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Reimagining Response to Vulnerable Populations in Crisis


  • Over-reliance on first responders in non-criminal or medical matters
  • Development of a framework for reimagining crisis response
  • Generation of materials for reimagining crisis response
The Challenge

Homelessness and untreated serious mental illness (SMI) and/or substance use disorders (SUD) are at the root of many crisis-related calls for emergency services. However, first responders often lack the necessary information, skills, resources, or coordinated support to engage safely, justly, and effectively with individuals experiencing such crises. As a result, these interactions often increase involvement in the justice system and rely too much on the emergency response system, neither of which was designed to deal with behavioral health issues.

The Approach

We conducted a broad Internet scan to collect information on U.S.-based, first responder-led programs that were designed to maximize diversion from the justice and emergency systems to treatment and community-based services. We organized the range of programs into program types and overarching program models. We also reviewed the research evidence for these programs to assess the effectiveness of the various approaches.

The Results

We provide a framework for considering the different types of programs for preventing crises or improving emergency responses for individuals experiencing SMI, SUD, and/or homelessness and are in crisis. The types of programs included in our framework support efforts to minimize involvement of first responders by engaging behavioral health or other specialists in the response and, when first responders are involved, ensuring they have the training and support to de-escalate, screen, and connect individuals to needed services and care. We also introduce factors, including the extent to which programs have been evaluated, for communities to consider when deciding on the type of program to implement or expand to improve responses to vulnerable populations in crisis.

Reimagining Response Materials:

A Guidebook to Reimagining America’s Crisis Response Systems: A Decision-Making Framework for Responding to Vulnerable Populations in Crisis.  For policymakers and emergency response agencies considering implementing or expanding crisis response programs in their communities. (pdf)