What are Crisis Response Programs?
Crisis Response Programs are designed to function as alternative response to law enforcement for individuals facing immediate mental health crises. These programs are staffed with unarmed mental health professionals who respond to non-violent calls for service and emphasize de-escalation and connection to long-term crisis prevention services for those in need (Blueprint for Change 2, 2022). Teams respond in groups ranging in size from 1-4 individuals and can be staffed with a combination of mental health professionals, medical workers, peer specialists and case managers to provide necessities including food, clothing, basic first aid, or simply someone to talk with and listen. Crisis Response Programs can be referred to as Mobile Crisis Response Teams, Alternative Response Teams, Community Response Programs to name a few (Bowers, 2023).
how does a crisis response work?
What kind of Crisis?
Symptoms may include paranoia, mood swings, hallucinations, multiple days of sleep deprivation, or threats of violence.
2) Substance abuse-related issues
This includes public disturbances associated to homelessness.
4) Non-violent
Crisis responders call for armed law enforcement backup if an individual is armed or immediately violent.
Services commonly offered
Crisis response teams respond to the immediate needs of community members and connect people facing mental health or substance abuse-related challenges with resources to support their long-term wellbeing.
Crisis response teams de-escalate and stabilize situations onsite, providing evaluations and assessments in order to determine the most effective method of intervention.
Crisis response teams can drive individuals to appointments or diversion centers. Transportation services are voluntary.
Call Comes in
Calls for service may be received through 911 or an external hotline, depending on program design.
1) 911
911 call takers ask additional questions incorporated into their standard call triaging process to determine calls appropriate for crisis response teams.
1a) Embedded Mental Health Professionals
Calls are still received through the 911 system, but 911 call takers can connect callers with mental health workers who can speak directly to callers and connect them to services.
2) Hotline
Calls for service are received, and resources are dispatched through a separate number and system than 911.
Diverting from
Team response
Crisis response teams operate in groups and arrive on-scene in stocked vans.
Typically a team of 2-4 responders with a combination of mental health workers, medics (paramedics or EMTs), peer specialists, and case managers arrives in a van commonly equipped with basic first aid, clean clothing, fidget toys, and snacks. They do not use lights or sirens during a crisis response.
diverting to
Crisis/triage centers provide voluntary resources such as mental health and substance abuse services for those in need.
Most recovery centers provide walk-in no refusal intensive support services.
Diversion centers are most commonly privately owned and do not have direct partnerships with the crisis response programs within their jurisdictions.
OVERVIEW
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Since deinstitutionalization in the 60s, people with mental health and substance abuse conditions have been diverted into the criminal justice system, which is not equipped with the proper resources for treatment. Crisis Response Programs link people to necessary services including sobering houses, residential treatment facilities, and crisis centers, which provide varying levels of supervision by mental health professionals, along with medical, therapeutic, and peer-support services. Source.
At most, police officers receive a mere 40 hours of Crisis Intervention Training (CIT). While this training does increase individual officer knowledge of and attitudes towards mental illness, it has not proved impactful in reducing arrests or violence. Between 2015 and 2024, 20% of individuals killed by police were suffering from a mental illness crisis. Crisis Response Programs combine the expertise of mental health professionals, medics, and peer specialists, making them most effective at de-escalation and diversion of those with mental health conditions, substance abuse issues, or developmental disabilities. Source 1. Source 2. Source 3.
· Crisis Response Programs continue to expand services beyond initial crisis management. San Francisco's Street Crisis Response Team designated a separate follow-up unit staffed by behavioral health clinicians, who link individuals to continued care and support. Peer specialists are also vital to the growth of crisis services, as they can build more friendly relationships with individuals, serving as an important support system in recovery. Source 1. Source 2
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· Crisis Response Teams struggle to balance expansion of their services with timely reactions. In Chicago, CARE expansion of coverage to include the downtown area was associated with a significant increase in the time required to arrive on scene. On average, CARE’s response time was double that of the Chicago Police Department. Additionally, more clarity around where these teams are dispatched from would aid in improvement of response times.
·Effective Crisis Response requires the buy-in of 911 dispatchers, who must undergo a “cultural shift” away from police as the default. Adding new services and requirements increases the burden on dispatchers, who may be hesitant to divert calls to Crisis Response Teams out of concern for liability.
·Police may be threatened by the loss of duties when more qualified service providers. In 1960s Pittsburg, Freedom House Ambulance Services was created to serve the predominantly Black neighborhood of Hill District, which had experienced mistreatment and neglect by police emergency services. Police responded aggressively and defensively, refusing to forward calls to the community-run EMS service, and threatening paramedics who tried to intervene in harmful police-led medical practices.
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·It is recommended that traditional police departments are restructured into a new public safety department, with Crisis Response Programs within. Establishing Crisis Response as a separate public safety department equal to police ensures both legitimacy and longevity.
·The field of 911 requires expansion for continued success. 911 dispatchers should be recognized as first responders, given the vital role they play in public safety. The field should be professionalized through high quality training and career tracks within higher education. It’s also recommended that 911 is established as and “independent and equal” organization – it can be difficult to prioritize linkage to community services when 911 is subordinate a police or fire department.
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In Ithica, NY and Brooklyn Center, MN, policing and community response have been integrated into new safety departments. In Ithica, the Community Safety Department features ‘community safety’ and ‘community solutions’ teams – both of which are unarmed 1st responders trained to handle varying levels of police-like calls. Police services are diverted to solely serious public safety threats. In Brooklyn Center, the Department of Community Safety and Violence Prevention contains community response, police, fire, and traffic as equal organizations.
https://drive.google.com/file/d/1adLHJwQeaaUf2WGaiZCgllqSEpa425Ma/view
Houston established a sobering center in 2010, a "grassroots" solution to public intoxication. Officers could admit people to the center as an alternative to legal action, and individuals received aid from psychiatric technicians and peer supporters. From 2012-2017 jail admission for public intoxication declined by 95%, and savings were evident, as treatment at the sobering house cost the city half the amount of jail admission.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6417567/
Eugene’s former CAHOOTS program, the first community responder model in the country, saw widespread success in police diversion. In 2019, out of 24,000 calls handled by CAHOOTS, only 311 (0.01%) needed police backup. Overall, CAHOOTS addressed 20% of calls made to the city’s public safety communications center.
So far, these programs rarely need to call for police backup.
There have been no known major injuries of any community responder on the job so far, according to experts. And data suggests unarmed responders rarely need to call in police. In Eugene, Oregon, which has operated the Crisis Assistance Helping Out On The Streets (known locally as CAHOOTS) response team since 1989, roughly 1% of their calls end up requiring police backup, according to the organization. Albuquerque responders have asked for police in 1% of calls, as of January. In Denver, the Support Team Assisted Response (STAR) team had never called for police backup due to a safety issue as of July 2022, the most recent data available. In Durham, members of the Holistic Empathetic Assistance Response Team (HEART) reported feeling safe on 99% of calls.