On June 6, 2021, New York City launched a pilot program known as the Behavioral Health Emergency Assistance Response Division (B-HEARD), which dispatched social workers and paramedics to certain types of mental-health-related 911 calls, without the presence of police officers on scene.
The initiative itself borrows from successful programs such as the Eugene, Oregon model and Miami's CHMP − with the exception of dispatching police with civilian staff concurrently, something that has divided some in the Big Apple.
In an article titled "No, social workers don’t do better than cops at mental health response," the New York Post concluded that civilian social workers may best serve as a back-up to police officers rather than as the tip of the spear. But municipalities that have led successful initiatives with civilian responders would disagree.
The success of Eugene, Oregon's CAHOOTs, which has been policy since 1989, and Miami's CHMP has led many to conclude that there are treatment-based solutions in the wild that may work. The success of these programs appears to have even inspired congressional action.
Nonetheless, New Yorkers are split over B-HEARD. We examine data as reported by the Mayor's Office of Community Mental Health − which recently reaffirmed its commitment to the pilot program by expanding its coverage to 26 of 30 precincts.
Statistics regarding the New York City Model
Approximately 500 mental-health-related 911 calls were managed during the first month of the program's launch. About 1 in 5 mental health-related calls were dispatched to B-HEARD. Program staff reported that they could handle roughly 100 calls, approximately 20% of the total the team received during the month, without additional support from law enforcement (7% of those calls required further police assistance).
After its first month, B-HEARD was extended an additional 90 days, in which, 1,478 emergency mental health calls were made to 911 where program staff was available to respond. Only 23% of those calls were routed to B-HEARD.
B-HEARD was also under-resourced with too few team members equipped to respond to the high demand of mental health calls. The program redirected 17% of calls back to the police.
What it got right and wrong
Many believe that the New York City Model has suffered from a separation of civilian staff and law enforcement. As referenced previously, successful civilian staffed programs exist in various forms throughout the country, but erasing law enforcement altogether leaves team members with no support in situations that turn violent.
For example, in Longmont, Colorado's co-responder model, behavioral-health experts, police, and paramedics arrive on the scene at the same time. The idea is to identify situations in which mental health services can be provided, safely, in lieu of criminal charges, which can be life-altering for the person experiencing mental health conditions and expensive for the organizations required to house and manage them.
Programs like this are created with a specific focus — to reduce violence between police and people in mental-health and addiction-related crises, and to ease the strain on police and local government resources. Research has found that the risk of being killed by law enforcement is 16 times higher for individuals with untreated serious mental illness than for other civilians.
Based on the limited amount of data available so far, however, it appears that these models work best with interagency support on the front lines. While B-HEARD routed 17% of calls back to police, the NYPD requested assistance from behavioral teams just 14 times.
On a positive note, it was reported that 95% of persons who interacted with B-HEARD staff accepted crisis-intervention-related medical care − up 13% from those who interacted with police only.
Conclusion
B-HEARD did see some success despite the issues that have divided those covering it. For one thing, only about half of patients were transported to the hospital (whereas police officers were previously sending over 80% of patients in crisis to the hospital), and all patients that interacted with B-HEARD received follow-up care. Additionally, 25% of patients were treated by the team at the scene, and 20% of patients were transported to community-based centers and resources.
Integrating both specialties (social workers and law enforcement officers) would likely improve the likelihood of success in mental-health crisis calls − while boasting some success, B-HEARD could be significantly better for NYC with the right blend of law enforcement and civilian staffed response teams.
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