The city of Austin has begun dispatching a team that includes both mental health experts and police to address mental health emergency calls coming from the downtown area.
The Austin Field Integrated Response Support Team, or Austin FIRST, includes an Austin-Travis County EMS paramedic, an Integral Care mental health clinician and an Austin Police officer who has received mental health training. They will jointly respond to 911 calls that involve a person experiencing severe or complex mental health conditions and symptoms, including delusions and paranoia, as well as people at risk of self-harm.
“The city is always looking for holistic approaches to deal with mental health, deal with the unhoused crisis — all of those things. And this is it,” said Austin Police Chief Lisa Davis at a briefing to Austin’s Public Safety Committee in September.
A 2018 audit found Austin had the highest per capita rate of fatal police shootings involving someone in the midst of a mental health crisis among the country’s largest metro areas. In response to those findings, 911 call operators in Austin began answering calls with a new script in 2021: “Do you need police, fire, EMS or mental health services?” Mental health-related calls are directed to Integral Care mental health clinicians, known as the C3 team.
Austin Chief Medical Officer Dr. Mark Escott said the program has been especially effective in avoiding arrests and unnecessary emergency room detentions during low and moderate-level crises. 86% of calls diverted to the C3 team between 2022 and 2024 were resolved without any police involvement, he said.
“Where this team identified the gap is our high-acuity incidents,” Escott said. “These are individuals experiencing a severe crisis. There may be a high risk of harm and some sort of imminent danger.”
Escott believes Austin FIRST marks the first time a U.S. city has attempted this kind of coordinated response to the most acute crisis calls. Historically, police have been dispatched to such calls first to secure the scene, with EMS and mental health sent later if requested.
“It is those high-acuity calls where de-escalation and medical interventions can be the most impactful,” he said. “So we tried to find a solution that allowed all three of those resources to be on the scene at the initial response.”
In preparation for the pilot, APD, Integral Care and Austin EMS have shared training, including how to assess scene safety.
The team “soft launched” on Oct. 6, responding to mental health emergencies in the downtown area between the hours of 8 a.m. and 6 p.m. Assistant Police Chief Michael Chancellor said early feedback from his staff has been positive.
“They're learning a lot of things that maybe they didn't know just by being in the car with EMS and Integral Care on a regular basis,” he said. “They're learning the other sides of the job and seeing like, ‘OK, this is an option we didn't realize was out there before.’”
Chancellor said he hopes the program will lighten the load for 911 operators, reduce use of force in crisis situations and help get mental health resources to people who need them.
The pilot officially begins on Oct. 20 and will last six months. The team’s leadership will present data from the program to Austin City Council in April.
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