In medical emergencies, house fires, or other dangerous situations, most Americans understand to call 911 for immediate help from a call specialist. The dispatcher will talk someone through a tough situation and may coordinate first responders to head toward the emergency.
But according to a new report and a former 911 specialist, employees who take those stressful calls may experience significant mental health challenges that lead to depression, anxiety, and burnout.
Some 911 specialists are leaving the job entirely due to the stress, which means there might not be enough people available to help callers through emergencies when time is of the essence.
The National Emergency Number Association, a nonprofit 911 association, recently released a 2023 State of the Industry survey, which sampled employees from 911 call centers across the United States to gauge how staff handle the pressures of 911 calls. And the results are troubling.
The report notes that symptoms of burnout and mental health issues are common among center administrators and call dispatchers.
The survey sampled call centers from all over the United States, with 1.55% of all respondents reporting out of Maryland.
According to the report, only 13% of call center workers said they had not experienced symptoms of burnout within the last six months. That includes 91% of respondents who were dispatchers and 90% of call center supervisors.
Of those who responded to the survey, 70% reported experiencing fatigue within the past six months. About 56% said that they've experienced anxiety.
"The job of a 911 specialist is oftentimes extraordinarily stressful," said Sue Greentree, a retired 911 call specialist for Anne Arundel County.
"You're the first person a caller will reach during an emergency. You have to remain calm to get all the information you need that will be the right help while also trying to talk to the caller, get units started, and ensure they're safe."
Greentree started as a call specialist in 1984 and retired in 2020. She is also a part of the Maryland 911 Board, which works to enhance 911 operations in the state.
She noted that sometimes 911 specialists have to coach callers through medical situations and give instructions on CPR, walk through first aid procedures, or even talk through delivering a baby.
"You never know what's coming. And when you hang up the phone — when you finish triaging it, and units are on location — when the phone rings, you will answer the next one."
In addition, the stress level among 911 specialists is probably worse than when she started back in the 80s, she said.
"The world was very different. We didn't have an extraordinary call volume. We didn't have the shootings…the constant overdoses, and a lot of things like that," Greentree said.
The NENA report says that 38% of respondents who work at a 911 call center nationwide feel inadequately trained to handle an active shooter situation. About 25% said they felt inadequately trained for someone experiencing a mental health crisis. Only 44% of respondents felt adequately trained to handle most 911 calls.
And similar to the findings of the NENA report, Greentree said that the stress of the job could lead to people leaving the profession sooner.
"A lot of people are done in five, maybe eight years, and they're like, 'I can't do this anymore,'" she said.
Sen. Cheryl Kagan (D-Montgomery) has sponsored more than a dozen successful bills to bolster the 911 system in Maryland.
She said that when there are not enough specialists to work in 911 call centers, people in crisis may not get the emergency services they need when needed.
"Three people in my district have died when 911 has failed," Kagan said. "And nobody ever thinks about 911. They take it for granted that when they need police, fire, or paramedics, they dial three digits, and help is on the way. That is only possible with sufficient numbers of dedicated, well-trained 911 specialists to accommodate the demand."
She noted that part of the concern facing 911 specialists is high call volume.
Kagan said that because so many people now have individual phones, sometimes multiple calls about the same emergency event will occur.
She also noted the importance of two other three-digit call lines. The first is 988, implemented nationwide last July and intended to handle calls for people facing a mental health crisis or considering suicide.
Training, and the addition of the 988 line, might help assist the 25% of 911 specialists who feel unsure of how to handle a mental health event, 12% who feel inadequately trained for disorderly persons or conduct situations, or 19% who do not feel trained to handle civil disturbance cases.
Kagan also highlighted the 311 line, available in Baltimore and the counties of Anne Arundel, Baltimore, Montgomery, Prince George's, and St. Mary's. The 311 line is aimed at helping people handle non-emergency situations with available government services.
"Too often, people can't navigate government. They don't know who to call. They get frustrated. So, they call 911… You still want government help, but it's not 911," Kagan said.
Greentree, the retired 911 specialist, said that 911 specialists need good training and mental health wellness to help ease staffing shortages among call centers. But she also said that recognition for 911 specialists' work can also help.
"The 911 specialists are a part of the same team as police officers, firefighters, and paramedics. I think that recognition could go a long way," she said.
And despite 911 callers' stresses, only 9% of respondents said they strongly do not enjoy their work, according to the NENA report.
"I loved my job," Greentree said. "I mean, I didn't love every day of it, but I did love my job, and I still feel very good about the job that I did."
"It's a very emotional job…and the people who do that job are incredibly dedicated to it," she said. "As emotional as that job is, as hard as it is sometimes…most people say 'I love my job. I love what I do.'"
Editor's note: This story has been updated to include St. Mary's County in the list of counties that maintain 311 service.
This article was originally published on MarylandMatters.org and is republished with permission.
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