Law enforcement and medical personnel will soon jointly respond to serious mental health emergency calls in Central Austin.

The setup

City efforts to offer different kinds of emergency responses to mental health crises stretch back years, including updates stemming from a wide-ranging 2019 report from the Meadows Mental Health Policy Institute.

For example, people calling 911 in Austin can now ask for a mental health response in addition to traditional options for police, fire or emergency medical services assistance. And, those first responder agencies have each updated their communications and staffing to reflect the need for a more deliberate approach at the scene of an incident.

With Integral Care call center clinicians in place to handle to mental health incidents alongside other trained personnel, Austin has reported notable improvements in both patient outcomes and personnel usage. Chief Medical Officer Mark Escott said over the past few years, the number of emergency detentions and arrests in those situations as well as the average amount of time first responders spend on scene have dropped significantly.

Of nearly 867,500 emergency calls to the Austin Police Department from 2022-24, more than 97,000 were mental health-related. Most still required a police response, but roughly 15,310—or 16%—were handled by Integral Care and a vast majority of those required no police involvement or emergency medical transport.

However, Escott and other officials say there's still a need to improve work with high-acuity calls, or the most difficult crisis situations posing a greater risk of harm to patients and those around them. That's led to the development of a novel collaborative team staffed by APD, Austin/Travis County EMS and Integral Care personnel.

“There is no roadmap for this particular thing because it’s not been done before. There’s plenty of jurisdictions around the U.S. that have coresponse, but they don’t respond to these kinds of incidents because they’re high-acuity," Escott told City Council members at a Sept. 22 briefing.

Zooming in

Starting mid-October, the "Austin FIRST" pilot program will see a multidisciplinary unit patrol and respond to severe mental health incidents around downtown. Escott said the initiative was formed given a growing recognition of "significant adverse events" from around the country during law enforcement responses to people in crisis.

The new team will include a police officer, paramedic and mental health clinician to handle high-acuity events. Escott said they'll both respond to active 911 calls and monitor the streets for people in need.

The program is beginning as a limited six-month pilot so public safety agencies can gather data, and evaluate the successes and shortcomings of the new approach. Officials said the FIRST team will initially operate only Monday through Thursday from 8 a.m.-6 p.m., times with the most reported mental health emergencies, and center around APD's George Sector covering the downtown area.

Along the way, police, EMS and mental health clinicians will track the program's staffing needs; the unit's response and on-scene times; adverse incidents, like injuries, diversions from arrest or jail; and emergency room visits and detentions. Findings will inform the program's expansion or adjustment going forward after the six-month pilot wraps up.

“It’s welcome and I appreciate the level of thought that’s gone into it, and I’m excited about what it ends up teaching us," Mayor Kirk Watson said.

Austin FIRST is launching a few months after city officials asked for a formal review of how mental health calls are handled in Austin, including years of 911 call data. That request also included a call for possible city policy changes to improve crisis response.

What they're saying

EMS Chief Robert Luckritz called the collaboration the logical next step toward addressing social determinants of health and root causes of public safety issues.

"This program focuses on the strengths of each of these organizations and brings them together, and allows us to really use those strengths and capitalize on those things that make each of us very unique," he said.

Dawn Handley, Integral Care chief operating officer, said the FIRST initiative will be a more focused approach to mental health diversion efforts. She also noted the real-time response won't be the final step for patients, with other local services available to continue treatment.

"This is not the group that’s going to carry them for care, but it’s the group that’s going to intervene, stabilize and then make that handoff," she said.

Police Chief Lisa Davis said the program could also help some of the city's "high utilizers" of emergency services who are known to law enforcement and frequently involved in emergency calls.

“As you know, the city’s always looking for holistic approaches to either deal with mental health, deal with the unhoused crisis, all of those things. And this is it," Davis said. "I’m really excited to see the data at the end of this pilot and see where we go from here: Is this something that can be integrated? Can we make it bigger? Can we make it sustainable where we’re doing good work? And I’ll tell you, we’ve got a great team here."