What to know about NYC’s B-HEARD mental health crisis response teams

There’s not much that former police officer and New York City Mayor Eric Adams could say to make socialist Public Advocate Jumaane Williams get to his feet in applause. But announcing a new investment in the city’s mental health crisis response teams accomplished just that earlier this week during Adams’ executive budget address.

Adams’ latest budget proposal would put $55 million a year towards the city’s Behavioral Health Emergency Assistance Response Division (B-HEARD) program, a pilot started under former Mayor Bill de Blasio that provides a way for 911 mental health calls to be routed to teams made up of one mental health professional and two EMTs – rather than being routed to the police. “B-HEARD is grounded in New York City's commitment to treat mental health emergencies as a health issue, not a public safety problem,” the program’s website reads. In the last fiscal year, the pilot was funded at $30 million.

Progressive lawmakers and advocates for police reform including Williams have long called for reducing – if not altogether eliminating – law enforcement’s role in responding to mental health calls. When police respond to mental health calls, the interaction can escalate into violence, hospitalization and incarceration of the people in crisis. The NYPD has killed 19 people who were experiencing a mental health crisis in the past seven years, according to the Correct Crisis Intervention Today, a coalition of advocates aiming to remove police from these situations. Sixteen of those people were people of color. 

New York City isn’t alone in moving to limit police involvement responding to mental health calls. The city of Rochester and Nassau County are among other locales in the state that have embarked on similar programs. Nationwide, advocates point to a program in Eugene, Oregon called CAHOOTS (Crisis Assistance Helping Out on the Streets), as the gold standard of how to involve mental health professionals in crisis response.

The B-HEARD program is currently operating in nine precincts in Harlem, Washington Heights, Inwood and parts of the South Bronx, and is already set to expand to two more precincts in the coming months. Adams’ investment in B-HEARD will allow the program to add more coverage, but City Hall did not specify how many precincts might be added. But while Williams got to his feet on Tuesday to applaud the expansion, he is among those who aren’t totally satisfied with B-HEARD. “I think the concept of expanding B-HEARD is good. So I want to make sure to give some credit there,” Williams told City & State on Thursday. “The way B-HEARD is operating now is not.”

Here’s what you need to know about the program.

How does the B-HEARD program work?

When people in mental health crisis – or those calling on their behalf – call 911, dispatchers can choose to deploy a B-HEARD team (assuming one is available in the precinct). Callers can’t specifically request that a B-HEARD team be dispatched. 

Police are still deployed in many of these mental health calls, however. If the 911 call is reporting a situation happening on subway tracks, or in which there are weapons involved, crime in progress or imminent harm, police are deployed instead of the B-HEARD teams. The fact that the majority of mental health calls still result in the deployment of police is one of mental health advocates’ major objections to the program.

How has the program been performing so far?

The B-HEARD pilot was launched last June, but only six months of data on its performance have been released by the city so far. According to that data, B-HEARD seems to have more success than a typical police response in aiding people in crisis. In situations where B-HEARD teams did respond to calls, 46% of people were transferred to a hospital – compared to 87% of people transferred to hospitals during typical 911 response. (Mental health advocates have long said that hospitalization is often not the best result for people in crisis.) When B-HEARD responded to calls, 28% of people were assisted on site, and 19% of people were transferred to a community-based health or social service center. Eight percent of people refused medical assistance.

The vast majority of mental health calls in areas where B-HEARD is operating are still being routed to police. From June to November of last year, only 22% of mental health calls to 911 were routed to B-HEARD teams. The B-HEARD teams didn’t actually respond to 18% of the calls that were routed to them – in those cases usually because a team was unavailable. City Hall did not provide any updated statistics on how the program has performed in the last few months.

According to a fact sheet released by the city, the goal is to eventually route half of mental health calls to B-HEARD. “B-HEARD is actively working to grow this number to approximately 50% of all 911 mental health calls, including by assigning additional EMS call-takers, analyzing calls to ensure that new protocols are followed, training patrol officers and EMS field units about the services B-HEARD teams can provide, and piloting new approaches to triage,” the sheet reads.

What are the criticisms of B-HEARD?

The fact that police are still responding to the majority of mental health calls in areas where B-HEARD teams are available is one of advocates’ primary objections to the program. “There’s very little about this that is truly a ‘non-police’ response,” said Ruth Lowenkron, director of the Disability Justice Program at New York Lawyers for the Public Interest. Though the teams are available seven days a week, Lowenkron objected to the fact that the B-HEARD teams are only available 16 hours a day. “How do you have a valid program for (addressing a) crisis that’s not 24/7,” she asked. According to the city, 80% of mental health calls occur in the hours that the teams are in operation.

Williams and Lowenkron both said that relying on 911 dispatchers to choose when to route calls to B-HEARD teams or police is problematic. “The framework is still built on a system that is usually for (when) crime is happening,” Williams said. “We have to break that whole model.” Williams and Lowenkron both said the program would function better if it relied on calls to 988 – what’s been called a “911 for mental health.” A 988 number is scheduled to go live in this July that will connect callers to the National Suicide Prevention Hotline.

What’s next?

The $55 million investment that Adams proposed in his executive budget will be used to expand B-HEARD teams to additional precincts. City Hall did not respond to questions about whether any of those funds would be used to expand the hours of operation for existing programs, or whether the city planned to connect the program to 988.

Additional reporting by Jeff Coltin.