Many state and local governments and communities across the country are redesigning their crisis response systems to better meet the needs of those who experience crises related to behavioral health — that is, mental health or substance use. The goal is to connect people to the services they need while reducing reliance on law enforcement and hospitals as the first line of response when behavioral health crises occur.

In light of new federal funding policies and the upcoming launch of the 988 behavioral health crisis line, Federal Policy Recommendations to Support State Implementation of Medicaid-Funded Mobile Crisis Programs identifies important issues in mobile crisis implementation and describes ways that federal agencies could support state and local efforts.

The federal government has created new policies in recent years to advance stronger crisis responses. For example:

• In 2020, Congress passed a law to make 988 the nationwide three-digit phone number for mental health crisis and suicide prevention, operating through the existing National Suicide Prevention Lifeline. By July 2022, all telecommunications companies will be required to route 988 calls to the lifeline, which has a nationwide network of call centers.
• The American Rescue Plan Act of 2021 (ARPA) established a new state Medicaid option to provide community mobile crisis intervention services for those experiencing a mental health or substance use disorder crisis.

These recent federal policies, which are being implemented at the state and local levels, build on national guidelines for behavioral health crisis care issued by the Substance Abuse and Mental Health Services Administration in 2020. The policies articulate core components of effective crisis systems, including 24/7 crisis lines, 24/7 mobile crisis response, and crisis stabilization programs.

While the paper focuses primarily on implementation of Medicaid mobile crisis provisions for people experiencing a mental health or substance use–related crisis, it also identifies opportunities to develop a broader service continuum that meets the needs of people experiencing a behavioral health crisis. This paper was authored by TAC’s John O’Brien, MS; Vikki Wachino, MPP; Jordan Gulley, LICSW; and Kevin Martone, LSW.

A companion paper Mobile Crisis Teams: A State Planning Guide for Medicaid-Financed Crisis Response Services offers a review of the requirements of ARPA related to community-based mobile crisis intervention services.

Both papers were published with support from CHCF and the Charles and Lynn Schusterman Family Philanthropies.