“These cities are using data to drive the conversation and inform their decision-making, guided by the core objective of improving public safety and health outcomes,” said Anita Ravishankar, director of criminal justice research at Arnold Ventures. “This approach is getting them to a place where they’re better able to deliver on what their residents need, when they need it.”
The national 911 system was launched over 50 years ago to offer rapid response to emergencies, including crimes. Today, 911 receives 240 million calls each year, but most don’t concern crime, ranging instead from noise complaints to alarms, traffic accidents to mental health crises. For those events, police can be unnecessary and costly — or even harmful. Although exact numbers are unknown, it is estimated that 25% of police shootings involve someone experiencing a mental health emergency. Tragic cases like those of Daniel Prude, who was killed by police during a mental health episode, and Elijah McClain, who was killed by police during a routine, noncriminal encounter, demonstrate the potential consequences of assigning overly broad roles to police.
Motivated to avoid such cases, many cities nationwide have sought to design new 911 responses that would reduce unnecessary police involvement and deliver better outcomes for individual and community safety and health. At the same time, the federal government has prompted state action with the recent national rollout of the 988 suicide and crisis prevention hotline.
In summer 2020, the government of Durham, North Carolina, began considering 911 diversion programs for certain calls, such as those involving mental and behavioral health crises, in an effort to devise more effective responses. The city partnered with RTI to analyze 911 call data and assist with implementation. Drawing on regional interest, Durham city leadership invited several nearby jurisdictions — Greensboro, Raleigh, Winston-Salem, Burlington, and Cary, North Carolina, and Rock Hill, South Carolina — to join the initiative. Each site launched its own efforts at reform, following a data-driven process to guide decision-making and learn from their partner sites in the cohort.
“Law enforcement, and the criminal justice system more broadly, are called upon to address a vast array of social issues they are not the best equipped or resourced to handle,” said North Carolina Attorney General Josh Stein. “Incorporating mental health professionals into the first line of response is better for those in crisis and frees up law enforcement to focus their time and effort on preventing and solving violent crime. These new programs let those best suited to addressing different problems concentrate on their strengths, ultimately leading to improved public safety and healthier communities.”
‘Law Enforcement Is Not Always the Best Response’
The RTI report analyzes dispatch data for 911 calls in Durham and the six other collaborating jurisdictions to identify the most common call categories and understand the top reasons the public calls for help.
It’s important to use a data-driven approach when taking on a challenging topic such as 911 diversion programs.Kevin J. Strom director of RTI’s Center for Policing Research and Investigative Science
“It’s important to use a data-driven approach when taking on a challenging topic such as 911 diversion programs,” said Kevin J. Strom, director of RTI’s Center for Policing Research and Investigative Science.
The major harm the report found was not related to police abuse or unnecessary arrests but a failure of existing response systems to meet people’s needs for care and services. Arrest rates for mental health calls, for example, are low, Strom said, and the issue is not that people with mental health issues are routinely being moved into the justice system in the sites studied. It’s that police are often dispatched to manage real or perceived mental health emergencies but lack the resources to address people’s immediate or underlying problems. As a result, the conditions people are facing remain untreated and persist, leading to frequent 911 calls in the future.
Using this information, alongside an inventory of available programs and services from across the country, RTI worked with cities to develop new policies that meet mental health, behavioral health, and other needs. Each city was able to customize a pilot designed to improve their crisis response systems, informed by the RTI analysis of calls for service and their available resources. They were motivated by a common set of goals: to improve public safety, save police the time and cost of unnecessary dispatches, and reduce the potential harms caused when police use arrest needlessly or simply can’t provide the services that citizens require.
“The cities have shown that these types of programs can be implemented effectively,” Strom said.
Durham created a new Community Safety Department to implement a suite of alternative responses, including dispatching unarmed teams to address nonviolent behavioral health and quality-of-life calls and offering follow-up care within 48 hours — similar to the well-known CAHOOTS model in Eugene, Oregon. More recently, the department began testing a response that pairs clinicians with police officers to respond to calls that pose a greater potential safety risk. They have had initial success, with no safety issues reported to date.
“We’re seeing continuing evidence demonstrating that you can send unarmed responders to calls that we used to send police to, and you can do so in a way that is consistent with the safety of everyone on scene,” said Ryan Smith, director of the Durham Community Safety Department.
Greensboro implemented a co-responder model to address certain types of crisis calls, moving six officers to a special Behavioral Health Response Team and pairing them with clinicians.
We need to address community issues, whether it’s homelessness, behavioral health, or juvenile issues around school, and expand our ability to get resources out there.John Thompson Greensboro police chief
“Now more than ever, we have to evaluate what we want our officers going to and what we train them for, not only from the organizational perspective but also for what’s best for our community,” said Greensboro Police Chief John Thompson. “Law enforcement is not always the best response. We need to address community issues, whether it’s homelessness, behavioral health, or juvenile issues around school, and expand our ability to get resources out there. That’s the holistic view of it.”
Thompson said the pilot has been a success, noting several instances when the team was able to direct people who experienced chronic homelessness to long-term housing and care or link people threatening suicide and their families to counseling. “We’re starting to see a significant number of success stories where the co-responder team is able to connect people to appropriate resources,” he said. “The officers absolutely love it.”
Strom noted a few key features of the jurisdictions that built such programs successfully: using data, identifying champions, planning up front, leveraging existing resources, and staffing adequately, often through partnerships with local universities and communities.
Most 911 Calls Are Not for Crime
In order to understand the cohort cities’ needs, researchers analyzed data on three years of 911 calls, totaling nearly 4 million events across the seven cities. Consistent with national trends, they found that a large share of 911 calls for police are for needs not related to crime, let alone violent crime.
While mental health-related calls were a major focus of concern for policymakers, the analysis of 911 call data found that they comprised only 1 to 2% of all calls. Police departments, however, noted that these calls take up disproportionate amounts of officers’ time and effort, and after digging into the data, the researchers suspect that they are in fact undercounted. Strom explained that it’s often not apparent to emergency communicators, who code the calls, that there is a mental health-related component until first responders arrive on the scene. This can cause underreporting and make it difficult to assess service needs appropriately.
A large share of calls for service were about traffic incidents and security alarms. Traffic calls accounted for around 10% of events overall. Even if local jurisdictions do not want to dispatch an officer, North Carolina law requires a uniformed police response to all traffic crashes, including minor collisions with no injuries. Security alarm calls made up around 200,000 calls (or 5%) across the seven cities. In Greensboro, 99% of those calls were false alarms, and in Raleigh, such alarm calls consumed more than 1 million minutes of officers’ time. For every officer dispatched to a false alarm, there is one less officer available to respond to serious crimes.
Greensboro is making legislative efforts to implement a civilian response to traffic calls without injuries, which would reduce the workload for officers. Others are changing protocols around alarm calls to identify false alarms and reduce the burden on officers.
“There are a lot of inefficiencies to police departments and communities if patrol officers are routinely responding to certain types of 911 calls that could be handled another way,” Strom said.
The Future of Alternative Responses
In general, alternative responses enjoy bipartisan support and the endorsement of law enforcement officials in North and South Carolina.
“Public safety is not a Democrat or Republican issue,” Attorney General Stein said. “Law enforcement officers know better than anyone the number of calls they receive related to substance use disorders, mental health crises, family dysfunction, and homelessness, and we will continue to work proactively with law enforcement, public health, and community leaders to secure better resources to assist people in crisis.”
With pilot programs up and running, adequate resources and sustainability are critical, researchers and local officials said. City and agency leaders should prioritize funding alternative responses that give people the help they need and create a pipeline of trained staff to continue their operations.
The cohort cities are tracking the implementation process and measuring effectiveness, so that both they and other jurisdictions can learn from them. Researchers are also learning from the pilots, since many 911 diversion programs have not been previously evaluated. Strom said RTI wants to understand whether programs are addressing community needs and improving public safety, while also placing less burden on first responders.
“Ultimately,” he said, “we can reduce the reliance on police to address problems that are outside of their control and also get people the help they need.”