New York City Public Advocate Jumaane D. Williams called for expanding non-police response efforts to mental health emergencies at a City Council oversight hearing today. The hearing convened several committees to focus on B-HEARD, an alternative response program which pairs mental health workers with paramedics/EMTs as a response team. Public Advocate Williams emphasized the importance of not relying simply on law enforcement in such emergencies, instead focusing on health professionals and peers, while highlighting several of the limitations the initiative currently faces.
“Many of the challenges that B-HEARD faces lie in inadequate staffing,” Public Advocate Williams noted. “There is a shortage of 911 operators who can appropriately triage the calls, leading to a default police response. It can be difficult to discern over the phone what is happening at the scene, and whether there is a risk of harm to the caller or to the responders… It is also imperative to ensure that 911 dispatchers are properly trained in how to effectively determine which calls can be sent to B-HEARD.”
B-HEARD reported last week that teams responded to 73% of eligible 911 calls in FY24, a significant increase from the previous year. The Public Advocate was “heartened” by this increase but cautioned “...Our goal should be for those teams to respond to every eligible call that comes in – Also note that when you count the quote on quote, ‘ineligible,’ that number drops very significantly to 30% and we have to look at the definitions of eligible and ineligible.”
This hearing comes days after a police shooting during a confrontation with a man struggling with mental health issues. The Public Advocate noted in his statement that “Mr. Mickles was failed by our system long before that shooting occurred.”
Public Advocate Williams emphasized the enormous discrepancy in resources for solutions like B-HEARD relative to the NYPD, and closed by saying “If we want an effective alternative to police responses to people in mental health crises, we must be meaningfully prioritizing resources for that response; otherwise, we are endangering not only those who need help but those who respond.”
The Public Advocate’s full comments as delivered are below. Video of the hearing is available here.
STATEMENT OF PUBLIC ADVOCATE JUMAANE D. WILLIAMS TO THE NEW YORK CITY COUNCIL HEALTH COMMITTEE JOINT WITH COMMITTEE ON MENTAL HEALTH, DISABILITIES AND ADDICTION, PUBLIC SAFETY, HOSPITALS, AND FIRE AND EMERGENCY MANAGEMENT SEPTEMBER 23, 2024
Peace and blessings everyone, Happy Monday, Good morning again.
My name is Jumaane D. Williams, and I am the Public Advocate for the City of New York. Thank you to Chairs Lee, Salaam, Narcisse, and Ariola and the members of the Committees on Mental Health, Disabilities and Addiction; Public Safety; Hospitals; and Fire and Emergency Management for holding this hearing today.
Each year, the NYPD responds to approximately 200,000 calls related to people experiencing a mental health crisis. Despite most often being the first responders, we know that our police are not the best equipped to safely and effectively handle these calls. Additionally, officers have also themselves expressed that they do not want to be responding to these calls. When law enforcement respond to people in mental health crises, those who need help are often subject to use of force, arrest, incarceration, and, at times, unfortunately, even death.
In light of tragedies where people in mental health crisis are killed by law enforcement, municipalities across the country have implemented various alternative response models. In 2021, New York City launched the Behavioral Health Emergency Assistance Response Division, or B-HEARD. B-HEARD teams are FDNY EMTs or paramedics teamed with a mental health professional from Health + Hospitals. These teams operate 16 hours a day, seven days a week, in 31 precincts (out of 77 total precincts).
It has been heartening to hear that the number of 911 calls that B-HEARD responds to is increasing. Responds to 73% of all eligible mental health calls in FY24. But our goal should be for those teams to respond to every eligible call that comes in – Also note that when you count the quote on quote, ‘ineligible,’ that number drops very significantly to 30% and we have to look at the definitions of eligible and ineligible. Though the number of 911 calls that B-HEARD responds to is increasing, they still only responded to just over half of eligible calls and a quarter of all 911 calls in the first half of 2023.
Many of the challenges that B-HEARD faces lie in inadequate staffing. There is a shortage of 911 operators who can appropriately triage the calls, leading to a default police response. It can be difficult to discern over the phone what is happening at the scene, and whether there is a risk of harm to the caller or to the responders. The city is hiring more 911 staff and allowing B-HEARD teams to join or take over the response to some calls that were initially routed to the NYPD or EMS, but we do not have data on how often the NYPD or EMS calls in B-HEARD to assist on a call.
It is also imperative to ensure that 911 dispatchers are properly trained in how to effectively determine which calls can be sent to B-HEARD. Dispatch training must be improved to incorporate dispatching for mental health crises through ways such as a mental health solution tree that will branch off into separate dispatching categories for various responses. Mental health training must be conducted regularly to ensure calls are being appropriately dispatched to the right teams. We can also learn from models in other cities: in Chicago, dispatchers are regularly updated on the outcomes of calls directed to their Crisis Assistance Response and Engagement teams, and other cities have invited dispatchers on ride-alongs to see teams in action, increasing dispatchers’ confidence in these teams.
Staffing of the B-HEARD teams themselves is also an issue. Currently, the teams only operate 16 hours per day, and calls that are determined to be eligible for a B-HEARD response may go to police or traditional EMS anyway, because a B-HEARD team isn’t available. It is understandable that B-HEARD responses may take much longer than a typical police response, as de-escalation and determining what an individual in crisis needs takes time. I just want to point out that shouting at someone to put something down is not a de-escalation tactic. These calls can also be more challenging than a non-mental health call to EMS; we should be incentivizing EMS workers and paramedics to join B-HEARD teams and compensating them fairly for the work that they are doing. The city should also be allocating funding directly to H+H to hire social workers and mental health professionals, also peers, for B-HEARD teams. While the city has not detailed what a citywide B-HEARD program would look like, if the program scaled up staffing at the same proportion it had to serve 25 precincts, that would mean just 280 people for all of the city’s 77 precincts, compared to 35,000 NYPD officers. If we want an effective alternative to police responses to people in mental health crises, we must be meaningfully prioritizing resources for that response; otherwise, we are endangering not only those who need help but those who respond.
And we have heard the names of Win Rozario, Kawaski Trawick, and Deborah Danner, Eleanor Bumpurs, I know Ms. Peggy Herrera is here, Mohamed Bah’s mother called to get help, and their children are no longer with us. I’d be remiss if I didn't mention the subway shooting – we do know that Mr. Mickles was failed by our system long before that shooting occurred. We are at a point in time where we all agree that we need to do more with mental health, and I hope we have the courage to actually put the system in place so we don’t have to have any more people added to those names.
Thank you.