As Momentum Builds for Mental Health Crisis Response Teams, Cuts Loom

When California rolled out its 988 mental health crisis response hot line in July 2022, architects believed it would lead to an overhaul of the emergency medical system. They envisioned callers in mental health crisis connecting with a system of trained first responders, largely keeping police at bay and instead dispatching appropriate mental health help.

That hasn’t quite come to pass, but most communities across the state have taken steps toward this vision — and some of them have robust systems. Now they are worried about losing them due to looming federal and state budget cuts, according to Le Ondra Clark Harvey, California Behavioral Health Association chief executive officer.

Last month, CBHA, a statewide association of mental health and substance use disorder agencies and businesses, delivered a message to the Senate Budget and Fiscal Review Committee pointing out that Gov. Gavin Newsom’s latest budget offers no new investment in the 988 system, despite the continued growth in demand. CBHA also warned that federal cuts because of the Trump Administration’s HR1 Act will increase strain on the public health safety net, resulting in more people experiencing mental and physical health coverage gaps and greater instability in communities.

Without adequate funding for mental health emergency response systems, we’re “chipping away at an imperfect infrastructure and fabric that already has holes in it,” warned Clark Harvey.

Jacob Rosen, a mental health clinician who manages Crisis Alternative Response of Eureka (CARE), has recently been speaking with lawmakers about defending the progress that mental health crisis response has made in communities.

Last year, Rosen’s staff of four trained mental health professionals engaged more than 1,500 times with community members to deescalate or provide phone-based or in-person intervention during mental health emergencies in their rural community, about 90 miles south of the Oregon border. They’ve been operating Monday through Friday from 8 a.m. to 7 p.m. When a CARE team hasn’t been on duty, however, police were forced to respond; The local police department handled over 1,700 mental health calls, Rosen said. Now CARE is expanding its services to seven days a week. “But it’s clear what we really need is around-the clock [mental health crisis] teams,” Rosen said.

Funding is the biggest roadblock, according to Tanir Ami, CEO of CARESTAR Foundation, a nonprofit that offers modest grants to fund an array of emergency medical efforts in communities. In the last few years, her applicants have been almost exclusively focused on securing money for mobile mental health crisis teams and integrating robust mental health crisis response into a community’s emergency medical system.

“Every county now has some of this [mental health crisis response] going on, but we’re sort of in the Wild West era of experimentation and learning,” Ami said. Communities are trying out various versions of crisis support — working with grassroots organizations, local emergency agencies and county services. “Many communities are desperately seeking funding and system integration,” Ami said.

If the relatively nascent mobile mental health crisis response programs don’t get support, advocates say even more mental health crisis calls will default back to police officers, most of whom are not adequately trained in mental health response.

“Police need to be doing the job of police and mental health professionals need to respond to mental health crisis 24-7,” Rosen said.

Communities seem to agree. An Ipsos poll commissioned by National Association of Mental Illness last year found that 86 percent of the 2,045 U.S. adults surveyed thought that people who were experiencing a mental health or suicide crisis should have a mental health response as opposed to a law enforcement response.

Tim Clement, vice president of federal government affairs for the nonprofit Mental Health America, says it’s precisely this public support that makes him largely optimistic that mental health crisis teams ultimately won’t see cuts. He says lawmakers — including governors —understand that cutting mental health response programs would be dangerous and more costly in the end.

“If you’re in crisis and you don’t have mobile crisis show up, maybe it’s the police that show up, or maybe you show up in the emergency department. That’s all more expensive than mobile crisis response,” Clement said. Furthermore, no one wants a tragedy in their community that a crisis team could’ve prevented.

In California, a state budget revision will happen in May. CBHA and other advocates are urging lawmakers to make sure the revision prioritizes behavioral health transformation.

“We are very concerned about any impact to mental health crisis response,” Clark Harvey said. “But I also know the state is working really hard to figure out what to do.”

This article first appeared on California Health Report and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.