TRANSFORM911Implementation Case Studies


NYC: Behavioral Health Emergency Assistance Response Division (B-HEARD)


  • City: NYC (B-HEARD) – Pilot began June 2021
  • Population Size: 8,804,190 (entire city, not pilot)
  • Jurisdiction Size: 302.64 sq miles (entire city, not pilot)


  • 0 – EMS +BH Clinician (B-HEARD)                   
  • 1 – co-responders

CIT (Crisis Intervention Training) Requirements

  • 16,894 NYPD officers and staff -including all patrol officers – trained in CIT between 2015 and 2020, when CIT operations were suspended during COVID-19

Model Components

  • Area of Jurisdiction
    • Pilot limited to East Harlem and parts of North and Central – Harlem (Area with most MH Calls)
    • Plans to gradually expand citywide
  • Staffing Structure
    • 16 hours a day with 2 teams per shift
    • 2 EMTs+1 Social Worker
    • Steering Committee chaired by the Mayor’s Office of Community Mental Health (OCMH) with representation from agency partners Health + Hospitals (H+H) and Fire Department of New York (FDNY) as well as, the New York Police Department (NYPD), the NYC Department of Health and Mental Hygiene (DOHMH)
    • OCMH oversees the implementation of this program, facilitating cross-agency coordination and ensuring citywide expansion
  • Staff Training/Qualifications
    • Clinicians are licensed (Master level)
    • 5 weeks of training- all staff (BH+EMS) in the same cohort. Social workers are employed by the NYC public hospital system, H+H
  • Dispatch Structure
    • Dispatched through 911
    • NYPD patrol officers and EMS field units can also request B-HEARD directly

Operating Structure

    • Operations
      • Mental health calls, lower acuity, no violence/no weapon
      • 911 operators use standard triage to categorize call as mental health call
      • Teams are dispatched by 911 operators in appropriate situations that occur within the catchment area
      • In the first six months of pilot, B-HEARD average response time was less than 14 minutes
    • Funding Mechanisms: Funded through NYC Health +Hospitals and FDNY
    • Management Structure
      • Social Work staff are employees of the NYC public hospital system (H+H) and EMT/ Paramedic staff are employees of FDNY. All staff are managed through their organization’s staffing structure                                    
    • Supplies/Equipment
      • EMT+BH clinician ride together in vehicle from FDNY- marked as such                           

Data Systems & Collection

  • Data Collection:
    • The following metrics are tracked and reported on the OCMH website:
      • Total number of mental health 911 calls
      • Number of mental health 911 calls eligible for B-HEARD
      • Number of eligible mental health 911 calls that B-HEARD Teams are dispatched to
      • Percent of eligible mental health 911 calls B-HEARD Teams are dispatched to
      • Number of unique individuals B-HEARD reached
  • Highlighted Statistics/Outcomes:
    • In the first six months of the pilot:
      • In the B-HEARD response, 92% of people accepted assistance
      • 46% of people assisted by B-HEARD were transported to a hospital for additional care – a much lower percentage than the traditional response, in which 87% of people were transported to a hospital.
      • 47% of people served by B-HEARD were served in their community, with options for behavioral healthcare that were not previously part of emergency response

Key Takeaways

  • Cross-agency collaboration and buy-in is critical
  • Determining which calls/ situations are most appropriate for this response continues to be a work in progress
  • Ensure safety for everyone
  • Community engagement and buy-in is key

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