NEW YORK — Newly elected New York City Mayor Zohran Mamdani, a self-described Democratic Socialist, has proposed creating a Department of Community Safety (DCS), a plan that could change how the city responds to mental health crises by placing FDNY EMTs and paramedics at the center of that response.
The proposal calls for a public health approach to safety, expanding the use of health professionals instead of police for nonviolent emergencies. It would move the Behavioral Health Emergency Assistance Response Division (B-HEARD) under the new department and expand it citywide.
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Expanding B-HEARD
B-HEARD currently deploys teams of FDNY EMTs or paramedics and mental health clinicians to respond to certain 911 calls involving people in crisis. Mamdani’s plan would add peer counselors to every team, implement trauma-informed training and make the program available 24/7.
The proposal also calls for a 150% funding increase and for B-HEARD teams to operate in every neighborhood — with multiple teams in the areas with the greatest need.
In addition, the city would integrate the 988 and 911 dispatch systems, allowing better coordination between crisis response teams and emergency communications. A public awareness campaign would inform New Yorkers that they can request a mental health response rather than a police response in certain situations.
Subway outreach and crisis intervention
The DCS plan also targets the city’s subway system as a major point of intervention.
Teams made up of EMTs, mental health professionals and peers would be stationed in 100 subway stations, focusing on engaging New Yorkers experiencing homelessness or mental distress. The city would use vacant MTA commercial space to create on-site service centers where people could receive medical support and be connected with long-term treatment options.
The proposal also includes hiring more Transit Ambassadors to assist riders and connect individuals in crisis with outreach teams.
Crisis residences and mobile units
To divert more people from emergency rooms and jails, the plan includes the creation of new Crisis Residences, formerly known as respite centers, designed to provide short-term care for those in crisis. The city would also triple the size of Mobile Crisis Teams and improve their pay to support round-the-clock coverage.
The proposal describes these investments as part of the largest mental health commitment in city history — totaling roughly $362.8 million across prevention, ongoing care and crisis response.
A broader public health approach
The Department of Community Safety would coordinate programs across multiple city agencies, including the FDNY, NYPD and NYC Health + Hospitals.
According to the proposal, the goal is to reduce police involvement in nonviolent emergencies and to ensure residents in crisis receive appropriate medical and behavioral health care. Officials say the changes would allow police to focus on violent crime while health professionals respond to behavioral health calls.
What’s next
The plan will need City Council approval, and details such as funding distribution, dispatch protocols and staffing remain to be finalized.
Do you think EMTs and paramedics should take the lead in responding to mental health crises instead of police?
EMS1 readers respond
“I have 40 years experience in emergency medicine as a registered nurse and have worked in a level 1 trauma center for twenty years so I have experience with mental health and homelessness issues. The main problem I see with the NYC mayor’s plan is lack of safety for the EMS teams that will be responsible for mental health responses without law enforcement first assessing the safety of the team. Due to dual diagnosis and the rampant drug and alcohol use in addition to the mental health issues, many of the patients who are treated are violent and dangerous and will put our EMS team at risk for injuries or even death. It has been important for law enforcement and emergency medical personnel to work together as a team for the safety of both the patients and the public not forgetting the safety of our EMS staff.”
“Yes if there is adequate staffing. What about social workers being part of the team?”
“Yeah it’s gonna work great until the mental health patient has a gun or knife or machete or pitchfork or bomb or … “
“No we as EMS providers would be going into a situation where the person is mentally ill. They could hurt or even kill providers. The mental health professional should ride with the police so they can be cleared of any weapons and be in a secured if they do become violent towards responders. Then they can be transported to the correct facility behavior health, detox, etc. and involuntary admit paperwork could be filled out. While the non violent could be referred to an outpatient facility for daily or weekly treatment that deemed correct for the patient.”
“Yes, I do; they are a better choice than sending the police only — what kind of message does that send? At least the paramedics could assess any medical issues they might have. Better yet, send paramedic, social worker and a police officer— that way you have all the bases covered.”
