From the day we are old enough to hold a phone, Americans are taught to dial 911 in the event of an emergency, no matter the type.
This will soon change.
Growing demand for mental health care, soaring youth suicide rates and the tireless work of health advocates have opened our communities’ eyes to the fact that a “one size fits all” approach does not work for emergency dispatch services. That’s why the FCC adopted rules to establish 988 as the new, nationwide, three-digit phone number for mental health emergencies, set to go live on July 16, 2022.
Creating these hotlines is just the first step on the path to ensuring that 988 callers with mental health challenges receive the care they desperately need – instead of police responses which can lead to arrests, injuries and even deaths.
That’s why Mental Health Colorado’s Equitas Project has launched Care Not Cuffs. Our national campaign aims to rally the nation to build healthier, safer communities that respond to people’s unmet mental health needs with care – instead of escalation, criminalization and imprisonment.
One of the best ways to do so is to understand and prepare for 988.
Today, 911 calls are routed to local dispatch centers using GPS to determine the caller’s location. From there, local dispatchers send the responders they believe are best suited to help. In most communities, mental health emergency calls lead to the dispatching of police officers, rather than trained mental health responders. Research suggests that at least 20% of police calls for service involve a mental health or substance use crisis, and for many departments, that demand is growing.
988 can revolutionize the system, enabling dispatchers to route calls with mental health needs to trained mental health responders, rather than to law enforcement.
This is critical, given that jails and prisons are the nation’s de facto psychiatric facilities. Close to 80% of the 11.2 million people who spend time behind bars in any given year have mental health needs that have often gone unmet for a lifetime. This is unacceptable. We can — and must — care more.
Here are the three steps local leaders must take over the next 10 months to ensure that in July 2022 people calling 988 get care, not cuffs, in response to their mental health crises.
Assess your community’s level of available resources
Naturally, local communities will prepare for 988 in different ways based upon the resources at their disposal. On a national level, jails and prisons cost taxpayers $80 billion per year. On a local level, some communities spend 30% of their budgets or more on policing. Consider shifting some of these funds to develop a crisis response system that can improve health outcomes, reduce incarceration rates and, ultimately, save taxpayer dollars.
Invest in what you can afford – and leave time for hurdles
Some cities across the country are already doing incredible work to ensure that when 988 goes live in 2022, their communities will be ready. Heroes such as Sheriff Jaime FitzSimons (who leads Summit County’s SMART co-responder team in Colorado), should serve as examples to communities that are just beginning to develop their 988 response plan.
Well-resourced communities must invest in the infrastructure needed to create entirely new teams of trained mental health workers dedicated to responding to mental health emergencies. The Denver STAR team, which was modeled on the successful CAHOOTS program in Eugene, Oregon, has responded to more than 1,200 mental health emergencies since June 2020 with no arrests. Such teams will need transportation (such as vans) as well as treatment centers that can stabilize and care for patients after the initial emergency response and triage.
Communities with fewer resources should invest in training their existing police force to recognize the differences between a mental health emergency and criminal behavior — and then provide the appropriate response.
Regardless of resources available, the path from investment to execution is not a straight one. Along the way, debates will likely arise about the best way to achieve the aim of safely providing care for those with unmet mental health needs. In Washington state, such conversations have recently been unfolding over HB 1310, a proposed bill that would create a statewide standard for the use of officer force during mental health emergencies.
These conversations aren’t easy, but they are important.
Collect data, create accountability
Accountability is key. Create data and information systems to measure the success of your mental health response team’s intervention outcomes. This will help programs identify gaps in implementation and focus time and money on efforts that are most relevant to the local community.
Finally, if you are not an elected official in your community, do not underestimate your ability to bring about change.
The recent failure of Congress to address police reform offers a valuable lesson: The effort to disentangle our nation’s mental health and criminal justice systems truly must start in our local communities — with you. Contact your local leaders and urge them to take these necessary steps to ensure that your community is ready to respond to 9-8-8 calls with care, not cuffs.
Your efforts will save both lives and taxpayer money. The time to start is today.
Vincent Atchity is president & chief executive officer of Mental Health Colorado and leads the organization’s Care Not Cuffs initiative. He previously served as executive director of The Equitas Project, a national initiative that works to disentangle mental health and criminal justice and is now part of Mental Health Colorado.
