A "No Wrong Door" crisis response center (CRC) is an approach that revolutionizes how first responders and law enforcement partners can help individuals in crisis get treatment instead of the alternative of jail or languishing in the emergency department (ED) waiting for a bed. Centers who operate as a “no wrong door” facility have become pivotal in reshaping the narrative around mental health emergencies.

The Need for "No Wrong Door” facilities

Mental health crises are inherently nuanced, often requiring a delicate balance of immediate intervention and ongoing support. In many communities, law enforcement and first responders have limited options to take an individual in crisis. Should they take an individual to an emergency room where they are likely to wait hours or days for an inpatient bed? If they get turned away, should they be taken to jail, where they are unlikely to receive any treatment? If their community has a center for behavioral health emergencies, is there a chance that the individual could be turned away for presenting as “too acute”? This navigation through a labyrinth of options could lead to delays, increased stress, and potentially inappropriate placements.

A "No Wrong Door" crisis response facility ensures that individuals in crisis receive the help they need promptly. "If you make it easy for law enforcement to do the right thing, use their training that they've received on how to recognize mental illness, the last piece of that is that you have to make it really easy for them to drop people off for care, " says Dr. Margie Balfour, chief clinical quality and innovation officer at Connections Health Solutions.

Key components of a "No Wrong Door" crisis response center

1. Dedicated first responder entrance with rapid drop-off process that returns the responder to the field in less than 10 minutes.

2. No exclusions for behavioral health acuity, mental health condition, or substance use disorder (SUD) status, meaning a true “no wrong door” crisis facility programs meet the needs of high acuity populations.

3. No refusal policy; never turning anyone (a person or first responder) away, even if they may need services at another program or facility. Rather the crisis facility staff will evaluate the person, stabilizes them and arranges a transfer, if needed.

4. No medical clearance required prior to arrival, instead the facility assesses the individual for medical stability upon arrival.

The impact on law enforcement partners

1. Reduced decision-making pressure: Law enforcement officers are often the first responders in crisis situations, facing intense pressure to make swift and informed decisions. The "No Wrong Door" model alleviates this pressure by presenting a unified entry point, allowing officers to focus on immediate needs and getting the person in crisis help fast.

2. A “health-first” response: By facilitating seamless collaboration between crisis response centers and law enforcement, the model aligns with "health first” approach. Officers become instrumental in directing individuals to the most suitable services, contributing to a more compassionate and community-centered response.

3. Minimized stigma and hurdles: The model diminishes the stigma associated with potential 'missteps' in choosing a crisis response option. Law enforcement officers can confidently engage with the crisis system, knowing that the emphasis is on getting individuals the help they need.

The "no wrong door" crisis response center model exemplifies a paradigm shift in mental health crisis intervention. By eliminating the notion of a 'wrong' choice, it empowers law enforcement partners to act decisively while ensuring individuals in crisis receive prompt and tailored support. The model paves the way for a more compassionate, collaborative, and effective approach to mental health crisis response.

Source: National Advancements in Crisis Services: Defining and Refining Responder Roles