Mobile Crisis Teams
The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Guidelines for Behavioral Health Crisis Care identifies mobile crisis teams (MCTs) as a core element of a crisis response system. When dispatched to a crisis, an MCT can de-escalate the crisis, administer medication (if necessary), establish rapport with the person in need, and connect them to appropriate treatment services.
MCTs typically consist of a nurse, social worker, and/or psychiatrist. However, due to mental health workforce shortages, it can be challenging to implement MCTs in rural areas. Rural mobile crisis teams require a unique composition to accommodate for workforce and financial limitations. For example, rural MCTs typically adopt a co-responder model in which one member of the team is a law enforcement officer. Alternatively, mobile crisis teams can consist of two non-clinical, non-licensed paraprofessional crisis intervention specialists, such as peer specialists or community health workers. These teams are supervised by a behavioral health provider and are trained to conduct mental health assessments, crisis interventions, de-escalation, suicide assessment and intervention, and follow-up.
Examples of Rural Mobile Crisis Programs
- In 2022, the Richmond Fire Department in Richmond, Indiana launched a mobile integrated health (MIH) program. The MIH team collaborates with law enforcement, firefighters, EMS, or other first responders in crisis response efforts. After a crisis, the MIH team follows up with the individual in need to connect them to community resources or treatment services. The MIH team also conducts outreach to provide resources to those in need.
- South Dakota's Virtual Crisis Care program aims to enhance collaboration between law enforcement and behavioral health professionals during a mental health crisis using virtual technology. When responding to a mental health crisis, law enforcement officers can provide the individual in crisis with a tablet to perform a video session with a crisis response team. The crisis response team then performs a safety assessment and offers follow-up recommendations to the person in need.
- In 2021, the Alabama Department of Health expanded the Alabama Crisis System of Care to include Mobile Crisis Teams (MCTs). The goal of this expansion was to improve access to crisis care for residents in rural Alabama and reduce the burden on emergency departments and law enforcement. The MCTs provide a variety of crisis response services including de-escalation, assessment, medical services coordination, counseling, and peer support.
Implementation Considerations
Although national guidelines encourage less reliance on law enforcement for crisis response, law enforcement officers are typically the first to respond to a mental health crisis in rural communities. To reduce the number of detained individuals with serious mental illnesses, rural communities may consider training law enforcement officers and jail staff in engaging, assessing, and assisting individuals experiencing a mental health crisis.
In addition, rural mental health programs may consider training and certifying peer support specialists, community health workers, clergy, and other community members to become crisis responders or part of a mobile crisis team. Crisis receiving and stabilization facilities, another key component of a crisis response system, are facilities that offer short-term care for people experiencing behavioral health crises. Law enforcement officers can bring individuals experiencing a mental health crisis to a crisis receiving and stabilization facility instead of arresting them or taking them to a psychiatric hospital. In rural areas, crisis receiving and stabilization facilities often face challenges like limited resources and staffing. Rural mental health programs may also consider training non-clinical mental health providers in crisis response to increase staffing at crisis receiving and stabilization facilities and improve access to care in these facilities.
Telehealth can significantly support or reduce the need for mobile crisis services. To better support crisis response, rural communities may consider equipping mobile crisis team members with internet-connected technology to connect individuals in crisis with a behavioral health specialist. Other technological enhancements such as live GPS tracking and coordination can ensure that the nearest mobile crisis team is dispatched to an individual in need. This technology can be costly and less feasible in rural communities where there is limited broadband connectivity. To offset costs and boost sustainability, rural mental health programs may consider sharing technological resources such as tablets, phone lines, and Wi-Fi.
Program Clearinghouse Examples
Resources to Learn More
How
to Successfully Implement a Mobile Crisis Team
Document
Provides an overview of a mobile crisis team, and offers tips and examples for various jurisdictions
intending to implement a mobile crisis team.
Organization(s) The Council of State Governments Justice Center
Date: 4/2021
Small & Rural Agency Crisis Response: A National Survey and Case Studies
Document
Findings from a national survey conducted by the National Police Foundation on rural communities and
their crisis response efforts.
Author(s): Davis, R.C., Lebron, M., & Reuland, M.
Organization(s): National Police Foundation
Date: 2022
Utah's
Crisis Worker Certification: Successes and Lessons Learned
Website
Describes Utah's Crisis Worker Certification program which was developed in response to the increasing
demand for mental health crisis services and need for a standardized crisis response system.
Author(s): Manz, J. & Mette, E.
Organization(s): National Academy for State Health Policy
Date: 6/2022