Getting the Right Response When Every Crisis Is Different: 4 States Share Lessons on Building Coordinated Crisis Systems

(Photo Credit: Sean Justice, CSG Justice Center)

Across the country, moments of crisis often begin with a call for help.  

Whether it is a late-night text from someone who feels unsafe with their thoughts, a family member seeking support for a loved one struggling with substance use, or a neighbor concerned about someone in visible distress, what happens next often depends on how prepared systems are to connect people to the right kind of help when they need it most.  

In response to situations like these, states are starting to test and scale locally driven innovations, programs, and training opportunities to tailor coordinated crisis responses across diverse geographies and varying levels of available resources.  

As part of our Aligning Health and Safety initiative, The Council of State Governments (CSG) Justice Center convened four states—New Jersey, Utah, Virginia, and Washington—in November to discuss their different approaches to crisis response and some of the challenges they’ve experienced. This involved several key cross-cutting areas related to coordination and integration between 911 and 988, workforce capacity, funding, and data sharing. Supported by The Pew Charitable Trusts, the convening was one part of a multi-year effort to help states and communities improve crisis response for people with behavioral health needs and reduce reliance on jails, emergency departments, and law enforcement.

Throughout the convening, several questions and lessons emerged that can help other states who are beginning to design and coordinate or are looking to sustain their own crisis response efforts.  

What are some practical strategies to strengthen crisis response ecosystems across 988, 911, law enforcement, health care professionals, and community members?

While each state that participated in the convening has been working to develop the most appropriate response in any given crisis situation—a goal reflected in national guidance on behavioral health crisis systems—many attendees described persistent barriers when crises move between systems. Uncertainty around call transfers, liability (or concerns of being held legally responsible if something goes wrong after a call is transferred), transportation, and decision-making authority came up as common frustrations.  Some state representatives noted that even when 988 is used to expand access to behavioral health support, unresolved operational questions can affect how quickly and appropriately people receive care.  

In Washington and New Jersey, for example, participants described ongoing hesitation around transferring calls from 911 and fears of liability, particularly when transportation is involved.  

Utah and Virginia emphasized that clearly defined dispatch protocols were most effective when implemented alongside defined roles across agencies, shared understanding of who is responsible across each decision point, and escalation criteria to help route crises to the most appropriate response. 

How can states train, sustain, and scale effective crisis response even when there are workforce capacity concerns?

State representatives consistently raised concerns about staffing shortages, training demands, and variation in credentialing and licensure requirements during the convening. 

For example, Virginia and New Jersey highlighted the difficulty of scaling workforce models statewide while maintaining consistency, especially when relying on a mix of public, private, and community-based providers.  

To help address these concerns, some states emphasized the value of standardizing crisis-specific training and response expectations across provider types, allowing a broader range of staff to be deployed more quickly without compromising quality or continuity. Others mentioned using tiered or blended workforce models to reduce variation in onboarding and training as a way to speed up scaling efforts and allow flexibility in who can deliver which parts of the response.  

Utah and Washington highlighted investments that have been made in standardizing their training models, including regional and on-demand trainings designed to build shared expectations across systems.  

What data and performance measures are needed to guide policy, identify system gaps, and support continuous improvement?

Being able to rely on accurate and up-to-date crisis response data has helped many of these states better understand call outcomes, identify system gaps, and inform funding and legislative decisions. Attendees noted that data can help public safety officials see when crises are resolved through 988, when mobile responses are deployed, and where additional capacity is needed.  

Utah shared how its public-facing dashboards provide transparency into call resolution and mobile response. New Jersey and Virginia described how analysis of crisis-related data has informed system redesign and statewide expansion, while also acknowledging continued challenges created by fragmented data systems and limited integration between 988 and 911.  

How can states strengthen community-based responses while maintaining shared standards and local flexibility?

There was overwhelming consensus that community-based response is most effective when states pair shared standards with local flexibility in how crises are defined and addressed. Attendees emphasized that crisis response must reflect local needs while operating within shared, state-level standards. Many of the state teams highlighted how community-based responders, mediation models, and peer-informed approaches, particularly in communities where trust in law enforcement is limited, can be used to rebuild credibility. 

For example, state officials in Washington and New Jersey identified gaps in traditional crisis response for situations involving housing insecurity, substance use, or community conflict, where neither law enforcement nor mobile crisis teams are the right fit.  

Attendees also raised concerns that narrow statutory definitions of crises can limit the role of community-based organizations already responding to crises in their daily operations. To address these concerns, some suggested that states may need to revisit their statutory definitions and eligibility criteria to better align crisis systems with how communities truly experience and respond to crises. They also pointed to the value of alternative dispatch and response pathways that allow calls to be routed directly to community-based providers when needed.  

Taken together, these efforts reflect both the progress states have made and the complexity of building crisis systems that are durable, interconnected, and responsive to community needs.  

While more work is still needed, through the Aligning Health and Safety initiative, the CSG Justice Center looks to continue its support of this cohort with policy recommendations and suggested strategies for scaling their pilot programs and creating sustainability statewide.  

Read more about the Aligning Health and Safety initiative—and how your state can improve crisis response.