10 Years of Stepping Up
Facing the Behavioral Health Crisis in Jails and Communities With Real Solutions
Across the country, local leaders are facing a shared crisis: how to meet the behavioral health needs of people who are cycling through jails. This challenge isn’t new, but trust in our institutions is fraying as jails remain crowded with people struggling with mental illness and substance use.
Yet over the past decade, we’ve seen a groundswell of progress. Through the Stepping Up initiative, launched in 2015, more than 500 counties and 50 Innovator Counties have joined forces to confront this crisis—using data to understand where people fall through the cracks, deploying mobile crisis and co-responder teams that include mental health professionals, diverting people before booking, embedding treatment in jails, and creating new accountability measures to track and improve outcomes.
What’s changed after a decade of Stepping Up is not the size of the challenge—but the clarity of how to overcome it. We now know what works, where to focus, and how to move from isolated efforts to broader transformation of the justice and behavioral health systems.
A Decade of Stepping Up
2015: Launched Stepping Up with events in Washington, DC; Johnson County, Kansas; Miami-Dade, Florida; and Sacramento, California
2016: Held National Stepping Up Summit with 50 counties, representing 37 states
2017: Expanded to 400 counties across America
2018: Created the Stepping Up Innovator County network—which spans more than 50 counties today—and established the Pennsylvania Stepping Up Technical Assistance Center
2019: Reached 500 counties and started the Strategy Lab so counties can learn about one another’s interventions that work
2020: Issued the “Set, Measure, Achieve” call-to-action for counties and developed telehealth resources
2021: Established the Kansas Stepping Up Technical Assistance Center
2022: Hosted a live event to celebrate counties’ achievements over the first seven years of Stepping Up, explore emerging trends, and chart a path forward
2023: Convened a lived experience advisory panel to provide insights for updating Stepping Up
2024: Kicked off the nation’s first Stepping Up for Youth Initiative in Kansas
2025: Celebrating 10 years of progress and building the foundation for future success
“I started off depressed—now I look forward to every day. I look to help others while I’m incarcerated and look forward to the day I return to society to be a positive, productive citizen. [Stepping Up] is a big start to healing some members of society, and I’m proud to be a part of that.”
—C.B., Erie County, New York
The Impact of Stepping Up
“With mental health challenges affecting one in five individuals, these initiatives demonstrate commitment to reducing stigma, expanding access to care, and fostering a system where individuals can seek help without fear or barriers.”
—Commissioner Doug Singleton, Montgomery County, Alabama
The Next Step
Today, more than ever, communities are looking for answers to this growing crisis. The tools, strategies, and partnerships developed through Stepping Up provide solutions for counties across the country. We’re working to bring this momentum where it’s most urgently needed by:
- Connecting jail-based care and reentry planning to Medicaid so people don’t fall through the cracks
- Expanding the Stepping Up for Youth framework to reach young people at risk earlier and more effectively
- Helping more states build technical assistance centers to guide counties through implementation
- Treating mental health and substance use as intertwined challenges—not separate issues
Stepping Up isn’t just a campaign—it’s a framework for action that’s already having a positive impact. Learn about how to get or stay involved: