Deflecting Suicide Calls From Law Enforcement With an Embedded Crisis Line Specialist at a 911 Center: A Synthetic Control Analysis.

Law enforcement are the default responders to suicide-related calls, and law enforcement can escalate mental health crises to hospitalizations, uses of force, and deaths. Mental health crisis lines, such as 988, are an alternative underutilized mental health crisis resource compared to estimated annual mental health-related 911 calls. This study assesses whether embedding a crisis line specialist at a 911 center could reduce suicide-related police responses by transferring 911 calls to a mental health crisis line. A quasi-experimental synthetic control analysis assessed police response rates after embedding a crisis line specialist at a 911 emergency communications center in Mesa, AZ in 2021. Authors used publicly available 911 data from 21 cities to create donor pools for a synthetic control analysis of police responses to suicide calls. Embedding a 911 crisis line specialist was associated with 22.27-47.96 fewer police responses to suicide calls per quarter per 100,000 people, relative to a synthetic control unit. The lower suicide call rate translated to an estimated 228.1-490.6 police hours reduced per quarter in Mesa. Mental health call definitions were not standardized enough across jurisdictions to warrant a cross-site comparison. The embedded presence of a crisis line specialist at a 911 center may facilitate interdisciplinary trust that enabled full implementation of a call routing to crisis line program. Emergency communication centers should consider embedding crisis line staff to divert calls from police, limiting the expansion of the police footprint.