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Crisis and Emergency Services

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Textbook of Community Psychiatry

Abstract

How a community responds to behavioral health emergencies is both a public health issue and social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments (EDs), boarding for hours or days while waiting for treatment. Such crises also account for a quarter of police shootings and 2 million jail bookings per year, and racism and implicit bias magnify these problems for people of color. Police reform movements like Black Lives Matter are causing communities to seek alternatives to law enforcement as the default first-responders for behavioral health emergencies, while implementation of the new nationwide 988 mental health hotline has prompted federal and state policymakers to focus attention on creating the crisis services callers will need. This chapter provides an overview of the rapidly evolving landscape of crisis services beginning with the core components of the crisis continuum, best practices for law enforcement-mental health collaboration, and policy considerations regarding the financing, governance, and oversight needed to sustain a high-quality system. The chapter also highlights opportunities for psychiatric leadership, advocacy, and strategies for creating a well-coordinated crisis system that meets the needs of the community.

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Author information

Authors and Affiliations

  1. Connections Health Solutions, Tucson, AZ, USA

    Margaret E. Balfour

  2. Department of Psychiatry, University of Arizona, Tucson, AZ, USA

    Margaret E. Balfour

  3. Comprehensive Crisis Services, San Francisco Department of Public Health, San Francisco, CA, USA

    Matthew L. Goldman

  4. Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, USA

    Matthew L. Goldman

Authors
  1. Margaret E. Balfour
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  2. Matthew L. Goldman
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Corresponding author

Correspondence to Margaret E. Balfour .

Editor information

Editors and Affiliations

  1. Clinical Professor of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Wesley E. Sowers

  2. Clinical Professor of Psychiatry, New York University Grossman School of Medicine | NYU Langone Health, New York, NY, USA

    Hunter L. McQuistion

  3. Clinical Professor of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA

    Jules M. Ranz

  4. Professor Emerita of Psychiatry, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Jacqueline Maus Feldman

  5. Vice Chair/Professor, Department of Psychiatry, Case Western Reserve School of Medicine, Ohio, OH, USA

    Patrick S. Runnels

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Balfour, M.E., Goldman, M.L. (2022). Crisis and Emergency Services. In: Sowers, W.E., McQuistion, H.L., Ranz, J.M., Feldman, J.M., Runnels, P.S. (eds) Textbook of Community Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-10239-4_27

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