Mobile crisis teams have emerged as a cornerstone of the behavioral health crisis care continuum. As the new frontier for 988, these teams offer a critical alternative to sending law enforcement to respond to individuals in behavioral health crises. They are reshaping how communities respond to mental health emergencies, yet a critical question remains: how do we measure their success?
While diversion rates—avoiding police involvement or hospital visits—have traditionally been a key metric, they don’t tell the full story of mobile crisis effectiveness. At Behavioral Health Link (BHL), we believe it’s time to move beyond diversion rates and focus on outcomes that truly matter to the people in crisis: reducing distress, enhancing safety, and fostering hope.
The Promise of Mobile Crisis Teams
The numbers tell a story of progress. According to a 2023 survey by the National Association of State Mental Health Program Directors (NASMHPD) Research Institute, mobile crisis services exist in 49 states and Washington, D.C., with over 770,000 people served last year—a 21% increase compared to 2022. These services are growing rapidly, fueled by increased state funding and a commitment to building robust crisis systems.
SAMHSA’s 2020 National Guidelines for Behavioral Health Crisis Care provide a strong foundation, emphasizing rapid response, de-escalation, safety, and connection to care. However, measuring the impact of mobile crisis teams requires more than tracking diversion rates. To transform crisis care, we need to redefine what success looks like.
The Limits of Diversion Rates
Diversion rates remain a common benchmark for mobile crisis teams, but they paint an incomplete picture.
- Diversion Isn’t Always Appropriate: Some crises require more intensive care or law enforcement involvement due to public safety concerns.
- One-and-Done Encounters: Many mobile crisis interactions are brief, with limited follow-up, leaving outcomes beyond the initial contact unclear.
- What Matters to Clients: People in crisis likely don’t define success as merely avoiding a hospital or police encounter. They care about feeling safer, less distressed, and connected to the support they need.
To truly assess the impact of mobile crisis teams, we must look beyond diversion rates and focus on meaningful clinical outcomes.
What Should We Measure?
When BHL surveyed mobile crisis team members in our community of practice, their priority was clear: they want to measure outcomes that reflect the difference their work makes in the lives of the people they serve. These outcomes include:
- De-escalation and Distress Reduction: How effectively do teams reduce immediate distress or suicidal ideation?
- Crisis Stabilization: Are individuals experiencing a tangible reduction in their crisis state during and after the encounter?
- Safety Enhancements: Are teams conducting and documenting safety planning and lethal means counseling?
- Connection to Care: How successful are teams in linking individuals to ongoing community services or support systems?
Despite their importance, these metrics are rarely tracked. For instance, while many teams conduct safety planning, few report how often these interventions are applied or their outcomes. Similarly, suicidal ideation—a common and critical factor—is not consistently assessed or reported during crisis team engagements.
The Need for Change
As mobile crisis teams continue to expand, we must prioritize tracking and reporting on these meaningful outcomes. This is not just about data collection; it’s about validating the critical work teams do, identifying areas for improvement, and ensuring that the services provided align with what matters most to the people we serve.
When I worked on a mobile crisis team nearly 30 years ago, I saw firsthand the profound difference our work made in people’s lives. As a clinical director, I was passionate about measuring our impact—not just to demonstrate effectiveness, but to continuously improve the care we provided.
It’s disheartening to see that decades later, many teams still lack the tools and frameworks to report on the outcomes that truly matter. But it’s also an opportunity. At BHL, we are committed to partnering with states and counties to collect and report data that reflects the lived experiences of the people in crisis.
A Call to Action: Measuring What Matters
In our view, the most important perspective on whether a crisis is resolved belongs to the person in crisis. Did they feel safer? Less distressed? More hopeful? Did they feel seen, heard, and connected to the support they need?
We invite states and counties to join us in prioritizing the metrics that matter most to those we serve. By redefining success through the lens of the individual, we can ensure that mobile crisis teams fulfill their promise—not just as a public health alternative to 911, but as a transformative force in behavioral health care.
Together, let’s measure what truly matters and continue to build a crisis care system that delivers on its potential to change lives.
John Draper, Ph.D., is President of Research, Development, and Government Solutions at Behavioral Health Link