emergency call centers 

The decision to use the 911 system or an external emergency hotline is a consideration of program design for crisis response teams.  An external hotline allows callers to directly reach crisis responders. Rather than being sent through a system of emergency communicators, the crisis response program staffs call takers to dispatch services to the community. LA County runs its Alternative Crisis Response program through a crisis hotline that is run by the Department of Mental Health (Alternative Crisis Response (ACR) - Department of Mental Health, 2025). While this model addresses the hesitancy communities may have to call 911 due to its association with policing, the drawbacks such as the technology demands, staffing concerns, and community education required are frequent deterrents for using an external hotline (Rodriguez, 2023). For these reasons, most jurisdictions choose to utilize the 911 system to address calls.  

When an individual calls 911, the call is sent to the nearest public safety answering point (PSAP), commonly referred to as a call center (HISTORY of 911 and What It Means for the Future of Emergency Communications, n.d). A 911 call taker is responsible for gathering the details of the emergency and inputting the information into a system that categorizes calls. Using this information, dispatchers send the appropriate response (Neusteter et al., 2020, p. 24).  Call takers have a triaging process they employ to determine the appropriate response, asking questions related to the type of emergency and hazards present (Neusteter et al., 2020, p. 26). The addition of a new branch of response beyond EMS, fire, or police affects this process. Communities must consider additional training and required resources to successfully triage all calls eligible for crisis responders, or it could affect the success of the program. In a recent audit of the NYC B-HEARD program, it was determined that between 2022 and 2024, over 60% of mental health-related 911 calls were deemed ineligible for B-HEARD service, partially due to an inability for calls to be properly triaged (New Audit: Comptroller Finds over a Third of Eligible Mental Health Calls Did Not Get a B-HEARD Team Response for Untracked Reasons, 2025).  

adding response to 911 requires training and resources for telecommunicators, highlightng the need for improvements in the 911 system.

crisis response programs can choose to RECEIVE calls through 911 or an external hotline.

Many communities have been successful in updating their 911 procedures. Denver released a “Multi-Agency Call Flow” for 911 call takers to follow for mental health-related calls with the introduction of the STAR program (STAR -RMCP Alternate Response, n.d.). This ensured that eligible calls were being appropriately directed to crisis responders.  

Some communities choose to embed mental health professionals into call centers to address triaging issues. In Louisville, Kentucky, if a 911 call taker determines a call is related to mental health, it is transferred to a Crisis Triage Worker who decides whether a mobile response team is necessary (Crisis Call Diversion Program, 2022). This model acknowledges the significant cultural change adding a response program requires for call takers, who are more likely to send a police response out of habit. It also reduces the workload for call takers. However, this model is also costly and space inefficient, as 911 call centers are limited in their capacity to add workspaces in order for call takers and mental health workers to be able to collaborate (Rodriguez, 2023).  

Regardless of the method employed, adding crisis response to communities requires additional training for 911 call takers and dispatchers. Since its inception, 911 has been a localized service. Because of this, there is no standardization across jurisdictions in training requirements or the information call takers obtain during an initial 911 call. In 2016, a working group led by the Association of Public-Safety Communications Officials International (APCO) released a report of minimum training guidelines (Recommended Minimum Training Guidelines for Telecommunicators - National Emergency Number Association, n.d). While these guidelines are comprehensive, there is no national mandate on them.  

Currently, 911 professionals are classified by the federal government as “administrative support,” meaning they do not have access to training, career mobility, and support services that recognized first responder programs have (Blueprint for Change 2, n.d., p. 44). If communities want their crisis response programs to be successful, they must consider how they are supporting the people who have the first point of contact with individuals in crisis. A professionalization and standardization of the 911 system is important to improve the landscape of emergency communications and response across the country.