Crisis stabilization centers

Crisis stabilization centers provide short-term access to emergency psychiatric services for individuals experiencing crisis. These centers often provide constant supervision throughout a person’s stay. Some centers provide care for less than 24 hours, while others provide short-term residential stabilization services. Policies are established that enable law enforcement officers to efficiently transport people in need to the center in lieu of arrest or hospitalization.

For more information on this intervention, see these resources:

• CSU Intake Procedures, Santa Barbara County
• Medical Clearance Procedures, Santa Barbara County

Local Examples

Mobile County, AL

• AltaPointe, a community-based mental health provider, operates a 15- recliner 23-hour observation unit and a six-bed extended observation unit as part of the local Behavioral Health Crisis Center.
• The center is designed to serve people with serious mental illnesses and substance use disorders. A person experiencing a psychiatric crisis can walk in on their own or with a family member, or be brought in by the Crisis Response Team or law enforcement.
• Intake procedures include the following:
  • The individual is screened for COVID-19 prior to entering the facility (unless it’s a law enforcement drop off, in which case the individual is screened in a holding area).
  • A nurse triage is completed to rule out any significant medical issues that would require more acute care (through the emergency department), such as a recent seizure, chest pains, open wound requiring dressing, etc., and to determine the person’s current crisis and/or substance use.
  • The nurse staffs the case with the physician and admits the patient.
  • The physician meets with the patient to complete the psychiatric assessment and start medication.
• The Crisis Center offers rapid stabilization and linkage to traditional and more intensive outpatient services, as well as assisting individuals with resources for other social determinants of health.

For more information on this example, see this resource:

• Behavioral Health Crisis Center

Dallas County, IA

• People who are in crisis can stay in the crisis center for three to five days while the crisis team works to identify community-based services to assist them with recovery.
• The crisis center is funded through Mental Health and Disability Services regional funding and Medicaid.
• Mental health and substance use treatment services are available on site.
• Extended stays are available as needed and funded through the Heart of Iowa Community Services region.

For more information on this example, see this resource:

• Crisis Services

Pima County, AZ Crisis Response Center (CRC) and Tucson Police Department

• The CRC provides 24/7 access to emergency psychiatric and substance addiction treatment services.
• The center has a secure, separate entrance for law enforcement to bring people to treatment rather than to the jail, hospital, or other facilities.
• The center strives to keep check-in time under seven minutes so that law enforcement can return to the field as quickly as possible.

For more information on this example, see these resources:

• Tucson Police Department Law Enforcement-Mental Health Learning Site Profile
• Pima County, Ariz.: Meeting Needs Along the Behavioral Health and Justice Continuum

Madison County, TN Crisis Stabilization Unit (CSU) and Madison County Sheriff's Office

• The CSU provides 24/7 access to emergency psychiatric and substance addiction treatment services.
• Officers can determine whether to transport people directly to the CSU or contact the mobile crisis unit for assistance.

For more information on this example, see this resource:

• Madison County Sheriff's Office Law Enforcement-Mental Health Learning Site Profile

Chatham County, GA Chatham County Behavioral Health Crisis Center

• The Chatham County Behavioral Health Crisis Center is operated by Gateway Community Services, a public community-based organization that serves eight Georgia counties. The Crisis Center is a 24-hour walk-in psychiatric emergency service with six 24-hour observation beds. It offers peer support, counseling, triage, and medications. It also provides treatment and connection to the community outpatient service or admission to inpatient care as needed.
• The Savannah Police Department’s Behavioral Health Unit works in partnership with Chatham County Behavioral Health Crisis Center to connect Savannah and Chatham County residents to resources.
• The Center does not require insurance. Medicaid and Medicare are accepted.

Athens County, OH Adam-Amanda Mental Health Rehabilitation Center

• The Athens-Hocking-Vinton Alcohol, Drug Addiction and Mental Health Services Board, its local community-based partners, the 21-county region’s behavioral health authorities, and National Alliance on Mental Illness Ohio developed the Adam-Amanda Mental Health Rehabilitation Center to provide residential rehabilitation services after inpatient psychiatric hospitalization. Since the center was established, forensic stays in the state hospital have decreased, and its patients have high achievements in stable housing after discharge.
• The center, locally called “Respite,” can receive people who are diverted from jail. Staff are well versed in community-based services and housing, reducing homelessness upon discharge.

Lucas County, OH Zepf Center

• The Lucas County Crisis, Access, Recovery, and Engagement (CARE) Center is a pilot program operated by the Zepf Center, a community-based provider. The CARE Center provides a safe and supportive environment for people in crisis who have mental illnesses and co-occurring substance use disorders.
• Upon identifying an individual in need of short-term immediate intervention, a law enforcement officer transports the individual to the CARE Center rather than booking them into jail.
• The CARE Center operates 24 hours a day, 7 days a week, and services provided include rapid intake; ongoing monitoring by a peer supporter or social worker for a maximum of 23 hours; referral, linkage, and time-limited support for individuals who want to connect with substance use treatment providers for assessment services; and transportation upon exit when appropriate.

Marin County, CA Marin County Behavioral Health and Recovery Services

• The Marin County Crisis Stabilization Unit (CSU) provides services to Marin County residents and visitors experiencing a mental health crisis, such as suicidal depression or psychotic behavior.
• The CSU is open 24/7 and has 6 client rooms with a total of 10 beds to serve youth and adults in psychiatric crisis. (Per California Department of Health Care Services certification requirements, CSUs provide care for up to 24 hours.)
• Services provided include crisis stabilization; evaluation; referrals to community-based service agencies; and linkages for clients to family partners.

For more information on this example, see this resource:

• Crisis Stabilization Unit

Douglas County, KS Treatment and Recovery Campus

• As part of the Douglas County Treatment and Recovery Campus, the Treatment and Recovery Center provides services to adults and children with serious mental illness and substance use disorders who are experiencing a crisis.
• Patients at the Treatment and Recovery Center move through the following three stages:
  • The access center is the entry point for services. There, people receive an initial assessment and further evaluation.
  • Patients then enter the 23-hour observation unit, which is staffed by behavioral health professionals who stabilize patients while working on a treatment and recovery plan with them.
  • Behavioral health professional staff include mental health professionals, peer support specialists, behavioral health technicians, licensed addiction staff, case managers, and psychiatric professionals.
  • Lastly, in the stabilization unit, patients recover for up to several days while receiving a treatment and recovery plan.

For more information on this example, see this resource:

• Treatment & Recovery Center

DuPage County, IL

• DuPage County’s Crisis Center, centrally located at a local community center, is a 12-bed facility that offers crisis residential services 24/7 to all county residents 18 years or older, regardless of insurance status or ability to pay.
• Services provided include case management, individual and group therapy, integrated assessment and treatment planning, and psychiatric evaluation.

For more information on this example, see this resource:

• DuPage Crisis Services

Whatcom County, WA

• The Whatcom County Triage Center (WCTC) is a partnership among Whatcom County and two community-based behavioral health treatment providers, Compass Health and Pioneer Human Services.
• The WCTC provides crisis stabilization and walk-in emergency services, operated by Compass Health, and can accommodate up to 16 people in mental health crisis.
• Pioneer Human Services operates a co-located detoxification facility that offers non-medically managed withdrawal and can accommodate 16 people.

For more information on this example, see this resource:

• Whatcom County Triage Center

Auglaize County, OH

• The We Care Crisis Center provides crisis intervention services in a “one-stop” setting.
• We Care Crisis Center is a 16-bed facility, with 8 beds available for medically managed withdrawal from opioids and stimulants and 8 beds for crisis stabilization.
• Services provided include crisis counseling; emergency diagnostic assessment; nursing; psychiatry; case management; and medically managed withdrawal from opioids and stimulants.
• The center accepts walk-ins and referrals from families and law enforcement personnel.

For more information on this example, see this resource:

• We Care Regional Crisis Center

Cuyahoga County, OH

• The Diversion Center program is a county initiative aimed at diverting individuals from jail when their underlying motivation for committing a crime may be related to substance use disorders or mental illnesses. In addition to local police departments having access to the center for drop-off purposes, individuals, their families, or other supports can utilize the center without law enforcement involvement.
• All involvement is completely voluntary for the individual.
• People in need of Diversion Center services access the county hotline managed by FrontLine services to complete a short screening to determine appropriateness for the Diversion Center versus a possible higher (or lower) plan of care.
• The Diversion Center uses an interdisciplinary approach to stabilizing people in a substance use or mental health crisis and linking them to the appropriate services.
• The Diversion Center is staffed by certified nurse practitioners, registered nurses, licensed practical nurses, and psychiatrists in addition to behavioral health specialist and clinicians. This team ensures that client symptoms can be stabilized using a multi-faceted approach.
• The Diversion Center ensures warm hand-offs and linkages directly to community resources by providing transportation to linkage locations at time of discharge as well as allowing community providers to conduct appointments within the center.
• This project was initiated by the county, which has contracted and funded the local Alcohol, Drug Addiction, and Mental Health Services (ADAMHS) board. The ADAMHS board has contracted with Oriana House Inc. and FrontLine to provide the needed services.

For more information on this example, see this resource:

• Cuyahoga County Diversion Center

For more information on this example, contact Allyse Hawkins, AllyseRHawkins@orianahouse.org.