Behavioral Health Emergency Response Initiative (BHERi)

BHERi is a collaboration with the SCALE + Lab at New York University’s Marron Institute of Urban Management. The Meadows Institute leads the Texas Behavioral Health Emergency Response Initiative, a three-year, statewide effort to support cities and counties in enhancing how they respond to behavioral health emergencies. BHERi is designed to build on local efforts, connect what’s working, and provide tools and data so every community can strengthen its approach in a way that fits its own context. Funding is generously provided by Blue Meridian Partners. Additional support is provided by the Pew Charitable Trusts.

Overview

Each year, an estimated 48 million calls to 911 in the United States involve behavioral health. Too often these calls result in a person who is experiencing a mental health or substance use crisis being arrested or brought to the emergency room. BHERi seeks to implement a framework that allows anyone in Texas who is experiencing a behavioral health emergency to receive a person-centered, health-forward response that reduces risk, connects people to care, and strengthens community trust.

A growing body of evidence underscores three essential elements of an effective behavioral health emergency response:

• Identify calls to 911 that involve behavioral health.
• Providing an appropriate response to these calls that effectively, efficiently, and safely connects people to the services they need.
• Ensuring options are available 24/7, other than the emergency room or jail, where first responders can bring people who need immediate care.

Increasing the likelihood a 911 call involving a person in crisis results in a connection to effective community-based care depends on extensive coordination among first responders (police, fire, EMS, and Emergency Communications Centers) and organizations that provide and administer behavioral health services. First responders and behavioral health organizations are funded and regulated by a complex web of local and state government agencies and public and private payers of health services. No single government agency runs this fragmented system.

How BHERi Works

BHERi provides technical assistance that adapts to each community’s starting point. Local teams move through four phases at a pace that reflects local needs:

• Engage & Assess: Understand current strengths and opportunities.
• Design: Co-create a local implementation plan with leaders and stakeholders.
• Implement & Track: Support local partners as they refine and expand response options.
• Measure & Improve: Provide shared metrics and evaluation tools to track progress.

Core Goals of BHERi

The core goals of BHERi are:

• Support 911 telecommunicators with training and certification to accurately identify and code behavioral health emergencies.
• Expand access to health-forward response options available around the clock.
• Increase officer safety and community confidence by reducing risk in crisis encounters.
• Strengthen innovation in 911 coding to better capture complex calls involving behavioral health and public safety.