911 call takers play a crucial role in deciding when to send police alternatives More cities are adopting alternative response models, where mental health clinicians respond instead of police. The question of who to send usually rests with 911 workers, who are often overworked and overstressed.

Many 911 call centers are understaffed, and the job has gotten harder

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MARY LOUISE KELLY, HOST:

For decades, 911 operators had three main options in terms of who to deploy - police, fire and EMS. Now, in a growing number of cities, there is a fourth option, sending a mental health professional instead of police. NPR's Meg Anderson reports that at a time when many 911 call-takers are under increasing stress, they sometimes struggle to know who to send.

MEG ANDERSON, BYLINE: Sara Harper says nothing can really prepare you for the moment you put on that 911 headset.

SARA HARPER: There's that little spike of adrenaline because you're like, oh, God, here we go. Like, what is this going to be? Is this going to be an easy one? Is this going to be an annoying one? Is this going to be the call that changes my life?

ANDERSON: It could be a traffic accident, a domestic disturbance, an active shooter.

HARPER: Any one of those things can drop in your ear, and you're expected to fully handle it with no issues because if there are issues, you could be sued, you could lose your job, you could potentially hurt or kill someone accidentally. So you immediately have to just figure out how to handle the situation the best you can with the training you've had.

ANDERSON: On call after call after call, talking to people on what might be the worst day of their life. Harper, who became a call-taker in Denver in 2013, says she found the job rewarding. She felt like she was really helping people. But she often had to work long hours, and...

HARPER: It definitely ramped up my personal anxiety where, after my four years of doing it, I had to just finally put the headset down and decide that it was in my best interest to stop doing that.

ANDERSON: Harper's experience is not unusual. That's according to Jessica Gillooly, a professor at Suffolk University who studies 911.

JESSICA GILLOOLY: Nationally, I'd say that, right now, it's not a great time in the 911 call-taking system. Some might say it's in crisis itself. Workers are overstressed. They're understaffed, and they're underpaid.

ANDERSON: Gillooly says many calls are difficult to handle in an already difficult work environment, and now more cities are adding a new option where mental health professionals respond to some 911 calls instead of police. A recent study found that 44 of the 50 largest U.S. cities now have an alternative 911 emergency response program. In Denver, that alternative to police is known as STAR. But for 911 operators, knowing when to deploy that type of response can be a tough, split-second decision to make.

GILLOOLY: They're often a little bit more ambiguous, and it can be hard to understand what's going on in the moment. The information can be incomplete. Call takers are trying to figure out, is this a call that we can divert to an alternative responder or not? Their decision right there is really going to shape the trajectory of that call.

ANDERSON: And it comes down in part to training.

JOHN SHRYOCK: All right, guys, we're going to get started here.

ANDERSON: In a Denver classroom, trainer John Shryock is teaching new 911 hires about the STAR program, which the city rolled out in 2020.

SHRYOCK: You're not going to send a cop to fight a fire. Why send a cop to deal with somebody who's in a mental health crisis?

ANDERSON: Every day, eight vans rove the city, each with an EMS and a mental health clinician on board. The people who will end up deciding when to send those vans and when not to are in this classroom, and the safety of alternative responders is in their hands.

SHRYOCK: They do not have any body armor. They don't have anything to protect themselves. So one of the concerns that we should have would be ensuring that the scene is safe for them.

ANDERSON: Denver 911 Director Andrew Dameron says part of getting that balancing act right is a robust training program. The academy here lasts around three months, plus three more months of on-the-job training. The other part, he says, is making sure employees are well supported.

ANDREW DAMERON: You take care of the people who take care of the people. And if we don't support the folks here, then how can we expect them to show up the way they do for our residents?

ANDERSON: But since STAR began, it's responded to just 1% of 911 calls in the city. One challenge - who to deploy isn't always cut and dry. For example, if there's a weapon, trainees are instructed to send a cop. But even what's considered a weapon is up for debate. A homeless person carrying a pocket knife, for instance, should not be considered armed unless they're threatening to use that knife. That feedback came from STAR clinicians, and 911 changed its policy.

DAMERON: We are working really, really hard so that we are constantly improving. There are still times where a call that would be perfect for STAR gets a police response instead or a call that is not appropriate for STAR gets dispatched to one of the vans.

ANDERSON: Sara Harper, the former call-taker, left Denver 911 almost a decade ago. She remembers calls where someone seemed to be having a mental health crisis - calls where it just felt obvious that police were not a good fit.

HARPER: A lot of sirens would show up on scene with a lot of noise, and I think that that really is not the best response for someone in a mental health crisis.

ANDERSON: Other calls, though, were more in a gray area. Her very first call out of training, for instance...

HARPER: Was a young girl who essentially asked me for help because she was being pimped out. And she was, like, 13, 14 years old, didn't know what to do, didn't know how to get out. At the end of the day, I couldn't get her help.

ANDERSON: When I asked Denver 911 about whether that call could have been for STAR, they said no. When I asked officials with the STAR program, they said yes. Those conflicting answers show just how difficult it can be for 911 operators to make those judgment calls.

Meg Anderson, NPR News.

(SOUNDBITE OF KID CUDI SONG, "DAY 'N' NITE")

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