“I think every city should have a HEART”: Neighbors’ reflections on the Holistic Empathetic Assistance Response Team (HEART) program and police in Durham, NC
Through interviews with service users in Durham, NC, this study finds that while the community highly values the Holistic Empathetic Assistance Response Team (HEART) as a trusted alternative to police for crisis intervention, participants emphasize the need for expanded program visibility and scope alongside a broader realignment of social services to better support neighbors in crisis.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In many American cities, when a neighbor is in crisis—perhaps experiencing a severe mental health episode, facing homelessness, or struggling with a behavioral health emergency—the default response is often the police. This happens because community resources are scarce, and the 911 system is the most visible tool people have to ask for help. However, bringing law enforcement into these situations can sometimes make things worse, particularly for Black and Latino individuals or those with mental illness, increasing the risk of injury, arrest, or incarceration. In recent years, cities have begun testing a different approach: sending unarmed teams of social workers, medical professionals, and peer supporters to handle these calls instead. These alternative response programs aim to de-escalate tension and connect people to care without the threat of force. The central question for researchers and communities alike is whether these new models actually work, how the people they serve feel about them, and what role, if any, police should still play when a crisis strikes.
A team of researchers from Duke University set out to answer these questions by listening directly to the people who have used a specific program in Durham, North Carolina, called the Holistic Empathetic Assistance Response Team, or HEART. This program, launched in 2021, operates as a branch of the city's Community Safety Department. It is designed to handle calls that do not involve immediate physical violence, such as welfare checks, trespassing, or suicide concerns. The HEART model includes several layers of support: clinicians who can de-escalate situations over the phone, unarmed field teams that include mental health experts and emergency medical technicians, and a care navigation service that helps people find housing, jobs, and other resources after an encounter. The researchers conducted in-depth interviews with 22 community members who had interacted with HEART, many of whom were experiencing homelessness or had previous encounters with the criminal legal system. Their goal was to understand the lived experience of receiving help from this new type of first responder.
The findings reveal a deep sense of trust and relief among the participants. Almost everyone who spoke with the researchers described their interactions with HEART staff as positive, calm, and humanizing. Unlike traditional police encounters, which can feel threatening or dismissive, HEART responders were described as compassionate listeners who treated people with dignity. One participant noted that simply seeing a HEART responder during a crisis felt like being "lifted up." Beyond the emotional support, the program provided tangible, life-sustaining aid. Many participants recounted receiving food, clothing, hygiene kits, and even tents and sleeping bags from the program's office. For some, these supplies were critical; one person described a snack received while homeless as the only meal they had for days. The program also successfully connected individuals to schools, job leads, and shelter waiting lists, acting as a bridge to stability that many felt the police could never provide.
Despite this overwhelming support, the participants offered clear and specific suggestions for how the program could grow. A recurring theme was the desire for HEART to have a more permanent and visible presence in the community. While the program is currently housed inside City Hall, some participants felt it should have its own building to feel more accessible and safe. Others suggested that the program should expand its hours to be available around the clock, noting that crises do not adhere to a nine-to-five schedule. There was also a strong call for the program to address the root causes of crisis, particularly the lack of affordable housing. Participants expressed a desire for HEART to do more than just distribute supplies; they wanted the program to actively help secure housing and provide mobile showers or employment assistance. The sentiment was so strong that several participants stated that every city in the country should have a program like HEART, viewing it as a vital resource that fills a gap left by the traditional safety net.
The study also uncovered a complex and nuanced relationship between community members and the police. While participants overwhelmingly preferred HEART for non-violent situations, their views shifted when they considered scenarios involving potential violence. When asked to choose who should respond to a hypothetical domestic violence call, a verbal argument, or a physical confrontation, many participants still selected a police response or a team that included both HEART and police. This was not necessarily because they liked the police, but because they believed police were better equipped to handle situations where weapons might be involved or where the situation could escalate quickly. Some participants felt that the presence of an officer could deter violence, while others saw the police as a necessary backup if a situation spiraled out of control. However, even in these cases, many expressed a preference for HEART to take the lead in de-escalation, with police standing by only if absolutely necessary. This suggests that while the community wants to move away from police-led crisis response, they do not necessarily want to eliminate police involvement entirely in high-risk scenarios.
The researchers concluded that alternative responder programs like HEART are a powerful tool for keeping people out of the criminal legal system and connecting them with the care they need. The study highlights that these programs work best when they are part of a broader, well-supported social service ecosystem that can address deep structural issues like housing and employment. The participants' feedback indicates that while they are grateful for the current services, the program's potential is limited by a lack of resources and visibility. The findings suggest that for these models to truly succeed, they need to expand their scope, operate around the clock, and maintain a clear separation from law enforcement while still having a plan for safety when violence is a genuine risk. Ultimately, the study paints a picture of a community eager for a different kind of first response—one that prioritizes empathy and connection over punishment, but one that still requires a thoughtful approach to safety and structural support.
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