The delivery of mental health services in emergency settings remains a significant challenge. Fragmented systems often struggle to provide the appropriate level of care at the critical moment when a person's crisis peaks. Comprehensive crisis centers offer a solution to this problem by integrating multiple levels of service within a single, coordinated system. 
 
The "no wrong door" approach is central to the comprehensive crisis model. Irrespective of how an individual presents, the center is equipped to immediately initiate assessment and treatment. This eliminates the risk of a person in crisis being denied care due to lack of availability or inappropriate levels of service. 
 
The comprehensive crisis center comprises four core components: 

A well-designed crisis care system has the potential to transform how individuals in need access timely and appropriate support. Central to this vision are crisis centers, which provide immediate interventions for those experiencing behavioral health emergencies. 

Arizona has evolved its crisis response system over the past 15 years, establishing a model that emphasizes coordination, accessibility, and fiscal responsibility. At the heart of this transformation is a managed Medicaid structure, a robust funding strategy, and a commitment to treating individuals in the community.

Oftentimes, people experiencing mental health and substance abuse-related problems end up incarcerated. How do we ensure that individuals in crisis are receiving the proper response, treatment, and services?   

In the realm of mental health much has been done over the past few years to advance the crisis response system. Leading the charge is the state of Arizona, who has charted a remarkable course, sculpting a system with four key components that form the backbone of an effective crisis response system. Let's delve into these pillars that collectively contribute to a comprehensive and impactful system.

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.

With an increase in fentanyl across the globe, Connections Health Solutions’ chief of quality and innovation officer, Dr. Margie Balfour, spoke to what Connections is doing and how crisis response centers can help. 

“Part of our mission is to get people into treatment instead of in the justice system,” Dr. Balfour stated.   

When 911 is called for a mental health crisis, the default response is often law enforcement rather than mental health professionals - but a proven response model is looking to change that.

In the United States, a community's response to a behavioral health crisis is often fragmented, inefficient, and inaccessible to those who need it most. In most communities, few treatment options are designed for and capable of safely managing the care of individuals in crisis. Additionally, the capacity of behavioral health services, both inpatient and outpatient, has struggled to keep up with rising patient volumes and requests for services. This challenge has been made worse by workforce shortages across the industry.   

As leaders in the behavioral health crisis care space, we often are asked, “What defines a crisis?”. At Connections, we believe a behavioral health crisis is determined by the individual. We describe it as an emergent situation where an individual finds themselves unable to cope with their thoughts, emotions, or circumstances. A failure to resolve such a situation could potentially endanger oneself or others. Common indicators of a crisis include struggling with suicidal thoughts, substance misuse, anxiety, psychosis, or social issues.