Mobile Crisis Teams (MCTs) are among the most rapidly expanding components of America’s crisis care continuum. As of 2024, the latest NRI State Profiles report 2,111 mobile crisis teams nationwide, serving nearly 900,000 people in the past year, supported by more than $900 million in public investment. From today’s vantage point, we appear within striking distance of a crisis response infrastructure capable of reaching people wherever they are—homes, schools, workplaces, shelters, jails, hospitals, sidewalks.
As states have rapidly expanded this capacity to meet urgent need, a new operational challenge has come into clearer focus:
How mobile crisis teams are dispatched varies widely across states and regions, often creating fragmentation, duplication, and inefficiency that limit the impact of these vital services.
As crisis system leaders seek to resolve these problems, many states are recognizing that clearer dispatch authority and coordination are essential—and that 988 crisis call centers are uniquely positioned to serve as the coordination hub, or “air traffic control,” for mobile crisis response.
The Patchwork Problem: Adding Rooms Without a Floor Plan
While mobile crisis systems have expanded quickly across most states—it’s often happening faster than dispatch governance and coordination systems can evolve. According to NRI’s latest data, while all states now have mobile crisis services, only 27 states have 988 centers that can dispatch MCTs.
That means in at least 18 states, a person can call 988 in crisis, spend 20 minutes building rapport with a counselor, explaining their situation, and undergoing a clinical assessment—only to learn that the counselor cannot send help. Instead, the caller must be transferred elsewhere, retell their story, and hope another dispatcher agrees that a mobile response is warranted.
Depending on the state—and sometimes the county—mobile crisis teams may be dispatched by:
- 988 crisis call centers
- 911
- local crisis lines
- behavioral health providers
- community mental health centers
- CCBHCs
- managed care organizations (including ASOs)
- regional access centers
- or the teams themselves (“self-dispatch”)
While each of these models reflects local history and stakeholder roles, the lack of a single, coordinated dispatch approach often creates confusion for both the public and providers.
Mobile dispatch is not a secondary operational detail. It is the pivotal decision point that determines:
- who responds and how quickly
- whether police are involved
- what risks responders face
- whether someone must repeat their story
- whether the response is proportionate and clinically appropriate
- whether resources are used wisely—or wasted
- whether the person experiences dignity—or additional trauma
In short, dispatch is frequently the hinge upon which the entire crisis continuum swings.
For people in crisis, this fragmentation isn’t just inefficient—it’s alienating. We ask individuals at their most vulnerable to navigate a maze of handoffs between call centers, dispatch points, providers, and systems. Each transfer is another chance to fall through the cracks. Each retelling is another burden.
The Trust Question States are Navigating
In many cases, the biggest barrier to change isn’t technology or funding—it’s trust, especially particularly around dispatch and field safety.
Mobile crisis providers—many of whom have been doing this work for decades—are understandably protective of dispatch decisions. One provider recently put it to me plainly: “Why should we put our safety in the hands of people who don’t really understand what we do?”
As someone who worked on a mobile team and dispatched our own service for eight years, I understand that concern. When I’m the one walking into an unknown situation, I want to know that whoever sent me there understood the risks and made an informed decision.
The fear is that 988 counselors, sitting in call centers, will send teams into unsafe situations, overlook the need for law enforcement support, or deploy scarce mobile resources to situations better handled through their own de-escalation and outpatient referral.
But this argument misses a critical point: 988 counselors are not traditional call service operators or basic vehicle dispatchers.
Unlike 911 operators, whose role is primarily routing responders, 988 counselors are trained crisis intervention specialists. They listen, assess risk, de-escalate, safety plan, and problem-solve. Sometimes the answer to what the caller needs is a supportive conversation. Sometimes it’s a referral to outpatient care and follow-up contacts. Sometimes it’s mobile crisis. Sometimes it’s emergency services. The 988 counselor is already determining where on that spectrum a caller sits. Why should someone else make that determination again? Most importantly, they resolve the majority of crises without dispatching anyone at all. They are already making nuanced clinical judgments across a spectrum of response options.
Dispatch authority is not a leap—it is a logical extension of the work they already do.
When callers contact mobile services following a referral from 988, 911 or another community source, many mobile services are focused on the safety and appropriateness of their self-dispatch. If they decide a dispatch is not safe or warranted, they are often less prepared than a 988 counselor to address how the caller’s needs might be better supported elsewhere. In that case, the person will either need to call 988 back or perhaps decide that they can’t get the help they are looking for in this confusing, fragmented system.
In these types of scenarios, our trust problem between crisis services now becomes the public’s trust problem…a problem in trusting our system to give them the care they need.
The Path Forward: Collaboration, Not Mandates
While sometimes bold policy decisions from public health authorities are critical, we can’t solve a trust problem between crisis service providers with simple mandates alone. Here’s three essential approaches to building trustworthy care coordination between 988 center mobile dispatchers and mobile teams:
First: unified dispatch protocols, developed collaboratively.
Behavioral health authorities, 988 centers, and mobile providers must jointly define response criteria. How states define response levels—ranging from telehealth-supported engagement to full mobile response with law enforcement involvement—should follow jointly developed protocols.
I recently participated in a task-oriented Mobile Crisis Community of Practice hosted by Vibrant, focused specifically on mobile dispatch triage for 988 centers. The group is identifying practical models already in use across states—defined “dispatch levels” ranging from low-risk telehealth-supported responses to high-risk law-enforcement-only interventions. These successfully operating models demonstrate that coordinated triage for mobile dispatch through a single 988 call is both feasible and effective. I look forward to Vibrant providing these recommendations to crisis service stakeholders from our task force soon.
Overall, routine meetings between the state/accountable entity, 988 centers and mobile teams should be occurring regularly to reinforce collaboration on protocols, trouble shoot difficult situations (including frequent users) and share data that helps all entities collectively improve their care coordination.
Second: joint training, in both directions.
988 counselors need to understand what mobile teams face in the field. Mobile teams need insight into the clinical assessment and de-escalation work that happens before dispatch is considered. And both need to explain to potential consumers what each service does.
When I helped launch the NYC crisis call center in the 1990s that would help connect people in the five boroughs to local mobile teams, we arranged with MCT service leaders for all call center counselors to join them in “ride-alongs.” That shared experience dramatically improved trust and decision-making. Today, we should be pairing in-person opportunities with shared virtual trainings and ongoing co-education efforts.
I spoke with my BHL colleague Andrea Corley about this MCT trust-building issue. Andrea is a great source, as she directed the Georgia Crisis and Access Line’s statewide dispatch of mobile teams for nearly a decade and now oversees BHL’s mobile dispatch service.
Andrea underscored the importance of 988 counselors having skills in accurately explaining what mobile crisis can do to help assure realistic expectations are set. “In my experience,” she noted, “some mobile crisis dispatches went poorly because the caller wanted something the mobile team could not produce in real time such as medication, transportation, housing, etc. Having the call center counselor work with the caller on what they can expect when mobile comes out goes a long way.”
Similarly, the more similar protocols and expectations for both mobile crisis dispatch and services are across communities in a region or state, the easier it is for public health administrators, media and other major stakeholders to accurately message to the public what mobile teams do. It may have taken years for the public to know what to expect from ambulance services—what emergent situations they are designed to address, how quickly they might arrive, who would come, what they might do when they arrive—but we’re pretty clear on what to expect from EMS in most places now. To gain and sustain public access and trust in relation to mobile crisis services will require consistent expectations to be set and maintained across local regions, states and nationally.
Third: real-time information sharing.
NRI’s 2024 survey found that only 24% of mobile crisis teams use integrated electronic health records. Mobile dispatching entities often lack real-time visibility into team availability, response status, or outcomes.
The 24% EHR integration rate reflects a broader coordination gap with real operational consequences.
When 988 centers and mobile teams operate on separate systems:
- Dispatchers can’t see if teams are already responding to another call, creating dangerous double-bookings or unnecessary delays
- Mobile teams can’t access the assessment and de-escalation work already done, forcing people to retell traumatic stories
- Supervisors lack visibility into response times, outcomes, or whether high-utilizers are getting coordinated care
- Public health authorities can’t answer basic questions: How many dispatches? What were the outcomes? Where are the gaps?
Integrated platforms solve this by giving everyone the right information at the right time. 988 counselors see team availability before dispatch. Mobile teams access caller history and risk assessments securely. Administrators track system performance in real time—not through manual reports weeks later. This isn’t about replacing clinical judgment with software. It’s about giving clinicians the information infrastructure to make better decisions faster.
988 centers need live views of team readiness. Mobile teams need secure, immediate access to call information. Automated time stamps—arrival, engagement, assessment, disposition—should replace manual tracking that introduces inconsistency and error.
If 988 centers and the teams they are dispatching are sharing the same technology platform, all this real time visibility, tracking and reporting capability is operating to assure accountability across the system. Such shared software tools that support live chat, safety alerts, and secure messaging allow call center staff and mobile teams to coordinate seamlessly during a dispatch, response and assessment. As Andrea noted, “We found that communication outside the formal triage document was often essential to setting up the most collaborative and effective intervention, including sharing key details from the call, clinical impressions, safety considerations, and guidance on how best to engage the individual and/or their family.”
FOR STATE BEHAVIORAL HEALTH AUTHORITIES
Questions to assess your dispatch integration:
- Can your 988 center dispatch MCTs directly?
- Do teams and dispatchers share protocols?
- Can both see real-time availability/status?
- Is there a single number the public calls?
- Do you track duplicate assessments?
If you answered “no” to 2+, your system has integration gaps costing time, money, and trust.
A Challenge to Our Leaders
As states continue strengthening their crisis systems, many are finding that positioning 988 as the coordination hub for mobile crisis response provides clarity for the public, safety for providers, and accountability for policymakers. In states seeking to transform their systems in this fashion, bold policy decisions may sometimes be necessary to jump start the essential cross-program collaborations that make care coordination successful. Providing a technology infrastructure to support real-time dispatch coordination can also be invaluable.
Many mobile crisis providers have understandable concerns about 988 dispatch potentially compromising their safety and autonomy. But trust can be established through routinely collaborative decision-making between 988 and mobile services. Shared dispatch infrastructure, common measures, and unified workflows create communities of practice that strengthen everyone. In the end, the greatest benefactor will be the consumer in crisis.
For 988 centers, dispatch authority must be earned. That means understanding field realities, building relationships, using data, sharing thorough (and well-documented) assessments, and engaging in continuous joint improvement. The forthcoming Vibrant 988 dispatch recommendations offer a solid foundation for this work.
The Bottom Line
We know what works: integrated systems with clear authority and shared protocols. Where this model has been implemented, states report cost savings, fewer care gaps, reduced law enforcement involvement, and better outcomes.
It’s time for 988 centers to become what they were meant to be: the air traffic control for behavioral health crisis response. One call, one story, one system supporting a person in crisis.
Behavioral Health Link works with states to assess dispatch integration readiness, align multi-stakeholder protocols, and develop implementation roadmaps. We support both the operational and technology sides of this work, grounded in real-world mobile crisis and dispatch experience.
For state leaders navigating how—and when—to integrate dispatch authority, we welcome the opportunity to share lessons learned and practical options that respect local context while strengthening statewide coordination.
Start the conversation with a strategy call with our industry experts.
by John Draper, PhD