A Comparison of Behavioral Health Crisis Response Models in Meeting Behavioral Health Goals and Improving Criminal Legal Diversion.

Abstract

Various behavioral health crisis models have been developed to advance the shared goals of improving behavioral health outcomes and increasing diversion from criminal legal systems. The effectiveness of these models is promising, yet research is needed to understand their comparative advantages. This study compares the effectiveness of three community mental health response models-co-response, mobile response, and office-based response-and law enforcement-only response in addressing key behavioral health and diversion goals. These goals include improvements to follow-ups, service linkages to community resources, crisis de-escalation, and dispositions (i.e., decreasing hospitalizations and arrests). Five partner sites in Michigan provided administrative data on crisis cases and outcomes. The sample included crisis cases from one office-based model (n = 91), two mobile response models (n = 306), and two co-response models (n = 322), along with data from the partnering law enforcement agencies at each site (n = 669). Results show that model type is associated with all key outcomes. Mobile response effectively met all examined crisis response goals, including by resolving crises informally or without hospitalization, providing links to community services, and conducting follow-ups. Co-response showed some success in meeting goals, while the law enforcement-only model showed more limited results. Additionally, law enforcement presence during a mobile crisis response produced worse disposition outcomes, while contacting a CMH during law enforcement response produced better disposition outcomes. Overall, this study contributes to SAMHSA's (2020) crisis response vision to effectively meet the behavioral health needs of those in need of service by providing "someone to respond."