More than a third of 911 calls in New York City about people in emotional distress that were eligible for a response from mental health workers did not receive one, a new audit by the city comptroller’s office found.
The program that sends the mental health workers, called the Behavioral Health Emergency Assistance Response Division, or B-Heard, began as a pilot in 2021 and does not cover the entire city. It dispatches teams of emergency medical workers and mental health professionals to assist people in crisis instead of police officers, who advocates say lack proper training and can escalate situations.
But often, B-Heard teams do not arrive at all, and police officers do instead, the audit found. Between 2022 and 2024, the teams did not respond to more than 13,000 calls that met the program’s criteria. That’s about 35 percent of all eligible calls, according to the audit.
“Thousands of people and their loved ones call 911 for mental health emergencies, because our current system has no better way of handling these crises,” Brad Lander, the comptroller, said in a statement announcing the audit.
“But despite B-Heard’s good intentions, thousands of these calls go unanswered or met with only a police response woefully unequipped to handle a medical episode,” said Mr. Lander, who is also a Democratic candidate for mayor.
The city started B-Heard to test alternatives to having the police respond to mental health calls. Such encounters can have tragic outcomes, as in the case of Win Rozario, a 19-year-old in distress whom officers shot and killed in his Queens apartment last year after he called 911 seeking help.
“People in mental health crisis don’t need a criminal response to what they’re going through,” said Jumaane Williams, the city’s public advocate. “And the question is, well, how do we create an infrastructure that provides what they need?”
Mr. Williams said B-Heard had languished because of underinvestment from city leaders. The program covers only some of the city, including parts of Manhattan, the Bronx, southern Brooklyn and western Queens. Response teams are available in those areas seven days a week, but only between 9 a.m. and 1 a.m.
In a letter responding to the audit, Eva Wong, the executive director of the Mayor’s Office of Community Mental Health, emphasized that B-Heard was a pilot program that exists within New York City’s sprawling, complex emergency response system.
“The report’s implication that any mental health call not responded to by B-Heard constitutes a failure is not only misleading but also overlooks the operational realities of this complex pilot program,” Ms. Wong wrote.
From January 2022 through September 2024, the city received nearly 96,300 mental-health-related calls from areas inside the program’s boundaries and during its hours of operation, according to the audit.
More than 60 percent of those calls were deemed ineligible for response from a B-Heard team, it said, which can happen for a range of reasons, including because the situation was potentially dangerous, because a mental health professional was already on the scene or because dispatchers were not able to collect enough information about the situation to respond properly.
Another 14,200 calls came during unstaffed hours, the audit found.
Ms. Wong said that B-Heard teams were “strategically deployed” only in certain circumstances where they could be most helpful. Patients who would be ineligible for a B-Heard response, she said, include a person who is immediately suicidal or who requires immediate hospitalization.
The program has faced funding cuts and staffing problems for years. Among its most pressing challenges are hiring enough emergency medical workers and social workers to fully staff its teams, Mr. Williams told a City Council committee earlier this year.
In March, there were a total of 18 B-Heard teams split between two daily shifts, which the audit said appeared to be an “insufficient” amount to respond to all eligible calls.
It is unclear what it would take for the teams to respond to a larger share of eligible calls, the audit found, because Office of Community Mental Health officials do not thoroughly track why calls go unanswered.
The agency told the comptroller’s office that it regularly evaluated the program’s staffing needs, but it could not say how much additional staffing or funding it would require to broaden the response.
When a B-Heard team arrives at the scene of a person in distress, workers are supposed to conduct mental and physical health assessments. They can also connect the person with medical care and mental health providers. In the 2024 fiscal year, according to the audit, teams filed mental health assessments for only a quarter of the calls they responded to.
The percentage of calls that resulted in an assessment has decreased each year since the program’s creation, it found, though the total number of assessments rose. In the 2022 fiscal year, 55 percent of all answered calls were followed by assessments; the next year, that percentage dropped to 31 percent.
Auditors found that there was no clear reason the rate of assessments had declined. Agency officials said that sometimes patients refuse help or leave before the teams can assess them.
City officials highlighted areas where the program has been successful. One of B-Heard’s focuses is decreasing the number of patients transported to hospitals unnecessarily. Since the program began, more than 3,300 people assessed by B-Heard teams avoided an unnecessary trip to the hospital, according to the mayor’s office.
William Fowler, a spokesman for City Hall, said in a statement that the audit blamed B-Heard for deeper challenges faced by New York City’s 911 system. Calls to 911 about life-threatening emergencies have risen in recent years, as have average response times.
“B-Heard has successfully responded to more than 24,000 mental health 911 calls with a mental health professional, when it is both safe and appropriate to do so, in a vast emergency dispatch system managing thousands of life-threatening emergencies each day,” Mr. Fowler said.
Mental health advocates are urging the city to allocate an additional $4.5 million to B-Heard to help close gaps in the program’s coverage and ensure that its teams are fully staffed, a proposal Mr. Lander’s office endorsed.
B-Heard and other citywide mental health programs have become talking points in the city’s mayoral race, and several of Mr. Lander’s fellow candidates have also endorsed programs like B-Heard to respond to mental health calls.
Maggie G. Mortali, the chief executive of the National Alliance on Mental Illness of New York City, said that additional funding for B-Heard was not a “wish-list item” but rather a necessity to ensure the program’s viability.
Without it, she said, more mental-health-related 911 calls will be answered by police officers.
“The mental health crisis is a public health issue,” she said. “Because of that, it really demands a public health response.”
Alyce McFadden is a reporter covering New York City and a member of the 2024-25 Times Fellowship class, a program for journalists early in their careers.
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