How Communication and Engagement Supports Mental, Behavioral Health and Public Safety

In fact, 1 in 5 adults aged 18 or older experience a mental illness every year, according to the Substance Abuse and Mental Health Administration (SAMHSA). Mental health conditions include anxiety disorders, depression, bipolar disorders, schizophrenia and eating disorders. And the number of residents struggling with a mental illness has steadily increased. For example, the rate of adults aged 18–25 who reported symptoms consistent with major depression jumped 63% from 2009 to 2017.  

SAMHSA reported that about 20 million Americans, ages 12 and older, had at least one substance use disorder (e.g., alcohol, opioids and cocaine). One aspect of substance use disorders is the use of opioids. Over 10 million people misuse opioids a year, and they are a factor in about 7 out of every 10 overdose deaths. The U.S. Department of Health and Human Services declared the opioid crisis a public health emergency in 2017.     

The steady increase — and acknowledgement — of people in need with mental health conditions and/or behavioral health issues are major public safety concerns for those on the front lines. 9-1-1 telecommunicators, law enforcement officers, firefighters and emergency medical services (EMS) personnel may not know about the history of the resident in need or have the full resources to support a mental or behavioral health emergency, making these some of the most challenging responses. And state and local government officials are being tasked with more ways to support residents, as well as ensure first responders have the necessary technology and information for safe responses.  

Then came 2020 and the coronavirus pandemic. The issues and complexities surrounding mental health conditions and behavioral health issues for residents were not only magnified but escalated.  

An Existing Mental Health/Behavioral Health Crisis 

Mental, behavioral and developmental disorders begin in early childhood, with 1 in 6 children (ages 2–8) diagnosed, according to the Centers for Disease Control and Prevention (CDC). But it’s when children enter adolescence or early adulthood that a mental health illness may become a lifetime condition.  SAMHSA said that 50% of all lifetime mental health conditions begin by age 14, with 75% by age 24. 

Other findings from the CDC, JAMA Pediatrics and the SAMHSA about mental health and behavioral health prior to COVID-19 include: 

• 1 in 6 youth (ages 6–17) had a mental health condition (e.g., anxiety and depression) every year. 

• 1 in 20 adults experienced a serious mental illness each year. 
• Suicide was the second leading cause of death among people aged 10–34. 
• About 9.2 million adults had both a mental illness and a substance use disorder. 
• Over 20 million people aged 12 or older had a substance abuse disorder (including 14.8 million with an alcohol use disorder and 8.1 million with an illicit drug use disorder). 

Mental Health/Behavioral Health and Front Line Response 

Those on the front lines are experiencing challenges that are making their jobs more complicated and, at times, difficult to carry out. 9-1-1 telecommunicators, law enforcement officers, EMTs, firefighters and other personnel are responding to hazardous calls, as well as managing social issues.  

• Out of 36 million calls, fire departments responded to more medical emergency calls (24 million) than fires (1.3 million). 
• The rate of naloxone (used to treat opioid overdoses) administered by EMTs recently increased by 75.1%. 
• Law enforcement officers, on average, spent 21% of their time responding to and transporting individuals with mental health illnesses.  

COVID-19 and Mental Health/Behavioral Health 

The challenges of identifying and helping those in need with a mental or behavioral health crisis became more complex and heightened in March 2020. COVID-19 and its multiple waves, along with social isolation, job losses, food insecurity and the social justice movement all took a toll on residents, bringing mental and behavioral health to the forefront. The Kaiser Family Foundation, for example, said 4 in 10 adults reported symptoms of anxiety or depressive disorder during the pandemic, up from 1 in 10 in 2019. Experts are unsure of the long-range impact on the public, though there are already indications. 

• The National Runaway Safeline (for ages 12–21) reported 88% of their contacts mentioned family dynamics, up from 57% in 2019. 
• 52.9 million people had a mental health illness, while 14.2 million experienced a serious mental illness 
• 17 million people had both a mental illness and a substance use disorder.  
• Over 100,000 people died from an overdose in 2021.  

• Alcohol-related deaths, including motor vehicle crashes, totaled 99,017 in 2020 — a 25.5% increase from 2019.  

The increase of mental health conditions and behavioral health issues led SAMHSA to recently distribute $3 billion to states and territories to support mental health and substance use programs. States, including Georgia, Nevada, Virginia and Washington, recently enacted legislation to help first responders with emergency responses for individuals with a mental or behavioral health crisis. For example, Virginia’s Marcus Alert System established a mental health awareness response and community understanding services alert system across the Commonwealth. The law promotes a behavioral health response to individuals in crisis. It also requires every locality to develop a voluntary database for 9-1-1 teams to provide mental health information and emergency contact details for a person in need.  

Public Safety and Helping Those in Need 

The growing mental and behavioral health crises and their potential impact on public safety continue to grow as residents get past another wave of COVID-19, return to offices and attend concerts, sporting events and other public spaces and events.  

Just about all respondents (94%) are concerned about state of mental health of Americans in general, according to Rave Mobile Safety’s 2021 Mental Health and Emergency Response Survey.  

Other findings of that survey include: 

• 49% of respondents said they or someone close to them experienced a mental health crisis.  
• 79% are completely or very willing to provide first responders with information about their mental health history or their loved ones. 
• 87% completely or somewhat agree that 9-1-1 call centers must have the ability to dispatch mental health professions along with police, fire and/or EMS personnel.   

Those on the front lines are also apprehensive about emergency responses with individuals in the midst of a mental or behavioral health crisis. Mental health was the third highest concern for 56% of respondents in Rave Mobile Safety’s 2022 Public Safety Trends Survey. It followed closely behind hiring and staffing (60%) and the public perception of first responders (56%).  

The Public Safety Trends Survey reported that emergency personnel are looking at ways to improve these responses. 

• 84% of respondents find it extremely or very helpful to have someone’s mental health history. 
• 72% believe first responders and mental health professionals together are best suited to emergency situations involving mental health crises.  
• 56% are increasing training in mental health for first responders. 

Critical Communication and Collaboration Platforms Help Support Mental Health/Behavioral Health and Safety 

Responding to a call about an individual with a mental or behavioral health crisis includes various complexities for 9-1-1 telecommunicators, law enforcement officers, firefighters, EMTs and other public safety personnel. There may be a lack of knowledge about the resident in need, not enough details about the situation or the necessary personnel may not be coming to the scene. State and local government officials may struggle ensuring information about mental or behavioral health support and resources get out to the community.  

A critical communication and collaboration platform enables those on the front lines to improve how they collaborate and coordinate an emergency response to an individual with a mental or behavioral health crisis. The consolidated platform provides a number of tools to have a better understanding of what’s happening on scene so emergency personnel can allocate an appropriate response. It also allows state and local government officials ways to engage their communities. These tools include: 

• Crisis management tool empowers emergency personnel to launch an action sequence at the onset of an event and those who are assigned tasks will receive alerts simultaneously. Tasks will be listed, show who has ownership of them, indicate the up-to-date status, and display additional notes — all providing administrators with a detailed timeline for after-action reporting. Prebuilt alerting templates will help save time during an event and Common Alerting Protocol (CAP) provides a seamless connection to additional devices, such as public address systems or digital signage. 
• Online emergency preparedness registry provides an in-depth view of community members, such as medications, transportation needs and other details. The registry’s interactive web-based map interface allows administrators to develop search criteria by demographics or location to focus on a group or segment in need of assistance. 
• CAD data sharing increases situational awareness across jurisdictions, allowing emergency personnel to collaborate more effectively and improve mutual aid coordination. It automates critical notifications to key stakeholders, while reducing time transferring calls and sharing information. 

• Text-from-911 enables 9-1-1 telecommunicators to initiate a two-way conversation if a resident calls and can’t speak. Telecommunicators can collect information through text messages and share directly with first responders. 
• Mass notifications send emergency and/or operational messages out simultaneously through text, email, voice calls, social media, IPAWS, digital signage and desktops — all through a single launch point. Residents can receive messages in the modes and languages they prefer.  

The escalating mental and behavioral health crisis has greatly impacted communities across the country. State and local governments are providing more funding for resources, while emergency personnel are bolstering the ways they respond to residents in need. Proactive and consistent communication is vital for a safe, successful mental or behavioral emergency response. A critical communication and collaboration platform allows 9-1-1 telecommunicators, first responders and state and local government officials to coordinate, collaborate and leverage their skills to best help their residents who are struggling with a mental health condition or behavioral health disorder. The platform will help everyone stay in the know when it comes to their residents’ well-being and strengthen their ability to work together, from 9-1-1 telecommunicators to government officials to the resident, ultimately saving lives.