Mobile Crisis

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Mobile Crisis, or Mobile Crisis Teams (MCT), are an emergency mental health service in the United States and Canada, typically operated by hospital or community mental health agency. They serve the community by providing emergency services to people in crisis, such as mental health evaluations, de-escalation, and/or pointers to local services (including potentially a ride). Evaluations are requested by hospital emergency rooms, ICUs, CCUs, jails, nursing homes, police, or EMS. These services are often available on a 24-hour basis. As of 2023, in parts of the USA and Canada teams can be called via the new suicide & crisis hotline 988 and some other crisis hotlines.^[1][2][3]

Mobile Crisis Teams can be requested by someone in distress, or by anyone who is concerned that someone might harm themselves or someone else, based on their words and/or actions. Support may be requested due to a person exhibiting signs of psychosis, grave disability, or altered mental status believed not to have an organic cause.

Criteria for sending Mobile Crisis Teams can vary across mental health agencies and legal jurisdictions. An assessment may be requested for situations involving alcohol and drugs (where there is not a mental health component), or "routine" evaluations requested where there is not a reasonable expectation of harm to the client or another individual, as long as psychopathology is not otherwise ruled out.

A Mobile Crisis clinician performing a formal evaluation has typically obtained her/his Master's degree in a mental health-related field (such as social work, mental health counseling, or counseling psychology).^{[citation needed]} The clinician performs the evaluation based on standard models of mental status examination (alert and oriented, mood, thought process, affect, etc.), and assigns a DSM-5 (Diagnostic and Statistical Manual of the American Psychiatric Association, Fifth Edition) diagnosis if this falls within their scope of practice. After completing the evaluation, the clinician makes a disposition, or placement, decision for the client. Placements can include involuntary in-patient hospitalization, voluntary in-patient hospitalization, or discharge to home with out-patient referrals. Following disposition, the Mobile Crisis Team can be expected to follow up with the client within a few days.

Many Mobile Crisis Teams also offer services such as de-escalation, some very basic health care, homeless street outreach including things as simple as some water or a blanket, and pointers to a wide array relevant services for people in crisis — including possibly a ride. Many of these elements were pioneered beginning in 1989 in Eugene, Oregon by CAHOOTS.

After the George Floyd protests in 2020, several hundred cities in the US interested in implementing similar programs requested information from CAHOOTS.^[4] Harris County, TX developed Holistic Assistance Response Teams (HART) that dispatch to behavioral and mental health crises, homelessness, and other non-emergencies.^[5] In 2021, the US enacted legislation to cover 85% of the first three years' expenses for starting & operating mobile crisis teams, directing $1 billion to the effort.^[6] In 2022, Oregon was the first state to qualify for funding.^[7]

By 2024, most US states had multiple cities with teams, or even had them available state-wide.^{[8] [9] [10]}

• Harris County, Texas - Holistic Assistance Response Teams (HART)

• Homeless street outreach

• https://www.tacinc.org/resource/state-planning-guide-for-medicaid-financed-mobile-crisis-response/

• https://www.samhsa.gov/sites/default/files/national-mobile-crisis-survey-report-summary.pdf

• https://nyc988.cityofnewyork.us/en/crisis-services/mobile-crisis-teams/

• https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3683432