Counselors embedded in 911 call centers benefit police, the public

When behavioral health clinicians at 911 call centers answer mental health and substance abuse calls, it not only reduces arrests, involuntary psychiatric detentions and use of force, but also enables police officers to spend more time ensuring public safety, according to new Cornell research.

It is the first study to analyze the effectiveness of embedding clinicians directly in a 911 call center. The research published April 20 in the Journal of Psychiatry Services.

The practice is especially positive for police departments with reduced workforces and for the public, the researchers said.

"In many cities, especially since George Floyd and the defund the police movement, many citizens have seen a big reduction in the number of police officers on staff," said Todd Olmstead, associate professor in the Department of Public and Ecosystem Health at the College of Veterinary Medicine, core faculty fellow of the Cornell Health Policy Center and lead author of the study, which analyzed an embedded clinician program in Austin, Texas.

"Austin has been down literally hundreds of police officers for the past several years now, and that's true in many big cities," he said. "So, programs like this can actually help a very resource-constrained police department."

Over five years, the program cut up to 13,000 hours of time that police officers otherwise would have devoted to nonviolent behavioral health issues. "It basically freed up an entire officer every year to focus on something else," Olmstead said.

From the police department's budgetary perspective, police officers cost more than behavioral health professionals, which can save money.

The Austin program is unusual in that the behavioral health professionals work in 911 call centers and resolve issues over the phone; other programs often include them in mobile outreach teams. The program is also the first in the U.S. to offer callers a choice of police, fire, emergency medical services or mental health services. Now, similar programs have been adopted in a few other cities, including Houston and Phoenix.

The rationale underlying these programs is that public health-related calls are best served by behavioral health professionals, while public safety-related calls are best served by law enforcement, according to the paper.

Public health-related calls may include a third party calling about someone who is upset or acting strangely. Calls may be related to drug use; disagreements, especially involving children; nonviolent domestic issues; and welfare checks.

The researchers analyzed data from December 2019 to February 2025, where 911 operators transferred calls to an embedded clinician.

Austin received more than one million 911 calls per year over the study period, though only a small fraction were handled by the clinicians.

In the analysis, 16,264 calls were transferred to a clinician and resolved. Though one to three clinicians were on staff 24/7, some calls could not be transferred to a clinician because they were unavailable or taking other calls. This group amounted to 4,365 calls. To measure the impact of the program, Olmstead compared outcomes in this latter group to those in the group that received a clinician's attention.

Anecdotal evidence suggests that most callers experiencing a behavioral health issue prefer to talk to a public health official as opposed to law enforcement, Olmstead said.

Coauthors include researchers from the Austin Police Department; Integral Care; Indiana University School of Medicine; and the University of Texas, Austin.

The study was funded by Integral Care, a counseling and mental health center in Austin.