The study, published in Community Mental Health Journal, is the first empirical test of a 911-to-crisis-line call routing intervention of this kind. Using a quasi-experimental technique known as synthetic control analysis, Leonard Swanson, Aaron Gottlieb, and Margaret Thomas compared Mesa’s suicide call rates after the intervention against a weighted blend of twenty comparable cities across the United States. Their findings indicate that embedding a crisis line specialist at the 911 center reduced police responses to suicide calls by roughly 22 to 48 calls per quarter per 100,000 residents relative to the synthetic control. Translated into officer time, that reduction amounts to an estimated 228 to 491 police hours saved per quarter in a city of just over half a million people.

The logic behind the intervention rests on a mismatch in how Americans reach help during a mental health emergency. The 988 Suicide and Crisis Lifeline, launched nationwide in July 2022, offers around-the-clock counseling through a network of roughly 200 local call centers, and fewer than 2 percent of its calls ever require an emergency dispatch. Yet 911 remains the number people actually know and dial. An estimated 240 million 911 calls are placed every day across the country, and some analyses suggest that as many as one in five involve a mental health component. Even under a conservative estimate, mental health-related 911 calls would vastly outnumber the roughly six million calls 988 receives annually. Survey research underscores the awareness gap: only about one in five Americans knew of 988, while more than half said they would call 911 in a crisis.

Mesa’s path to reform began years before the embedded specialist arrived. In 2019, the Mesa Police Department and Solari, the nonprofit crisis line that answers 988 calls for Arizona, drafted a policy allowing 911 call-takers to route suicide calls to the crisis line when the caller expressed suicidal thoughts without plans or means and consented to the transfer. Dispatchers received an hour of training on identifying eligible calls. A similar policy for broader mental health calls followed in August 2020. But the decisive change came on June 5, 2021, when Solari placed a licensed counselor inside the emergency communications center itself. The embedded specialist did not take calls. Instead, the counselor sat alongside 911 professionals during their shifts, listened for the types and severity of calls Solari could handle, coached dispatchers in real time, and translated abstract routing policies into concrete, call-by-call decisions.

That physical presence, the researchers argue, may have been the ingredient that previous paper policies lacked. Emergency communication centers are overwhelmingly police-operated, and 911 professionals frequently default to law enforcement responses out of concern for legal liability and a lack of trust in alternative resources. Call-takers feel personally responsible when a caller expresses suicidal ideation, and strict call-taking protocols often leave little room for nuance. By working shoulder to shoulder with dispatchers, learning their procedures, norms, and coding practices, the embedded specialist built the interpersonal and institutional trust needed to make call routing a routine practice rather than a risky exception. Once the program was established, a behavioral health technician with a lower credentialing burden could assume the role, making it financially sustainable for other jurisdictions.

To measure the effect, the team turned to the synthetic control method, an approach originally developed in comparative politics and increasingly used in criminology. Rather than hunting for a single comparison city with matching pre-intervention trends, which is notoriously difficult, the method constructs a weighted combination of donor cities whose pre-intervention suicide call rates collectively mimic Mesa’s. The researchers scoured public data portals from all 369 U.S. cities with populations above 100,000, searching for jurisdictions that published computer-aided dispatch or calls-for-service data containing suicide-related call types. Twenty cities made the final donor pool. The resulting synthetic Mesa drew most heavily from Everett, Seattle, and Tacoma, with smaller contributions from New Orleans and Norman, and tracked Mesa’s actual suicide call rates closely before the intervention, with differences never exceeding 18 calls per 100,000 people per quarter.

After the specialist was embedded in mid-2021, the trajectories diverged. Mesa’s suicide call rate fell below its synthetic counterpart in quarter after quarter, with the gap widening to nearly 48 calls per 100,000 people by late 2022 before narrowing somewhat in 2023. To rule out chance, the researchers ran placebo tests, constructing synthetic controls for each donor city as if it too had received the intervention. Mesa’s observed decline exceeded nearly all of these placebo estimates, reaching conventional significance thresholds in several post-intervention quarters, including one quarter in which Mesa’s difference was larger than every placebo site. The team also conducted robustness checks, dropping individual cities to test for outsized influence and examining non-suicidal call trends for confounding influences, and the core result held.

The implications extend beyond officer hours. Police responses to mental health crises can escalate situations that might otherwise be resolved peacefully, sometimes ending in arrest, use of force, or death. Officers predominantly transport people in crisis to emergency departments, where patients can wait weeks for psychiatric placement in a practice known as ED-boarding, and where connections to follow-up care are often tenuous. Crisis lines, by contrast, can de-escalate a caller over the phone, activate a mobile crisis team, and link the person to ongoing mental health resources, all without a uniformed response. Deflecting calls upstream, before they enter the criminal-legal or acute care systems, is precisely the kind of intervention that crisis system frameworks from the Substance Abuse and Mental Health Services Administration envision, and the quantifiable reduction in police labor may give law enforcement administrators a pragmatic incentive to support such programs.

The study also exposes a stubborn data problem that hampers research in this field. The researchers had hoped to analyze whether Mesa’s broader mental health-related call rate declined as well, but definitions and coding practices for mental health calls vary so widely across jurisdictions that no meaningful cross-city comparison was possible. Some calls coded as mental health-related are not, and many genuinely mental health-related calls are buried under categories like check welfare or public disturbance. Suicidality, with its clearer concepts of ideation, threats, and means, proved far more comparable across cities. The authors note that this coding ambiguity itself shapes outcomes: when 911 professionals lack confidence in identifying mental health concepts that require clinical judgment, they tend to default to dispatching officers, and the absence of a standard definition inhibits empirical evaluation of deflection programs nationwide.

The authors are careful about causal claims. Mesa’s earlier routing policies laid groundwork that the embedded specialist built upon, and other cities may not replicate the results by embedding a counselor without first establishing transfer policies and training. The synthetic control method absorbed the effects of those earlier policies into the pre-intervention baseline, which strengthens the case that the observed decline reflects the embedded specialist’s distinctive contribution. Still, the association is striking: a single embedded clinician, working within a police-operated dispatch center, coincided with hundreds of police hours redirected away from suicide calls each quarter. As cities across the United States and abroad experiment with alternatives to police-led crisis response, the Mesa model suggests that the most powerful lever may not be a new mobile team or a retrained officer corps, but a counselor with a headset sitting in the room where the first call for help arrives.

Subject of Research: Embedding a mental health crisis line specialist in a 911 emergency communications center to reduce police responses to suicide calls

Article Title: Deflecting Suicide Calls From Law Enforcement With an Embedded Crisis Line Specialist at a 911 Center: A Synthetic Control Analysis

Article References: Swanson, L., Gottlieb, A., & Thomas, M. (2026). Deflecting Suicide Calls From Law Enforcement With an Embedded Crisis Line Specialist at a 911 Center: A Synthetic Control Analysis. Community Mental Health Journal. https://doi.org/10.1007/s10597-026-01726-2

Image Credits: AI Generated

DOI: 10.1007/s10597-026-01726-2

Keywords: 911, 988 crisis line, suicide prevention, mental health crisis response, police deflection, synthetic control method, emergency communications center, Mesa Arizona, crisis intervention, mobile crisis teams, law enforcement, community mental health

The study posits that lived experience advocacy, defined as guidance and support provided by individuals who have themselves grappled with mental health issues, creates a crucial bridge for young people. This type of support serves to dismantle stigma, promote understanding, and provide relatable role models who can inspire and encourage youth facing similar challenges. The methodology employed by the researchers includes a comprehensive review of existing literature, surveys, and interviews with both advocates and youth beneficiaries, providing a multifaceted perspective on the subject.

As mental health issues among youth continue to escalate, particularly in the wake of global crises such as the COVID-19 pandemic, the need for effective interventions becomes more urgent. The importance of advocacy rooted in personal experience cannot be overstated, as it addresses the unique hurdles faced by young individuals, often preserving their dignity while rigorously challenging systemic barriers. This research not only highlights existing gaps in traditional support systems but also proposes innovative solutions fostered through peer-led initiatives.

The researchers observed a distinct correlation between participation in advocacy programs and improved educational outcomes among youth. Specifically, those engaged in mental health advocacy reported higher levels of motivation, academic achievement, and a greater sense of belonging within educational environments. This enhanced sense of community is attributed to the empowering nature of shared experiences and collective resilience fostered in advocacy settings.

Moreover, the study draws attention to the implications of advocacy on employment prospects for young individuals. The ability of lived experience advocates to share pragmatic advice, networking opportunities, and job-readiness skills profoundly impacts how youth perceive their employability. This influence often translates into increased confidence, equipping them with the tools necessary for successful job searches and interviews.

In examining the broader societal implications, Wainwright, Harris, and O’Leary emphasize the role of educational institutions and employers in recognizing the potential of lived experienced advocacy. By fostering environments where such advocacy can thrive, stakeholders not only benefit from a more skilled workforce but contribute to a more inclusive society. The message is clear: supporting mental health advocacy initiatives is not merely an act of charity; it is an investment in the future.

The research underscores the importance of training programs for advocates. Ensuring that individuals who take on advocacy roles are equipped with the requisite knowledge and skills is paramount to the successful impact of these initiatives. Such training can cover topics ranging from effective communication to understanding the intricacies of mental health diagnoses, thus enabling advocates to navigate conversations and support youth more effectively.

Another critical aspect of the study is the role technology plays in augmenting mental health advocacy. Digital platforms have allowed advocates to reach broader audiences, breaking down geographical barriers that once limited access to resources. Social media campaigns, online support groups, and virtual events are highlighted as powerful tools in disseminating information and creating supportive networks.

As the mental health discourse evolves, the researchers call for policy changes that prioritize lived experience advocacy in educational and employment strategies. This calls for a collaborative approach between mental health professionals, educators, policymakers, and advocates to develop comprehensive frameworks that can truly support youth facing mental health challenges while promoting their engagement in education and work.

While the findings of this study are poised to contribute significantly to the existing body of knowledge, they also serve as a clarion call to society. Acknowledging the lived experiences of individuals as valid and powerful tools in the mental health landscape could transform how we address the myriad challenges faced by youth today, ultimately leading to better educational and employment outcomes.

Furthermore, the research delves into the personal narratives of young people who have benefited from these advocacy programs, painting a vivid picture of resilience and empowerment. Their stories illuminate the profound difference that understanding and shared experiences can make, inspiring others who may feel isolated in their struggles.

In conclusion, the impact of mental health lived experience advocacy on youth education and employment engagement cannot be underestimated. The findings from Wainwright, Harris, and O’Leary’s research will likely resonate in various sectors, prompting essential discussions about how best to support and empower the next generation facing mental health challenges.

Subject of Research: The impact of mental health lived experience advocacy on youth education and employment engagement.

Article Title: The impact of mental health lived experience advocacy on youth education and employment engagement.

Article References:

Wainwright, C., Harris, N., O’Leary, R. et al. The impact of mental health lived experience advocacy on youth education and employment engagement.
Discov Ment Health (2025). https://doi.org/10.1007/s44192-025-00339-7

Image Credits: AI Generated

DOI:

Keywords: mental health, youth advocacy, education, employment, lived experience, peer support, empowerment, systemic barriers.

Mental health has become a pressing concern, especially as individuals grapple with anxiety, depression, and trauma related to COVID-19. The Center, staffed by a team of clinical psychologists, psychiatrists, and licensed clinical social workers, is now ready to extend its support to New Yorkers aged 18 and older. This decision reflects a growing recognition that the psychosocial impact of the pandemic extends beyond health care workers; it touches every individual in society. Recent studies have shown that the community is facing a mental health crisis of monumental proportions.

The services offered by the Center encompass a range of evidence-based therapeutic approaches designed to help individuals navigate life’s challenges. Cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and medication management are just a few modalities available, each tailored to foster resilience and improve emotional well-being. The compassionate framework in which these services are delivered cultivates an atmosphere of trust, which is critical for effective mental health intervention and recovery.

Dr. Jonathan M. DePierro, Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Associate Director of the Center, emphasizes the urgency behind expanding their services. The knowledge gleaned from over 18,000 behavioral health visits to health care workers has equipped the Center to now apply these insights to the broader public. With evidence-supported strategies, the aim is to bolster resilience among a wider audience, thereby enhancing individuals’ capacity to cope with life’s inevitable stresses and strains.

The past five years have seen the Center grow into a nationally recognized program, proving instrumental in not only helping Mount Sinai’s workforce but also setting a precedent for mental health initiatives across the United States. Its success in reducing anxiety and depression during the pandemic has opened pathways for understanding and addressing community mental health needs. Researchers and clinicians together have delivered over 600 educational courses on mental health, further embedding resilience education within the organizational fabric of the system.

This initiative’s expansion can be seen as a proactive response to an urgent public health need. As public discussions around mental disorders become less stigmatized, support services like those at Mount Sinai can serve as essential resources for individuals feeling overwhelmed by their circumstances. The integrated approach that the Center takes, reminding us that mental health is inextricably linked to overall well-being, ensures that treatment is holistic rather than merely symptomatic.

Despite the Center’s focus on health care professionals during the pandemic’s height, the data collected during this period highlights the unforeseen mental health challenges faced by the general population. The Center has put resources behind understanding these dynamics, and preliminary findings indicate a significant decrease in symptoms of anxiety, depression, and PTSD among participants in treatment, underscoring the effectiveness of their approaches.

Dr. Deborah Marin, Director of the Center for Stress, Resilience, and Personal Growth, adds a note of optimism. The initiative aims to teach both individuals and communities how to cultivate resilience in the face of adversity. The Center’s commitment to sharing expertise and experience through accessible services represents a testament to the power of science-based interventions in enhancing mental health.

This proactive approach opens up new avenues for educational outreach and engagement, encouraging individuals to seek help when needed while simultaneously contributing to a collective understanding of mental health in the wake of a global crisis. The ability to navigate complex emotional landscapes fostered by professional guidance prepares individuals to face challenges with newfound strength and resilience.

As the effects of the pandemic continue to unfold, the collaboration between institutions like Mount Sinai and community members will be crucial. Understanding that mental health is a shared societal responsibility encourages communities to foster a culture of support where individuals are empowered to take charge of their mental well-being.

In conclusion, the evolution of the Center for Stress, Resilience, and Personal Growth during these tumultuous times stands as a vital reminder of the importance of mental health. By extending its reach beyond health care workers to the general public, the Center not only addresses immediate psychological needs but also promotes long-term overall health and resilience in the face of ongoing societal challenges.

For those interested in accessing these critical support services, the Center invites individuals to reach out via email or phone for more information and to schedule appointments. The message is clear: help is available, and the pathway to stronger mental health and resilience begins with reaching out.

Subject of Research: Mental Health Services Expansion in Response to COVID-19
Article Title: Mount Sinai Expands Center for Stress, Resilience, and Personal Growth to General Public
News Publication Date: February 2024
Web References: Mount Sinai Health System
References: American Journal of Public Health
Image Credits: Credit: Mount Sinai Health System

Keywords: COVID-19, Anxiety, Psychological Stress, Depression, Post Traumatic Stress Disorder, Psychiatry, Mental Health