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Research finds local investment needed for 911, 988 systems to optimize crisis response services

RAND report finds 911 and 988 mental health hotline require coordination from law enforcement, mental health specialists and others to promote interoperability

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By Bill Carey
EMS1

SANTA MONICA, Calif. — Research shows that local representatives from both 911 and 988 call centers, public safety, mobile crisis teams, peer support specialists and behavioral health specialists need to be involved to optimize each system.

The RAND report, “The Road to 988/911 Interoperability,” highlights that to work together, the 988 and 911 emergency telephone systems require detailed planning and close cooperation from having one or two people at the local level with a focus on interoperability.

“The 911 system essentially remains as the default people call when there is an emergency, even if there is a mental health component to the crisis,” said Stephanie Holliday, lead author of the report and a senior behavioral scientist at RAND, a nonprofit research organization. “It is critical that the 911 and 988 systems work together so that each call is handled appropriately.”

Since its creation in 2022, the use of the 988 mental health hotline has risen sharply, however, several surveys show that many people are unaware of the service and uncertain when to use it.

Without knowledge of 988, many people will likely call 911 when faced with a mental health crisis.

“For the system to work to its full potential, the two systems need to be interoperable—to work together to make sure the proper resources are used, regardless of which number a caller uses,” Holliday said.

RAND researchers studied efforts in the City of Sioux Falls and Minnehaha County in South Dakota, Orange County in New York, and Fairfax County in Virginia. The jurisdictions have worked to establish different models of 988/911 interoperability.

The researchers found that planning and implementation should be collaborative, engaging a variety of contributors and have a shared language.

“Interoperability requires more than protocols for transferring calls between 988 and 911— it also must be considered within the larger continuum of crisis services available in a community,” Holliday said.

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