BHERi is a joint, national venture seeking to improve the response to calls to 911 that involve a person experiencing a mental health and/or substance use emergency.

It is a collaboration between NYU's SCALE + Lab at the NYU Marron Institute of Urban Management and three implementing partners:

- The Center for Behavioral Health and Justice at Wayne State University in Michigan

- Clear Pathways at Peg’s Foundation in Ohio

- Meadows Mental Health Policy Institute in Texas

BHERi is concentrating initially on making significant, measurable progress in these three states, with a long-term vision for making a major impact on this issue nationally.


Research points to approaches that improve outcomes for millions of calls to 911 that involve behavioral health.

Each year, an estimated 48 million calls to 911 in the US involve behavioral health. Too often these calls result in a person experiencing a mental health or substance use–related crisis being arrested or brought to the emergency room.

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

- Identifying calls to 911 that involve behavioral health

- Providing an appropriate response to these calls that effectively, efficiently, and safely connects them to the services they need

- Ensuring options are available 24/7, other than the emergency department or jail, where firstresponders can bring people who need immediate care


Translating what works in BHER into policy and practice is complicated.

Increasing the likelihood a call to 911 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.

A range of cities and counties across the US has demonstrated, to varying degrees, how to overcome this fragmentation and how to design and implement evidence-based approaches to BHER.


Implementing partners can accelerate the pace of change.

The SCALE + Lab's theory of change is that select organizations outside government, called “implementing partners” or “IPs,” are uniquely positioned to accelerate the pace and scale of change of BHER via:

- Local Action and State Policy: IPs design and execute multiyear strategies in a cross section of urban, suburban, and rural locations to demonstrate local success. Simultaneously, they develop and advocate for state-level policy changes that facilitate the scaling of those local initiatives.

- Technical Assistance and Statewide Coordination: In individual cities and counties, IPs identify and convene stakeholders, provide expertise on BHER, collect and analyze complex data, and ensure the perspectives of all affected people are included. IPs also coordinate efforts among local governments within a state, providing trainings, sharing best practices, and supporting multisite evaluations. IPs do not provide direct services to people in crisis.

Each of the SCALE + Lab's IPs has a distinguished leadership team, a strong track recordof system transformation in their state, and an active role in current BHER system reform.

The SCALE + Lab's vision is to facilitate the identification and incubation of additional IPs in states outside Texas, Ohio, and Michigan. In the coming months, the Lab will share more information about what makes a successful IP and opportunities to engage further with BHERi.


The SCALE + Lab amplifies the impact of individual IPs, helping them function as a cohort.

Cohort Coordination: The Lab provides opportunities for the IPs to coordinate their efforts, share insights, and leverage each other’s strengths. The diversity of the IP cohort enhances learning about what works in different settings.

- Organizational diversity: The Center for Behavioral Health and Justice is an academic center within the Wayne State University School of Social Work; Clear Pathways is a project of Peg’s Foundation, a philanthropy that works to improve outcomes for people with serious mental illness; and Meadows Mental Health Policy Institute is a large nonprofit that provides technical assistance.

- Complementary strengths and orientations of the IPs range from the role of Medicaid in financing crisis services, the development of a crisis care workforce, and the enhancement of911 call-taking centers to identify behavioral health calls.

- Geographic diversity: Michigan, Ohio, and Texas are populous states that still vary considerably in size and encompass two very different regions of the country.

System Deep Dives: The Lab conducts "deep dives" into challenging issues—like 911 workforce development—that hinder system reform.

Grant Administration: The Lab simplifies and streamlines the process for grantmakers by aggregating and regranting capital. It also serves as a single point of accountability for monitoring, measuring, and reporting on the partners' collective progress.

Funding is provided by Blue Meridian Partners. Additional support is provided by the Pew Charitable Trusts. 


Get In Touch 
For more information about BHERi, please contact: 
Tina Chiu 
Research Scholar 
NYU’s SCALE + Lab 
tina.chiu@nyu.edu

SCALE + Lab Homepage