Behavioral Crisis and First Response: Qualitative Interviews with Chicago Stakeholders

Area of Science:

• Public Health
• Emergency Services
• Mental Health Services

Background:

• Interactions between first responders and individuals in behavioral crisis present significant public health challenges.
• Effective crisis intervention requires understanding stakeholder perspectives on current response systems.

Purpose of the Study:

• To explore the experiences and expectations of community stakeholders regarding first responder interactions during behavioral crises.
• To identify areas for improvement in the current 911 behavioral crisis response system.

Main Methods:

• Qualitative interviews were conducted with 25 key informants from Chicago-based community organizations and shelters.
• Informants provided detailed accounts of 911 calls, first responder engagements, and desired outcomes.

Main Results:

• Stakeholders reported frequent 911 calls (2-3 times/month) for behavioral crises, often related to involuntary hospitalization.
• First responder engagements sometimes resulted in unnecessary escalation, coercive tactics, or service refusal.
• While Crisis Intervention Team (CIT) trained police were valued, stakeholders advocated for reduced police involvement and enhanced social/behavioral health services.

Conclusions:

• Current first responder strategies for behavioral crises require significant improvement.
• There is a critical need for integrated crisis response models prioritizing de-escalation and community-based mental health support over law enforcement intervention.