Tex. 9-1-1 Patient Information Program Proving to be Inefficient
Aug. 06—More than a year has passed since the launch of a promising new 9-1-1 feature that could provide Houston-area first responders with information from gate codes to mental health issues.
Yet the program has only a few thousand users out of a service area with 5.3 million residents, and—despite the city's police chief touting it on Twitter—Houston's dispatch center doesn't have access to the profiles.
The Greater Harris County 9-1-1 Emergency Network, the fourth largest in the country, launched the "emergency profiles" program in May 2016. Residents can fill out an online form with information that dispatchers pass on to police, to firefighters and to EMS personnel who answer the area's 4 million emergency calls a year.
These profiles hold the promise of helping police and others tailor their responses for people with mental health issues, possibly averting situations such as a Houston police officer's 2012 fatal shooting of a mentally ill double amputee in a wheelchair.
The program, which the regional network said cost $150,000 to develop, also allows residents to associate wireless numbers with a precise street address and to convey mundane but useful details about allergies, languages spoken, vehicles, specific street addresses and even pets.
"This is a great tool to let us know about special circumstances you want us to be aware of before we arrive," wrote Art Acevedo, Houston's police chief, in a July 3 tweet. The Greater Harris County network, the umbrella agency that coordinates service in Harris and Fort Bend counties, created fliers and advertises the service prominently on its website, www.911.org.
Katy's police department has used the profiles several times to find information like names and vehicles, spokeswoman Ondrea Baker said. The city has recently promoted the service through notices sent along with water bills.
Yet since the introduction of the feature more than a year ago, the regional network counts only 4,100 users.
"I think awareness has been a little slow," said Sonya Clausen, spokeswoman for the regional network. She added in an email that "the number of registrations is actually in line with other similar 911 services across the U.S."
What's more, dispatchers for the largest police agency—Acevedo's Houston Police Department—do not have access to the emergency profiles.
"It appears we really don't have this program up and running," HPD spokeswoman Jodi Silva wrote in an email.
The manager of Houston's 9-1-1 call center said he was not ready to use the emergency profiles because of potential limitations.
"It's good stuff," said Joe Laud, administration manager for the Houston Emergency Center. "It could work. But for right now, there's just some missing key factors. The information that you're going to have on the database is only for the number that's associated with it. And as far as police responding to incidents, what they're concerned about is the area, the location."
Laud's main issue was that the profiles only come up when residents call from the phone numbers listed on their profiles. The information doesn't appear if the same resident calls 9-1-1 from a different number. And the information from the profiles describes only one specific address, not all addresses on a block —and police want to know about the whole area, not just one house. Also, he asked, what if residents were calling about a neighbor rather than about themselves?
Laud also expressed concern about out-of-date information, but Clausen said users get an email every six months asking them to update their information or to confirm that it remains accurate. Profiles are removed when users don't respond.
Laud said he did not know about that feature until a reporter described it to him. He said he recently discussed the program with Clausen because HPD wanted to hold a news conference about the program. Those plans hit a snag when the department learned its dispatchers, who work out of the Houston Emergency Center, don't have access to the profiles.
Charles Dempsey, a Los Angeles Police Department detective who trains officers on how to interact with the mentally ill, said such "smart 911" systems are becoming more common nationally.
Dempsey said knowing about mental health issues and developmental disabilities can help first responders better plan their response to a 9-1-1 call. Officers often ask dispatchers for information they can't provide.
"Officers being armed with that additional information can make better decisions," said Dempsey, who joined the police force after working several years as a psychiatric nurse in the 1980s. "The more you know, the better the likelihood that you'll have good outcomes."
If no life-threatening situation, like an active shooter or a robbery in progress, needs to be immediately addressed, then officers can slow things down and put information to use, Dempsey said. However, he added, that all depends "on the willingness of the person to comply."
The detective gave a hypothetical example of how information from the emergency profile could help: A dispatcher gets a call from a family member about a person who was just released from the hospital, but the family member hangs up to go talk with the person.
The profile might say that while the person has a history of suicide attempts, the family does not keep a gun in the house. The profile could describe how the person reacts to uniformed police, which could lead officers to call for backup so one person can enter calmly and without a weapon at the ready.
As another example, a parent might describe an autistic teen who waves his arms as part of a coping mechanism called "flapping." That parent could make an emergency profile that associates that fact with the home address, the landline number and the teen's cellphone number. The 9-1-1 dispatcher then can pass along that information, possibly averting a situation where officers perceive the teen's motions as threatening. Even if officers have to handcuff the teen because of procedure or safety concerns, they might let him flap for a while before putting him in handcuffs.
Thomas Dunn, a University of Northern Colorado psychology professor who practices in a Denver hospital and has worked decades in emergency medical services, said the profiles could help EMS providers as well as police.
"I'm a big believer in the best predictor of future behavior is past behavior," Dunn said. Profile writers could include details about how to address family members' agitation. It could be as simple as making them take deep breaths or as serious as indicating which medication successfully calms them.
Along with personal information, the profiles could help dispatchers give more precise addresses to first responders.
Landline numbers are automatically associated with specific street addresses, Clausen said. Cellphone numbers are not, and those now account for 84 percent of emergency calls in the Houston area.
Wireless networks usually provide approximate GPS coordinates of a cellphone that calls 9-1-1—within 50 meters nine times out of 10, and often within 10 feet, the spokeswoman said. And, of course, callers can give details.
But the approximate location doesn't always yield an exact street address. The profiles might prevent a situation where paramedics have to go door-to-door on a residential street or floor-to-floor in an office building.
"More information is always better," said Dempsey, the LAPD detective.