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In Austin, Texas, when someone calls 911, they say, “Do you need Austin 911, police, fire, EMS, or mental health services?” He hears. As of February 2021, Austin’s 911 Mental Health Diversion Program now forwards more than 600 911 calls per month to mental health professionals, connecting those in need with the mental health treatment system, connecting them with the criminal justice system, and freeing up critical emergency resources – this essential implementation. A fourth option is to call 911.
The program is a series of results. City recommendations from Meadows Mental Health Policy for Texas (MMHPI).. Austin believes that adding a mental health option to 911 calls is the first step toward the ultimate goal of diverting 100% of callers with mental health concerns from law enforcement response. The operational model, key considerations, and outcome data are briefly discussed Justice Clearinghouse webinar.
About the panel
The panel includes:
- Colin McCollough, Program Manager at Integral Care. She manages clinics in the 911 Call Center, which integrates first class and nationally recognized mental health clinics into the local emergency response system (ie, 911). Contact McCullough at colleen.mcculloch@integralcare.org.
- and Murphy, The Austin Police Department (APDD) lieutenant has served as director of the Emergency Communications Division for the past five years. Leads a team of over 200 telecommunicators and support staff including administrative assistants, training team and IT support analysts. Find Murphy at kenneth.murphy@austintexas.gov.
- BJ Wagner, M.SIn the year She joined the Meadows Institute in late 2015. In her current role, BJ works to expand the Institute’s efforts in health and public safety, including multidisciplinary law enforcement and first responder projects focused on mental health emergency response, first responder health and safety, and more. Find Wagner at bjwagner@mmhpi.org.
Top quotes on mental health 911 response
Following are some top quotes from the webinar.
- “Develop as strong relationships as you can with hospitals, so you can get callers the best possible care.” – Colin McCollough
- “Being in the 911 center together — the more relationships we developed, the more calls we got.” – Colin McCollough
- We are wary of calls from parents to ask the police, as this creates stigmatization of the police from a young age. – Lt. Ken Murphy
- “About 15 percent of all calls to the service have some mental health component.” – Ken Murphy
- “We’re moving away from voice to texting. Studies show that the younger generation prefers texting over speaking. Increasing the ability to communicate and receive messages in multiple languages ​​may be a plus for texting 911 and 988 (in the future).” – Lt. Ken Murphy
- “Start with your own call center data to understand what happens when a call leaves your call center.” – BJ Wagner, MS
- “Beware of ‘sending sensationalism’. In other words, what is said to the officer on the street is so important that it affects his reaction to the scene. – BJ Wagner, MS
911’s top take on mental health disparity
Colleen McCollough, Ken Murphy, and BJ Wagner, MS, (left to right) share action estimates and outcome data from the Austin 911 Mental Health Diversion Program.
The following are suggestions for how Austin handles 911 training, operations, and call scheduling for mental health diversity.
1. Training clinics and 911 operators
Integrating licensed clinicians into the mental health crisis call process and having them act as counselor/counselor response units allows for a more informed response, reducing harm to callers and officers. This approach allows 911 operators to quickly divert police-related calls that do not pose a threat to the public or the safety of the caller to the appropriate source. Law enforcement response.
If the caller only requests mental health services, the 911 operator will immediately transfer to a clinic without further questions. The clinician will forward the call to determine if the clinic’s or Integrated Care’s Expanded Mobile Crisis Outreach Team (EMCOT) can manage the call or if the call requires a police response. In this case, the 911 operator will remain on the line while the clinic resolves the call, as is currently the case with EMS and fire calls. This allows the 911 operator to process requests for mental health services and make an informed decision regarding the response of a trained medical professional.
Austin began training on the following to prepare themselves to provide the services.
- Basic computer-aided design (CAD) on-call training (an extension of the current practice of the medical professional)
- Make a quick decision (60-120 seconds) about the appropriate response to a mental health service request
- When the medical professional is not available for immediate transfer, call the triage tree using mental health risk assessment
- Reviewing mental health data as call volume suggests when a 911 call center should operate a second clinic.
2. 911 operator procedure
911 operators ask the following mental health screening question on every call for service:They may or may not know that the person is in a mental health crisis.?
911 operators must complete a mandatory mental health field in the CAD for each call for service. A mandatory field indicates that a condition may include a mental health component. A mandatory field is a drop-down field with the following options.
- No or unknown mental health department
- Yes, a certified or potential mental health unit
- Yes, C3 transfer eligible call, however, the clinic cannot be reached
- Mental health services
Appropriate calls to 911 for referral to mental health services include: |
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911 calls that do not qualify for referral to mental health services include: |
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3. Call resolution
A 911 operator confers with first-party callers at the clinic when there is a safety concern and an officer’s response is appropriate. While he’s on the line, the clinic officers try to mitigate the damage while they’re on the road. Decoupling results in a better outcome for the caller and the authorities, and provides the 911 operator with additional information that would otherwise be unknown to first responders arriving on the scene.
4. Expanded Mobile Emergency Response Team (EMCOT) model
EMCOT is comprised of mental health clinics in Travis County that support adults and children with mental health issues. They can remove barriers to seeking mental health crisis care and collaborate with community partners at key interceptions.
EMCOT also provides training to first responders and other partners in their communities and can prevent overuse and misuse of emergency rooms, psychiatric hospitals, and unnecessary law enforcement involvement. Clinics provide the right care in the right place at the right time and can provide up to 90 days of community-based follow-up services.
5. Integrated Care Telehealth
To enable more consultation, improvement, treatment and positive outcomes, by April 2021, more than 500 iPads will be provided to trained Austin Police Department officers for mental health calls. This allowed officers to speak face-to-face with on-site clinicians and counsel a person in distress on camera.
6. The first evidence of the value of the fourth option
The study found that up to 10% of police time involves responding to mental health calls, and individuals with mental illness have 3-5 times more contact with the police than people without mental illness. Most individuals with mental illness who come into contact with the police have prior convictions reflecting minor violent offenses. The interaction between people with mental illness and the police is under control, and more than 40% of individuals with mental illness have been arrested at least once.
Combining these assumptions, police officers found that outward signs of mental illness could be interpreted as irrational and unstable behavior, which contributed to the study’s findings that police used more force against people who had contact with mental health services.
The results of the study showed that when APD officers responded to calls for service that initially referred callers to mental health services, arrests and use of force rates were lower compared to cases where mental health units were diverted later in the process.
When officers knew there was a mental health patient on the scene, arrest rates dropped 45.5 percent.
The observed reductions in the use of force on these calls suggest that allowing callers to request mental health services early in the call may be a useful tool to prevent minor mental health issues from escalating when police respond.
7. Results information
In the results data to date, calls identified as potential or confirmed mental health crises include:
- 2020: 43,646
- 2021: 48,404
Forwarded calls include:
- 2020: 1,526 (4%)
- 2021: 5,699 (12%)
- 2022: 7,800 (projected)
All Austin call center clinicians are graduate or master’s level social workers or psychologists. Primary diagnoses are determined by duty clinicians using their professional knowledge to make the diagnostic decision. Clinicians recommend the following primary tests:
- Psychosis: 44%
- Suicidal thoughts: 14%
- Emotional Disorder: 12%
- Behavioral health issues: 11%
- Cognitive issues: 7%
- Material Issues: 4%
- Family Conflict: 4%
- Housing: 4%
Main outcome data showed that more than a quarter of those who received emotional support, an additional 16% received follow-up from a critical care team, and 18% of callers were returned to 911.
8. Austin and 988
This article focuses on an excellent program in the city of Austin. The program was developed in advance of the new national 988 number and it was clear from the Q&A in the webinar that there is a relationship and collaboration between 988 and APD. It remains to be seen how the relationship will develop and how 911 callers and 988 customers will be directed between each system.
Additional resources on police mental health outreach programs
Learn more about mental health response through these Police1 resources:
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