In a North Carolina community, mental health workers respond to 911 calls


In an emergency, everyone is taught to call 911, alerting the fire department, emergency medical services or police for help. But what if the caller does not need help due to a fire, accident, or crime?

As a 911 caller in Durham, North Carolina, said, “I feel kind of a danger to myself. Not anyone else. I’d like to go to the hospital. I have no way of getting there.”

It was Leigh Mazur who answered the call, but she’s not a typical 911 responder.

“When you mention that you have thoughts, that you have thoughts about endangering yourself, have you ever tried to harm or kill yourself before?” Mazur asked.

She’s a licensed clinical social worker and one of a handful of mental health professionals working with the city’s Comprehensive Empathy Assistance Response Team, or HEART, a pilot program that hopes to better match 911 responses to callers’ actual needs by placing mental health professionals at the call center Himself.

“We as clinicians have more training in mental health and are only evaluating people who have that,” said Jordan Heller, a licensed mental health practitioner and member of HEART. I spoke with CNN’s chief medical correspondent Dr. Sanjay Gupta, who recently visited the team to report on their unique approach.

“I think we’re able to ask those kind of specific questions to determine if this is something they’ve been dealing with for a long time and assess the risks of harm to themselves or someone else,” Heller said.

In the case of Mazur’s caller, the HEART team was able to get them to the hospital. But Heller told Gupta that callers could vary as needed; Some may seek help with self-harm or suicide, but others may experience domestic violence and abuse. Other calls may be for loitering and trespassing reports – one of the team’s most common calls. It is often associated with a non-residential person and deals with substance abuse and mental health problems.

National surveys estimate that 19% to me 38% of 911 calls relate to these kinds of issues – and don’t necessarily require a response from the armed police.

From an initial 911 call, Heller and her colleagues can determine how to defuse the situation and whether it needs follow-up, either by an unarmed community response team — which includes a mental health physician, a peer support specialist and an EMT — or by a joint response team. From a doctor and law enforcement officer.

According to new exploratory study From CNN and the Kaiser Family Foundation, about 1 in 5 Americans called 911 because they or a loved one had a mental or behavioral health crisis.

But more than 1 in 4 people surveyed believe that calling the emergency line will actually make these situations worse.

Most important concern: lack of training and awareness from police on how to deal with mental health issues. Of this group, 10% were specifically concerned that it could lead to arrest or hospitalization.

Opinions about calling 911 were similar across racial and ethnic lines, but opinions about the number’s effectiveness varied by age, with 44% of adults under the age of 30 skeptical that calling would help while more than half of older adults thought it might be helpful.

The KFF CNN Mental Health Survey was conducted by the SSRS from July 28 through August 9 among a random national sample of 2,004 adults. The survey includes 1,603 adults surveyed online after being recruited using probability-based methods and 401 adults selected by random dialing and reached on landlines or cell phones by the direct interviewer. Results for the full sample have a sampling error margin of plus or minus 3 percentage points.

In 2017, the non-profit organization Therapeutic call center It surveyed 355 law enforcement agencies across the country and found that they spent about 20% From working time responding to and dealing with mentally ill people. In most states, the center has found that more people with mental illness languish in prisons or prisons than in the largest psychiatric hospitals.

Daniela Gilbert of the State Department explained that “the concern about police being responders is that their involvement can cause serious harm.” Vera Institute, an advocacy group for criminal justice reform. “The tragic killing by police of people suffering from mental health crises is a worst-case scenario in this regard.”

At least according to the Clinical Advocacy Center 1 in 4 fatal shootings by police It includes a person with a mental illness.

These are the outcomes that programs like HEART try to prevent by connecting neighbors with resources. “If we can get someone out of prison, we’d like to do that,” Heller told Gupta.

HEART is not only trying to defuse the situation at the moment, it is trying to help with the bigger problems at hand.

“Peer support professionals are trained to really meet a neighbor where they are and be kind of that voice to help draw someone in, recommend resources, recommend advice, and sometimes even be a shoulder to cry on,” said one specialist Christopher Laurets.

Mental health already carries a stigma, and that can increase the presence of law enforcement officers in premium cars. About 7% of CNN/KFF survey respondents who thought calling 911 would make the situation worse were concerned about stigma and embarrassment. It’s something the HEART team is all too aware of, so follow-up teams ride white trucks with the green and purple team crest, instead of patrol cars.

“Even when officers are trained in de-escalation, the presence of armed responders can heighten feelings of distress,” Gilbert said.

Myra, who responded to the CNN/KFF survey, says she called 911 in the early 2000s when she was depressed and took too much acetaminophen.

“I just wanted all the pain to stop,” said Mira, who asked that only her first name be used to protect her privacy.

She said it was already a tough time for her personally, but the response made the situation worse. Call the police, the fire department, everyone. You remember “The Troops Come In”. “It’s like come on, a little hush, please?”

Another way for the HEART team is that they call everyone they work with “the neighbours.”

“They are not subjects. They are not patients or clients,” said team member Ebina Pediakou. “I might be the one who might have to help one day. It could be you.”

Tying people into services, driving in humble white vans, and simply doing a shoulder strap — these may not seem like revolutionary steps, but they do seem to make a difference. For the first eight weeks the heart was working, Team says They were able to resolve 68% of neighbors’ calls at the site and divert 82% of the calls they received away from law enforcement.

Ryan Smith, director of Durham’s Department of Community Safety, says the added hands of HEART are appreciated in a city like his, which already has a police shortage. He thinks of the team like the fourth branch of first responders: “Police, fire, EMS and now the heart.”

The program covers only part of the city and has limited hours, but officials hope to expand it.

Cities across the country – including EugeneOregon Denver; And the OlympiaWashington – I started using programs similar to HEART.

There have been increasing calls from criminal justice reform advocates for changes in policing and the use of force, especially after the killing of George Floyd by the police in 2020 following the killing of George Floyd by the police. 911 caller He stated that he used a fake $20 bill to buy cigarettes. So that there benefit In these community response programs from the federal government Justice Help Desk.

Pediakou is reminded of Floyd in the calls she receives and the neighbors she visits. “I think the kinds of calls we’re getting were similar to the calls that came to George Floyd,” she said.

She sees her role not only to help connect her neighbors with services but to serve as a voice for them.

Sometimes the neighbors don’t know how to fend for themselves. “They don’t know how to handle situations,” Pediako said. “If we can be there for them, even in that brief moment, that could save a life.”

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