Enhancing suicidal risk detection in 911 calls with embedded mental health counselors: improving safety for callers and officers

The accurate identification of 911 calls involving suicidal ideation is essential for mobilizing an effective system-level response. Crisis call diversion (CCD) programs that embed mental health counselors in 911 emergency communication centers can address key challenges faced by 911 call-takers in flagging suicidal calls, as the counselors possess clinical expertise to ask targeted mental health questions and do not face the same time-related pressures as call-takers. Using administrative data from a well-established CCD program, we found that embedded counselors identified more than fourteen times as many suicide threats as 911 call-takers. Our analysis of counselors’ narratives suggests that call-takers did not misclassify calls; rather, counselors used their skills to collect more details on the complexity of the caller’s needs. Counselors enhanced on-scene safety by communication with Dispatch and officers about callers’ circumstances, as well as by de-escalating callers, safety planning, and encouraging cooperation.