- A New York City pilot program, also known as B-HEARD, responds to mental health calls with paramedics and mental health professionals instead of police.
- Only 50% of people treated by B-HEARD were transported to the hospital, compared to the 82% who were transported with a traditional 911 response.
- Similar programs exist nationwide.
A New York City pilot program that sends mental health professionals and paramedics instead of police for nonviolent emergency calls has succeeded in keeping more people out of the hospital and getting them treatment, according to new data.
In an effort to better respond to mental health crises, last month, New York City launched their Behavioral Health Emergency Assistance Response Division, also known as B-HEARD. This change arrives just over a year after George Floyd’s murder, which pressured states to find ways to curb violence and systemic racism in policing.
During certain nonviolent situations, in lieu of police, the city is now dispatching B-HEARD teams, which consists of emergency medical technicians (EMS) or paramedics and mental health professionals from NYC Health + Hospitals. The program was designed to de-escalate emergency situations, provide immediate care, and handle people experiencing suicidal ideation, substance use, and other mental health illnesses.
“Early data shows that more individuals are accepting assistance and fewer people are being sent to the hospital, as a result of the B-HEARD program,” Anton C. Bizzell, MD, former practicing physician based in Maryland, who is not involved with the program, tells Get Meds Info.
Since the B-HEARD’s inception, the program has already had some success. Only 50% of people treated by B-HEARD were transported to the hospital, compared to the 82% who were transported with a traditional 911 response. And everyone served by B-HEARD was offered follow-up care.
How the Program Works
During this pilot, 911 operators and EMS dispatched B-HEARD teams to 25% of all mental health emergency calls. But calls that involve a weapon, risk of violence, or immediate transport to a medical facility were still met with an ambulance and police officers.
The program operates seven days a week for 16 hours per day. Under the pilot, B-HEARD only serves communities in East Harlem and parts of Central and North Harlem. These areas were chosen based on the previous volume of 911 mental health calls and the availability of community-based mental health resources.
According to this latest report, of the people assisted by B-HEARD teams:
- 25% were served onsite, including de-escalation, counseling, or referral to community-based care
- 20% were transported to a community-based care location
- 50% were transported to a hospital for additional care
Will B-HEARD Help?
Alyssa Mairanz, LMHC, CDBT, licensed mental health counselor based in New York, believes that B-HEARD will be an effective intervention, especially for individuals at risk for mental health emergencies.
“As someone who works regularly with at-risk clients, I have had to make the judgment call whether to reach out to 911 on occasion and know firsthand how the situation can improve,” Mairanz tells Get Meds Info.
She adds that people may be hesitant to call out of fear for the police. In 2020 alone, 1,126 people were killed by police. And Black people were three times more likely to be killed by police than White people. Most of these killings began as a traffic stop or mental health check.
By dispatching mental health professionals instead of police, “this can be a much softer or positive approach to help at-risk people get help in a less resistant way,” Mairanz says.
“Many of those who called 911 with mental health issues were admitted to the hospital against their will or incarcerated,” Mairanz explains. “These supposed solutions not only fail to correct mental health but can exacerbate the situation and cause more trauma while increasing the number of people in hospital beds or jail cells without need.”
What This Means For You
New Yorkers experiencing a crisis that does not involve an immediate in-person response can call 1-888-NYC-WELL or chat online at nyc.gov.nycwell to connect with a trained counselor.
This Kind of Program Isn’t New
Programs like B-HEARD are not new. Thirty-two years ago, the city of Eugene, Oregon launched a community-based safety program called Crisis Assistance Helping Out On The Streets (CAHOOTS) to provide mental health first response to calls involving homelessness, addiction, and mental illness.
The program involved mobilizing two-person teams of a medic (nurse, paramedic, or EMT) and a crisis worker with substantial mental health training. Using de-escalation and harm reduction techniques, the CAHOOTS teams handle a myriad of situations that involve conflict resolution, welfare checks, substance use, and suicide. CAHOOTS teams do not carry weapons.
As a result of CAHOOT, the city of Eugene an estimated $8.5 million in public safety spending annually.
Other cities have recently followed suit, including Olympia, Washington, and Denver, Colorado. Denver’s program, Support Team Assistance Response (STAR), directs emergency calls to a two-person team, consisting of a medic and clinician. The STAR program launched in June 2019 and also reported promising results in its six-month progress report. So far, STAR has responded to 748 calls regarding welfare checks, narcotic incidents, and mental health episodes.
“These types of programs are designed to send the right kind of first responders into crisis situations where crime is oftentimes not being committed,” Bizzell says. “With the support of these programs, key people are collaborating to address and deescalate high-stress mental health situations, while at the same time acquiring the skills to handle escalated developments.”