A woman is afraid that she’s about to be abducted by aliens. A man sees a drunk college student stumbling down the middle of Main Street, disrupting traffic. A restaurant owner is concerned that a panhandler may be scaring away customers. A mother fears her son may attempt suicide in the coming hours.
They all call 911. When the cops arrive, officers handle the situations however they do: maybe they write a citation or make an arrest; maybe they perform a welfare check; in worst-case scenarios, they might use unnecessary physical force while confronting the panhandler or cart the son off to the psych ward without confirming that he’s really suicidal.
Though police officers are dispatched, their skills aren’t particularly useful here—what the callers really need is a mental health professional, a peer support specialist, a list of resources, and a promised follow-up in a few days—and when someone gets shot across town, the handful of on-the-clock officers are tied up with situations where their guns and handcuffs aren’t needed.
This is the type of scenario that the City of Durham hopes to prevent with its new community safety pilot programs, three of which launched last week. The programs, which operate under the name HEART—Holistic Empathetic Assistance Response Teams—aim to better connect those experiencing mental or behavioral health crises with the proper care, starting from the moment a person calls 911.
The pilots were implemented by the Durham Community Safety Department, which works to provide community-based approaches to public safety as alternatives to traditional policing. Though the department celebrated its first birthday only last week, HEART is years in the making. Two years ago, around the time of the national George Floyd protests, a cohort of city and state employees led by then Durham city manager Tom Bonfield teamed up with the Research Triangle Institute (RTI) to lay a foundation of research for the pilots. When the department was formed in 2021, its fledgling staff hit the ground running, creating a multi-agency planning team, compiling data from cities piloting similar programs, and conducting resident interviews and focus groups.
As a result, Durham is now the first city in North Carolina to dispatch mental health professionals in response to 911 calls.
The first pilot, Crisis Call Diversion, makes several changes to the system that Durham’s Emergency Communications Center uses. Emergency dispatchers will ask callers the same script of questions they usually do, but now, the software may recommend a new type of first responder—a mental health professional—instead of police, firefighters, or emergency medical services. The program embeds a mental health clinician in the 911 center, allowing callers who are at risk of self-harm or undergoing mental health crises to be transferred to an expert.
To assess which calls warrant a mental health response, the Community Safety Department utilized data from an RTI-led analysis of 911 calls. After examining three years’ worth of Durham 911 data, the analysis concluded that 15 percent of Durham’s 911 calls could be addressed by mental health professionals instead of police officers.
“There’s a misconception about 911 calls,” says Anise Vance, assistant director at the Community Safety Department. “Folks think 911 calls are either there’s a cardiac arrest or there is some violent incident occurring. The truth is, most 911 calls have nothing to do with any kind of violent or threatening incident. Many calls are just people who are scared or worried or confused and are calling to ask for a little help, because they don’t know where else to turn.”
Calls currently eligible for a community safety response include suicide threats, trespassing, welfare checks, panhandling, and intoxication, among others.
In some cases, callers may trigger the second pilot program, a three-person team of skilled first responders—a mental health clinician, a peer support specialist, and an emergency medical technician—who can now be dispatched in response to nonviolent mental health crises or quality-of-life concerns.
HEART responders, who have already successfully cleared several trespass and welfare checks, are uniformed in friendly teal T-shirts branded with the team logo: a heart sandwiched by two chat bubbles, signifying care and communication. They’re also unarmed.
“We don’t arm firefighters,” says Community Safety Department director Ryan Smith. “We don’t arm paramedics. As a rule of thumb, we only want to send weapons into scenes where we feel it’s absolutely necessary.”
As a precaution, the team’s location will be tracked by emergency dispatch services, and responders can quickly radio a request for police backup.
The HEART team is operating primarily within a limited region for now—covering about 15 square miles selected due to the high volume of crisis calls. The service area is shaped like a heeled boot, with the toe touching Old West Durham, the heel hovering over NC Central University, and the leg reaching up to Hebron Road.
Forty-eight hours after a HEART team’s initial encounter, the third pilot, Care Navigation, comes into play, sending a two-person team of a licensed clinician and a peer support specialist to follow up with the person in need and ensure that they’ve been connected with the proper resources or care.
According to Vance, the emerging literature on alternative crisis response work strongly indicates that the “follow-up moment” is crucial for long-term progress.
“We want to be in a position where we’re not always just ‘responding,’ but we’re proactively out in communities, changing the trajectories of some of our neighbors,” Vance says.
The fourth and final program, slated to launch later this year, will dispatch pairs of mental health clinicians and police officers in response to behavioral health-related 911 calls that may pose greater safety risks.
The three functioning pilots currently operate from eight a.m. to five p.m. on weekdays, with plans to expand hours into the evenings and weekends sometime in the next few months. One year from now, the efficacy of all four programs will be measured using surveys, call outcome data, formal third-party evaluations, and in-depth interviews with both first responders and crisis response recipients.
Durham Beyond Policing, an activist group working to defund prisons and police departments and reinvest resources into Black and brown communities, is pleased about the launch of the HEART programs and commended local advocates for the years they’ve spent protesting, writing letters, and signing petitions in support of the cause.
In a Facebook post, though, the group shared concerns that the pilots are so underfunded they may be set up for failure. The Durham City Council last month signed off on a budget that adds only seven new employees to the Community Safety Department, requiring the four HEART programs to be operated by a staff of 20: five administrative personnel and 15 field-workers.
Manju Rajendran, a community organizer for Durham Beyond Policing who also serves on Durham’s Community Safety Task Force, says the city should have approved twice as much funding for the pilot rollout: there’s plenty of demand for HEART services, but spread too thin, the two teams of responders may burn out. Minimal staffing may also prevent the programs from being adequately evaluated next year, she says.
“When will [the Community Safety Department] have time to be able to respond to the current demand for calls, much less conduct the kind of rigorous data collection and qualitative research they need to be doing along the way for us to really understand the value of these pilots?” Rajendran says. “I don’t understand why they didn’t provide the staffing that would set up these programs for success.”
She points to Albuquerque, NM, a city comparable in size to Durham whose similar crisis intervention pilot, launched last year, has proven successful with 36 first responders and 12 administrators—though even the Albuquerque team has found itself shorthanded at times.
In its Facebook post, Durham Beyond Policing condemned the city council for its January vote against reallocating 15 vacancies in the Durham Police Department to the Community Safety Department. At the time, those vacancies were frozen in the police department’s budget.
“Their pro-cop ideological stance disallowed them from allocating staffing that would have cost them nothing additional—those vacancies continue to sit vacant in the DPD department budget,” the post reads.
The advocacy group has similarly criticized the council’s decision to fund the forthcoming ShotSpotter pilot program, which will see gunshot detection sensors installed in some areas of Durham later this year. ShotSpotter, which aims to help first responders save shooting victims and make arrests by detecting the precise location a shot was fired, has been a divisive issue among both the council and the community at large, with many dubbing the technology overpriced, ineffective, and conducive to overpolicing.
While the ShotSpotter and HEART pilots each seek to enhance public safety, there are some stark contrasts between the two. ShotSpotter was approved without an in-depth community engagement process, its critics say, and threatens to advance mass incarceration in Black and brown neighborhoods and squander first responders’ time with false positive alerts. It also shows little favorable data from its implementation in other cities and has no concrete evaluation plan.
The HEART pilots, on the other hand, were born out of local organizing; stand to prevent communities of color from overpolicing and free up the availability of first responders; mirror programs that have seen widespread success in other cities; and pose clear and thorough evaluation metrics.
On its website, ShotSpotter maintains that it has a 0.5 percent false positive rate, though numerous third-party investigations in cities including Chicago and San Diego have found that percentage to be much higher. A MacArthur Justice Center investigation found that ShotSpotter false alarms dispatch Chicago police on as many as 60 trips a day.
Meanwhile, according to the Community Safety Department–cited RTI analysis of 911 calls, skilled, unarmed HEART teams could address an average of 1,585 calls a month—and save law enforcement around 971 monthly hours—if the program had the funding, Rajendran notes.
Though Rajendran is disappointed that the HEART pilots didn’t receive more funding, she says she’s thrilled to witness the rollout nonetheless.
“I have been in a number of different situations where I’ve needed to reach out for help for myself or for loved ones over the years, in moments of crisis, and needed for better options to be available in terms of accessing appropriate care,” Rajendran says. “I’ve just been feeling goose bumps of joy all week.”
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Follow Staff Writer Lena Geller on Twitter or send an email to firstname.lastname@example.org.