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Building a behavioral health crisis response program: a qualitative implementation case study
Teja Pattabhiraman1, Mark Fleming2, Theodore Michaels1,2
1School of Medicine, University of California, SanFrancisco, CA 94143, United States.
Health Affairs Scholar
|May 29, 2026
Summary
Mobile crisis response programs (MCPs) are vital alternatives to law enforcement for behavioral health crises. Key factors for successful MCP implementation include political will, cross-sector collaboration, workforce flexibility, and clear coordination protocols.
Area of Science:
- Public Health
- Health Services Research
- Mental Health Services
Background:
- Mobile crisis response programs (MCPs) are emerging as effective alternatives to traditional law enforcement interventions for individuals experiencing behavioral health crises.
- Limited research exists on the specific strategies and contextual elements that influence the design and implementation of these crucial programs.
Purpose of the Study:
- To characterize the key factors influencing the early development and implementation of a county-led mobile crisis response program (MCP) in Northern California.
- To identify actionable strategies for establishing and scaling MCPs effectively.
Main Methods:
- Qualitative study design utilizing 58 semi-structured interviews.
- Participants included stakeholders involved in program design and implementation, as well as frontline staff.
- Data analysis focused on identifying major themes related to program development and operationalization.
Main Results:
- Sociopolitical momentum was crucial for securing political will and funding.
- A collaborative design process fostered community buy-in and tailored services.
- Workforce shortages were addressed through flexible hiring and staffing.
- Effective coordination with law enforcement and emergency medical services required strong relationships and clear protocols.
Conclusions:
- Actionable policies for MCPs include protocolizing collaboration and cross-sector engagement.
- Implementation flexibility is essential for adapting to challenges like workforce shortages.
- Findings can inform the establishment and optimization of MCPs in diverse settings.
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