Home Local News NCDHHS pilots mobile crisis, co-responder models for behavioral health crisis response

NCDHHS pilots mobile crisis, co-responder models for behavioral health crisis response

Almost every N.C. county is flagged for mental health care shortages, and the state only meets about 15% of its need for behavioral health providers, according to the Kaiser Family Foundation, a national nonprofit research organization.
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RALEIGH — The North Carolina Department of Health and Human Services this week announced a $1.35 million investment to begin piloting trauma-informed mobile crisis and crisis co-responder services.

These services will deploy teams who are trained and experienced to respond to people experiencing a behavioral health emergency, including mental health professionals and peer support specialists who can de-escalate crisis situations and provide appropriate support. This investment is part of the department’s ongoing effort to transform the behavioral health crisis response system to ensure North Carolinians have someone to call, someone to respond and somewhere to go for care. These pilots focus on the second piece of that crisis response system: someone to respond.

“We’re building the behavioral health care system in North Carolina from the ground up,” said N.C. Health and Human Services Secretary Kody H. Kinsley. “By intervening earlier and with better care options, we can break the cycle that funnels people in crisis towards emergency departments and incarceration. This starts with having the right responders to de-escalate situations and connect people with the support they truly need, paving the way for a healthier future for both them and our communities.”

In communities lacking robust behavioral health services, law enforcement becomes the default response for those experiencing mental health emergencies, contributing to the continued cycle of overrepresentation of people with complex behavioral health needs and substance use disorder among the justice-involved population. In North Carolina, serious mental illness affects 15% of men and 31% of women in jails, and 85% of the prison population has a substance use disorder or was incarcerated for a crime related to substance use.

Mobile crisis and co-responder services provide an alternative response to behavioral health emergencies, where professionals trained in trauma-informed care and de-escalation techniques can respond alongside or instead of law enforcement. The goal is to ensure that people experiencing a mental health or substance use crisis receive a timely response from someone who is trained to meet their behavioral health needs when they call 988 or if they come to the attention of law enforcement.

“Handcuffs and emergency departments can be disorienting and traumatizing for people experiencing a mental health or substance use crisis,” said Kelly Crosbie, MSW, LCSW, director of the NCDHHS Division of Mental Health, Developmental Disabilities, and Substance Use Services. “By investing in trained responders with mental health expertise, we are building a more compassionate system that prioritizes de-escalation and connects people to the support they need when they need it, setting them on a path to recovery. This is one of the ways we’re shifting our entire system from a state of crisis to a state of care.”

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NCDHHS’ investment includes nearly $775,000 in federal funding from the Bipartisan Safer Communities Act (BSCA) granted to Vaya Health and RHA Health Services to pilot a Crisis Co-Responder for Law Enforcement model in Buncombe County, Person County and the City of Burlington. Under the CORE model, mental health professionals trained in trauma response work together with law enforcement to determine the best response when someone is experiencing a behavioral health crisis.

The pilot will include an evaluation of the startup, implementation process and outcomes for each CORE team site. Based on results of the initiative, NCDHHS’ goal is to continue to expand co-responder services across the state.

In addition to the CORE model, NCDHHS is investing nearly $580,000 from the $835 million investment in behavioral health to pilot mobile crisis response services in Orange County. The department is partnering with Alliance Health, Orange County and the Chapel Hill Police Department to develop a Crisis Assistance, Response and Engagement team. The unarmed CARE team — including a crisis counselor, peer support specialist and EMT — will respond in lieu of law enforcement to behavioral health and low-level, non-violent offense calls as designated by the Chapel Hill Police Department and 911 Call Center.

The outcomes of the two-year pilot with the Chapel Hill Police Department will be evaluated by the UNC School of Government Criminal Justice Innovation Lab with the goal to expand mobile crisis services to all law enforcement agencies in Orange County in 2026. NCDHHS will use the evaluation and pilot data to inform decisions related to how mobile crisis teams are structured and further integrated into the state’s behavioral health crisis response system in the future.

More than $130 million of the $835 million in the 2023 state budget is dedicated to improving North Carolina’s crisis response system. NCDHHS is working to build a system that ensures anyone experiencing a behavioral health crisis has someone to call, someone to respond and somewhere to go for care. The 988 Suicide and Crisis Lifeline and North Carolina’s new statewide peer warmline (1-855-PEERS-NC) offer people someone to call when in crisis, and recent investments in behavioral health urgent care centers and community crisis centers and peer respite programs give people more places to go for care. In combination with these investments, mobile crisis and co-responder services provide alternative options to law enforcement when responding to a person in crisis.

NCDHHS will continue to invest in initiatives across the state that strengthen the behavioral health system and ensure access to services whenever and wherever people need help.