Addressing Mental Health, Substance Use and Homelessness

The broad goal of this project is to provide a resource to help city leaders implement effective strategies for emergency response and crisis stabilization for individuals experiencing mental illness, substance use disorder and/or homelessness. City leaders may adapt the strategies to address their city’s specific challenges in these areas.

Brief No. 1:  Advancing Coordinated Solutions through Local Leadership

Mental illness, substance use disorder, and homelessness pose significant, interconnected challenges for cities as they affect millions of people nationally. City leaders play a key role in ensuring individuals receive the appropriate treatment and services at the right time.

Traditional approaches to addressing these challenges have proven less than effective. Many individuals with mental illness, substance use disorder, and/or homelessness lack access to important health and social services. Responses often have funneled vulnerable populations into emergency departments, jails, and prisons, imposing both human and financial costs. Innovative efforts like emergency response teams and crisis stabilization centers have the potential to serve as doorways into more appropriate services and treatments.

Cities across the country are implementing innovative approaches to improve outcomes. Newer approaches in emergency response and crisis stabilization prioritize programming that increases the capacity of first responders to safely deescalate emergency situations involving individuals with mental illness, substance use disorder, and/or experiencing homelessness. These approaches maximize diversion to treatment and services instead of arrest or unwarranted emergency department visits.

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Brief No. 2:  Working Across Systems for Better Results

Cross-system approaches can produce better outcomes for vulnerable populations during emergency and crisis stabilization responses. Instead of organizations working in silos, cross-system collaboration can enable stakeholders in a community to leverage their skills, expertise, and resources to more effectively assist vulnerable populations.

First responders play a unique role in emergency response and crisis stabilization initiatives by serving as an entry point to broader systems of care. By diverting vulnerable individuals to vital services and supports, first responders can help individuals receive the care and services they need while avoiding incarceration.

Several cities across the country attribute the success of their emergency response and crisis stabilization efforts, in part, to cross-system collaboration. These cities serve as exemplars to other cities as they work towards developing more effective emergency crisis and stabilization responses to help support individuals with mental illness, substance use disorder and/or experiencing homelessness.

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Brief No. 3: Emergency Response and Crisis Stabilization

Cities are implementing innovative, cross-systems approaches to emergency response and/or crisis stabilization for those experiencing substance use disorder (SUD), homelessness and/ or mental illness. However, they face a number of challenges including data collection and analysis; data integration and sharing; facility and workforce development; flexible, sustainable funding; and cultural attitudes, among others.

Opportunities for cities to collaborate with and utilize resources from federal, state and county governments can support and spread the innovative, cross-systems approaches being developed at the municipal level.

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Advancing Coordinated Solutions Through Local Leadership

This issue brief examines the challenges posed by mental illness, substance use disorder and homelessness and introduces innovations with a focus on emergency response and crisis stabilization. This series provides local leaders with tools and strategies to better address emergency response and crisis stabilization systems for those experiencing mental illness, substance use disorder and/or homelessness.

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Working Across Systems for Better Results

This issue brief discusses city-level approaches and practices for emergency response and crisis stabilization for individuals experiencing mental illness, substance use disorder and/or homelessness. The second in a series of issue briefs, it explores approaches in detail and with a focus on working across systems.

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Emergency Response and Crisis Stabilization

This third issue brief explores the challenges faced when implementing these approaches and how city leaders have overcome barriers related to the development and implementation of emergency response and/or crisis stabilization efforts. This brief also explores ways for state and federal partners to help overcome these challenges.

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Case Studies

The cities interviewed for this project include Fort Collins, Colorado; Huntington, West Virginia; Indianapolis, Indiana; Manchester, New Hampshire; Philadelphia, Pennsylvania; Rapid City, South Dakota; San Antonio, Texas; Wake County, North Carolina; and Wichita, Kansas.

Director, Health and Wellness