9-1-1: What it is and what it could be!

Heads up! I mention suicide and mental health concerns later in this blog! If that isn’t going to be a helpful thing for you, feel free to skip over the last paragraph of the recommendations!

Honestly, one of the first things I remember learning was my home phone number, my address, and how to call 911 in case of emergencies. As it was defined back in 1960’s when the function was first implemented, people wanted a centralized place to report fires. The US rolled out their system in 1968 and designed the phone number to be most easily dialed on a rotary phone. Since then, the conversation surrounding the use of 911 has evolved significantly. The service is now monitored by several thousand specially trained 911 operators, with calls covering truly every subject. My goal in this blog is to articulate the history and provide some recommendations and food for thought regarding the intended versus the actual use of emergency response services.

History

Prior to the existence of 911, a person was expected to know the numbers for their local fire department and police station if they were to ever experience a crisis. Honestly reading this, I realized how few numbers I actually know off the top of my head. For me personally, this included my elementary school best friend’s house phone, every home phone number I have ever had, and certainly none of my current emergency services. While I exclusively rely on 911, the roll out for the service took several years to become funded and supported by each municipality. As it currently exists, approximately 98.9% of people have access to use 911 (source) . This was due to the reluctancy to fund it and the mistrust in the service.

https://www.911.gov/about_national_911program.html

911 uses an enhanced program that matches the person’s phone to a specific address, through a database called the Automatic Location Identification alongside a Master Street Address Guide (MSAG). However, this process is used primarily for landlines. For mobile phones, 911 use a combination of radiolocation or GPS from the phone itself. Given the location tracking services generally available on cell phones, this is an easy dual use of the existing technology. With the addition of the Voice Over Internet Protocol (the use of internet and broadband services over traditional phone service) it has become harder to map out the location of callers as they are unable to trace any location. This is a prime example of the government’s inability to regulate this service has prevented any use of this service to enhance access or clarity for 911 callers.

Recommendations

As noted, there are currently gaps in the 911 system. I would recommend increasing access to ensure everyone has access to the emergency services. I would also recommend allowing text messaging or another form of instant written correspondence to eliminate the inevitable miscommunication of addresses and exact street names and enhance access to those who are deaf or hearing impaired. This service is currently available and being tested across the US, but still has glitches and cannot receive pictures or videos.

911 has also become a trusted and reliable service for people who are experiencing any kind of crisis, so it currently received calls for a variety of emergencies. As it currently exists, if a person is experiencing a crisis, we are all taught to call 911 to get help from one of three organizations: Law Enforcement, Emergency Medical Services, or Fire Fighters. Several or the things people call about fall outside of the purview of these services, so it can be difficult to determine who shows up and what their procedure is. Some of these things are responding to people experiencing homelessness, people experiencing a mental health crisis, or even responding to student disciplinary issues in schools.

In the past several years, many public incidents indicated a need for a reexamination of how crisis response is structured and performed in the US. Notably, the presence of law enforcement during what is objectively not safety-related is one example of a gap in expertise as well as being asked to perform a job outside of the traditional role of a police officer. Public officials worked alongside activists and community organizers to assess the current use of the system that alerts crisis response personnel and reallocate specific responsibilities to better serve all populations.

Instead, resources should be allocated to alternative solutions, aimed primarily at prevention and treatment rather than incarceration. One proposed solution is the implementation of 988 alongside 911 as a crisis response hotline. 988 was recommended for use in August 2019 as the national phone number to connect those experiencing mental health crisis and/or suicide ideation with trained counselors rather than law enforcement. I would recommend expanding these services to include a variety of alternatives with the last resort being incarceration, at the recommendation of the LA county working group’s research finds here.

My hope is this is a precursor to my next blog regarding campus crisis on call response, which I serve as a part of!

10 comments

  1. I recall when I pushed for the initiative to add mental health hotline numbers on the back of ID cards in undergrad, and it gained support pretty easily. Before you know it, all campus ID cards were re-issued the following week with additional information and resources for students to use when needed. 911 had been a hot topic as well, like you mentioned, who has time to call that long number in times of crisis. Why can’t we just dial another three digit number and connect to a representative? I wish I knew. I’d like to continue reading onto your next blog and draw parallels to this blog you’ve written. Thanks for bringing to this to our attention.

  2. Very interesting read! Personally, I have not thought too much about 911 before reading your blog. I am very surprised that texting 911 isn’t more common. For example, if someone was in a dangerous situation such as an home invasion, being able to text 911 as opposed to calling and revealing their location could be a matter of life and death. I would go step further and say being able to video call or facetime with 911 would be extremely beneficial. For instance, if someone was in need of CPR a 911 operator could ensure that the bystanders were performing the procedure properly until medical professions are able to arrive on the scene.

    I wonder why we are so behind the times? Billions of text messages are sent each day, I would imagine that we would have or be able to easily create the infrastructure to handle this.

    1. The video chat capability seems like such a crucial oversight, with the technology available for these emergency services to integrate. I would love to see the actual data behind how many 911 calls would have benefited from the operator being able to visually see the situation and either provide help or forward the call to a specialist on-call… especially when it comes to mental health emergencies. Just being able to gauge the urgency of the caller by their facial expression would probably provide 10x more information than operators are currently able to gather with only audio communication. Assuming operators were trained for these video-chat scenarios, seeing another person’s face on the line would also probably benefit someone in a mental health emergency, as it adds an extra layer of human interaction that could make the difference.

  3. I think this is a topic that is really easy for most people to overlook until they actually need emergency services. While effective, there is a considerable amount of room for improvement especially as society has evolved enough to recognize that there are many different types of crises’ that each may require different resources. I would have thought that by now we would have a centralized app that everyone knew of, just like the number. It’s encouraging that there are apps focusing on this as I found a couple just from a quick search, Smart911 being the one that looked the most useful although it seems to be geared towards families.

    I’ve only called 911 once before and it was about 5 years ago. There was a girl in the North End that was absolutely wasted, so wasted that there was no doubt in my mind that I needed to call 911 for her safety. The operator was incredibly rude and seemed to almost joke around about the situation while downplaying it. It left me absolutely furious. Police officers eventually came after a couple of other people stopped and called as well…there was a small group of people waiting for probably 45 minutes. It left me thinking that I maybe should have just looked up the number for an ambulance company and called them, but I thought that’s what 911 was for, the master connector. So much room for improvement.

  4. I wasn’t aware that the 988 hotline recommendation had been previously considered. So I certainly agree with you that 911 shouldn’t be clogged up with less important issues such as complaints of homelessness or student misbehavior at school. I believe that mental health crisis should remain on 911 because law enforcement should remain involved in those situations to deescalate the situation and protect the volunteer crisis responders (VCRs) that often accompany them.

    As a side note, incarceration is a product of the rule of law and due process. What it is not is a course of action that law enforcement can freely administer thanks to Habeas Corpus. If the LA County working group’s research were to be implemented there would be a lot of dead social workers and free criminals. Thankfully it has yet to do so and only has to experience free criminals and a homelessness crisis.

  5. I know there is also a 311 number for non-emergency phone calls in Boston. When I do a quick search I can see that each town can have its own way to deal with non-emergencies. It would be good to have a unified approach for this nationally for sure. I recently saw a movie (The Guilty), the whole movie took place in a 911 calling center, and this was the first time I realized that the operators don’t automatically know your location from the call! Here is the 311 site. Also saw that in Plano TX, there is a number of various non-emergencies that people can call. But again, having one number for non-emergencies would be super helpful
    https://www.cityofboston.gov/311/
    https://www.plano.gov/1534/Important-Phone-Numbers

  6. Shannon, fantastic blog! I wonder if you got your inspiration from the new Jake Gyllenhaal movie on Netflix called The Guilty. I don’t want to spoil the film for you or any readers, but I can tell you that the movie is about a 911 dispatcher. After watching that movie, I went straight to google to figure out what technology was available to contact 911. I was surprised that the technology is not great, especially providing the information to find a person’s exact location. Most of the time, they need to rely on the caller communicating their location, which can be challenging if someone is calling from an area they are not familiar with. Some counties’ are introducing your text recommendation, which I believe will be great when fully implemented. At the beginning of the semester, I Twittered about What3words, a company whose revolutionary technology allows people to find someone’s exact location by the three words that the app generates. What3words would be an excellent asset for the 911 system. Thanks for showing some light on this topic.

  7. Thanks for bringing up this topic. 911 is often under the radar until someone needs it or realizes they need to call the authorities but is not an emergency issue per say. I didn’t realize that the 911 system was a bit outdated, the TV show 9-1-1 definitely makes it look like they are much more sophisticated than they are. In your blog you also mentioned alternatives uses of 911 vs 988 and tend to agree that there are other services needed to address mental health crisis or social issues and I wonder if an alternative number would be the right solution.

  8. Really cool way of addressing such a helpful and useful tech service. Luckily, I’ve only had to use the 911 service a couple times, none of which for my use, but it can be so beneficial to save those crucial seconds in getting the help you need by reaching a dedicated person to help. This intrigues me because I wonder how tech will transform this over the next decade. I love that older people can use life alert buttons that can call 911, or that apple watch can auto contact 911 in the event of a fall, but I wonder how this service can go even further to help keep people safe!

  9. Well written and informative article. I had no idea people were expected to memorize local numbers to get help during an emergency, because the idea of “9-1-1” seems so simple. One advancement would be to move from actually dialing in to having an app or method to call for help via your phone or desktop. Perhaps there’s already something like this in-progress, but there’s certainly use cases where hitting that help button vs having to call in would expedite. Many cars have a similar button installed for roadside services.

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