Is it time to incorporate mental health calls into BC's 911 system?

Content warning: This story contains references to suicide and mental health challenges. If you or someone in your life is having thoughts of suicide, you can call or text 988 for help. For support through a mental health crisis, you can also call 310-6789 (no area code needed). 

Fire. Ambulance. Police. Those are the options you get when you call 911, the emergency line that is perhaps the most well-known phone number in North America. But for someone experiencing a mental health crisis or having thoughts of suicide, those three core emergency services usually aren’t the most effective or efficient means of intervention. 

One of the main organizations that provides over-the-phone assistance to people during a mental health crisis is advocating for a fourth 911 option to be added that could quickly and directly connect them with those callers. 

Stacy Ashton is the Executive Director of the Crisis Centre of BC, a charity based in Vancouver that provides 24/7 support for people across the province, and even nationwide, who are experiencing mental health distress and crisis. 

“We know that a lot of those [mental health crisis] calls could be handled over the phone,” Ashton told Vancity Lookout. Currently, these types of calls usually default to police services, which is expensive, often unnecessary, and can be counterproductive, Ashton explained. 

“About 99 per cent of our calls we handle through a conversation with the person… so you're diverting folks away from a police intervention or a hospital intervention that just wouldn't be necessary,” Ashton said, whereas 911 services are currently focused on dispatching someone to the caller. 

If crisis services like Crisis Centre of BC were integrated into the 911 system, they could dispatch a mental health team in those infrequent instances where an in-person response was required, Ashton said. 

On a local level, taking an alternative approach to divert some of these mental health calls away from police is something Vancouver has been experimenting with over the past two years.

Since 2023, the city has provided approximately $11.5 million in grant funding to Vancouver Coastal Health (VCH) for programs addressing urgent mental health and substance use situations. One of those is the Mobile Crisis De-Escalation Team (MoDe), which VCH created to provide urgent in-person mental health crisis response without police involvement. 

The MoDe teams include nurses, physicians, social workers, care coordinators, and mental health clinicians who provide assessment, intervention, and support to people who are in a non-violent mental health crisis. 

It’s an approach that’s seen success in diverting people away from emergency services, according to Vancouver Coastal Health. Following interactions with a MoDe team in 2024, there was a 38 per cent reduction in emergency room visits. “What we’re seeing is this is a very effective model,” Ashton said. “It works in Vancouver. It will work in other communities.”

However, people can only be referred to MoDe through certain groups, like supportive housing and shelter operators, community service providers, public libraries, and the Vancouver Police Department (VPD). 

The city funding has also allowed VCH to add nurses to the VPD’s command centre, who can divert mental health calls away from police when appropriate. In the first half of 2025, that program resulted in an estimated average of 10 calls per day being diverted. 

The MoDe program also led to a 35 per cent reduction in referrals to the Car 87/88 program, a response team that includes both a police officer and a mental nurse.  

Additionally, the funding enabled VCH to establish an Indigenous Crisis Response Team in 2024, similar to MoDe, but focused on providing culturally appropriate care for Indigenous clients. 

Continued funding for VCH’s suite of programs in 2026 will be considered by city council as part of its social policy grants later this year. 

Need for an overhaul

More broadly, the current 911 system in BC is in need of change. As it stands, local governments in BC are responsible for providing 911 services, and an overwhelming majority of them use E-Comm, a non-profit organization that handles 99 per cent of 911 calls in the province. 

“Municipally-funded 9-1-1 services in B.C. face a number of pressures, including growing call volumes, necessary and costly technology improvements, and coverage gaps in parts of the province… a new solution is urgently needed,” according to E-Comm 911’s website. The City of Vancouver noted in its proposed 2026 budget that rising E-Comm fees are one of the many financial pressures the city is currently facing.

But complaints about unpredictable and non-transparent fee increases for E-Comm’s services prompted the province to commission a pair of independent reviews of the service, which were released last week. The reviews made over two dozen recommendations for E-Comm to improve its governance and budgeting practices, while highlighting the need for the province to clearly define its role in emergency communications. 

The review presented a variety of options to move forward, but recommended that the province manage E-Comm or other emergency response services through legislation, which would standardize 911 service levels and cost throughout BC.

“While most actions fall to E-Comm, successful implementation will require collaboration among the Province, local governments, public safety agencies, and E-Comm,” the review concluded. 

For Ashton with Crisis Centre of BC, the review creates new opportunities to integrate mental health services, like the ones they or Vancouver Coastal Health provide, into a new version of the 911 service.

“Now would be the time to start to embed that in, because we're opening up the whole structure now and rebuilding it essentially from scratch,” Ashton said, who noted the Crisis Centre has already been in conversation with E-Comm for several years about integrating their services together.  

While E-Comm has said it will act on the recommendations as soon as possible, the province has not committed to the approach it will take on emergency dispatch services moving forward.

“The priority is for E-Comm to strengthen its financial and operational efficiencies, as well as governance practices, to get a clear picture of the true cost of service and to help ensure that costs to local governments remain sustainable,” the province said in a press release.  

“[I] think it's inevitable [to have a fourth 911 option for mental health resources], because police and ambulance are just such an expensive tool to use for mental health crises,” Ashton said.