Association for Public Policy Analysis & Management

911 calls often involve individuals in behavioral crisis. Accompanying contacts between police and individuals in behavioral crisis have a higher chance of escalating into a violent or otherwise harmful outcome than other emergency situations. Subjects of these emergency events are also likely to be ‘high-users’, calling and using 911 services frequently, which increases the risk that these individuals will eventually be involved in a harmful encounter with police. Such frequent contacts also present an opportunity, because first-responders and mental health providers can identify these frequent-users from available agency data and proactively intervene. Several cities have piloted “identify and intervene” approaches in conjunction with first responders, public health officials and mental health services providers. While identification strategies have varied due to variability across cities in organizational capacity, coordination, and emergency response data practices, identification efforts have often focused on high-users of emergency services with serious mental illness (SMI) including schizophrenia and bipolar disorders. Interventions for these individuals have focused on provision of comprehensive mental health and other supportive services.

We present early findings from Chicago “identify and intervene” partnerships that seek to use agencies’ administrative data identify high-users of emergency services who experience behavioral crises. These partnerships involve the Office of Emergency Management and Communications (OEMC/911 call center), Chicago Police Department (CPD), and Chicago Fire Department (CFD).

In one approach, our research team collaborated with CFD staff, using existing data collected at each event, to flag CFD transport events as mental health-related. We then identified individuals based on accumulation of 3 or more MH-related transport events. In particular, we identified 94 unique individuals with 3 or more MH-related transport events in June and July of 2016. These 94 individuals accounted for approximately 400 MH-related transport events, eight percent of all identified mental-health-related transport events in Chicago over this two-month period. Our analyses also indicated that standard approaches within city data systems—such as relying upon police-identified mental health codes compiled after emergency calls—inconsistently documented whether a mental health problem occasioned or influenced the encounter, which hinders efforts to identify specific needs among frequent users.