Preparedness & Recovery

Homeless Crisis, Mental Health Problems Just a Couple Issues That Tie Up Fire Department

Seattle Fire Department looking for solutions to help with the 79,000 EMS response calls.

by Jim McKay / February 9, 2018
Joseph Nalty, a 64-year-old homeless man who grew up in Iowa, dampens his hat to cool off in the Waterfront Park area of Seattle on Thursday, Sept. 28, 2017. A homeless crisis of unprecedented proportions is rocking the West Coast. AP/Jae C. Hong

Traditionally, 911 calls to fire departments were for a fire or a life-threatening emergency. A lot has changed over the last few decades, and in Seattle as well as nationally, fire departments have become, in the words of Seattle Fire Chief Harold Scoggins, the first line of the health-care system.

The 911 system has “evolved” for a multitude of reasons, one being technology, into a public solution to an increasing number of incidents and situations, including a homeless crisis and mental health. In Seattle, of the 97,000 911 calls made annually, 79,000 will be for a health-care situation, according to Scoggins.

It’s become overwhelming and fire departments nationally are trying to figure out how to keep up with all the demands being put upon them. Some departments have added hazmat teams, nurses, technical teams, EMS as a formal service and more.

“Locally, we deploy social workers as part of our team,” Scoggins said. “We haven’t been able to keep up with all that’s coming in. Nationally, we’re in a strange place and just trying to figure it out.”

Technology plays a role. It’s easy now, if there’s a homeless person lying on the sidewalk or someone who looks as if they need mental help, to pull out the cellphone and call 911. “In the early days of 911 it didn’t happen that much,” Scoggins said. “People stood around, they didn’t have cellphones.” He said they might go to a landline, then went back to the person needing help to make sure responders could actually help.”

Now people don’t stop but will make that call. “As technology has evolved it’s become very easy for us humans to feel like we’re doing the right thing as long as we make a call. That’s okay, it’s not a bad thing, it’s where we are today.”

The call load is a challenge and there are increasingly more challenges as fire departments have had to evolve as society changes. There’s more mandated training to incorporate best practices, there’s more equipment being used by firefighters and it’s different than it used to be; it’s less mechanical and more electronic and more complicated.

And society’s homelessness and mental health problems have certainly contributed. The Seattle fire department has just added a new feature where it will be tracking the homeless and mentally ill. “We’ll know where we’re going and who we’re seeing as far as people living on the streets under the freeways that we may not have been seeing five or 10 years ago and how that affects us,” Scoggins said.

He said the homeless problem compounds the problem of using 911 as the first line of health care. “If you’re living on the street and have an illness, it quickly becomes a chronic illness, because of the lack of care, so the needs of our services automatically grow,” Scoggins said. “If you have a mental health or substance abuse issue that’s going to be magnified also.”

Scoggins is working with the City Council to try to find solutions to calling 911 for a homeless person. One potential solution is hiring a 911 dispatcher with medical credentials to help by perhaps sending an advocate, such as someone from the sober vans service to help the person instead of sending fire or EMS. Another is to incorporate knowledge of homelessness and what to do with a homeless call among 911 dispatchers.

Jim Vollendroff is division director of King County Behavioral Health and Recovery. He says one possibility is creating an alternative line to 911, but it could be hard to get the public to buy into that.

“We have a lot of resources we’re deploying,” Scoggins said. “We just have to hit the combination right.”