When someone calls 9-1-1 in mental health crisis, what happens next matters

The opening scenario is a fictionalized composite inspired by the real experiences. It does not represent any specific individual.

It is 2 a.m. on a Tuesday. A person sits alone in their apartment, the city quiet outside their window. They have been struggling for weeks: with loss, with isolation, with thoughts that have grown darker than they can manage on their own. Tonight, something has shifted. They need help. They reach for their phone.

They dial 9-1-1. It is the only number they can think of. It is the number we all grow up knowing.

The call connects, and the dispatcher on the other end is professional, caring, and doing their job well. But their job is built for emergencies of a different kind: fires, accidents, medical crises requiring immediate physical intervention. A person in psychological distress, alone at 2 a.m., needing someone to talk them through the night, that is not a gap in the dispatcher’s compassion. It is a gap in the system.

A police unit is sent. It is the available response. It is not always the right one.

When someone calls 9-1-1, they have three choices: police, fire, or ambulance. For a person experiencing a mental health crisis or having thoughts of suicide, none of these may be the right first response. And yet, right now in British Columbia, there is no other pathway.

The Crisis Centre believes that must change.

We are advocating for a fourth option within 9-1-1: a dedicated pathway that connects people in crisis directly to trained crisis line responders when police, fire, or ambulance is not the most appropriate first response. Not as a replacement for emergency services, but as the right response for a different kind of emergency.

A practical, proven pathway for crisis response

The Crisis Centre’s crisis lines already resolve the vast majority of calls without any need for police or ambulance dispatch. Only 0.28% of calls to the Centre from Provincial crisis lines require an in-person dispatch. This extremely low number is a sign that what we do is working.

Crisis responders listen, de-escalate, assess risk, and connect people to supports, often helping someone through the hardest moment of their life without a single vehicle being dispatched. A fourth option within 9-1-1 would extend that kind of response to more people, through the system they already know how to reach.

We aren’t alone in this work

Ecomm 9-1-1 and the Canadian Mental Health Association of BC are also working towards better options for people in emotional and mental health crisis. Building a fourth option requires bringing emergency response, crisis response, and community-based mental health into an integrated system. It is complex work, and it will take time. But the need is clear, the evidence is strong, and the conversations are taking place. We will keep making the case until the right response is available to everyone who needs it.

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Crisis lines are available across British Columbia 24 hours a day, 7 days a week. If you or someone you know needs help, please call:

• 9-8-8 (call or text)
• 310-6789 (no area code needed)
• 1-800-SUICIDE / 1-800-784-2433
• 604-872-3311