A dispatchers’ problem? Sending non-cop response to mental health crises: “Give it a chance,” says Mayor

Fewer psychiatric emergencies got a response from B-HEARD squads this year than in their 2021 debut — but Mayor Eric Adams is still forging ahead with expansion of what he calls a “successful pilot.”

July 19, 2022 Greg B. Smith, THE CITY
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Logo for THE CITYThis article was originally published on by THE CITY.

Last year, a pilot program debuted in Harlem to try and reduce the number of police responses to 911 calls for people experiencing a mental health crisis. Instead of cops, teams of EMT and social workers trained to de-escalate these interactions would show up instead.

Since then, Mayor Eric Adams has announced plans to expand the program from four Harlem precincts to 11 precincts in Manhattan and The Bronx, citing the “already successful pilot of answering non-violent 911 mental health calls with mental health professionals.”

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But a review by THE CITY of the program — known as Behavioral Health Emergency Assistance Response Division, or B-HEARD — has found that since it kicked off in June 2021, the program has been anything but a success.

For starters, through March 911 dispatchers have continued to route the vast majority (75% to 78%) of mental health calls straight to the NYPD in the five precincts that were online. Since then four more have entered the program, with two more to be added soon.

In fact, in its first 10 months, B-HEARD’s response rate has actually dropped, THE CITY found.

In June 2021, the first month of B-HEARD, the teams managed to respond to about 20% of the 911 mental health calls in their coverage area. From June through November, the response rate dropped to 18% and in the first three months of this year the teams were now handling slightly less than 16% of the 911 mental health calls in the catchment area they’re assigned to cover.

B-HEARD was former Mayor Bill de Blasio’s response to a long string of incidents in which cops responding to 911 calls about individuals in crisis wound up killing them, with 19 such fatal interactions in the last six years. The idea — based on efforts in other cities, notably Eugene, Ore. — was to remove police from the equation.

New York City first tried pairing NYPD patrol officers with social workers in “co-responder” units, but that program was never linked to 911 and was limited in scope. Then in 2020 de Blasio, in his last term as mayor, went a step further and announced zero-cop teams of EMTs and social workers.

The pilot started in four Harlem precincts, handling cases where violence or self-harm did not appear imminent. De Blasio said B-HEARD would eventually expand citywide.

Last week Adams touted his role in that expansion during a press conference in The Bronx announcing the opening of a new, long-in-the-works site staffed by mental health professionals where B-HEARD or cops can bring individuals in crisis instead of jails or hospital emergency rooms.

“We have more than doubled the B-HEARD pilot area and we’re not just talking about it,” Adams said. “We’re putting the money there: a $55 million investment.”

But THE CITY found that by March, B-HEARD remained far behind the original goals promised by de Blasio, who at first vowed that when the program was up and running, 70% of 911 mental health calls would be handled by the no-cop teams. That was later amended to 60% and then 50%.

But the most recent statistics posted by City Hall show that they’re nowhere near even that. From January through March 2022, 911 dispatchers routed a mere 23% of the 2,400 mental health calls in the pilot area to the no-cop teams after determining the incident did not involve the potential for violence.

Among the 911 calls that got a police response was one from a Harlem woman who in January called for help in a stand-off with her son. The NYPD officers who showed up, Wilbert Mora and Justin Rivera, died in a hail of bullets fired by that son, Lashawn McNeil — who himself was shot to death by a third member of the NYPD.

Even with the calls they get, it’s become increasingly difficult for B-HEARD to keep up. In June 2021, B-HEARD responded to 80% of the mental health calls routed to them by 911 dispatchers. In the January through March 2022 report, the teams were responding to 68% of those calls.

That report states this happened “typically because the B-HEARD teams were unavailable, responding to another call.” This means dozens of calls initially routed to B-HEARD wound up being handled by the NYPD.

Paramedics load a patient into an ambulance in the East Village, Dec. 4, 2020.
Paramedics load a patient into an ambulance in the East Village during the second wave of the coronavirus outbreak, Dec. 4, 2020. Photo: Hiram Alejandro Durán/THE CITY

As a result, although they fielded 23% of the calls, the teams actually handled only 16% of them (383 of 2,400) from January through March, according to the report, which is the most recent released by the Mayor’s Office of Community Mental Health. The NYPD handled the vast majority — 84%.

In interviews with THE CITY, members of Correct Crisis Intervention Today (CCIT), a coalition pressing to significantly reduce police interaction with the mentally ill, questioned the wisdom of Adams’ expansion plans.

“I’m incredibly disappointed in the trend and my question is, why is the city expanding this program when it is clearly not meeting its stated objective?” asked CCIT member Cal Hedigan, CEO of the non-profit mental health support group Community Access. “On every trend it was going in the wrong direction.”

“I find it horrifying,” said Ruth Lowenkron, director of the Disability Rights Program at New York Lawyers for the Public Interest, another CCIT member. “They’re definitely doing less well than they were doing before and it’s extraordinary. And nobody seems to be alarmed about it.”

Judgment calls

The CCIT coalition seeks a 100% zero-cop system where peer counselors — individuals who have themselves experienced mental health crisis — team up with trained EMTs.

Mayoral spokesperson Kate Smart defended the program, emphasizing that far more individuals in crisis accept services such as therapy and medication monitoring after interactions with B-HEARD than after interactions that involved the police.

“The success of the B-HEARD pilot program is demonstrated by more people — over 90% — accepting help from B-HEARD teams compared to a traditional response,” she said, also noting that 30% of individuals who interact with B-HEARD wind up “being treated and served in their community with options for behavioral health care that were not previously part of emergency response.”

But Lowenkron, who has long argued that the B-HEARD program was flawed from the start, observed that even with B-HEARD being assigned only a small fraction of the 911 calls in their assigned precincts, the teams can’t keep up with the demand.

“How is it that you are referred the calls and you can’t even handle that tiny number that you are referred?” she asked, also noting that the teams are on-duty only 16 hours per day. “Emergencies don’t conform to a clock,” she said.

A key issue seems to be staffing. City Hall says they’re planning on assigning additional staff and Owen Barzilay, president of the 4,100-member Fire Department EMS Local 2507, said the FDNY just put out a request looking for more EMTs to take the required training, which includes self-defense and de-escalation techniques.

But he also noted that the proposed expansion is occurring just as the city is experiencing staff shortages across agencies due to what appears to be a mass exodus of city workers.

“You have to understand that we are short staffed. People are leaving this job in droves,” he said, adding that some members are reluctant to go into B-HEARD because they’re comfortable with their current hours and schedules and don’t want to risk disruption for a mere 6% pay differential.

“We have a lot of single parents, and we have a lot of people who have two or three jobs, and they set up their schedule and life around that,” he said.

B-HEARD also appears to be failing to reverse a stubborn problem it was specifically set up to address: cops who just drop the subjects of mental health 911 calls off at hospital ERs, to be typically released back to the streets within days. The data show that under B-HEARD, the percentage of subjects assisted by B-HEARD that wind up transported to ERs instead of diversion centers has actually increased since the program debuted — from 46% in the June to November report to 59% in January through March.

City Hall said that 59% is still better than the 82% of calls handled the traditional way by police that wind up with hospital drop-offs, and that one of B-HEARD’s goals is to reduce the number of what they called “unnecessary hospital transports,” not to reduce hospital transports overall. They also noted the opening of the center with mental health staff that Adams announced last week where individuals can be brought instead of hospitals.

Lowenkron and Hedigan say a crucial flaw in the system is the continued reliance on 911 dispatchers who, they say, acts as judge and jury in deciding whether to route a call to B-HEARD or to cops. B-HEARD teams aren’t supposed to handle any 911 mental health calls “where violence and/or imminent harm is identified by the 911 operator,” according to the program’s website.

And there are, in fact, two levels of dispatchers involved. According to the NYPD, 911 mental health calls are first routed through NYPD’s Communications Division, then transferred to FDNY Communications “where it is triaged by their dispatchers to determine if the call is eligible for a B-HEARD response.”

“There is someone making a judgment about, ‘Is this a call that we can divert?’” Hedigan of Community Access said. “And they perhaps do not have the right perspective or training to help them make that decision to move forward. The objective is for people having access to a non-law enforcement response when they’re in a mental health crisis.”

The most recent report from City Hall states that “B-HEARD is actively working to increase the percentage” of 911 mental health calls they handle by hiring more team members. City Hall also says B-HEARD reviews 911 calls to assess what does and doesn’t work, and assigns B-HEARD staff on site with FDNY dispatchers to advise on appropriate calls to refer to B-HEARD.

The Office of Community Mental Health is also letting more cops in the assigned precincts know about B-HEARD. The B-HEARD teams attend roll call in the assigned precincts, letting patrol officers know about the service and letting them know when it’s appropriate to seek B-HEARD’s support when in the field.

That approach appears to be helping. In the first month of B-HEARD, there were only seven calls where NYPD officers sent to the scene wound up requesting support from B-HEARD teams. By November, there were 72 such cases, indicating the word is getting out across the B-HEARD precincts.

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