Community-Based Mental Health Crisis Services

October 2019

When people experience a mental health crisis (e.g., has suicidal thoughts, symptoms of psychosis, or relapse of substance use), they often seek assistance from mental health crisis services. Psychiatric Services has published several seminal studies regarding crisis services, as highlighted in this month’s Editor’s Choice.

The first three articles in this collection detail how crisis services have been prioritized by state and federal policy makers as a response to system pressures such as emergency department boarding of psychiatric patients and limited psychiatric inpatient bed capacity. Subsequent articles are organized by service models described in the 2016 National Action Alliance for Suicide Prevention’s Crisis Services Task Force report, “Crisis Now: Transforming Services is Within Our Reach.” In a comprehensive crisis system, community-based services can be utilized as a continuum of care; whereas some crises will resolve with a phone call to a crisis call center, others will require mobile crisis team dispatch, and a minority will require further escalation to a crisis facility with services such as 23-hour observation, short-term respite, or longer-term crisis residential services. Access to these services relies on collaboration with law enforcement through models such as the crisis intervention team, which are described in the last section of the collection.

Matthew L. Goldman, M.D., M.S.
Lisa B. Dixon, M.D., M.P.H.

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Capacity Issues and the Role for Crisis Services

Correlates of Length of Stay and Boarding in Florida Emergency Departments for Patients With Psychiatric Diagnoses
Joseph L. Smith, M.P.H., Alessandro S. De Nadai, M.A., Eric A. Storch, Ph.D., Barbara Langland-Orban, Ph.D., Etienne Pracht, Ph.D., John Petrila, J.D., LL.M.
2016, Volume 67, Issue 11, pp. 1169–1174


In response: Emergency Department Boarding: Nowhere Else to Go
Marvin S. Swartz, M.D.
2016, Volume 67, Issue 11, p. 1163


In response: Alternatives to the Emergency Department
Margaret E. Balfour, M.D., Ph.D., Chris A. Carson, M.D., M.B.A., and Robert Williamson, M.D.
2017, Volume 68, Issue 3, p. 306

Crisis Call Centers

Trainer Fidelity as a Predictor of Crisis Counselors’ Behaviors With Callers Who Express Suicidal Thoughts
Wendi F. Cross, Ph.D., Tian Chen, Ph.D., Karen Schmeelk-Cone, Ph.D., Xin Tu, Ph.D., Marjorie Kleinman, M.S., Madelyn S. Gould, Ph.D., M.P.H.
2017, Volume 68, Issue 10, pp. 1083–1087


Increases in Demand for Crisis and Other Suicide Prevention Services After a Celebrity Suicide
Rajeev Ramchand, Ph.D., Elan Cohen, M.S., John Draper, Ph.D., Michael Schoenbaum, Ph.D., Dan Reidenberg, Psy.D., Lisa Colpe, Ph.D., M.P.H., Jerry Reed, Ph.D., Jane Pearson, Ph.D.
2019, Volume 70, Issue 8, pp. 728–731

Also featured in the Suicide Prevention, Part 1: Identifying and Predicting Risk, Vulnerable Populations, Public Perceptions, and Priority Settings collection.

Featured in our Alexa Flash Briefing, Psychiatric News Brief.

Mobile Crisis

A National Survey of Mobile Crisis Services and Their Evaluation
Jeffrey L. Geller, M.D., M.P.H., William H. Fisher, Ph.D., Melissa McDermeit, M.S.W.
1995, Volume 46, Issue 9, pp. 893–897


Evaluation of a Mobile Crisis Program: Effectiveness, Efficiency, and Consumer Satisfaction
Roger L. Scott, L.C.S.W.
2000, Volume 51, Issue 9, pp. 1153–1156


Assessing the Impact of Community-Based Mobile Crisis Services on Preventing Hospitalization
Shenyang Guo, Ph.D., David E. Biegel, Ph.D., Jeffrey A. Johnsen, Ph.D., and Hayne Dyches, Ph.D.
2001, Volume 52, Issue 2, pp. 223–228


Impact of Mobile Crisis Services on Emergency Department Use Among Youths With Behavioral Health Service Needs
Michael Fendrich, Ph.D., Melissa Ives, M.S.W., Brenda Kurz, Ph.D., Jessica Becker, M.S.W., Jeffrey Vanderploeg, Ph.D., Christopher Bory, Psy.D., Hsiu-Ju Lin, Ph.D., Robert Plant, Ph.D.
2019, Volume 70, Issue 10, pp. 881–887

Crisis Facilities

A Randomized Trial of Short-Term Acute Residential Treatment for Veterans
William B. Hawthorne, Ph.D., Elizabeth E. Green, Ph.D., Todd Gilmer, Ph.D., Piedad Garcia, Ed.D., Richard L. Hough, Ph.D., Martin Lee, Ph.D., Linda Hammond, Ph.D., and James B. Lohr, M.D.
2005, Volume 56, Issue 11, pp. 1379–1386


Clinical and Cost-Effectiveness of Acute and Subacute Residential Mental Health Services: A Systematic Review
Kerry A. Thomas, B.Sc.(Psych.), B.Soc.Sc.(Psych.), and Debra Rickwood, Ph.D., B.A.
2013, Volume 64, Issue 11, pp. 1140–1149


The Effectiveness of a Peer-Staffed Crisis Respite Program as an Alternative to Hospitalization
Ellen E. Bouchery, M.S., Michael Barna, M.A., Elizabeth Babalola, M.P.H., Daniel Friend, M.S., Jonathan D. Brown, Ph.D., Crystal Blyler, Ph.D., Henry T. Ireys, Ph.D.
2018, Volume 69, Issue 10, pp. 1069–1074

Also featured in the Peer Support collection.

Law Enforcement Collaboration

The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers’ Knowledge, Attitudes, and Skills
Michael T. Compton, M.D., M.P.H., Roger Bakeman, Ph.D., Beth Broussard, M.P.H., Dana Hankerson-Dyson, M.P.A., M.P.H., Letheshia Husbands, B.A., Shaily Krishan, M.P.H., Tarianna Stewart-Hutto, M.S., Barbara M. D'Orio, M.D., M.P.A., Janet R. Oliva, Ph.D., Nancy J. Thompson, Ph.D., M.P.H., and Amy C. Watson, Ph.D.
2014, Volume 65, Issue 4, pp. 517–522


The Police-Based Crisis Intervention Team (CIT) Model: II. Effects on Level of Force and Resolution, Referral, and Arrest
Michael T. Compton, M.D., M.P.H., Roger Bakeman, Ph.D., Beth Broussard, M.P.H., Dana Hankerson-Dyson, M.P.A., M.P.H., Letheshia Husbands, B.A., Shaily Krishan, M.P.H., Tarianna Stewart-Hutto, M.S., Barbara M. D'Orio, M.D., M.P.A., Janet R. Oliva, Ph.D., Nancy J. Thompson, Ph.D., M.P.H., and Amy C. Watson, Ph.D.
2014, Volume 65, Issue 4, pp. 523–529


The Tucson Mental Health Investigative Support Team (MHIST) Model: A Preventive Approach to Crisis and Public Safety
Margaret E. Balfour, M.D., Ph.D., Jason M. Winsky, B.A., and Jill M. Isely, B.A.
2017, Volume 68, Issue 2, pp. 211–212


Specialized Police-Based Mental Health Crisis Response: The First 10 Years of Colorado’s Crisis Intervention Team Implementation
Hari-Mandir K. Khalsa, M.S., Attila C. Denes, M.B.A., Diane M. Pasini-Hill, M.A., Jeffrey C. Santelli, M.S., Ross J. Baldessarini, M.D.
2018, Volume 69, Issue 2, pp. 239–241

Also featured in the Mental Health Criminal Justice Diversion collection.

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