Emergency Responders Team Up to Reduce Mental Health 911 Calls
A police officer has already determined that the man, at home in southeast Memphis, is safe when paramedic Demetria Davis and social worker Jacy Boyd arrive.
It takes just a few minutes for Davis, using a mobile emergency medical bag, to take the man’s vitals and medically clear him. The man is calm, but distressed. Boyd asks a series of questions, unpacking this most recent mental health crisis.
“He stated that he was suicidal with a plan to jump in front of a train,” Boyd says. “And he feels like he has intent on acting on those thoughts.”
Days earlier, the man ran out of the medication he takes for depression and hallucinations. With no money or transportation to refill his prescription, he dialed 911.
The call center dispatched Davis, Boyd and a police officer specially trained to deal with mental health situations. They agree to have the man transported to a crisis assessment center and then refer him to a psychiatric hospital for more comprehensive treatment.
These are the types of calls the new Crisis Assessment and Response to Emergencies (CARE) program is designed to handle. They bring a specialized response to mental and behavioral health 911 calls that might otherwise tie up other emergency services such as an ambulance. They started last September.
“Unfortunately, in our society, many times behavioral health patients are not cared for the way that they should be,” says Memphis Fire Department Lt. Kevin Spratlin, a CARE program coordinator. “Those patients fall into the hands of police and EMS to handle, and we’re trying to find a better way of handling those patients and truly serving their needs.”
The team works weekdays from 7 a.m. to 10 p.m. The police officer shows up first in a squad car to ensure safety and deescalate any potentially fraught situations. Then, a special minivan equipped similar to an ambulance arrives, bringing the paramedic and a clinician.
“The clinician is there to provide that mental health assessment and see if this individual actually needs to be transported to the...crisis assessment center for mental health help,” says Michael Sims, a CARE team coordinator with Alliance Healthcare Services, which operates a crisis assessment center.
He says people in need of long term help are steered away from using 911.
“We have a resource package that we can give them with the crisis center line,” Sims says. “We don’t mind if they call Alliance’s hotline, that’s what we’re there for.”
Lt. Spratlin says one of the program’s priorities is reducing unnecessary trips to the emergency room, which saves money and frees up the city’s fleet of 34 ambulances for true emergencies.
It also typically streamlines a person’s treatment.
“Simply taking those patients to an emergency room by ambulance doesn’t really help their needs,” Spratlin says. “Because they’re in the ER for an extended period, and then they’re just simply sent to a behavioral health facility.”
The CARE program also addresses the problem of so-called “high utilizers.” These are people who call 911 more than three times a week. There are a few hundred of them. Spratlin estimates that about a third have a diagnosed mental or behavioral health condition.
“We recently on the CARE team worked on a patient referred by police who had called them over 700 times in three weeks,” he says.
Some emergency responders, like police officer Christopher Ross, keep their own personal list of high utilizers that they’ll check on regularly.
“Most of your high utilizers are people who are diagnosed paranoid schizophrenic or it could be an elderly person with dementia, and they don’t have anyone,” says Ross, who is specially trained in crisis intervention. “So they just want someone to talk to.”
Dr. Randolph Dupont, a University of Memphis criminology professor, says that the underfunding of community mental health services has led to a larger volume of mental health 911 calls, ranging from people with suicidal thoughts to substance abuse struggles.
“We should take a new study and take a look and ask the question, ‘Are people getting adequate care?'” Dupont says. “I think the answer would be they’re not, and so that does raise a great deal of concern.”
For now, CARE is still a pilot program, funded for a year. Assessment data is still coming in,” says Officer James Lash, the CARE program’s police coordinator.
So far, the team has responded to about 450 calls.
Lash says that while that may not sound like many overall, mental health situations often get complicated and can take hours to resolve. To him, that's time well spent.
“I like to think that first and foremost that individual that we are there speaking to is receiving the best help that they can get for their situation,” he says.