By Benjamin Appleton and Emily Audet
The Community Response Team in Washington, D.C., has responded to thousands of crisis calls, including some diverted from 911. Two-person teams of responders with specialized training in behavioral health aim to de-escalate behavioral health- and mental health-related crises and often seek to connect individuals with the care they need to stabilize. At a recent panel hosted by Blue Meridian Partners, Dr. Richard Bebout, Chief of Crisis Services at the D.C. Department of Behavioral Health, Dana Brooks, Senior Program Manager for the Community Response Team, and Gloria Gong, Executive Director of the Government Performance Lab (GPL), discussed the GPL’s work with Washington, D.C., to support the District’s efforts to respond to more behavioral health-related 911 calls with trained behavioral health experts. The goal, as Dr. Bebout said, is to “create a health-first, not a law enforcement-first, response to behavioral health crises in D.C.”
Dana Brooks recounted one instance in which the Community Response Team responded to a situation where a man was having a loud conversation with himself and dodging erratically in and out of traffic, putting himself and others at risk of injury. “The team assessed that he was disoriented and unaware of his surroundings. They successfully de-escalated the situation without force, calming the man down and getting him to come out of the path of traffic by talking with him,” Brooks recalled. “The man was also moving spastically, which the Community Response Team believed to be possibly related to psychotropic medication and not intentionally threatening movements. But, to someone without specialized training in behavioral health, his movement could have been seen as threatening.”
The Community Response Team determined that the man needed further psychiatric evaluation, so they contacted the police department to transport him to the hospital. “When the police arrived, one officer shared how he was glad the Community Response Team arrived on the scene first because they were the most appropriate response for the situation,” Brooks continued. “This example shows why police are not always the most appropriate response to calls for help, especially those involving behavioral health issues. It demonstrates the need for more behavioral health expertise in emergency response.”
From left to right: Dana Brooks, Senior Program Manager for D.C.’s Community Response Team; Gloria Gong, Executive Director of the Government Performance Lab; and Dr. Richard Bebout, Chief of Crisis Services at the D.C. Department of Behavioral Health, at a recent panel hosted by Blue Meridian Partners.
The GPL has provided technical assistance and research support to Washington, D.C., for the past nine months through the Alternative 911 Emergency Response Implementation Cohort. In its work with the District to date, the GPL has supported the Department of Behavioral Health, the Metropolitan Police Department, and the Office of Unified Communications in advancing towards a major milestone: agreeing to significantly expand the types of 911 calls eligible for response by the Community Response Team.
“The Department of Behavioral Health applied and was selected for the GPL’s Implementation Cohort in order to expand the impact of our alternative response program. When residents call 911 for help with an emergency, they should receive a response appropriate for the situation – not a ‘one size fits all’ approach,” Dr. Bebout said. “With the GPL’s assistance, we’ve settled on an expansion plan that significantly expands the types of 911 calls eligible for diversion.”
To inform the expansion of Washington’s alternative response program, the GPL analyzed past 911 call data, shared best practices from peer jurisdictions, and synthesized existing research on racial disparities in arrests in Washington and other cities. Throughout this process, the GPL engaged front-line staff – including 911 call takers and dispatchers, and first responders from the Community Response Team – and facilitated inter-agency communication among leaders to cultivate buy-in for the program’s expansion.
“We were stuck thinking through ‘what if’ scenarios and couldn’t move beyond this hypothetical stage to reach a decision about which other types of 911 calls to divert to the Community Response Team,” Brooks said. “Our GPL fellow facilitated communication between the multiple agencies involved in decision-making. Most meaningfully, they elevated the voices of our Community Response Team, who shared that they already respond to many of the call types we were considering – but they do so directly through our hotline instead of 911. This work helped us reach a consensus about which call types to include in the program’s expansion. Having worked in government for many years, the communication between agencies during this process was the smoothest I’ve experienced.”
In addition to increasing the program’s reach in Washington, the GPL’s work with the District seeks to develop model practices for the operational integration of 911 and 988, the national suicide and crisis lifeline. In the District, eligible 911 calls are diverted to the same call center that manages 988 calls. Thus, no matter whether someone calls 911 or 988 for help, they can still receive the response that best meets their needs.
During the panel, GPL Executive Director Gloria Gong underscored the importance of reaching key milestones, like agreeing on a plan to expand eligible call types, while also recognizing that for many jurisdictions, alternative response is still in its earliest stages.
“Setting up a new branch of emergency response is not simple. It requires, among other things, selecting eligible call types, building or expanding teams of responders, and training 911 dispatchers,” Gong said. “But the hard work that Washington, D.C., and other cities are doing to divert more emergency calls to trained community responders is an important step in helping people in distress get the help they need. We’re energized by the progress we see in communities across the country as they test and expand alternative 911 emergency response.”
The GPL contributes to the development of the alternative response field by identifying and supporting demonstration projects across a diverse set of jurisdictions, including Durham, NC; Harris County, TX; and Allegheny County, PA. The GPL also runs a community of practice for government staff from jurisdictions exploring, planning, implementing, or expanding alternative 911 emergency response teams.