Dispatching Mental Health Specialists to Nonviolent 911 Emergencies Shows Benefits

New research has found strong evidence that dispatching mental health professionals instead of police officers to some nonviolent 911 emergencies could have significant benefits.

Researchers at Stanford studied a pilot 911 response program in Denver, Colorado, in which mental health specialists responded to calls involving trespassing and other nonviolent events. According to the study results, researchers found a 34% decrease in reported crimes during the 6-month trial. The study also found that direct costs of the alternative 911 approach were 4 times lower than police-only responses.

“We provide strong, credible evidence that providing mental health support in targeted, nonviolent emergencies can result in a huge reduction in less serious crimes without increasing violent crimes,” said researcher Thomas Dee, PhD, in the press release. “In our politically divisive times, this first-responder innovation provides a rare opportunity for consensus on meaningfully improving public safety and health.”

National discussions around police reform and first responders have become highly controversial, including growing awareness of the need for experts in situations involving mental health or substance abuse. Currently, a small but growing number of cities around the country are exploring programs that embed mental health care and other social services in first responder procedures. Despite the controversy, Dee said the study’s findings suggest that there are sensible ways to reinvent first responder services in approaches that could have universal appeal.

Several cities—including New York City; Austin, Texas; San Francisco and San Mateo, California; and Washington, DC—are experimenting with new approaches to responding to mental health emergencies through little or no law enforcement involvement. According to the study, cities have been motivated by not only high-profile cases of police brutality, but also by data suggesting that police spend more time responding to “low-priority” calls than any other type of emergency. According to the study authors, as many as two-thirds of these types of 911 calls could be directed to mental health experts.

Cities are generally exploring 3 alternative responses. In one model, police officers are trained to direct people in crisis situations to appropriate services. A second approach involves partnering law enforcement with mental health professionals. Finally, a third reform approach removes police altogether from some 911 calls.

Descriptive evidence from other studies suggests that these models may be effective, but until now, no studies have tied the cause-and-effect of these alternative approaches with empirical evidence that they work. However, a pilot program in Denver could offer this much-needed empirical evidence.

For 6 months in 2020, officials in Denver tested the third, more radical approach by removing police officers from specific 911 calls. In emergencies involving low-risk infractions, such as public intoxication, welfare checks, trespassing, and public disorder, the dispatchers would send a mobile team with 1 mental health specialist and 1 paramedic. The program was called the Support Team Assistance Response (STAR).

The initiative covered 8 precincts in Denver’s downtown neighborhoods, where 911 calls involving low-income, at-risk individuals in nonviolent situations were expected to be high. The team of responders handled nearly 750 incidents involving mental health, homelessness, and/or substance abuse issues during the pilot period.

Interestingly, not all incidence started with a 911 call. In some cases, STAR teams were contacted directly by police officers or they responded to situations that they encountered on their own. In each case, the STAR team would direct individuals to substance abuse treatment centers or other support services as needed.

Using granular crime data publicly released by the city, researchers were able to track all of the adult criminal offenses reported across the 36 police precincts from the period before STAR operations began as well as the time in which the program was active.

The investigators found that dispatching mental health workers made a dramatic difference. Over the span of the pilot program, reports of less serious crimes in STAR-patrolled neighborhoods fell by 34% relative to crime levels observed in neighborhoods where STAR was unavailable. This drop in crime is attributed to fewer citations for public intoxication and other low-level infractions, as well as the likelihood that potential repeat offenders were now getting necessary help.

“The community-response program has 2 benefits,” Dee explained in the press release. “One, it directs people in crisis to appropriate mental health care instead of directing them to the criminal justice system. Two, it prevents future criminal activity because the people who are now receiving mental health care are not committing more offenses.”

In a quality check of their data, the researchers also examined reports of more serious crimes that police, not STAR teams, responded to in the precincts covered. They found no detectable increase in those crime rates, which suggests that the STAR program drove the decrease in low-level criminal activity, according to the researchers.

The STAR program also saved money, with the direct cost of responding to each offense at $151 on average, which is 4 times less than the estimated average of $646 direct cost per minor criminal offense, according to the study.

“These results are extraordinarily promising,” Dee said in the press release, although he noted that more pilots and studies are needed to make sure that any permanent reforms are correctly implemented. “This is not something that every 911 system should be implemented tomorrow. This reform requires thoughtful and detailed implementation—from training people who field 911 calls to hiring the right kind of mental health interventionists and coordinating carefully with law enforcement agencies.”

REFERENCE

A new Stanford study shows benefits to dispatching mental health specialists in nonviolent 911 emergencies. News release. Stanford News; June 8, 2022. Accessed June 23, 2022. https://news.stanford.edu/2022/06/08/stanford-study-shows-benefits-reinventing-911-responses/