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Conducting Emergency and Non-Emergency Call Triage

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Conducting Emergency and Non-Emergency Call Triage

Effective call triaging enables communities to connect people in need of emergency and non-emergency assistance to the most appropriate response as quickly as possible. Most community responder programs receive, organize, and allocate calls for service through 911, although some programs can also receive calls through non-emergency phone numbers such as 211 and 311 or through 24/7 crisis lines. The triage process can be used to determine when to dispatch a community responder team to address calls that involve mental health and substance use crises, non-emergency medical needs, public disturbances, welfare checks, and housing crises. There are multiple ways to conduct call triage, but many emergency and non-emergency communications centers use standard call triage protocols, such as asking specific screening questions. Through these protocols, operators are able to determine which types of call they route to community responders, how those teams receive call information, and how responders are dispatched.

Key Strategies for Conducting Call Triage

1. Identify a method for categorizing calls

Programs should analyze the types and volume of calls received by the local emergency call center(s) as part of an initial assessment process. Read More…

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This will help determine what type of call triage process(es) is most appropriate for their community (see below for the most common options). Many communities will decide to implement more than one call triage process with community responders in mind to ensure that people can access their services no matter who they call for help. One important consideration for jurisdictions to consider is whether they will establish different call codes for people with mental health needs, substance use issues, or housing needs, or those seeking services for other basic needs, and how this coding will determine which responder team to use. Note: While call triaging can help direct people to the most appropriate responder team, there may be times when it is not possible for call takers to know if someone is experiencing a substance use or mental health crisis, as symptoms can look similar.


2. Establish a call triage approach that enables calls to be routed from multiple public safety answering points

Each jurisdiction should establish a clear way of identifying and allocating calls that are appropriate for community responders. Read More…

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Below are the three most common ways that calls are routed to community responder teams.

  1. 911/Emergency Communications Center: Trained 911 dispatchers code and determine the appropriate response, sometimes with the help of embedded behavioral health specialists, for immediate assessment and intervention. From there, dispatchers may route the call to community responders or other first responders for help. Essential elements include:
    • Screens for mental health needs: Call scripts can be used to determine if the person is making the call because of a mental health need (e.g., “Are you calling for police, fire, EMS, or mental health services?”). An additional benefit to these screening questions is that callers may feel more comfortable dialing 911 for assistance during an emergency response if they know they can access a mental health response instead of a police response.
    • Screens for substance use crisis: Call scripts can also help to determine if someone is experiencing a drug overdose or acute intoxication; this should be identified as quickly as possible to ensure that the appropriate medical personnel are able to respond to the call for service. Jurisdictions will need to determine if their community responder teams will address these kinds of calls or handle less acute substance use crises.
    • Within-center triage: Dispatchers categorize the call by obtaining information on the potential threat level, urgency, location, and other key information to assess whether law enforcement, community responders, or other first responders are appropriate.
    • Police or Fire/EMS radio dispatch: Working in collaboration with the local police, fire, or EMS departments, community responder teams in some communities can use department radios to identify and self-dispatch themselves to calls that might otherwise be claimed by police or fire/EMS.
  2. Independent phone line or existing crisis line: Many jurisdictions have created an independent phone line that links directly to community responder teams who conduct triage and self-initiate responses in the field when the crisis cannot be resolved over the phone. In other jurisdictions, community responder programs can be deployed by the 24/7 crisis line; this can be helpful because crisis line staff are able to provide services such as telephone counseling and referrals, but they can also deploy the community responder team in situations where the caller needs in-person support. It is important to conduct marketing and outreach campaigns if using this method of call triage, however, since many people will automatically default to calling 911 if they do not know other options are available. Note: as the United States begins to implement 988 as a national crisis line, communities should consider how and if community responder programs are connected through this line.
  3. 211 or 311 call center: Some jurisdictions use the city’s 211 or 311 non-emergency phone number as the primary method of triaging calls and dispatching community responder teams. The staff who handle these calls already have protocols for answering the phone lines and initiating responses, so community responder programs can usually be easily incorporated into these processes. Public education and community engagement should be included as critical elements for setting up a direct line to ensure community members are aware of this option.


3. Provide ongoing training and supervision for call center staff/dispatchers

Jurisdictions should develop clear protocols for routing calls to community responders and include a clear list of call types and screening questions in the training materials for call center staff and dispatchers. Read More…

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These training materials should be regularly updated and also involve practical examples of instances when a community responder is the most appropriate first responder. There should be ongoing communication among the call center leadership and community responder programs and other first responders to update the policies as needed, especially as leaders receive feedback on what is working and not working for call center staff and community responder programs. While there still needs to be more research conducted around the impact of implicit bias training on behaviors, it may be helpful to educate call takers and dispatchers about the potential impact of racial bias on decisions they make about which calls to send to community responder programs and which to send to law enforcement.

Resources


This brief highlights the different ways call triage can be used to inform and dispatch community responders.


This brief provides recommendations for ensuring a successful, strong call triage process for community responder programs.