The tragedy that became national news began with a calm call for assistance. Around 6:30pm on Friday, January 21st, a woman dialed 911 from her Harlem apartment to report that her son had threatened her. She made no mention of weapons or violence. Three NYPD officers arrived and spoke with the mother, who directed them towards the back bedroom.
The officers called out to the son, who appeared in the door and opened fire down the cramped hallway. The son, Lashawn McNeil, shot and ultimately killed two officers, Jason Rivera and his partner Wilbert Mora. The third officer shot McNeil, who died days later.
McNeil had reportedly posted anti-police messages and videos on his social media. His mother later reported that her son’s mental state was “distorted.” But in her 911 call, she was calm and said she was not at risk of immediate harm, according to police.
In a press conference responding to the shooting, Mayor Eric Adams said, “[mental health professionals] should be the first line of responding to some of these conditions where the person does not have – knowingly has a weapon – they should be the first line of response.”
That first line does exist in the form of B-HEARD, a new city initiative that sends social workers instead of police to respond to mental health crisis 911 calls—and that was active that night in the precinct that responded to the call.
So why were police sent to respond? A spokesperson from the Mayor’s Office of Community Mental Health (OCMH) said that domestic violence calls are not eligible for a B-HEARD response; it’s unclear whether that would apply in this case, given that McNeil’s mother did not mention violence. But even if dispatch did make that determination, it likely wouldn’t have mattered: the large majority of crisis calls in the pilot area still receive a traditional police response.
Former Mayor Bill de Blasio’s administration promised lawmakers a year ago that B-HEARD “will be the new primary response to mental health emergencies.” But seven months into the program’s launch, few neighborhoods have access to the initiative’s benefits. In those that do, police still respond to four out of every five crisis calls—more than twice as many as the city had initially projected.
The Adams administration has not publicly discussed the B-HEARD program, and did not answer questions for this article about the program’s future—but several developments have raised mental health advocates’ hopes that the new administration be more receptive to their ideas for how to improve the program.
Adams appointed Dr. Ashwin Vasan to lead the city health department, starting in March. Vasan is the former president of Fountain House, a mental health nonprofit that has advocated for sending peer supporters as mental health professionals to crisis calls instead of police.
And Ruth Lowenkron, director of New York Lawyers for the Public Interest, one of the groups pushing for non-police responses to crisis calls, said that advocates received a “warm welcome” from the Adams transition team and that some of their recommendations were forwarded to the administration, but she hasn’t heard anything yet from the administration itself.
A Slow Start
B-HEARD currently operates in just five of the city’s 77 police precincts. Last spring, de Blasio allocated $112 million for a “citywide expansion,” and the city has plans to expand to the Bronx next.
City officials told advocates in January 2021 that the city’s target was for social workers to respond to 70 percent of all crisis calls. In July, a month into the program’s launch, the city reported that just a quarter of crisis calls had been routed to B-HEARD, but that “in the coming months, this number is projected to grow to approximately 50%.”
But subsequent data releases on the first quarter and first six months of operations reveal that B-HEARD responded to a decreasing fraction of calls as the program expanded, with just 22 percent of calls being referred to B-HEARD.
In interviews and statements to New York Focus, officials from a host of agencies—the NYPD, FDNY, NYC Health and Hospitals (H+H), and OCMH—blamed the low rate of B-HEARD responses on a lack of social workers and EMS dispatchers. Some cited a nationwide shortage of social workers. “We desperately need more social workers,” said Rebecca Linn-Walton, a social worker and senior official with H+H.
Beyond a staffing shortage, officials also described a culture of defaulting to police.
An FDNY deputy chief, who spoke on condition of anonymity, said that when NYPD dispatchers don’t have enough information to determine whether people pose a threat to public safety, they may “err on the side of caution” and send police.
When a 911 dispatcher determines that a call is about a mental health crisis, they refer it to an EMS dispatcher, who then decides whether to send B-HEARD. But when EMS dispatchers are tied up—and the FDNY official said there was an acute shortage of EMS dispatchers, too—police and an ambulance are sent by default.
Another factor limiting how many calls are sent to B-HEARD is the decision tree used by dispatchers, which the FDNY deputy chief described as “slanted” towards sending police. The FDNY team working on B-HEARD is looking to change questions to undo that slant: for example, instead of asking a caller, “are you concerned for your safety?” the dispatcher would ask, “are you in danger at the moment?”
The deputy chief said the decision tree changes were part of a desire in multiple agencies “across the board” to increase the number of cases going to B-HEARD. “Overall, the feeling is that the number of calls we’re getting is low,” they said.
Immediately following his statement in support of having mental health workers on the frontline, Adams emphasized the need to keep police in the mix as well, pointing to the tragic results of the Harlem shooting. “We need to be very careful because you know that many people stated on the campaign trail that at no time should a police [officer] respond to a mental health job, and you saw what happened here.”
Others have drawn the opposite lesson from the incident. “Might a different presence have been more successful at defusing the situation than the police?” asked civil rights attorney Scott Hechinger in an essay published this week.
A survey of 33 crisis response teams found that no staff members have been seriously injured or killed during a crisis call. B-HEARD has called for police backup due to security concerns in only two of their 564 responses. (Of course, this may be in part because the most dangerous situations tend to be routed to the police.)
The Path to B-HEARD
B-HEARD came about after years of advocacy by Correct Crisis Intervention Today – NYC (CCIT-NYC), a coalition of more than 80 mental health advocacy and other community organizations. The coalition has pushed for a program that looks quite different from B-HEARD: their proposal would employ peer-counselors instead of social workers, set up a separate three-digit number instead of 911, and be available 24/7. (Mental health professionals in other cities implementing parallel programs, such as Toronto, have proposed similar ideas.) Still, CCIT-NYC called upon city lawmakers to approve the Mayor’s $112 million allocation to B-HEARD, which came from federal stimulus funding.
That push came in response to a spate of NYPD killings of people in mental health crises, the most recent of which occurred in December. A coalition of advocacy groups filed a class action lawsuit against the city in December for failing to provide safe responses to mental health crises.
Nationally in 2021, one in three police killings began with a mental health crisis, domestic disturbance, or other non-violent offense – calls that can receive non-police responses in some other American cities.
B-HEARD is explicitly modeled after the 32-year-old CAHOOTS program in Eugene, Oregon. Initially designed to help people having challenging experiences with psychedelics, CAHOOTS is now integrated with and funded by the Eugene police department. The program responded to nearly 16,000 calls in 2019, diverting an estimated five to eight percent of police responses, and responds to a wider range of calls than B-HEARD, such as welfare checks and domestic disputes. CAHOOTS reports that its responses have never involved any serious injuries or deaths.
In New York City, police receive only one week of crisis intervention training (CIT) during their six months in the academy. A 2019 academic review found that nationwide, CIT has “not shown consistent reduction in the risk of mortality or death during emergency police interactions.”
In contrast, a B-HEARD responder must be a state-licensed social worker, which requires a masters degree and 900 hours of internship experience, as well as five weeks of training with EMS responders.
That training can enable them to engage differently with people in distress. B-HEARD teams can provide assistance onsite, helping people access substance abuse programs, therapy, and medication refills. The only mode of care police can provide, by contrast, is transporting people to emergency rooms, which often aren’t able to connect people with longer term care and quickly discharge them back to the street.
And their presence can be far less threatening. Janine Perazzo, a senior H+H official and social worker, recounted a story of a 14 year old girl who locked herself in her room. A B-HEARD responder was able to enter the room and sit on the floor next to her, meeting her on her level—literally.
In the first six months, over a quarter of B-HEARD calls involved onsite assistance, and almost one in five resulted in transfer to a Harlem-based dedicated mental healthcare facility. Less than half of B-HEARD calls resulted in a hospital transport, compared to 87 percent of police responses.
Crisis calls represent a rare area where many police and activists agree that the role of policing should be diminished. An NYPD chief, who spoke on condition of anonymity, said there has been no pushback within the department to the program—and that in the first six months of operations, NYPD requested backup from B-HEARD teams 72 times.
Police officers generally acknowledge that mental health professionals have a deeper and wider skillset for helping those in mental health crisis, the chief said:
“If you’re an officer on patrol, don’t you think it’s more logical to have the appropriate health agency that can better address a mental health crisis response than an officer?”
Sean Redding, then an OCMH spokesperson, said in a November interview that the agency is pleased with the speed of B-HEARD’s rollout. “I think we’re really happy with it. Five precincts in five months,” Redding said.
At that rate, B-HEARD will reach the remaining 72 precincts in just six years. But the bigger question may be how many calls B-HEARD teams respond to in the places it operates.
Currently, police respond to over 99 percent of crisis calls. In January 2021, then OCMH director Susan Herman told advocates in a meeting that the city wanted police to only respond to 30 percent of crisis calls after B-HEARD expands city-wide. Around 30 to 40 percent of 911 mental health calls involve an imminent risk of harm and will still receive a traditional police response no matter what, an OCMH spokesperson told New York Focus.
Redding said the city has no plans to expand to 24/7 coverage. Without all-day coverage, Herman’s ambitious goal will be unachievable.
Beyond the Adams adminstration’s approach to B-HEARD, the program’s success will also depend on whether a number of players, like 911 dispatchers and EMTs, buy into it.
One early skeptic has come around. Oren Barzilay, the president of FDNY EMS Local 2507, told THE CITY last spring that he was wary of sending his union members to respond to mental health crises without a cop: “We all know EMS get assaulted on a daily basis and that’s with police on the scene. There’s a fear that without having police on the scene, who is going to mitigate?”
He now says he’s “open minded” to the B-HEARD program. He told New York Focus in October that none of the program volunteers have raised any concerns to him, and that there haven’t been any serious issues during the pilot.
His only frustration was with the speed of the launch. “I hope we can get this thing moving quicker than it currently is,” he said.