers, 25 said their call-takers and dispatchers had not received specialized crisis intervention team (CIT) training or training related to mental health or substance use-related crises. In addition, 23 of the 37 responding centers said they did not have access to behavioral health clinicians, Pew found.

“To develop best practices for these emergencies — including possible alternatives to arrest or other criminal justice responses — it is crucial to identify, understand, and address crisis response system deficits,” Pew said in a statement.

“While Pew’s research presents only a snapshot of 911 crisis services in a small number of communities across the country, the findings suggest a need to better understand the challenges call centers face in addressing mental health and substance use-related emergencies, and to develop policy solutions tailored to the unique circumstances of each call center and its service area.”

The survey is particularly relevant as some cities have moved away from dispatching police to deal with such situations, wary the interactions may lead to fatal shootings or the deaths of those in crisis. Several high-profile incidents, such as the death of Daniel Prude in Rochester, New York, or the 2015 police shooting of a naked, mentally ill Black veteran in Georgia, have emphasized the fatal risks involved.

The police killing of George Floyd in Minneapolis last May, and the resulting Black Lives Matter protests, also led some cities to take a closer look at sending trained social workers to deal with crisis situations rather than armed police officers.

Perhaps the foremost model for such a system is the CAHOOTS program in Eugene, Oregon. CAHOOTS — or Crisis Assistance Helping Out on the Streets — is made up of a team of young medics and mental health counselors who are sent out to respond to mental health crises, homelessness, substance abuse and threats of suicide.

According to the agency, CAHOOTS responders handled 17 percent of the city’s 911 calls in 2017. The program said of the 24,000 calls it responded to in 2019, only about 150 of them required police backup.

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CNN’s Peter Nickeas and Christina Maxouris contributed to this report.

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